Mubarak Muhammad Mutawakkil

Preliminary Matters
1. The Panel has been convened to undertake the review of a substantive
suspension order that has been imposed in respect of the HCPC
registration of the Registrant, Mr Mubarak Muhammad Mutawakkil, a
Physiotherapist. The review is being conducted 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 29 June
2026 that was sent to the email address provided by the Registrant to the
HCPC. The email informed the Registrant of the date and time of this hearing, and also of the fact that the hearing would be conducted by the
use of Microsoft Teams. The Panel was satisfied that this communication
constituted a valid notice of hearing.

Proceeding in the Registrant’s absence
3. After the Panel announced its decision that it was satisfied that there had
been good service of the notice of hearing, the Presenting Officer applied
for a direction that the hearing should proceed in the absence of the
Registrant. This application was made on the basis that it is clear that
the Registrant has voluntarily absented himself from this hearing.
4. The Panel received and accepted the advice of the Legal Assessor on
the issue of proceeding in the absence of the registrant the case
concerns. It also followed the guidance contained in the HCPTS Practice
Note on the topic.
5. Having carefully considered the matter, the Panel concluded that the
hearing should proceed in the Registrant’s absence. The reasons for that
decision were as follows:
• It is clear that the Registrant has disengaged from
communication with the HCPC and participation in this fitness to
practise process. He did not attend the final hearing of the
Allegation in October 2024, and he did not attend the review
hearing in October 2025. Since that review hearing the HCPC
has sent emails to the Registrant concerning the proceedings on
five occasions (namely, on 18 December 2025, 9 April 2026, 7
July 2026, 25 August 2026 and 22 September 2026) but he has
not responded to any of them.
• There is a mandatory statutory requirement that the suspension
order is reviewed before it expires on 14 November 2026. There
are no factors that could lead the Panel to conclude that there
would be any prospect of the Registrant attending a hearing
before that date if it adjourned the hearing today.
• In view of these factors, it is in the public interest that the review
is undertaken without further delay.

Background
6. The Registrant is registered with the HCPC as a Physiotherapist.
7. The matters underpinning the Allegation arose while the Registrant was
employed as a Band 6 Musculoskeletal Physiotherapist by the North
Cumbria Integrated Care Foundation Trust (“the Trust”). He commenced
this employment on 21 November 2022, was suspended from it on 30
January 2023, and dismissed on 21 March 2023.
8. Upon commencing his employment with the Trust the Registrant
underwent a two-week induction, after which he was given a reduced
caseload. Concerns about the Registrant’s practice were raised within
the first two week, following which the manager of the Musculoskeletal
Physiotherapy Team at the hospital where the Registrant was working
carried out observations. In her evidence to the final hearing panel the
manager described the shortcomings that were identified and also
explained that the Registrant was provided with a lot of support,
confirming that the Registrant had been receptive to the support he had
been offered. The evidence given to the final hearing panel was that
although improvement was noted in the Registrant’s communication
skills, his clinical skills did not improve.
9. The final hearing of the Allegation took place between 14 and 17 October
2024. At that hearing the panel conducing it found most of the factual
particulars to be proven by the HCPC (as indicated by the table at the
head of this determination).
10. The Allegation alleged that the factual particulars constituted “misconduct
and/or lack of competence”. When it made its decision on those statutory
grounds, the final hearing panel recognised that with regard to several of
the proven failings there was a breadth of matters which breached a
number of the standards of proficiency that have to be observed by
Physiotherapists, and that the Registrant’s conduct had the potential to
have serious consequences for service users, particularly with regard to
missed red flags. However, the final hearing panel recognised that the
failings were essentially omissions and it did not conclude that they were
subjectively reckless, still less intentional behaviour. That panel found
that there was a serious mismatch between the Registrant’s ability and
the standard of performance that was expected by someone in the role
for which he was employed. The conclusion of the final hearing panel
was that the statutory ground made out was that of lack of competence
rather than misconduct.
11. When it turned to consider the issue of impairment of fitness to practise,
the final hearing panel recorded the fact that the absence of the
Registrant from the hearing was that it had no evidence of acceptance of
shortcomings, development of insight or of any work undertaken to rectify
deficiencies. In those circumstances, and in the light of the past lack of
competence, that panel concluded that there was a high risk of repetition.
That finding meant that the personal component of impairment of fitness
to practise was met. With regard to the public component, the panel
decided that members of the public would be alarmed if no action was
taken.
12. The final hearing panel determined that the only sanction that would
provide sufficient protection was a suspension order, and it made such
an order for a period of 12 months. That order came into effect on 14
November 2024 on the expiry of the 28 day appeal period.
13. The suspension order made on 17 October 2024 was reviewed on 23
October 2025. The panel that conducted the review decided that the
Registrant’s fitness to practise remained impaired and that the
appropriate sanction was a further suspension order for a period of 12
months from the expiry of the earlier order. It is the order made on 23
October 2025 that is currently being reviewed by the present Panel.

