Mark William Stokes

Preliminary Matters

1. The Panel has been convened to undertake a review of a substantive order of suspension that has been imposed in respect of the Registrant, Mr Mark Stokes, an Operating Department Practitioner. It is a review under the provisions of Article 30(1) of the Health Professions Order 2001.

Service of the Notice of Hearing

2. The Panel was shown an unredacted copy of an email dated 19 December 2025, in which the Registrant was informed that it was intended that this review would be conducted today. The Panel was satisfied that it constituted a valid Notice of Hearing and that the Panel therefore had jurisdiction to consider matters arising in the case.
Proceeding with the hearing in the absence of the Registrant

3. The Presenting Officer applied for a direction that the hearing should proceed in the Registrant’s absence.

4. In advancing the application to proceed in the Registrant’s absence, the Presenting Officer submitted that there had been no contact from the Registrant since the last review and that he is not engaging in the fitness to practise process. She submitted that the public interest required the hearing to proceed.

5. The Panel took and accepted advice from the Legal Assessor, and it acknowledged that the fact of good service of the Notice of Hearing, while being necessary, was not a sufficient factor to justify proceeding in the Registrant’s absence. The conclusion of the Panel was that the hearing should proceed in the Registrant’s absence. The reasons for that decision were:

• The Panel was unable to come to any conclusion other than that the Registrant has decided to comprehensively disengage from engagement in this fitness to practise process. He attended neither the final hearing nor the first substantive review. With regard to the present review he has been sent six communications. In addition to the Notice of Hearing sent on 19 December 2025, the HCPC or HCPTS communicated with him on 30 October 2025, 12 December 2025, 2 January 2026, 12 January 2026 and 19 January 2026. He has not responded to any of those communications, and he has not attended this hearing;

• It follows that the Registrant has voluntarily waived the right to participate in the hearing;

• If the present hearing did not proceed, jurisdiction to consider whether a further order should be made would be lost. A substantive review must be undertaken before the expiry of the Order being reviewed. The Order being reviewed in this case expires on 27 January 2026, and it would not be possible for a valid Notice of Hearing to be provided for another hearing to be conducted by that date;

• For these reasons, the public interest requires the hearing to proceed.

Conducting the hearing partly in private

6. The Presenting Officer applied for a direction that the hearing should be conducted partly in private. This was so that there should be no mention made in public of matters relating to the Registrant’s health.

7. The Panel sought the advice of the Legal Assessor and determined that the direction sought should be made for the reasons advanced for the application. The same factor has resulted in the Panel issuing a redacted public version of its fully written determination.

Background

8. The Registrant is registered with the HCPC as an Operating Department Practitioner (“ODP”).

9. In 2009, he began working as an ODP at The Dudley Group NHS Foundation Trust’s (“the Trust”) Theatres’ Department.

10. The Registrant took numerous unplanned absences during his employment, some of which were for reasons understood by the Trust at the time. The Trust managed these absences with HR support, resulting in several 'Stage 3' meetings under the Trust's Sickness/Absence policy. The Trust also conducted multiple risk assessments to support the Registrant.

11. From 26 March 2020, the Registrant took 7 days sick leave, which was then extended for another week. He was thus expected to return to work on 11 April 2020.

12. It was alleged that between 13 April 2020 and 19 April 2020, and again from 3 May 2020, until his dismissal on 24 June 2020, the Registrant was absent without notifying his employer. This led to unauthorised and unpaid leave from 11 April 2020 to 19 April 2020. After a period of annual leave (20 April to 1 May 2020), the Registrant did not return to work, resulting in further unauthorised and unpaid leave.

13. The Trust held a disciplinary hearing for the Registrant on Wednesday 24 June 2020. The allegations against the Registrant were (1) Failure to follow reasonable management instruction and (2) Repeated unauthorised absence. The Registrant did not attend the hearing, and it was heard in his absence. The allegations were upheld and the Registrant was dismissed the same day.

14. The Trust referred the Registrant to the HCPC on 30 July 2020.

15. On 6 October 2021, a panel of the Investigating Committee met to consider whether there was a case to answer in relation to an Allegation that should be referred for hearing. The decision of that panel was that there was a case to answer in relation to a “mixed allegation”, that is to say, one that alleged that the Registrant’s fitness to practise was impaired by reason of impaired health and that his fitness to practise was impaired by reason of misconduct. That mixed allegation was referred to the Health Committee for hearing.

16. In due course the allegation that the Registrant’s fitness to practise was impaired by reason of impaired health was considered by the Health Committee at a hearing the Registrant did not attend. That Committee determined that the health allegation was not well founded, as a result of which it was necessary for the allegation, that his fitness to practise by reason of misconduct, to be decided at a hearing before the Conduct and Competence Committee.

