Mr Howard William Graham

Preliminary Matters

Service

1. The Panel was provided with a signed certificate as proof that the Notice of Hearing (hereafter ‘the notice’) had been sent by email, on 13 June 2025, to the email address shown for the Registrant on the HCPC register.

2. The Panel also had sight of an email, from the Registrant, dated 22 September 2025, timed at 07.10am which stated:
‘I have received your email now and unfortunately I am unable to attend the hearing today due to being unwell. I will send an update later today.’

3. The Panel accepted the advice of the Legal Assessor and was satisfied that the notice had been properly served in accordance with Rule 3 (Proof of Service) and Rule 6 (date, time and venue) of the Conduct and Competence Committee Rules 2003 (as amended) (hereafter ‘the Rules’).
Proceeding in absence of the Registrant

4. Mr Maughan, appearing on behalf of the HCPC, made an application for the hearing to proceed in the Registrant’s absence as permitted by Rule 11 of the Rules. In doing so, he drew the Panel’s attention to the Registrant’s email, dated 22 September 2025, addressed to the HCPTS. Further, Mr Maughan, also submitted the following:
i. the Registrant has decided of his own volition not to attend and has not sought an adjournment, nor has he provided any medical evidence to attest to his fitness to attend the hearing;
ii. any further deferment of the regulatory proceedings would serve no useful purpose in this case and would only delay matters unnecessarily at an additional cost to the public;
iii. a further listing would prolong matters for all involved, including the four witnesses who are present and ready to give oral evidence to the Panel;
iv. there is an expectation that hearings be conducted within a reasonable time;
v. whilst the Registrant would be at a disadvantage by voluntarily choosing not to attend, the HCPC submits that the interests of the witnesses and public outweigh any disadvantages to the Registrant in this case should the Panel decide to proceed in the Registrant’s absence.

5. The Panel accepted the advice of the Legal Assessor and took into account the guidance as set out in the HCPC Practice Note “Proceeding in the Absence of the Registrant”.

6. The Panel determined that it was reasonable and in the public interest to proceed with the hearing for the following reasons:
a) the Panel was satisfied that the Notice had been served in accordance with the Rules and the Registrant had been afforded with over three months’ notice of this hearing;
b) the Panel noted that there has been no application to adjourn and the email from the Registrant, outlined above, provides no indication that the Registrant was unaware of the hearing, nor has he indicated that he would be willing or able to attend on an alternative date. Further, the Panel noted that the Registrant had also not provided any medical evidence to confirm his inability to attend the hearing. Therefore, re-listing the Substantive Hearing would serve no useful purpose and the Panel was of the view that the Registrant had voluntarily absented himself from the proceedings;
c) the Panel recognised that there may be some disadvantage to the Registrant in not being able to give evidence or make oral submissions. However, the Panel was satisfied that the Registrant had an opportunity to attend and/or make detailed written representations and he had not done so; and
d) as this is a Substantive Hearing there is a strong public interest in ensuring that it is considered expeditiously, especially in view of the four witnesses who are warned to give evidence before it. The Panel was also of the view, that it is also in the Registrant’s own interest that the Allegation is heard as soon as possible.
Privacy application

7. Mr Maughan, appearing on behalf of the HCPC, invited the Panel to conduct parts of the hearing in private. He submitted that it was necessary to do so to protect the Registrant as matters pertaining to the Registrant’s health and family life would be raised during the course of the proceedings.

8. The Panel accepted the Legal Assessor’s advice which had drawn its attention to Rule 10 of the Rules and to the HCPTS Practice Note on ‘Conducting Hearings in Private’. The Panel had regard to the practice note and to Mr Maughan’s submissions. The Panel also carefully considered the public interest grounds in the case being heard in public.

9. Having done so, the Panel was satisfied that the parts of the hearing pertaining to the Registrant’s health and family life ought to be considered in private. The Panel was satisfied having considered the matter carefully, that should it not conduct proceedings in part in private that the Registrant and/or others may suffer disproportionate damage.

10. The Panel therefore ordered that parts of the hearing, pertaining to the Registrant’s health and/or private family life, be conducted in private.
Background

11. The Registrant is registered with the HCPC as an Operating Department Practitioner (‘ODP’).

12. At the relevant time, the Registrant was employed as an ODP at the Ashford and St Peters Hospitals NHS Foundation Trust (‘the Trust’) having commenced employment on 04 December 2000.

13. On 04 December 2023, the Registrant was arrested for attempting to communicate online with a 14-year-old and attempting to communicate online and engage in sexual acts with a 13-year-old. It was alleged that between June and December 2023, the Registrant was communicating online with both profiles, who were in fact under-cover police officers, portraying themselves as 13- and 14-year-old boys.

14. After arranging to meet the 13 years old profile, the Registrant was arrested by the police.

15. Following a search after arrest, controlled drugs namely Fentanyl and Midazolam were found at the Registrant’s address and later traced as originating from the Trust and issued to the operating theatre at St Peters Hospital where the Registrant worked.

16. The Registrant was later charged by the Police and initially pleaded not guilty.

17. On 08 March 2024, the Registrant pleaded guilty to the following offences:
a. Attempting to engage in sexual communication with a child, contrary to section 1(1) of the criminal attempts act 1981.
b. Attempting to engage in sexual communication with a child, contrary to section 1(1) of the criminal attempts act 1981.
c. Attempting to meet a boy under 16 years of age following grooming, contrary to section 1 of the criminal attempts act 1981.

