public record - mpts...• dr scerif’s cv, as well as copies of 360 degree reviews dating from...

Record of Determinations –

Medical Practitioners Tribunal

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PUBLIC RECORD

Dates: 19/08/2019 - 22/08/2019

And 30/10/2019 – 01/11/2019

Medical Practitioner’s name:

Dr Sharifa SCERIF

GMC reference number: 7558426

Primary medical qualification: MB ChB 2017 University of Birmingham

Type of case Outcome on impairment New - Conviction Impaired

New - Misconduct Impaired

Summary of outcome

Suspension, 8 months. Review hearing directed

Tribunal:

Legally Qualified Chair: Mr Miran Uddin

Lay Tribunal Member: Mr Andrew Waite

Medical Tribunal Member: Dr Noel Bevan

Tribunal Clerk: Ms Zaheda Razvi

Attendance and Representation:

Medical Practitioner: Present and represented

Medical Practitioner’s Representative: Ms Johannah Webster, Counsel, instructed by BMA Law

GMC Representative: Ms Kathryn Johnson, Counsel, instructed by GMC Legal

Attendance of Press / Public In accordance with Rule 41 of the General Medical Council (Fitness to Practise) Rules 2004 the hearing was held partly in public and partly in private.



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Overarching Objective Throughout the decision making process the Tribunal has borne in mind the statutory overarching objective as set out in s1 Medical Act 1983 (the 1983 Act) to protect, promote and maintain the health, safety and well-being of the public, to promote and maintain public confidence in the medical profession, and to promote and maintain proper professional standards and conduct for members of that profession. Determination on Facts - 21/08/2019

Background

1. Dr Scerif qualified in 2017 and at the time of the events in question was working as a Foundation Year 1 junior doctor at Kettering General Hospital NHS Foundation Trust (‘KGH’). Dr Scerif is currently working as a Foundation Year 2 junior doctor at Leicester Royal Infirmary. 2. When travelling to work, on 1 February 2018 Dr Scerif was asked to show her pass after entering the automated ticket barrier at King’s Cross Station. Dr Scerif produced a ‘Freedom Pass’ (‘the pass’) which is a concessionary document which had been issued to her sister, Ms A. The pass gives the holder free travel on London underground. The GMC alleges that Dr Scerif knew that the pass did not belong to her, and that she acted dishonestly. Further, it is alleged that when she was stopped at Kings Cross station and asked to produce her travel pass, Dr Scerif gave an untruthful account to the ticket inspector and in so doing she acted dishonestly. Additionally, it is alleged that at a later stage, she acted dishonestly in that she made untruthful statements to Transport for London (TfL). Dr Scerif states that she did not know that Ms A’s pass was in her ticket card holder, and that she had used Ms A’s pass unknowingly. 3. On 5 July 2018 at Lavender Hill Magistrates’ Court Dr Scerif was convicted of entering a compulsory ticket area without having a valid ticket, as set out in the body of the Allegation below. Dr Scerif was subsequently fined £200. The Court also ordered her to pay compensation of £396.90 relating to an offence taken into consideration which was that she had travelled on 80 occasions without a valid ticket. The Allegation and the Doctor’s Response

4. The Allegation made against Dr Scerif is as follows:

Paragraph One Between 4 December 2017 and 1 February 2018 you entered a compulsory



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ticket area using a Freedom Pass belonging to Ms A, (the ‘Pass’) on 80 occasions and:

a. You knew you had the Pass in your possession; To be determined

b. you knew the Pass did not belong to you; To be determined

c. you knew that you were not entitled to use the Pass. To be determined

Paragraph Two Your actions described at paragraph 1 were dishonest by reason of paragraphs 1 a to 1 c. To be determined

Paragraph Three On 1 February 2018 you produced the Pass to Transport for London (‘TfL’) Revenue Control Inspector, Ms B, at Kings Cross St. Pancras and stated:

a. that the Pass was yours; To be determined

b. ‘I can bring you a doctor’s letter’, or words to that effect, in relation to the Pass; To be determined

c. ‘That’s a name I sometimes use’, or words to that effect, when you showed Ms B a copy of an email that had the name Sharifa Scerif on it. To be determined

Paragraph Four You knew that the statements described at paragraph 3 were untrue. To be determined.

Paragraph Five On or around 11 February 2018 you submitted a statement to TfL in which you stated:

a. ‘I have since realised that my 3 year old niece had put my sister’s pass in my card holder before I left home possibly thinking that it was my sister’s card holder’, referring to your journey on 1 February 2018; To be determined

b. that your use of the Pass on 1 February 2018 was an ‘…isolated incident’. To be determined

Paragraph Six You knew that the statements described at paragraph 5 were untrue. To be determined



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Paragraph Seven Your actions described at paragraphs 3 and 5 were dishonest by reason of paragraphs 4 and 6 respectively. To be determined

Paragraph Eight On 5 July 2018 at Lavender Hill Magistrates’ Court you were convicted of:

a. On 1 February 2018 at Kings Cross St. Pancras did enter a compulsory ticket area without having with him [sic] a valid ticket contrary to byelaw 17(1) and 23 of the Transport for London Railway Byelaws made under paragraph 26 of Schedule 11 to the Greater London Authority Act 1999 and confirmed under section 67 of the Transport Act 1962. Admitted and Found Proved

Paragraph Nine On 5 July 2018 you were fined a sum of £200.00. Admitted and Found Proved

The Admitted Facts

5. At the outset of these proceedings, through her Counsel, Dr Scerif made admissions to paragraphs eight and nine of the Allegation, as set out above, in accordance with Rule 17(2)(d) of the General Medical Council (GMC) (Fitness to Practise) Rules 2004, as amended (‘the Rules’). 6. In accordance with Rule 17(2)(e) of the Rules, the Tribunal announced these paragraphs and sub-paragraphs of the Allegation as admitted and found proved. The Facts to be Determined 7. In light of Dr Scerif’s response to the Allegation made against her, the Tribunal is required to determine whether Dr Scerif knowingly used Ms A’s pass between 4 December 2017 and 1 February 2018, and whether her actions in doing so were dishonest. 8. The Tribunal is further required to determine whether Dr Scerif subsequently provided TfL with statements that she knew to be untrue and whether, in so doing, she acted dishonestly. Factual Witness Evidence 9. The Tribunal received evidence on behalf of the GMC from Ms B, Revenue Control Inspector for TfL (referred to as ‘Ms B’ in the Allegation).



