Mr Christopher Losinski

Preliminary Matters
Proceeding in private
1. Ms Whitby, on behalf of the HCPC, submitted that the entire hearing should be conducted in private as this review hearing solely relates to the Registrant’s health and should be treated as confidential. The Registrant supported the application. He stated that he would appreciate as much privacy as possible. Having accepted the advice of the Legal Assessor, the Panel determined that the hearing should be conducted entirely in private to protect the Registrant’s right to a private life. The Panel also determined that references to the Registrant's health should not form part of the public record.

Background
2. The Registrant was employed by Walsall Healthcare NHS Trust as an Occupational Therapist from 10 August 2015 to 1 February 2016. This was his first post-qualification role as an Occupational Therapist. During this period of employment concerns were raised about the Registrant which, in turn, led to the referral to the HCPC.

Substantive Hearing

3. At the substantive hearing which concluded on 26 July 2017, the Allegation was found proved in its entirety. The substantive hearing panel went on to conclude that the Registrant’s fitness to practise was impaired. At the sanction stage the substantive hearing panel imposed a 12-month Suspension Order.

First Review Hearing
4. At the first review hearing on 19 July 2018, the panel concluded that the Registrant’s fitness to practise remained impaired as he had not provided any of the material that the original panel suggested would be of assistance to a reviewing panel. There was also no independent evidence to indicate a change in the Registrant’s state of health.

5. The first review panel extended the Suspension Order for a further period of 12 months. The panel suggested that the Registrant should, if he wished to return to work as an Occupational Therapist, consider engaging with the HCPC and complying with the suggestions made by the original panel.

HCPC Submissions
6. Ms Whitby, on behalf of the HCPC, outlined the background circumstances and the history of this case. She invited the Panel to conclude that the Registrant’s fitness to practise remains impaired as there has been no material change in circumstances since the original Suspension Order was imposed and that the Suspension Order should be extended.

Registrant’s Submissions
7. The Registrant informed the Panel that he is now working in a different field and has no intention of returning to practice as an Occupational Therapist. He suggested that his health problems, whilst working at the Trust, were brought on, at least in part, by working in a hospital environment and being allocated a supervisor on his second rotation who was more critical and less supportive than his previous supervisor. The Registrant stated that his fitness to practise is no longer impaired and that he no longer suffers from any health problems. He also stated that his current employment is progressing well and there are no concerns.

Panel’s Approach
8. In undertaking this review, the Panel took into account the submissions from both parties.

9. The Panel accepted and applied the advice it received from the Legal Assessor as to the proper approach it should adopt. In particular that:
• The purpose of the review is to consider the issue of impairment based on the previous panel’s findings of fact, the extent to which the Registrant has engaged with the regulatory process, the scope and level of his insight, and the risk of repetition.
• In terms of whether the Registrant’s previous health concerns have been remediated, relevant factors include whether the Registrant:
i. fully appreciates the gravity of the previous panel’s finding of impairment;
ii. has maintained his skills and knowledge;
iii. is likely to place service users at risk if he were to return to unrestricted practice;
iv. has provided any independent medical evidence.

10. The Panel should have regard to the HCPTS Practice Note: Finding that Fitness to Practise is ‘Impaired’ and take account of the following components:
i. the ‘personal’ component: the current competence, behaviour etc. of the individual registrant; and
ii.  the ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

11. It is only if the Panel determines that the Registrant’s fitness to practise remains impaired, that the Panel should go on to consider sanction by applying the guidance as set out in the HCPTS Sanctions Policy (SP), and the principles of proportionality, which require the Registrant’s interests to be balanced against the interests of the public.

Decision
Impairment
12. The Panel noted that there was no material change in circumstances since the last review. The Panel was encouraged by the Registrant’s attendance by telephone. It noted that there was no evidence that the health concerns that led to the original finding of impairment have been addressed. Although the Registrant stated that he is now fit and well, in the absence of independent verifiable medical evidence, the Panel could not be satisfied that his health had improved and was now being appropriately managed. Without this evidence, the Panel concluded that the Registrant continues to pose a risk to service users in his professional capacity as an Occupational Therapist.

13. The Panel noted that a significant aspect of the public component is upholding trust and confidence in the profession. Members of the public would be concerned to learn that an Occupational Therapist  whose fitness to practise had been found to be impaired by reasons of adverse health, had been able to return to the register unrestricted, despite being either unable or unwilling to provide medical evidence that he was fit to do so. The Panel concluded that, in these circumstances, a finding of no impairment would undermine public trust and confidence in the profession and in the HCPC as a professional regulator.

14. Therefore, the Panel was led to the inevitable conclusion that, the Registrant’s fitness to practise remains impaired on both the personal and public components.  

15. Having determined that the Registrant’s fitness to practise remains impaired the Panel went on to consider what sanction, if any, to impose.

Sanction
16. The Panel first considered taking no action. The Panel concluded that, in view of the nature and seriousness of the Registrant’s misconduct which remains un-remediated, to take no action on his registration would be inappropriate. Furthermore, it would be insufficient to protect the public, maintain public confidence and uphold the reputation of the profession.

17. The Panel went on to consider a Caution Order. As the Registrant has provided no evidence that his health concerns have been remediated, the risk of repetition remains. Therefore, the Panel concluded that a Caution Order would be inappropriate and insufficient to protect the public and meet the wider public interest.

18. In considering Conditions of Practice, the Panel noted that the Registrant no longer wishes to practise as an Occupational Therapist and therefore, even if suitable conditions could be formulated, the Panel would have no confidence that he would comply with them.

19. The Panel next considered extending the current Suspension Order for a further period. The Panel noted that a Striking Off Order could not be imposed today as the Registrant has not been continuously suspended for a period of 2 years.

20. This Panel cannot bind a future reviewing panel, however, the Panel recognises that if the Registrant has not taken any of the steps suggested by the substantive hearing panel or has not entered into an agreement with the HCPC with regard to voluntary removal, the next review hearing may result in a Striking Off Order. In these circumstances, the Panel concluded that the Suspension Order should be extended, at this stage, for a period of 6 months.

That the Registrar is directed to suspend the registration of Mr Christopher Losinski for a further period of 6 months from the expiry of the current order.  

The order imposed today will apply from 23 August 2019.
This order will be reviewed again before its expiry.

History of Hearings for Mr Christopher Losinski