18. On 05 June 2024, the Registrant was sentenced to concurrent sentences of 9 months in custody suspended for 2 years. He was also ordered to participate in an accredited programme for 30 days, complete 100 hours
of community service in 12 months, register with police for 10 years and was subject to a Sexual Prevention Order for 10 years.

Decision on Facts

Summary of Evidence

19. Mr Maughan opened and summarised the HCPC’s case. In doing so, he outlined that the HCPC relied upon the certificate of conviction as proof of the Registrant’s convictions, along with the other documents contained within the HCPC 229-page bundle, which included the Crown Court Judge’s sentencing remarks and he also outlined that the HCPC intended to call four witnesses to give evidence to the Panel.

Witness evidence
The witness accounts below are provided as a summary of the evidence to the Panel and are not a verbatim account of the evidence provided to it.

Mary Mault (MM):
20. MM told the Panel that she is a registered nurse, and provided her NMC registration ‘PIN’ number. MM stated that she is employed as Head of Nursing for the Trust and that she has been in this role since 2022. MM told the Panel that this role is predominately a Quality and Safety role which requires her to have day-to-day leadership, with operational and governance responsibilities.

21. MM gave evidence to the Panel that the Registrant worked as an ODP in ‘theatres’ across the St Peter’s and Ashford Hospital Trust and that he had been employed from 04 December 2000 and took an additional role as advisor for medical engineering in February 2008.

22. MM stated that on 05 December 2023, she was informed that the Registrant had been arrested by Police and that the details of the arrest were made available to her on the same date. MM stated that the Registrant was held in custody and that he had been arrested on grounds of potential theft of controlled drugs and that the Police had enquired about
making a ‘safeguarding referral’. MM also told the Panel that later the same day (05 December 2023), the Police also informed her that the Registrant had been arrested on the grounds of attempted sexual offences with a child. MM stated that the Trust’s Human Resources (‘HR’) department were also informed of events.

23. MM told the Panel that the Registrant was not able to inform the Trust of his arrest, as he was being held in Police custody however, it would be expected that employees inform the Trust of any arrest.

24. The safeguarding concern was that the Registrant, as an ODP, was in a role where he had access to children and he also assisted with anaesthetising patients so he had access to controlled drugs (‘CDs’). MM told the Panel that CDs are medications which are locked in two cupboards and have restricted use due to being potentially dangerous and as such, need to be signed out by two qualified staff members of which the Registrant was qualified to do as an ODP. A CD check was requested from the Trust’s central pharmacy to identify if there were any missing CDs because at the point of the Police referral, the Trust was not aware of any missing CD’s or discrepancies in CD records.

25. MM told the Panel that she had been informed by the Police, that they had found ampoules of Fentanyl and Midaxolam and a packet of Oxazempam in the Registrant’s home. MM stated that these medications are prescription only medication and are strong sedatives and pain killers and are classed as CDs. MM told the Panel that it would be unusual to have these medications at home.

26. MM told the Panel that her understanding of the process was that CDs would be ‘signed out’ of a CD book and ‘signed back in’ if the drugs were not used. MM stated that it would not be usual practice to take any CD’s home.

27. MM told the Panel that on 06 December 2023, she held a meeting with the Registrant where he was suspended from work whilst an internal investigation took place into the concerns reported by the Police. MM told the Panel that following this meeting, she produced a letter outlining their discussions and that a letter confirming the same was delivered to the Registrant.

28. MM informed the Panel that during the meeting with the Registrant on 06 December 2023, the Registrant informed her that he did not believe that he had CDs at his home address and that it was alleged that he had tried to ‘coax’ three minors to have sex with him and he said that this was ‘completely untrue’ and that he thought someone was playing a prank on him and so he played along.

29. MM told the Panel that on 20 December 2023, the Police provided the batch numbers of the CDs found in the Registrant’s home and that she forwarded these batch numbers to the pharmacy and requested that they check for any matches with Trust stocks. MM informed the Panel that she recalled that some batch numbers matched stock at the Trust, but that she was not involved with the CD investigation any further regarding this.

30. MM stated that following numerous well-being and support meetings with the Registrant, on 13 March 2024 she was informed by the Police that on 08 March 2024, the Registrant had pleaded guilty to three counts of sexual misconduct and that sentencing was scheduled for 03 May 2024. MM informed the Panel that a follow up meeting was scheduled with the Registrant on 14 March 2024, and during the course of this meeting, the Registrant was advised that a Trust disciplinary hearing was arranged for 20 March 2024.

31. MM provided a number of documentary exhibits, attesting to the aforementioned, in addition to other matters referred to by her, for the Panel’s consideration.

Sue Sexton (‘SS’)
32. SS told the Panel that she too is a registered Nurse and provided her NMC ‘PIN’ number to the Panel. SS told the Panel that she is currently employed as Divisional Chief Nurse for General Surgery, Anaesthetics Critical Care and Theatres, at the Trust, and that she has been in this role since April 2023.

33. SS told the Panel that because she was on annual leave at the time the concerns first arose, MM was in receipt of the information directly from the Police. However, upon her return from leave, SS stated that MM had informed her that the Registrant had been suspended from work on 06 December 2023, on the basis that he had been found in possession of a number of ampoules of CDs.