The final hearing of the Misconduct Allegation

17. The final hearing of the Misconduct Allegation took place between 25 and 27 February 2025. The Registrant did not attend the hearing, which proceeded in his absence. The panel conducting the hearing heard evidence from two witnesses from the Trust, the Matron in the Trauma and Orthopaedics Department and the Deputy Matron in Theatres. The conclusion of the panel was that the HCPC had proved to its satisfaction particulars 1 and 2(a). While it accepted the evidence that the Registrant had not attended the Trust’s disciplinary process, it decided that particular 2(b) was not proven on the basis the HCPC did not prove that the Registrant had been under an obligation to attend it.

18. When it considered whether the proven facts constituted misconduct, the final hearing panel stated that it had decided that the Registrant had breached the following standards of the HCPC’s Standards of conduct, performance and ethics promulgated in 2016, namely:

Standard 2.6, “You must work in partnership with colleagues…”

Standard 2.8, “You must treat your colleagues in a professional manner showing them respect and consideration.”

Standard 9.1, “You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.”

Standard 9.6, “You must co-operate with any investigation into your conduct or competence …”

19. The panel also referred to the evidence of the two witnesses from the Trust who have already been identified, quoting extensively from the evidence they gave about the operational and financial consequences occasioned by it not being known whether cover would be needed for an absent member of theatre staff.

20. The final hearing panel expressed its conclusion on the issue of misconduct in paragraph 68 of its written determination, which was in the following terms:

“The Panel was satisfied that the Registrant’s conduct, as reflected in the facts found proved, fell far short of the standard expected of an ODP and would be considered deplorable by fellow members of the profession and the public alike. He was in breach of a number of important parts of the Standards of Conduct, Performance and Ethics to be followed by all HCPC registrants. His failure to attend work and communicate over a prolonged period put patients at risk of harm. It also impacted upon his work colleagues at a time of heightened anxiety due to the COVID-19 Pandemic, requiring ODPs to be deployed across whole critical care areas within the hospital. The Panel was satisfied the facts found proved were sufficiently serious to amount to misconduct.”

21. The final hearing panel determined that the Registrant’s fitness to practise was impaired in respect of both the personal and public components. It expressed its reasons for this finding in paragraphs 72 to 74 of its written determination as follows:

“72. The Panel considered all these limbs of the Grant test to be engaged in this case. By not attending work and not notifying his employer that he would not be attending work, patients were put at unwarranted risk of harm for the reasons already referred to when the Panel considered the question of misconduct above. In the absence of any evidence of insight, remorse or remediation that risk continues today. Behaving in this way and not cooperating into the investigation into his conduct brings the profession into disrepute and, with the risk of repetition, is likely to do so in the future. Furthermore, putting patents [sic] at risk of harm is not putting patient welfare first and represents a breach of this fundamental tenet of the profession, which is likely to be repeated.

73. Having found there to be a risk of harm to patients and a risk that the behaviour would be repeated, the Panel concluded that the Registrant’s current fitness to practice [sic] is impaired on public protection grounds.

74. The Panel went on to consider whether this was the type of case that required a finding of impairment on public interest grounds in order to maintain public confidence in the profession and the Regulator and in order to uphold proper professional standards. The Panel was satisfied that a fully informed member of the public, who was aware of all the background to this case, would have their confidence in the profession and the Regulator undermined if a finding of impairment were not made, given the nature and seriousness of the Registrant’s misconduct.”

22. When it addressed the issue of sanction, the final hearing panel decided that the case was characterised by the Registrant’s persistent failure to engage, initially with his employer, but then with his regulator. Expressing the view that the failings could be remedied, the panel stated that remediation could only happen when the Registrant chooses to engage with the HCPC, shows he has insight and demonstrates that he has taken steps to remediate his misconduct. Without any contact from the Registrant it could not be known if he would be committed to resolve the issues. Accordingly, although in some circumstances conditions of practice might have been considered appropriate, without engagement on the part of the Registrant, it was necessary to go on to consider the sanction of suspension. It was this outcome that the final hearing panel decided to apply, concluding that the Suspension Order should be made for a period of four months, that being a period that would mark the seriousness of the Registrant’s behaviour while allowing him a period of time to engage in the process.

23. The final hearing panel concluded its written determination with paragraph 89 in which the following guidance was provided to the Registrant:

“This Order will be reviewed shortly before its expiry. A reviewing panel will be assisted by:

• the Registrant’s engagement with the HCPC and attendance at the review hearing;

• a reflective piece, explaining the Registrant’s behaviour and demonstrating the Registrant’s awareness of the impact of his conduct on patients, colleagues, the profession, the HCPC as Regulator and the general public;

• an update on the Registrant’s current health, if that was a contributing factor;

• evidence of Continuing Professional Development;

• references and testimonials from any paid or unpaid work in any field."