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10. Dr Scerif provided her own witness statement dated 18 July 2019, and a supplementary statement dated 12 August 2019. Dr Scerif also gave oral evidence at the hearing. Documentary Evidence 11. The Tribunal had regard to the documentary evidence provided by the parties. This evidence included, but was not limited to, the following:

• Email correspondence from Dr Scerif to the GMC, KGH, and University Hospitals of Leicester NHS Trust.

• An email dated 7 August 2018 from Lavender Hill Magistrate’s Court to the

GMC, enclosing Dr Scerif’s written guilty plea, memorandum of conviction, and other supporting documentation.

• Information from TfL, including a record of journeys undertaken using the

pass between 2 December 2017 and 2 February 2018.

• A number of professional and personal testimonials received in support of Dr Scerif.

• Dr Scerif’s CV, as well as copies of 360 Degree Reviews dating from October

2017 to February 2019.

The Tribunal’s assessment of the witnesses 12. The Tribunal heard from one witness called on behalf of the GMC and from Dr Scerif herself. It makes the following observations:

• Ms B, Revenue Control Inspector ('RCI') for TfL – the Tribunal found Ms B to be a credible witness. She was open, direct and honest. Ms B maintained throughout her evidence that she had no actual recollection of the event on 1 February 2018 and that she relied entirely on her notes. The Tribunal considers it a possibility that the notes do not record the entirety of the conversation that she had with Dr Scerif but regard them to be of sufficient detail and regard them to be near contemporaneous. Furthermore, Dr Scerif was given an opportunity to read the notes and comment on them but chose not to do so.

• Dr Sharifa Scerif – the Tribunal found Dr Scerif’s evidence to be lacking in detail, her explanations lacked credibility and on occasion she failed to provide any explanation at all.



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The Tribunal’s Approach

13. In reaching its decision on facts, the Tribunal has borne in mind that the burden of proof rests on the GMC and it is for the GMC to prove the Allegation. Dr Scerif does not need to prove anything. The standard of proof is that applicable to civil proceedings, namely the balance of probabilities, i.e. whether it is more likely than not that the events occurred. 14. It is alleged that Dr Scerif’s action in relation to paragraphs 1, 3 and 5 of the Allegation was dishonest. As advised by the Legally Qualified Chair, the Tribunal adopted the test for determining dishonesty which is set out in the case of Ivey (Appellant) v Genting Casinos (UK) Ltd t/a Crockfords (Respondent) [2017] UKSC 67, which states: ‘1. First ascertain (subjectively) the actual state of the individual’s

knowledge or belief as to the facts. The reasonableness or otherwise of his belief is a matter of evidence (often in practice determinative) going to whether he held the belief, but it is not an additional requirement that his belief must be reasonable; the question is whether it is genuinely held.

2. When once his actual state of mind as to knowledge or belief as to

facts is established, the question whether his conduct was honest or dishonest is to be determined by the fact-finder by applying the (objective) standards of ordinary decent people. There is no requirement that the defendant must appreciate that what he has done is, by those standards, dishonest.’

The Tribunal’s Analysis of the Evidence and Findings 15. The Tribunal then considered the outstanding facts in dispute with regard to each paragraph of the Allegation. Paragraphs 1a, b and c 16. In relation to the stem of paragraph 1 – the Tribunal has taken account of the schedule of journeys provided by TfL at pages 41 – 46 which sets out the journeys undertaken by Dr Scerif during the relevant period, namely the 80 occasions when Dr Scerif did not have a valid ticket, from 4 December 2017 to 1 February 2018. 17. In relation to 1a – the Tribunal has considered the overall evidence in this case. In her written statement, Dr Scerif says: ‘On the date in question, 1 February 2018, I was asked to show my ticket after entering the barriers at Kings Cross station. I handed over my ticket card holder that I had swiped at the reader on the barrier. In my ticket card holder was my sister’s Freedom Pass, together with my Oyster Card (which allows me to travel within London) and my Gold Card (which gives me a discount on Oyster Card fares and allows me to travel to Kettering to go to work). I