34. SS produced correspondence with the Trust’s pharmacy department which showed that out of the controlled drugs found at the Registrant’s home, ampoules of Midazolam and Fentanyl were traced as batches that had come from the Trust which had been issued to the Operating Theatre’s team at St Peter’s Hospital, where the Registrant worked.

35. SS told the Panel that Midazolam is a sedative and Fentanyl is a strong pain killer, both of which are used in anaesthesia and both of which are subject to strict guidelines regarding storage, administration and disposal. SS also told the Panel that both CDs are potentially harmful if unaccounted for or in the ‘wrong hands’.

36. SS told the Panel that on 11 January 2024, she met with the Registrant and an HR business manager, from the Trust. SS stated that the purpose of the meeting was to discuss the controlled drugs found in the Registrant’s home. SS informed the Panel that during the course of the meeting, the Registrant admitted to having Trust CDs in his possession and that he had sought to explain how the CDs may have come to be at his home address. One of which was that he might have placed the ampoules into his pocket, rather than putting it back in the cupboard or tray alongside the Anaesthetist, because an Anaesthetist may have requested more drug be provided if a patient’s condition changed. The Registrant is also said to have informed SS that there were times when he went straight home in his ‘scrubs’ uniform, and that he did not change prior to returning home and that he may then have thrown the drugs in a drawer full of rubbish where he ‘dumped stuff’. SS told the Panel that the Registrant informed her that he rarely used the drawer and that he had forgotten about the medication. SS told the Panel that one ampule dated back to 2007.

37. SS informed the Panel that it was not acceptable for the Registrant to remove CDs from the Trust premises and that CDs should only be prescribed for appropriate use. SS stated that if the Registrant signed the drugs out for patient use and then took the CDs home, that this was in breach of the policy on administration, storage and discarding of CDs. SS also told the Panel that it was not acceptable for the Registrant to place CDs in his pocket.

38. SS stated that she would have expected the Registrant to be “well versed” in the Trust’s policies, which included ‘Medicines Management’ as he had been employed by the Trust for a long time and because he was up-to-date with his mandatory training, which included the aforementioned ‘Medicines Management’.

39. SS also told the Panel that she would not expect any employee to take CDs home accidently because this would mean that the Trust policy was not being followed. However, if the situation did occur, SS told the Panel that she would also have expected the employee to notify their line manager as soon as they noticed that this had occurred and that she would expect the staff member to return the CD back to the Trust immediately. SS stated that it would be considered to be an extremely serious incident by the Trust, which would result in a ‘Datix’ report being undertaken.

40. SS stated that on 15 February 2024, she commissioned a formal investigation into the concerns raised in respect of the Registrant’s conduct.

41. SS also told the Panel that on 12-13 March 2024, the Police notified the Trust that the Registrant had pleaded guilty to three counts of sexual misconduct, via a solicitor at Court. In view of this, SS told the Panel that a disciplinary meeting which was convened to meet on 20 March 2024 to review the concerns regarding the CDs was cancelled.

Alex Dumitrescu (‘AD’):
42. AD told the Panel that she is a registered nurse and provided the Panel with her NMC ‘PIN’ number. AD stated that she was employed as ‘matron’ for the theatres department at the Trust, and in this role since 2019.

43. AD informed the Panel that she was aware of the Registrant, but that she was not the Registrant’s direct line manager.

44. AD stated that as an ODP, his responsibilities for CDs were the same as an anaesthetic nurse in that, if on duty, she was qualified to hold the key to the CD cupboard in the anaesthetic room that she was working in. AD also stated that the Registrant was qualified to dispense CDs from the cupboard to the Anaesthetist, per the Anaesthetists request and that the Registrant was required to follow the CD policy. AD also informed the Panel that CD was responsible for checking CDs and checks must be carried out by two qualified practitioners at the beginning and end of every shift.

45. AD told the Panel that each individual CD record in the CD book must be checked, so that the physical number of each CD must match the stock level recorded for the specific drug in the CD book. As part of these checks, each record for the day is checked to confirm that any dispensed drugs have been recorded correctly and any dispensed drugs have been signed for. When a CD is dispensed from the cupboard, the name of the patient and their hospital number must be recorded under the drug that is being dispensed for them. The amount dispensed, the amount administered and the amount of any wastage of the CD must be recorded. Each of these amounts must be signed by the Anaesthetist and the qualified practitioner that has dispensed the drug.

46. AD further informed the Panel that at the end of each case, when a patient is settled into surgery, the qualified practitioner starts recording what was dispensed and what was administered and at the end of surgery, it is recorded what was discarded. AD also told the Panel that it would not be usual policy for an ampule to be carried by a practitioner in a pocket as the ampoules are fragile and break easily. AD stated that the usual process was for practitioners to carry an ampule in their hand or on a tray, prior to giving it to the Anaesthetist. AD told the Panel that the ampule is then shown to the Anaesthetist and then the Anaesthetist uses it there and then, or only part of the contents of the ampule and the remaining is left in the ampule on the tray.