24. The Suspension Order for a period of 4 months came into effect on 27 March 2025, after the expiry of the appeal period. It was therefore due to expire on 27 July 2025.

The first substantive review hearing

25. The first substantive review hearing was held on 7 March 2025. The panel conducting that review concluded that the Registrant’s fitness to practise remained impaired. Concluding that the misconduct was not of the most serious nature, it also concluded that it was fair and proportionate to give the Registrant a further opportunity to engage. It concluded that a period of suspension for six months would be sufficient to provide that opportunity. The first reviewing panel concluded its written determination by reiterating the suggestions that had been made by the final hearing panel, and which are reproduced in paragraph 23 above.

Submissions made to the present Panel

26. The Presenting Officer commenced her submissions by stating that the HCPC requested the Panel to make a striking off order. In support of this submission, she referred to the procedural history of the case and to the fact that the Registrant had not engaged in the process.

27. No submissions have been received from or on behalf of the Registrant with regard to the present review.

Decision

28. The Panel accepted the advice it received and followed the guidance contained in the HCPTS Practice Note entitled, “Review of Article 30 Sanction Orders” dated August 2025. What a panel undertaking a review of a substantive sanction order is required to do can be summarised as follows:

• The reviewing panel is obliged to accept as settled the finding of facts made by the final hearing panel and also the decision of that panel in relation to the statutory ground(s) made out.

• The task of the reviewing panel is to decide whether the registrant’s fitness to practise remains impaired, and, if it is, whether the existing order or some other order needs to be in place upon the expiry of the existing order.

• Included in the issues to be considered are those listed in paragraph 12 of the Practice Note. The reviewing panel is required to consider whether all the concerns raised in the original finding of impairment have been sufficiently addressed. In reaching its decision, it is appropriate for the reviewing panel to take the view that the registrant carries the persuasive burden of demonstrating that matters have been satisfactorily addressed.

• If the reviewing panel is of the view that a registrant’s fitness to practise remains impaired and that a further order is required upon the expiry of the existing order, then ordinary sanction principles apply. The decision should be made by following the guidance contained in the HCPC’s Sanctions Policy. It is necessary that any further order decided upon should satisfy the requirement that it represents a proportionate response.

29. Consistent with the advice it received, the Panel first decided whether the Registrant’s fitness to practise is still impaired as a consequence of the finding made in February 2025, that the proven facts constituted misconduct. The conclusion of the Panel was that his fitness to practise remains impaired in relation to both the personal and public components. It is unacceptable for a registered health professional to behave in the manner proven against the Registrant. It has clear and obvious implications not only for the efficient running of the department in which that professional is working, but has patient safety implications, as demonstrated here where it was necessary to cancel procedures. The Registrant has not only provided no information from which it could be concluded that he would not behave in a similar manner in the future, but his continued failure to engage with the HCPC tends to suggest that he would so behave. This means that his fitness to practise is impaired in respect of the personal component. Furthermore, the public concern about the Registrant’s past behaviour and his failure to account for it, as well as the need to declare and uphold proper professional standards means that a finding of impairment of fitness to practise is required in respect of the public component.

30. Having decided that the Registrant’s fitness to practise remains impaired, the Panel went on to consider whether a further sanction is required when the present period of suspension ends on 27 January 2026.

31. In the judgement of the Panel, it would not be appropriate to permit the Registrant to return to practise as an ODP (or to be able by the absence of restriction on his registration to be able to do so) without there being confidence that he would not behave in the future as he has behaved in the past. In the absence of any information from the Registrant, this fact means that neither a caution order nor a conditions of practice order would satisfactorily address the significant risk that the Registrant would (or would be permitted to) behave in the future as he behaved in the past. Furthermore, after two periods of suspension, each of which was of sufficient length to allow the Registrant to reflect on his position, nothing would be gained by ordering a yet further period of suspension. The Panel therefore arrived at the conclusion that in all the circumstances, the only appropriate outcome is that of striking off.

32. The Panel addressed the issue of whether it was proportionate to make a striking off order, and concluded that it is. It must be clearly understood why the Panel has arrived at decision. It is not the Panel’s decision that misconduct of the type found in this case can only result in striking off. The imposition of two periods of suspension only serve to underline that fact. What makes striking off the unavoidable outcome in this case is that the Panel cannot allow the Registrant to return to practise as an ODP (or to be in a position where he could do so) in circumstances where he has provided absolutely no information from which it could be concluded that he would not behave in the future as he has behaved in the past.

ORDER: The Registrar is directed to strike the name of Mark William Stokes from the Register on the date this Order comes into effect.

The Order imposed today will apply from 27 January 2026.

History of Hearings for Mark William Stokes