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had no idea that my sister’s pass was in there, nor how long it had been in there. I later came to realise that it had been in there for a two month period between 4th December 2017 and 1st February 2018 and that I was using it, unknowingly, for that period to get to Kings Cross from Highbury (which is the first leg of my daily commute from London to Kettering for work).’ 18. The Tribunal also took account of Dr Scerif’s oral evidence in which she was questioned as to how she would have travelled to work prior to December 2018 and she explained that she used to walk from her home to Kings Cross. In about late November /early December 2018, she decided to use the underground to make the journey between Highbury (the nearest station to her home) and Kings Cross. She stated that her mother offered to set up a direct debit payment to top up her oyster card to ensure that she would have no delays to her journey and that it was only when she was stopped by Ms B and her oyster card was scanned that she realised it did not have sufficient funds. The Tribunal notes the statement from Dr Scerif’s mother that she forgot to set up the direct debit. 19. The Tribunal also took account of the evidence provided by Dr Scerif’s sister, at page 51 of the bundle in which she states: ‘I confirm the Freedom Pass in question was in my possession until 1st February 2018. I left the Freedom Pass at home on the morning of the 1st February 2018 as I did not need it for travel on that day.’ 20. The Tribunal does not regard Dr Scerif’s evidence that she undertook 80 journeys using the Freedom Pass without realising that it was in her pass holder to be credible. On Dr Scerif’s own evidence, the pass holder contained her photocard, her oyster card and her gold card. During the London to Kettering leg of her journey, she said in her oral evidence that there would have been occasions when she would have had to have opened her pass holder in order to show ticket inspectors the gold card which served as her ticket for that leg of the journey. The Tribunal considers that it is implausible that the pass would have been in her possession for a two month period without her realising it or without her sister not realising that her pass was missing. The Tribunal also noted that there was approximately £2 credit on her oyster card on 1 February 2018 and that the last time it had been used was in October 2017. 21. On the basis of the above, the Tribunal concluded that Dr Scerif must have known that the Freedom Pass was in her possession. 22. Accordingly, paragraph 1a is found proved 23. In relation to 1b – the Tribunal has taken account of Dr Scerif’s own evidence that the Freedom Pass belonged to her sister. 24. Accordingly, paragraph 1b is found proved



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25. In relation to 1c – the Tribunal has already found that Dr Scerif knew that on the 80 occasions when she entered a compulsory ticket area, she was using a Freedom Pass that did not belong to her. It therefore follows that Dr Scerif must have known that she was not entitled to use her sister’s pass. The Tribunal further notes that when questioned by Ms B, after an initial denial, Dr Scerif accepted that the Freedom Pass belonged to her sister and that she was not entitled to use it. 26. Accordingly, paragraph 1c is found proved. Paragraph 2 27. In determining this paragraph and also paragraph 7, the Tribunal bore in mind that Dr Scerif is a person of good character. The Tribunal, in applying the test in Ivey is in no doubt (despite her good character) that Dr Scerif’s conduct, in using a pass that she knew did not belong to her and knew that she was not entitled to use, would be regarded as dishonest by the standards of ordinary and decent people. 28. Accordingly, the Tribunal has found paragraph 2 proved. Paragraphs 3a, b and c 29. The Tribunal has taken account of the evidence of Ms B who, in her statement, confirmed that she stopped Dr Scerif at around 7:18am on 1 February 2018 at King's Cross Underground Station. She stated that Dr Scerif initially told her that the Freedom Pass she was using was hers. Ms B stated that the photograph on the pass was rubbed off a little bit which made her question what Dr Scerif had told her and as she did not believe that the photograph on the pass was that of Dr Scerif, she asked her for something with her name on it. Ms B stated that Dr Scerif told her that she did not have anything. Ms B stated that Dr Scerif then offered to bring a doctor's letter and stated ‘l think she thought I was questioning why the pass was issued but I explained that I did not believe the pass was hers. Dr Scerif looked through her bag and told me she did not have anything. I could see college books in her bag. I persevered with Dr Scerif She showed me an email that had the name Sharifa Scerif on it. She told me that this is sometimes the name she uses.’ 30. In her oral evidence, Ms B maintained that she just wanted to see something with Dr Scerif’s name on to prove that the pass was hers. Dr Scerif asserts that Ms B asked her to show her, amongst other things, her social media account to establish her identity. When questioned about how she ‘persevered’, Ms B stated that she had no recollection of asking Dr Scerif about social media. She said “I asked her if she had something in her bag and she showed me an email with her name on – I wouldn’t ask about social media as people don’t use their names and it’s not what I usually ask – as far as I’m concerned the interaction we had is what is in my notes.”



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31. Ms B maintained in her oral evidence that she had not made an error in her notes as to what Dr Scerif had said to her regarding the doctor’s letter and the email. When it was suggested that she had misinterpreted what Dr Scerif had said in order to pursue a prosecution, Ms B stated “I don’t have opinions – I deal with facts – I didn’t believe it was her pass but gave her the opportunity to prove it.” 32. In her oral evidence, Dr Scerif denied saying to Ms B ‘I can bring you a doctor’s letter’, she said that the words used were “I can bring you my doctor’s card”. Dr Scerif was questioned about her doctor’s card and she told the Tribunal that she did not have it in her possession on that date as she usually leaves it in the locked staff room at work. Dr Scerif denied having her doctor’s pass on her and denied trying to ‘hoodwink’ the inspector. As to the email, Dr Scerif told the Tribunal that when Ms B asked her for photo ID, she looked in her bag, but did not have anything with her photograph on it so she showed Ms B her email and said “this is an email I sometimes I use”. Dr Scerif explained that she said this as she was not sure which email was associated with her oyster card. Dr Scerif denied saying ‘this is a name I sometimes use’. 33. In relation to 3a – the Tribunal has noted the conflict of evidence as to what was asked and presented to Ms B. Ms B said she would have asked for the ticket and that is what she was handed. Dr Scerif’s evidence is that she handed her passholder that contained all the cards and did not know which card Ms B was looking at when she was asking her questions and had assumed that Ms B was looking at her photocard. 34. Ms B was clear as to what was handed to her by Dr Scerif (a Freedom Pass) which is consistent with what she has recorded in her notes (made near contemporaneously) and with her oral evidence as to what her usual practice was which was to ask for individual tickets and not for the ticket pass holder. The Tribunal accepts Ms B’s account that when she asked for the ticket, she was handed it and not a ticket pass holder. The Tribunal preferred the evidence of Ms B over that of Dr Scerif because Ms B’s evidence is clearly supported by a near contemporaneous note and the Tribunal has accepted that the notes set out in sufficient detail what occurred during their interaction. 35. Accordingly, the Tribunal finds paragraph 3a proved. 36. In relation to 3b – the Tribunal has noted the differing accounts between Ms B and Dr Scerif as to what was said. Ms B in her handwritten note has recorded Dr Scerif as saying ‘Its mine, I can bring you a doctor’s letter’ which she relied upon in her oral evidence to the Tribunal. The Tribunal considers that whilst it might be possible that Ms B may have misheard what Dr Scerif said, on the balance of probabilities the Tribunal is satisfied that it is more likely than not that Dr Scerif did state the words as alleged at paragraph 3b. The Tribunal also considered the context of the conversation and regards Ms B’s response to be logical in that she said she