47. AD also informed the Panel that sometimes an Anaesthetist might request further drugs for maintenance of the anaesthesia or if the surgery is prolonged. The qualified practitioner would dispense these drugs and bring them to the Anaesthetist and if the drug is not used immediately or the patient does not require the drug that has been requested, if not opened, it would be left on the tray. AD told the Panel that CDs are never left unattended and at the end of a case, the Anaesthetist is responsible for discarding any unused CDs and/or any unopened CDs might be returned to the CDs cupboard. This process is undertaken by the qualified practitioner and the Anaesthetist signs the CD book to confirm what has been wasted, dispensed and/or administered. AD told the Panel that the Anaesthetist will not necessarily see the CDs being return to the cupboard by the qualified practitioner. AD informed the Panel that by adopting this process, any discrepancies should be picked up and if anyone got to the point where they took ampoules home with them, it would mean that the checks had not been done as any missing CDs should be picked up at the end of the shift. AD told the Panel there was the possibility that CDs could be ‘signed’ back into the cupboard and then not actually returned to it by the qualified practitioner. However, this would be in breach of the CD policy and the registered practitioner’s responsibility for safe and appropriate management of CDs.

48. AD also told the Panel that if someone did accidently take CDs home, then she would expect them to report it to the nurse in charge and return the drug straight away and this could then be reported as a serious incident.
Janet Wright (‘JW’):

49. JW told the Panel that she is an HCPC registered ODP, who has been employed by the Trust, as Team Leader for ODPs for the Trust, since 2014.

50. JW told the Panel that the Registrant commenced his employment with the Trust in December 2000 and that she was responsible for managing the Registrant, as part of a team of 50 ODPs and anaesthetic nurses.

51. JW told the Panel that the Registrant worked, within the Trust, in the anaesthetics team, so it was his responsibility to assist the Anaesthetists. As part of his role, JW informed the Panel, that the Registrant was responsible for holding the CD ‘key’, carrying out CD checks twice a day and signing out CDs requested by the Anaesthetists.

52. JW stated that CDs are categorised as Class A drugs and informed the Panel that they are drugs which are addictive and can have serious side effects. JW told the Panel that if a drug is categorised as a CD, it must be stored in a cupboard that is double locked. JW also informed the Panel that CDs are subject to strict policies regarding who can handle them and also regarding checking stock balance and documentation of their use.

53. JW also confirmed that checks on the CDs were carried out twice a day, once in the morning and last thing at night. JW also informed the Panel of the process for doing so, as outlined by the other witnesses, and also reiterated that all Trust staff were bound by the Trust’s policy on Medicines Management.

54. JW also set out the process for handing the CDs to the Anaesthetist and also confirmed that her understanding of CDs being handed to an Anaesthetist was that the CD would be carried, or placed in a tray. JW also set out the process for recording and providing CDs and for their safe disposal.

55. JW further informed the Panel that she was not aware of any discrepancies with the CD records or that the Registrant had reported taking any CD’s home with him. JW stated that the concern with CDs is that there is a risk of abuse if they are unaccounted for and that they can be harmful in terms of their side effects and potential for addiction.
Email from the Registrant

56. After the conclusion of the HCPC evidence, and at the outset of Day 2 of the hearing, the Panel was notified that the Registrant had sent an email to the HCPTS, dated 22 September 2025 and timed at 23:23pm, which stated:
…Thank you for your understanding and kind thoughts. [Redacted] I sometimes do not check my emails regularly, and therefore, I apologise for slow replies. I am content for the hearing to proceed in my absence, as I currently honestly think that I will not have the ability to do a live remote attendance. I have some additional information which I would like the panel to take into account.’

57. In response to the Registrant’s email, Mr Maughan submitted that the Panel could adopt one of two courses of action. Firstly, it could pause the hearing and await further information being provided by the Registrant. Or, secondly, the Panel could determine to proceed with the hearing. Mr Maughan further submitted that he was ‘neutral’ as to the option to be adopted by the Panel. However, he drew the Panel’s attention to the fact that the Registrant had taken over twelve hours to reply to the HCPTS’ email dated 22 September 2025 and timed at approximately 09.30am; and that the Registrant had not indicated what information, or when the information referred to in his email, would be provided to the Panel.

58. The Panel accepted the Legal Assessor’s advice, which had, amongst other things, reminded the Panel of its duties to ensure: fairness to both parties; public protection; and public confidence in the regulatory process.

59. The Panel noted from the correspondence before it, that the Registrant is clearly aware of the hearing and had not sought an adjournment of the proceedings to provide the information. Further, the Panel also noted that the notice issued to the Registrant, dated 13 June 2025, stated ‘…Please note that you are required to serve the documents you intend to submit to the HCPC at least 28 days before the hearing...’.

60. Consequently, the Panel considered that the Registrant had been put on notice of the hearing and of the fact that should he wish to rely on any documentation it needed to be provided to the HCPC not less than 28 days before.

61. In consideration of whether to proceed with the hearing or await the provision of further documentation by the Registrant, the Panel also noted that the Registrant’s email, dated 22 September 2025, was not specific about what information the Registrant intended to provide, or when. Nor did the Registrant’s email outline what stage of the proceedings the information might be relevant to. Further, the Panel also noted that the Registrant had not attached the information to his email to the HCPTS. The Panel also noted that the Registrant had also not asked for an adjournment of the hearing to provide the information to it. Rather, the Registrant’s email, in the Panel’s view, seemed to presume that the Panel could be provided with information whenever the Registrant felt able to.