Submissions to the Panel
14. In advance of the hearing the Panel was provided with a copy of a
Skeleton Argument on behalf of the HCPC prepared by Ms Sampson
dated 29 September 2026. This document contained a clear and
comprehensive account of the background of the case. Submissions as
to the proper approach to be followed by the Panel in making a decision
on the review were advanced. As to the outcome of the review sought
by the HCPC, the submission was made that nothing has changed since
the substantive hearing and that the non-engagement on the part of the
Registrant means there is nothing before the Panel that could lead to
finding that the past impairment of fitness to practise has been
addressed. Therefore, it is submitted, there remains a significant risk of
repetition with the associated risk that service users would be placed at
real risk of harm. Furthermore, the HCPC contended, the requirement to
uphold professional standards and the need to maintain public
confidence additionally require a finding that the Registrant’s fitness to
practise is still impaired. For these reasons, it was submitted, a further
sanction is required. The HCPC requested the Panel to make a further
suspension order, on this occasion for a period of 4 months. Such an
order would extend to the Registrant a yet further opportunity to engage
in the process and it would also provide the next reviewing panel with the
jurisdiction to make a striking off order should that then be considered
appropriate at that time.
15. In her oral submissions the Presenting Officer adopted the submissions
advanced by her Skeleton Argument.
16. No submissions were received by the Panel from or on behalf of the
Registrant.

Decision
17. The Panel accepted the advice it received and followed the guidance
contained in the HCPTS Practice Note entitled, “Review of Article 30
Sanction Orders”. 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 exiting order, then ordinary sanction
principles apply. The decision should be made by following the
guidance contained in the HCPC’s Sanctions Policy. As the
finding of the final hearing panel in this case was one of lack of
competence and the Registrant has not, as at today’s date, been
continuously suspended for a period of two years, the available
sanctions do not include the making of a striking off order. It is
necessary that any further order decided upon should satisfy the
requirement that it represents a proportionate response.
The Panel confirms that in reaching its decision it has applied these
principles.
18. There has been no information provided by the Registrant since the final
hearing decision was made nearly two years ago. It follows that the
present Panel has no information of any relevant CPD or training courses
that the Registrant might have undertaken. Neither does it have any
testimonials from anyone who might be in a position to attest to his
professional performance. The consequence of the absence of any such
information is that there is no information to suggest that the impairment
of fitness to practise identified by the final hearing panel does not
continue.
19. In circumstances where the present Panel can only assume that the
wide-ranging clinical shortcomings have not been satisfactorily
addressed, there can be no conclusion other than that there remains a
risk of repetition of those shortcomings. Were they to be repeated there
would be a clear and obvious risk to service users whom the Registrant
might be called upon to treat as a Physiotherapist. Quite apart from the
risk of future service user harm, the Panel considers that it would be
failing in its duty to uphold proper professional standards and to maintain
confidence in the profession were it not to mark the matter. The
consequence of these findings is that the Registrant’s current fitness to
practise remains impaired in respect of both the personal and public
components.
20. Having concluded that the Registrant’s fitness to practise remains
impaired, the Panel then went on to consider whether a further sanction
is required when the present period of suspension expires. It reached
that decision by applying the factors identified above that resulted in the
impairment decision to the guidance contained in the Sanctions Policy.
21. The Panel first considered whether it would be appropriate to take no
action or to impose a caution order. The Panel concluded that neither
outcome would be appropriate. Neither provide the required degree of
protection against the risks of future service user harm. Furthermore,
neither would sufficiently underline the importance of marking proper
professional standards and neither would sufficiently reassure the public
that the profession of Physiotherapy is robustly regulated.
22. Having rejected a caution order as an appropriate outcome, the Panel
next considered a conditions of practice order. In that regard the Panel
heeded the guidance contained in paragraph 153 of the Sanctions Policy,
which is in these terms:
“A conditions of practice order is likely to be appropriate in cases
where:
• the registrant has insight;
• the concerns are capable of being remedied or managed;
• there are no persistent or general concerns which would.
prevent the registrant from remediating;
• appropriate, proportionate, realistic and verifiable conditions
can be formulated;
• the panel is confident the registrant will comply with the
conditions;
• a reviewing panel will be able to determine whether or not those
conditions have or are being met; and
• a panel is satisfied that a registrant may continue to practise
with conditions without exposing the public to risk of harm.”
23. In the view of the Panel, the present circumstances do not fit with the
factors suggested in paragraph 153. There is no evidence of insight. The
non-engagement by the Registrant means that there would be no
confidence that he would comply with any conditions that could be
formulated. The concerns at the Trust continued despite a great deal of
support being extended to the Registrant, and that would make it difficult
to formulate appropriate conditions of practice to mitigate risk even if
there were not other factors making a conditions of practice order
inappropriate.
24. The Panel therefore rejected a conditions of practice order as an
appropriate outcome.
25. The rejection of conditions of practice resulted in the Panel arriving at a
consideration of a suspension order. The Panel considered that a
suspension order is an appropriate outcome; in circumstances where the
option of striking off is not available, no lesser sanction will provide
sufficient protection against the risk of future service user harm and no
lesser sanction will remind fellow professionals and the general public of
the importance of providing safe and effective practice.
26. The Panel’s decision was that upon the expiry of the current period of
suspension on 14 November 2026, a further suspension order for a
period of 4 months should be made. That will enable a future reviewing
panel the option of making a striking off order.
27. In the event that the Registrant belatedly decides to engage in the
process with a view to preserving his HCPC registration, then he would
be well advised to consider the helpful suggestions in paragraph 150 of
the final hearing decision of 17 October 2024, and paragraph 35 of the
decision of the panel that undertook the first review on 23 October 2025.

ORDER: The Registrar is directed to suspend the registration of Mubarak
Muhammad Mutawakkil for a further period of 4 months on the expiry of
the existing order.

The Order imposed today will apply from 14 November 2026.

History of Hearings for Mubarak Muhammad Mutawakkil