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was not questioning the legitimacy of the pass being issued she was simply trying to ascertain whether the pass was Dr Scerif’s. The Tribunal preferred the evidence of Ms B and finds it unlikely that she misinterpreted what was said to her by Dr Scerif. It finds that Ms B had no motivation to make inaccurate notes when she knew that she would be offering Dr Scerif the opportunity to check them, which she did at the end of their interaction. Ms B explained that TfL offers ticket inspectors no added incentive to secure prosecutions. Therefore, in the Tribunal’s judgement Ms B was simply doing her job. It found she gave an honest account of the conversation with Dr Scerif. 37. Accordingly, the Tribunal finds paragraph 3b proved. 38. In relation to 3c – the Tribunal has considered the flow of the questions put to Dr Scerif and the answers she gave to Ms B. It considered the conflicting evidence of Ms B and of Dr Scerif as to what was said. The Tribunal is of the view the words used by Dr Scerif, namely ‘this is an email account I sometimes use’ does not fit with what she was being asked, nor is it relevant. 39. The Tribunal rejects the defence submission that Dr Scerif thought that Ms B was looking at her photocard and that the words ‘sometimes use’ has been misconstrued in an attempt to support the allegation against Dr Scerif. It accepts Ms B’s evidence that Dr Scerif did use the words ‘That’s a name I sometimes use’ when she showed her a copy of an email with her name on it. 40. The Tribunal noted the doctor’s account that she had been misheard over the issue of offering to the inspector her doctor’s card and what was said about the email address but considered this explanation was not credible. The Tribunal finds that she did this in order to support the account that the pass was hers. 41. Accordingly, the Tribunal finds paragraph 3c proved. Paragraph 4 42. The Tribunal has preferred the evidence of Ms B’s account of what was said to her when she was questioning Dr Scerif. It has rejected Dr Scerif’s account. It follows that Dr Scerif must have known that the statements she made at paragraph 3 were untrue. Paragraph 5a and 5b 43. The Tribunal has taken account of Dr Scerif’s written account sent to TfL on 11 February 2018. It notes that, as a matter of fact, the statements set out at paragraph 5a and 5b are contained in the response sent from Dr Scerif at page 49 of the bundle.



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44. Accordingly, paragraphs 5a and 5b are found proved. Paragraph 6 45. In considering, whether Dr Scerif knew that the statement she made at paragraph 5a was untrue, the Tribunal considered her oral evidence, in which she said that when she was asked questions by the inspector “I didn’t even attempt to explain why the card was in the pass as at that point I was shocked and didn’t know how it had got in there so didn’t know how to explain it.” She stated that when she went home she told her family what had happened and that is when her sister told her that she had found her 3 year old daughter had swapped items that belonged to them previously. 46. The Tribunal has noted the statement provided by Dr Scerif’s sister who states: ‘It has come to my attention that my three year old niece had placed my Freedom Pass in my sister’s card holder on 1st February 2018. She has swapped items belonging to us several times before. I have had to look for my Freedom Pass several times and found it in the bags of other family members. On this occasion I did not look for the Freedom Pass as I did not need it for travel.’ 47. It has also noted the statement from the mother of the three year old (another of Dr Scerif’s sisters) who states that ‘it is very likely that my 3 year old daughter misplaced the travel pass of my sister …’ 48. The Tribunal does not accept Dr Scerif’s explanation of how the Freedom Pass came to be in her travel pass holder as being plausible. In particular, it did not consider that it is plausible that it remained there for such a long period without her noticing it was there and without her sister noticing that her Pass was missing. Furthermore, the Tribunal considers that had this been the case she would have raised this point at the outset, when she was questioned by Ms B. Dr Scerif’s account is also inconsistent with the content of the letter from her sister in which her sister confirmed that the pass had been in her possession until 1 February 2018 and it was only that date alone when the pass was not in her possession. 49. In considering, whether Dr Scerif knew that the statement she made at paragraph 5b was untrue, the Tribunal considered her response as to why she wrote that her use of the Freedom Pass was a one off isolated incident. She stated that “at that point I was asked to explain only the incident on 1 February, I wasn’t asked about other uses of the card.” Dr Scerif was then asked if she only changed her account after she received the response from TfL which indicated that it was not a one-off journey, to which she replied “no”. She stated that at the time she wrote her response she was not aware that TfL were looking at the use of the Pass on other dates and therefore in her oral evidence she maintained her position that it was an isolated incident. The Tribunal rejects this explanation. It took into account its finding that Dr Scerif knew in December 2017 that the pass was in her possession.