62. Whilst the Panel had regard to the difficulties that the Registrant had referred to in his email, the Panel also noted that the Registrant had also not provided any evidence to support his assertions.

63. The Panel reminded itself that it had a duty to ensure fairness to both parties and that it had a duty to conduct proceedings in an expeditious manner. Having regard to aforementioned, the Panel therefore determined to proceed with the hearing without waiting for the Registrant to provide the information referred to in his email. In doing so, the Panel had regard to its overriding objective of public protection and of preserving the public interest.

Decisions on Facts

Panel’s Approach

64. The Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything and the individual particulars of the Allegation could only be found proved if the Panel was satisfied on the balance of probabilities.

65. In reaching its decision the Panel took into account the documentary evidence contained within the HCPC bundle, as well as the oral evidence of the witnesses and the submissions made by Mr Maughan.

66. The Panel accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Notes: “Conviction and Caution Allegations”.
Stem
‘As a registered Operating Department Practitioner (ODP16652):

67. The Panel was satisfied on the evidence before it, namely the certificate confirming the Registrant’s registration status with the HCPC, that the Registrant is a registered ODP with the HCPC registration number 16652.

Particular 1 - PROVED
1. On one or more dates prior to 5 December 2023, you:
a. did not return one or more unused controlled drug (‘CD’) ampoules to the CD cupboard in Ashford and St Peter’s Hospitals NHS Foundation Trust (“the trust”);
b. took home from the Trust one or more CD ampoules;
c. upon discovering one or more CD ampoules in your uniform pocket, did not:
i. inform a senior member at the Trust of your discovery; and/or
ii. return the CD ampule to the Trust.

68. The Panel had regard to the totality of the evidence before it which it noted included both documentary and oral evidence.

69. In particular, the Panel had regard to the contents of the Registrant’s Police interview and the communication between the Police and the Trust. In doing so, the Panel noted that it was confirmed by the Police, that the Registrant’s home address was searched on 04 December 2023 and that upon his arrest and search of his home address, the Registrant was found to be in possession of three CD ampoules (Fentanyl x2 ampoules and Midazolam x1 ampule). The Panel also noted that the ampoules were seized by the Police as part of its investigation into the Registrant’s, alleged at the time and subsequently convicted of, conduct in respect of online grooming of young boys, in an attempt to meet with them when he knew that they were under the age of 16, with a view to engaging in sexual activity with them.

70. The Panel also noted, from the documentary and oral evidence provided to it, that the three CD ampoules seized by Police at the Registrant’s home address, contained Fentanyl and Midazolam and that each of the CD ampoules had a ‘batch’ number printed upon it. Further, the Panel also accepted the witnesses’ oral evidence to it, that it was confirmed as part of the Trust’s internal investigation, that the ampoules contained CDs and that each CD could be linked to ‘batch’ numbers identified as matching those belonging to the Trust. Meaning therefore, that the seized CDs were considered to be Trust property and not prescribed to the Registrant for his own use.

71. The Panel also had regard to the Trust’s policy on ‘Operating Departments and Day Surgery Units Medicines Management Policy’ (hereafter ‘the Medicines Handling Policy’) and the witnesses detailed and consistent explanations to it, on the appropriate management and handling of CDs.

72. The Panel noted that two of the witnesses (SS and JW) both confirmed to it that the Registrant had not, upon discovering that he had CDs in his possession at home, informed a senior member of Trust staff that an error had been made in the handling of CD, and that they would have expected him to do so. Further, both witnesses also confirmed that the Registrant had not returned the CDs to the Trust. The Panel also accepted the witnesses’ evidence to it that such an incident, in the Registrant taking CDs home, would have been likely to be regarded as “exceptional serious”, and also a breach of the processes outlined in the Medicines Handling Policy. Further, the Panel also noted that both SS and JW confirmed that the Registrant had not raised the mishandling of CDs with them, nor had a DATIX report been raised by any other person at the Trust.

73. In addition, the Panel also noted the contents of the Registrant’s contemporaneous and recorded responses during his Police interview. In doing so, the Panel noted that the Registrant accepted that the CDs were found at his home address and that he had not returned them to the Trust, but rather, had explained to Police, and subsequently, to SS during a meeting with the Trust on 11 January 2024, that he did not recall how the CDs had come to be at his home address and that he had just “put the CDs in a drawer”.

74. Having regard to the aforementioned, the Panel therefore found the following facts:
i. the Registrant’s home address was searched and he was arrested, by Police, on 04 December 2023;
ii. during the course of its search, the Police seized, from the Registrant’s home address, three ampoules of CD registered and belonging to the Trust;
iii. the Registrant had taken the CDs home, and in doing so he did not return the CDs to the CD cupboard, as required by the Trust’s Medicines Handling policy; and
iv. upon the Registrant discovering that he had CDs in his possession, in his uniform pocket, he did not inform a senior manager at the Trust of his discovery, nor did he return the CD ampoules to the Trust.

75. The Panel was therefore satisfied, to the required standard, that the facts contained within Particular 1a), 1b) and 1c) were proved.

76. Consequently, Particular 1 is proved in its entirety.
Particular 2 – PROVED
2. On 8 March 2024, you were convicted in the Crown Court at Reading of:
a. Attempting to engage in sexual communication with a child, contrary to section 1(1) of the Criminal Attempts Act 1981;
b. Attempting to engage in sexual communication with a child, contrary to section 1(1) of the Criminal Attempts Act 1981;
c. Attempting to meet a boy under 16 years of age following grooming contrary to section 1(1) of the Criminal Attempts Act 1981.