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By 1 February 2018, she had travelled on 80 occasions using it, therefore, it cannot be considered an isolated incident. 50. The Tribunal rejects Dr Scerif’s explanation as to why she regarded it as an isolated incident and has found that she knew when she wrote her response that it was clearly untrue. 51. Accordingly, the Tribunal has found paragraph 6 proved. Paragraph 7 52. In her oral evidence, Dr Scerif denied using her sister’s pass deliberately and dishonestly. 53. Having found particulars 3 and 5 proved, the Tribunal again applied the test in Ivey. In responding in the way she did to firstly to Ms B and thereafter to TfL, Dr Scerif was attempting to justify her use of a pass that was not hers and which she was not entitled to use. The Tribunal has found that her responses to Ms B and to TfL were untruthful. In the Tribunal’s view such conduct is dishonest by the standards of ordinary decent people. 54. Accordingly, paragraph 7 is found proved. The Tribunal’s Overall Determination on the Facts

55. The Tribunal has determined the facts as follows:

Paragraph One Between 4 December 2017 and 1 February 2018 you entered a compulsory ticket area using a Freedom Pass belonging to Ms A, (the ‘Pass’) on 80 occasions and:

a. you knew you had the Pass in your possession; Found Proved

b. you knew the Pass did not belong to you; Found Proved

c. you knew that you were not entitled to use the Pass. Found Proved

Paragraph Two Your actions described at paragraph 1 were dishonest by reason of paragraphs 1 a to 1 c. Found Proved

Paragraph Three On 1 February 2018 you produced the Pass to Transport for London (‘TfL’) Revenue Control Inspector, Ms B, at Kings Cross St. Pancras and stated:



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a. that the Pass was yours; Found Proved

b. ‘I can bring you a doctor’s letter’, or words to that effect, in relation to the Pass; Found Proved

c. ‘That’s a name I sometimes use’, or words to that effect, when you showed Ms B a copy of an email that had the name Sharifa Scerif on it. Found Proved

Paragraph Four You knew that the statements described at paragraph 3 were untrue. Found Proved

Paragraph Five On or around 11 February 2018 you submitted a statement to TfL in which you stated:

a. ‘I have since realised that my 3 year old niece had put my sister’s pass in my card holder before I left home possibly thinking that it was my sister’s card holder’, referring to your journey on 1 February 2018; Found Proved

b. that your use of the Pass on 1 February 2018 was an ‘…isolated incident’. Found Proved

Paragraph Six You knew that the statements described at paragraph 5 were untrue. Found Proved

Paragraph Seven Your actions described at paragraphs 3 and 5 were dishonest by reason of paragraphs 4 and 6 respectively. Found Proved

Paragraph Eight On 5 July 2018 at Lavender Hill Magistrates’ Court you were convicted of:

a. On 1 February 2018 at Kings Cross St. Pancras did enter a compulsory ticket area without having with him [sic] a valid ticket contrary to byelaw 17(1) and 23 of the Transport for London Railway Byelaws made under paragraph 26 of Schedule 11 to the Greater London Authority Act 1999 and confirmed under section 67 of the Transport Act 1962. Admitted and Found Proved.

Paragraph Nine On 5 July 2018 you were fined a sum of £200.00. Admitted and Found Proved.



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Determination on Impairment - 31/10/2019 1. In accordance with Rule 17(2)(k) of the Rules, the Tribunal now has to decide whether, on the basis of the facts found proved, Dr Scerif’s fitness to practise is impaired by reason of misconduct, and by reason of her conviction. The Outcome of Application Made during the Impairment Stage 2. The Tribunal granted Ms Webster’s application, made pursuant to Rule 34(13) of the General Medical Council (Fitness to Practise Rules) 2004 as amended (‘the Rules’), that, Dr Scerif be permitted to give evidence via skype or a telephone link. The Tribunal’s full decision on the application is included at Annex B. The Evidence 3. The Tribunal has taken into account all the evidence received during the Facts stage of the hearing, both oral and documentary. In addition, the Tribunal received further evidence relating to impairment, as follows:

• CV of Dr Scerif dated 2019;

• Reflective statement of Dr Sharifa Scerif, dated 30 October 2019; • Team Assessment of Behaviour for Dr Scerif, dated 11 October 2017, 20

February 2018, 18 October 2018 and 11 February 2019; and • Testimonials.

Submissions On Behalf Of The GMC 4. Ms Johnson submitted that Dr Scerif’s fitness to practise is impaired by reason of her misconduct and conviction. She submitted that the two are connected but that it is the misconduct that is more serious as the Tribunal has found that her use of the pass was dishonest whereas the conviction relates to an offence of strict liability where the doctor’s intention was not relevant. 5. Ms Johnson invited the Tribunal to bear in mind the overarching objective and to adopt the two stage process. She submitted that that a finding of misconduct is necessary to protect patient safety and to promote and maintain public confidence in the medical profession and to promote and maintain proper standards and conduct for those within the profession. Ms Johnson referred the Tribunal to Good Medical Practice (GMP) and specifically to paragraphs 65 and 71 which she submitted had been breached by Dr Scerif’s conduct and submitted that the misconduct in this case amounts to serious misconduct.



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6. Ms Johnson submitted that although Dr Scerif’s conduct is not directly connected to her work as a doctor it demonstrates a pattern of serious and repeated dishonesty. She added that it is of concern that the doctor failed to accept responsibility for what she did; she lied to Transport for London in an attempt to persuade them not to prosecute and she was more concerned with the impact on her career than accepting responsibility for her actions. Ms Johnson reminded the Tribunal that when it became clear that her account was contrary to the evidence that the Freedom Pass had been used regularly by her over a two month period, the doctor still refused to accept that she had been using the pass knowingly. She maintained the pass must have been in her possession for the whole of that period despite this being completely at odds with the account set out in her sister’s letter. 7. Ms Johnson submitted that the Tribunal could not be confident that if faced with a problem at work that Dr Scerif could be trusted to be open and frank and she therefore presents a risk to patient safety. She submitted that Dr Scerif has shown no real insight and the Tribunal has found that she was an untruthful witness. 8. Ms Johnson concluded that the dishonesty found in this case is sufficient to amount to serious misconduct. She submitted that it has not been admitted or acknowledged by Dr Scerif and no steps have been taken to remediate her behaviour. Ms Johnson submitted therefore, given the serious nature of the findings, a finding of impairment is necessary to protect the public, to maintain appropriate standards of behaviour and to maintain public confidence in the profession. On Behalf Of Dr Scerif 9. Ms Webster, submitted that since the end of August, prior to this hearing adjourning, Dr Scerif knew the position the GMC were going to take but she was hoping this independent Tribunal would accept her version of events – that did not happen. She submitted that what Dr Scerif has said in her reflection is that she totally accepts that a finding of dishonesty was open to the Tribunal to make and that having been found, she respects the legitimacy of the Tribunal. However, Ms Webster submitted that Dr Scerif “cannot now make a confession simply to demonstrate she has the required insight; that would be disingenuous”. She submitted that Dr Scerif has had to reflect on how the findings could impact on her personally and professionally and this is set out in her reflective statement. 10. In relation to public safety, Ms Webster submitted that these events unfolded in February 2018 and Dr Scerif has been in unrestricted practice since, having completed her FY2 training during this period. She referred the Tribunal to the evidence adduced including the 360 Team Assessment of Dr Scerif’s behaviour since October 2017 to February 2019 and submitted that it “is illuminating on her trustworthiness and reliability in the workplace”. She highlighted the section on maintaining trust where she referred to the “glowing comments” made. Ms Webster submitted that Dr Scerif has demonstrated that she is a caring and trustworthy



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doctor who is well regarded by those who have worked with her. She added that Dr Scerif is a “safe” doctor. 11. Ms Webster referred the Tribunal to Dr Scerif’s reflective piece and to the two specific examples given where she has been open and honest in the workplace, namely when she had given a wrong prescription and an occasion where she could have received money through a tax rebate. She highlighted that it was Dr Scerif who brought the current matters to the attention of the GMC 12. Ms Webster submitted that Dr Scerif’s case has been widely circulated in the press which has had a significant impact on her personally and given her “a window how the general public would perceive such behaviour”. She submitted that it is accepted that the public would be shocked but that it is in the past. 13. As to insight, Ms Webster submitted that Dr Scerif has during the past two months tried to get on courses to explore in detail issues of candour and the fact that she has started looking at these demonstrates that she is seeking to gain insight, which is difficult for her as she maintains denial of dishonesty. 14. Ms Webster referred the Tribunal to caselaw including Blakely v General Medical Council [2019] EWHC 905 (Admin) and to Yusuff v General Medical Council [2018] EWHC 13 (Admin) (10 January 2018) and reminded the Tribunal that Dr Scerif is entitled to say that she accepts the findings of the Tribunal in the sense that she does not seek to go behind them while still maintaining a denial of the conduct underpinning the findings. Ms Webster submitted that Dr Scerif is able to demonstrate insight and because of this experience, including adverse press reporting, the Tribunal can rest assured that this behaviour will not be repeated. 15. Ms Webster concluded by submitting that Dr Scerif’s conduct can be remediated and invited the Tribunal to find that her fitness to practise is not impaired. The Relevant Legal Principles 16. The Tribunal reminded itself that at this stage of proceedings, there is no burden or standard of proof and the decision of impairment is a matter for the Tribunal’s judgment alone. 17. In approaching the decision, the Tribunal was mindful of the two-stage process to be adopted: first, whether the facts as found proved amounted to misconduct which was serious and secondly, whether that misconduct led to a finding of impairment. The Tribunal must determine whether Dr Scerif’s fitness to practise is impaired today, taking into account Dr Scerif’s conduct at the time of the events in question, as well as any relevant factors since then such as whether the matters are remediable, have been remedied, and any likelihood of repetition.



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18. The Tribunal has already given a detailed determination in relation to the facts of Dr Scerif’s case. It has taken those matters into account in its deliberations. It has also taken into account the submissions made by Ms Johnson and Ms Webster. 19. Throughout its deliberations, the Tribunal has been mindful of its responsibility to uphold the overarching objective as set out in the Medical Act 1983 (as amended). That objective is the protection of the public and involves the pursuit of the following:

a. to protect, promote and maintain the health, safety and wellbeing of the public;

b. to maintain public confidence in the profession; c. to promote and maintain proper professional standards and conduct

for members of the profession. 20. The LQC referred the Tribunal to the case of Yusuff v General Medical Council and in particular to the following paragraphs:

’18. It would be wrong to equate maintenance of innocence with a lack of insight. However, continued denial of the misconduct found proved will be relevant to the Tribunal's considerations on review. As paragraph 52 of the Sanctions Guidance makes clear, refusal to accept the misconduct and failure to tell the truth during the hearing will be very relevant to the initial sanction. … A want of candour and continued dishonesty may be taken into account by the Tribunal in reaching its conclusions on impairment.’

20 ‘I conclude having reviewed all the relevant authorities that at a review hearing: a. The findings of fact are not to be reopened; b. The registrant is entitled not to accept the findings of the Tribunal; c. In the alternative, the registrant is entitled to say that he accepts the findings in the sense that he does not seek to go behind them while still maintaining a denial of the conduct underpinning the findings; d. When considering whether fitness to practise remains impaired, it is relevant for the Tribunal to know whether or not the registrant now admits the misconduct; e. Admitting the misconduct is not a condition precedent to establishing that the registrant understands the gravity of the offending and is unlikely to repeat it; f. If it is made apparent that the registrant does not accept the truth of the findings, questioning should not focus on the denials and the previous findings;



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g. A want of candour and/or continued dishonesty at the review hearing may be a relevant consideration in looking at impairment.’