77. The Panel had regard to the Rules and in particular Rule 10 (1)(d) which, in terms of the evidence required to prove a conviction, states:
“where the registrant has been convicted of a criminal offence, a certified copy of the certificate of conviction (or, in Scotland, an extract conviction) shall be admissible as proof of that conviction and of the findings of fact upon which it was based”.

78. The Panel accepted the documentary evidence placed before it. Noting, in particular, the Certificate of Conviction, in addition to His Honour Judge Millard’s sentencing remarks and the record of the Registrant’s Police interview. The Panel was therefore satisfied, to the required standard, that the facts contained within Particular 2a), 2b) and 2c) were proved.

79. Accordingly, the Panel found Particular 2 proved in its entirety.
Decision on Grounds

80. The Panel next considered the statutory grounds. In doing so, it took account of Mr Maughan’s written and oral submissions on behalf of the HCPC and it accepted the advice of the Legal Assessor.

81. The Panel was satisfied that a conviction is one of the statutory grounds under Article 22(1)(a) of the Health Professions Order 2001 and it considered that by being convicted of three criminal offences that this statutory ground was made out (Particular 2).

82. The Panel next considered whether any of the facts found proved in Particular (1) amounted to the statutory ground of misconduct, under Article 22(1)(a)(i).

83. In order to assist with its decision, the Panel considered the HCPC’s ‘Standards of Conduct, Performance and Ethics’ (dated Pre and Post – 01 September 2024) and the Standards of Proficiency for ODP’s in England.

84. Having done so, the Panel determined that the Registrant had breached the following:
Standards of Conduct, Performance and Ethics
• 9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
The Standards of Proficiency for ODP’s in England:
Post 1 September 2023
• 2.1 maintain high standards of personal and professional conduct;
• 2.4 understand what is required of them by the Health and Care Professions Council, including, but not limited to, the standards of conduct, performance and ethic; and
• 12.10 understand how to order, store and issue drugs to service users safely and effectively.
Pre 1 September 2023
• 2.2 Understand what is required of them by the Health and Care Professions Council;
• 3 be able to maintain fitness to practise;
• 3.1 Understand the need to maintain high standards of personal and professional conduct; and
• 13.10 Understand how to order, store, issue, prepare and administer prescribed drugs to service users, and monitor the effects of drugs on service users.

85. The Panel considered that not following the Trust’s policy on the safe handling, management and/or disposal of CDs, constituted a serious failing and falling short of the expected standards by the Registrant. In forming this view, the Panel noted that whilst the Registrant had first indicated to the Police that he had taken the CDs by mistake, the Panel noted that the Registrant had also, upon finding the CDs on his person, failed to take the appropriate action and/or steps to rectify his claimed mistake.

86. Further, the Panel noted that the Registrant was an experienced ODP, who the witnesses had attested was “up-to-date” on his continuing professional development (‘CPD’) and internal Trust training, which the Panel noted included the safe handling, management and/or disposal of CDs. Consequently, the Panel considered that the Registrant ought to have been very aware of the policy and process of signing CDs in and out of the CD cupboard, what to do if they needed to be returned to the CD cupboard because they were unused during a procedure and that, most importantly, CDs were not to be removed from Trust premises under any circumstances.
87. In the Panel’s view, when the Registrant engaged in the conduct outlined within Particular 1, namely: not returning the CDs back to the CD cupboard; taking the CDs home in his uniform pocket; and not informing senior management of his actions; nor seeking to return the CDs to the Trust upon finding them, the Panel considered that the Registrant had placed the public at risk of significant harm by not adhering to the Trust’s policy and the Panel accepted the witnesses explanation that this was to ensure safe handling and disposal of very potent medications. In forming this view, the Panel also noted that witness SS had described the Registrant’s actions as a “serious incident”.

88. Consequently, the Panel considered that the matters outlined at Particulars 1a), Particular 1b), and Particular 1c) each represented serious breaches of professional standards, falling far below the behaviour expected of a registered ODP, and that each matter amounted to misconduct.
Decision on Impairment

89. Having found misconduct and the statutory ground of conviction made out, the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired. In doing so, the Panel took into account all of the evidence before it, and it had regard to the oral and written submissions made by Mr Maughan, in addition to the HCPTS practice note titled ‘Fitness to Practice Impairment’. The Panel also accepted the Legal Assessor’s legal advice.

90. The Panel first considered whether the Registrant’s fitness to practise was impaired on the personal component.

91. In addressing the personal component of impairment, the Panel asked itself whether the Registrant is liable, now and in the future, to repeat conduct of the kind that led to his misconduct and his convictions. In reaching its decision the Panel also had particular regard to the issues of insight, remorse and remediation.

92. The Panel noted that in the case of CHRE v NMC & Grant [2011] EWHC 927 (Admin) Mrs Justice Cox stated:
“When considering whether or not fitness to practise is currently impaired, the level of insight shown by the practitioner is central to a proper determination of that issue.”

93. The Panel also had careful regard to Silber J’s guidance in Cohen v GMC [2008] EWHC 581 (Admin) that panels should take account of:
o whether the conduct which led to the charge is easily remediable;
o whether it has been remedied; and
o whether it is highly unlikely to be repeated.

94. The Panel first considered the Registrant’s conduct in respect of Particular 1. In doing so, the Panel considered that the Registrant’s actions were remediable. However, the Panel noted that the Registrant had not engaged in the regulatory proceedings in a meaningful manner, nor had he provided any evidence of his reflections on his actions, or any steps taken to ensure that his conduct is not repeated moving forward. This concerned the Panel because it noted that the witnesses’ oral evidence indicated that when the Registrant was confronted about his actions he did not appear to be concerned by what others considered to be a “serious incident” and was described by the witnesses as having a “cavalier attitude” towards the breach of the Trust’s policy. The Panel therefore concluded that the Registrant had not taken any steps to remediate his conduct and it was therefore highly likely that the Registrant’s conduct would recur. In the Panel’s view, this placed the public at risk of serious harm.

95. The Panel next considered Particular 2 from the personal component. In doing so, the Panel noted that the Registrant had not provided any written submissions for the Panel to consider as part of this hearing nor had he expressed any apology or remorse for his actions which led to his convictions. The Panel noted that the criminal convictions in this case concerned the Registrant attempting to engage in sexual communication with more than one under-age child and also attempting to meet a boy under 16 years of age following grooming.

96. Having regard to the Registrant’s lack of engagement, the Panel considered that the Registrant had demonstrated no remorse for his actions and that he had failed to demonstrate any insight whatsoever, into the impact that his actions would have had upon vulnerable children, had the individuals he been corresponding with not been undercover police officers. Further, the Panel also determined that the Registrant had failed to address how his actions and/or convictions may have impacted on the reputation of the wider profession.

97. In the Panel’s view, the convictions are for extremely serious offences and apart from the fact that the Registrant pleaded guilty before the Crown Court, and the Sentence Hearing transcript provided some mitigation on the Registrant’s behalf, the Panel was not aware of any other compelling mitigation offered on the Registrant’s behalf.

98. The Panel determined that it has no evidence of insight and the Registrant has demonstrated no expression of remorse. Whilst the Panel noted from the Crown Court Judge’s sentencing remarks that he has, as part of the criminal proceedings, engaged with the probation service, the Panel also noted that it has not been provided with any further details around this, nor has it been provided with documentary evidence, by the Registrant, to confirm the same. The Panel could therefore not be satisfied that the Registrant has addressed the underlying causes of his conduct or predilections. Consequently, the Panel was also not satisfied that there is not a high risk of repetition of the Registrant’s conduct given his actions.

99. Accordingly, having regard to all of the aforementioned, the Panel considered that the Registrant’s fitness to practise is impaired on the personal component.

100. The Panel next considered whether the Registrant’s fitness to practise is impaired on public interest grounds.

101. In relation to the public component of fitness to practise, the Panel had careful regard to the critically important public policy issues identified by Silber J in the case of Cohen when he said:
“Any approach to the issue of whether .... fitness to practise should be regarded as ‘impaired’ must take account of ‘the need to protect the individual patient, and the collective need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour.”

102. In the Panel’s view, the Registrant’s conduct falls extremely far below the required standards of his profession and as such, bring his profession into disrepute. The Registrant’s conduct and convictions were for acts which are extremely serious in nature and which were repeated. The Registrant remains the subject of: a suspended custodial sentence (imposed for two years); a requirement to participate in an accredited programme for 30 days; a community order to comply with 100 hours of unpaid work within twelve months; and a reporting restriction (imposed for 10 years). The Panel was also of the view that the public have to be able to trust healthcare professionals and having been convicted of such abhorrent offences, the Panel was satisfied that the public would determine that it could no longer trust or have faith in the Registrant. ODPs are placed in a position of trust with often very vulnerable service users, who are unconscious at the time, and the Panel was of the view that an informed member of the public would be extremely shocked to learn that a registered ODP had been convicted of the aforementioned criminal offences. The Panel also considered that public trust and confidence in the wider profession and the HCPC as its regulator, alongside the need to maintain confidence in the profession and to declare and uphold proper standards, would be undermined if a finding of impairment were not made in the circumstances of this case.

103. Accordingly, the Panel finds that the Registrant’s fitness to practise is currently impaired by reason of his misconduct and convictions.
Decision on Sanction
Panel’s approach

104. In reaching its decision on sanction, the Panel took into account the submissions made by Mr Maughan, on behalf of the HCPC.

105. The Panel also referred to the ‘Sanctions Policy’ issued by the HCPC.

106. The Panel had in mind that the purpose of sanction was not to punish the Registrant, but to protect the public, maintain public confidence in the profession and maintain proper standards of conduct and performance. The Panel was also aware of the need to ensure that any sanction is proportionate.

107. The Panel accepted the advice of the Legal Assessor.

108. The Panel considered whether there were any mitigating factors in this case and determined that there were not.

109. The Panel considered the aggravating factors in this case to be that:
i. the Registrant’s conduct in respect of his convictions, was predatory in nature, repeated, and motivated by a desire to establish a sexual relationship with underage children;
ii. service users were put at risk when the Registrant removed CDs from the Trust and did not follow Trust policies; and
iii. the Registrant has demonstrated no insight, remorse or remediation.

110. The Panel considered the option of taking no action. This is an exceptional outcome and the Panel was of the view that the circumstances of this case were not exceptional. The Panel decided that the option of taking no action was not sufficient to uphold the public interest in this case.

111. The Panel next considered the option of a Caution Order. The Panel considered the guidance in the Sanctions Policy that:
“A Caution Order is likely to be an appropriate sanction for cases which:
o the lapse is isolated, limited, or relatively minor in nature;
o there is a low risk of repetition;
o the registrant has shown good insight;
o and has taken appropriate remediation”.

112. The Panel was of the view that such a sanction would not reflect the seriousness of the findings in this case and therefore determined that a Caution Order was not appropriate. The Panel was also of the view that public confidence in the profession, and the HCPC as its Regulator, would be undermined if the Registrant’s behaviour were dealt with by way of a caution.

113. The Panel next considered whether to place conditions of practice on the Registrant’s registration. The Panel considered that it might have been possible to draft conditions of practice in respect of the Registrant’s misconduct, outlined within Particular 1, if this was the only matter before it and if the Registrant had engaged in the proceedings. However, the Panel considered that it would not be possible to draft conditions of practice which address the Registrant’s convictions (Particular 2), as the Panel considered that the Registrant’s conduct was attitudinal in nature. Further, owing to the fact that the Registrant has failed to engage with the regulatory process and has failed to demonstrate remorse or a willingness to address his conduct and behaviour, the Panel determined that a conditions of practice order was not workable, proportionate or appropriate in this case.

114. The Panel next considered a suspension order. The Panel noted that the sanctions policy states:
‘A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register. These types of cases will typically exhibit the following factors:
o …
o the Registrant has insight;
o the issues are unlikely to be repeated; and
29
o there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings’

115. Having regard to the sanctions policy, the Panel considered that a suspension order was not appropriate in this case. In forming this view, the Panel again noted that the Registrant has not demonstrated any insight into his conduct or convictions, nor has he provided any information regarding remorse or attempts to address his conduct or convictions and the Panel was not satisfied that the Registrant’s conduct was unlikely to be repeated. Given the seriousness of the Registrant’s convictions, and his lack of engagement in the proceedings, the Panel was of the view that public confidence in the profession and regulatory process would also be undermined if a suspension order was imposed.

116. The Panel next considered a striking off order. The Panel was aware that this was a sanction of last resort. The Panel noted that the HCPC ‘Sanction Policy’ document states that a striking off order is appropriate where:
‘there has been serious, persistent, deliberate or reckless acts involving:
o …
o …
o …
o …
o …
o sexual abuse of children or indecent images of children;
o criminal convictions for serious offences; and
o …’

117. The Panel also noted paragraph 85 of the Sanctions Policy, which states:
‘Although inclusion on the sex offenders’ database is not a punishment, it does serve to protect the public from those who have committed certain types of offences. A panel should normally regard it as incompatible with the HCPC’s obligation to protect the public to allow a registrant to remain in or return to unrestricted practice while they are on the sex offenders’ database.’

118. The Panel was of the view that the circumstances of this case are such that the Registrant acted in a sustained, deliberate and predatory manner, engaging with under-cover police officers whom he believed to be children, in an attempt to groom them, with a view to meeting them. The Panel also noted that the Registrant was subject to a suspended prison sentence of two years and that he has been entered onto the sex offenders register for a period of 10 years (2024-2034).

119. Further, the Registrant has also failed to engage in any meaningful manner in the regulatory proceedings. Consequently, the Panel was of the view that these factors, when taken together, demonstrate a Registrant who lacks any insight, has demonstrated no remorse for his actions and one who has not shown any willingness or intention to resolve matters nor one who has taken steps to demonstrate that his actions would not be repeated.

120. Having regard to the aforementioned, the Panel was satisfied that a striking off order was appropriate to protect the public and the public confidence in the profession and the regulatory process and that it would also send a clear message to other professionals. The Panel also considered that any lesser sanction would be insufficient to protect the public, public confidence in the profession and public confidence in the regulatory process.

121. In making its decision on sanction, the Panel had regard to the impact of an order on the Registrant. However, the Panel was of the view that the public interest considerations in this case significantly outweighed any detriment that might be caused, by the imposition of a striking off order, to the Registrant. Additionally, the Panel also noted that the Registrant had requested voluntary removal from the HCPC Register.

122. Accordingly, the Panel made an Order directing the Registrar to strike off the Registrant from the HCPC Register.

Order: That the Registrar is directed to strike the name of Howard William Graham from the HCPC Register on the date that this Order comes into effect.

Interim Order:

1. The Panel accepted the advice of the Legal Assessor and took into account the guidance as set out in the HCPTS Practice Note “Interim Orders”.

2. The Panel makes an Interim Suspension Order, for a period of 18 months, under Article 31(2) of the Health Professions Order 2001. For the same reasons given in its determination on sanction, the Panel concluded that an Interim Conditions of Practice Order would not be appropriate. The Panel was of the view that to make no order in this case would be wholly inconsistent with its earlier findings. The Panel concluded that an interim order was necessary for the protection of the public and was also necessary in the public interest. The Panel therefore determined that an eighteen-month Interim Suspension Order is appropriate and proportionate pending the expiration of an appeal period.

3. This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; or (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Mr Howard William Graham