21. The LQC advised that in light of Dr Scerif’s evidence at this stage of the proceedings and Ms Webster’s submissions, the Tribunal should bear in mind the guidance provided by Mrs Justice Yip in the paragraphs referred to above. He also advised that whilst the case of Yusuff concerned review hearings, in light of the decision in Blakely there was no reason in principle why the guidance in Yusuff could not apply in this case. 22. Ms Johnson, in response to the LQC’s advice submitted that the fact that the denial is maintained is a matter the Tribunal can take into account and is a matter for it as to the weight to give to it. The Tribunal’s Approach 23. The Tribunal first determined whether Dr Scerif’s actions amount to misconduct. 24. In doing so, it had regard to Dr Scerif’s evidence at stage one of these proceedings relating to the circumstances which gave rise to her using her sister’s Freedom Pass. It also took into account her evidence given via skype during this impairment stage and also to the documents adduced on her behalf, including her reflective statement. The Tribunal’s Determination Misconduct 25. The Tribunal next asked itself whether Dr Scerif’s actions amounted to misconduct and, if so, whether her fitness to practise is currently impaired by reason of that misconduct. 26. In its findings on the facts, the Tribunal has found proved that:

• Between 4 December 2017 and 1 February 2018 Dr Scerif entered a compulsory ticket area using a Freedom Pass belonging to her sister on 80 occasions and she knew she had the Pass in her possession; she knew the Pass did not belong to her and that she was not entitled to use the Pass. The Tribunal found these actions to be dishonest.

• On 1 February 2018 Dr Scerif produced the Pass to Transport for London

(‘TfL’) Revenue Control Inspector, at Kings Cross St. Pancras and stated that the Pass was hers; ‘I can bring you a doctor’s letter’, or words to that effect, in relation to the Pass; ‘That’s a name I sometimes use’, or words to that effect, when she showed the Inspector a copy of an email that had the name



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Sharifa Scerif on it. The Tribunal found that Dr Scerif knew that these statements were untrue.

• On or around 11 February 2018, Dr Scerif submitted a statement to TfL in

which she stated: ‘I have since realised that my 3 year old niece had put my sister’s pass in my card holder before I left home possibly thinking that it was my sister’s card holder’, referring to your journey on 1 February 2018; and that her use of the Pass on 1 February 2018 was an ‘…isolated incident’. The Tribunal found that these statements were untrue.

• The Tribunal found Dr Scerif’s actions described above to be dishonest.

27. The Tribunal had regard to paragraphs 65 and 71 of GMP (2013 version).

‘ 65. You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.

71. You must be honest and trustworthy when writing reports, and when completing or signing forms, reports and other documents. You must make sure that any documents you write or sign are not false or misleading.

a. You must take reasonable steps to check the information is correct. b. You must not deliberately leave out relevant information.’ 28. The Tribunal has found a course of repeated dishonesty which breached the above fundamental tenets of GMP. It considered that Dr Scerif’s actions were seriously below the standards of behaviour expected of doctors and would be regarded as deplorable by fellow practitioners. It therefore concluded that her conduct fell short of the standards of conduct reasonably to be expected of a doctor and amounted to misconduct. Impairment 29. The Tribunal having determined that the facts found proved amounted to misconduct, went on to consider whether, as a result of that misconduct, Dr Scerif’s fitness to practise is currently impaired. 30. The Tribunal considered the statutory overarching objective, and the factors identified by Dame Janet Smith, and cited at paragraph 76 in the case of Grant [2011] EWHC 927 (Admin), both of which recognise that as part of the process of determining whether a doctor is fit to practise today it must take account of past actions or failures to act. In particular, whether she:

a. ‘has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or



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b. has in the past brought and/or is liable in the future to bring the medical

profession into disrepute; and/or

c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession

d. has in the past acted dishonestly and/or is liable to act dishonestly in the

future.’ 31. The Tribunal considered whether Dr Scerif’s actions had in the past or were liable in the future to put patients at unwarranted risk of harm. In doing so, it took account of the significant evidence that Dr Scerif is a good and safe doctor who is well regarded by those who have worked with her and the fact that the misconduct was not in the context of her professional work. The Tribunal did not consider that the misconduct found impacted directly on patient safety but nevertheless concluded that there was some risk that this type of misconduct could occur in a workplace context. 32. The Tribunal considered that limbs b, c and d identified above were applicable in this case. It has determined that Dr Scerif’s misconduct had brought the medical profession into disrepute and breached fundamental tenets thereof. 33. The Tribunal considered the bundle submitted on behalf by Dr Scerif and has taken account of the positive comments made in her 360 feedback reports from a range of colleagues who have worked with her. It also took account of the positive testimonials, particularly that submitted from Mr C, Consultant Urologist, dated 22 July 2019, in which he describes her ‘admirable qualities’ as a caring doctor. Dr Scerif is clearly well regarded professionally. 34. The Tribunal noted that while it was difficult to remediate dishonesty, it was not impossible. However, given Dr Scerif’s continued denial of the dishonest conduct, no specific steps have been taken to address that element. However, in her reflective statement dated 30 October 2019, Dr Scerif states:

‘The GMC investigation and more recently my MPTS hearing have been very difficult and stressful for me to deal with. It has had a huge impact on me both personally and professionally. Specifically, the last 2 months have been particularly challenging. This was made worse by finding out that the media had widely published my story on numerous newspaper websites and was further exacerbated by comments left by the public on these pages. I am still finding it hard to deal with the consequences of this. However, importantly this time has given me the necessary opportunity to reflect on the decision made by the Tribunal and my actions that led to this decision. I have read the Tribunal’s reasoning behind their decision in detail and I can now see how my



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actions can reasonably be interpreted as dishonest by the Tribunal and thence the public therefore I respect the judgement of the Tribunal. In addition, the media publication, although it has been painfully difficult for me to deal with, has given me insight into the public's view. I have come to the dreadful realisation that my actions could negatively impact on the reputation of doctors. Further still, the media publication and the public's comments were left before the Tribunal had reached their decision. Although I wasn’t aware of this until after the Tribunal’s decision, it has now made me realise that the fact that a doctor can be involved in a situation like mine, whether I believe it was intentional or not, is enough for the public to feel as they do and to undermine public confidence in the profession. I want to unreservedly apologise for all of this.

More importantly, from my reflection it became apparent to me that it could be extrapolated by the public that I could be dishonest in my professional life. This would have serious patient safety implications for example, when owning up to mistakes or honesty associated with patient examination findings, and therefore would impact on a patient’s trust and confidence in doctors. Again, I am very sorry that my actions have led to this. However, I want to reassure the Tribunal that I am aware of the GMC’s Good Medical Practice guidelines of being open and honest and that this experience of going through a GMC investigation and a MPTS hearing has further imprinted on me the importance of this. I have always implemented the GMP guidelines of being open and honest in my professional life. For example, firstly, I would like to remind the Tribunal that, in line with the guidelines, it was myself who initially disclosed this current matter to the GMC and so it came to the GMC’s attention because of my recognition of the importance of being honest. Additionally, there have been no concerns regarding my honesty at work. … Moreover, there have been examples at work were as a result of my mistakes it would have been easier for me to cover up my mistake and not try to correct the problem however, I have always chosen to put patient safety first and to be honest. For example, I had accidentally prescribed fucidin as opposed to the more potent fucidin H for a patient with eczema and I realised the error only after the patient had gone home. I immediately followed the local guidelines and called the patient, apologised for my mistake, explained the error and gave a new corrected prescription. Lastly, I recently received payslips of £208 in the end of august and again of £208 and £160 in the end of September from my previous hospital trust. After enquiring what this was for, I was told by the payroll department that it was a tax rebate for locum shifts that I had done whilst employed at the trust. At this point I could have just accepted the money however I knew that had never done a locum shift and so this money was therefore mistakenly given to me. Therefore, I was honest and informed them that this was a mistake.



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I hope that though my reflection it can be seen that I am truly sorry for my actions and that I have realised the seriousness of it. I have put in place methods to prevent any chance of re-using my sister’s pass and since the incident it has not reoccurred. In addition, given the chance to continue practising as a doctor, I will attend this course https://professionalboundaries.org.uk/maintaining-professional-ethics/ on professional ethics to give me the opportunity for deeper reflection guided by a specialist and will enable me to develop techniques and a personal plan to maintain good professional ethics at work. Furthermore, I will attend the MDU’s courses on essential communication skills and the duty of candour, which will amongst other things, help me to develop important communication skills especially those needed for challenging interactions when events haven’t gone to plan. I am also happy to undertake any other courses or remedial actions advised by the Tribunal.’

35. Dr Scerif was also called to give further oral evidence via skype. She described how the hearing has affected her personally and the realisation that there is a possibility of “losing my career”. She said that it had affected her professionally as the outcome of the hearing may prevent her from completing her training and “will more or less finish my career”. 36. In cross-examination Dr Scerif was asked if she now accepted that she had knowingly used her sister’s pass; lied to the ticket inspector; lied to TfL; persuaded members of her family to lie to cover for her to which she replied “No” to all. Dr Scerif maintained that the use of the pass was unintentional. She also stated “I think the Tribunal would want me to agree with them and I haven’t so I’m not just trying to say what they want to hear … I always knew findings of dishonesty would impact the profession but I didn’t see my case as being so but when the Tribunal found against me I realised an impartial person could also view it as dishonest.” 37. In relation to the ethics courses, which she has yet to attend, Dr Scerif explained that there had not been enough time to complete them in the intervening period since August. She told the Tribunal that she sent the MDU an email on 1 September enquiring about relevant courses but was told that the next available course was at the end of October, on the dates of this hearing and she therefore could not attend. Dr Scerif stated that there is another ethics course scheduled at the beginning of December on which she intends to secure a place. 38. The Tribunal considered Dr Scerif’s reflective statement and is satisfied that, given its content, Dr Scerif has shown some insight into the impact of dishonesty on the reputation of the profession and also insight as to how the public would view such misconduct. However, she does not accept that she has been dishonest. The Tribunal is therefore of the view that she does not have insight into her own dishonesty. Although the actual act of deception did not result in a significant



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financial gain, the dishonesty was planned and she dragged others into her deception. 39. In addressing the future risk of repetition, the Tribunal has had to balance the supportive character evidence, against the seriousness of the findings and ongoing denial of dishonesty. Having considered these factors, the Tribunal is of the view that there remains some risk that such conduct could be repeated in the future. 40. Given the nature of the misconduct found proved, the Tribunal concluded that confidence in the medical profession would be significantly undermined if a finding of impairment were not made in these circumstances. 41. In all the circumstances, the Tribunal considered that a finding of impairment was necessary to promote and maintain public confidence in the medical profession, and to promote and maintain proper professional standards and conduct for members of the profession. 42. The Tribunal has therefore determined that Dr Scerif’s fitness to practise is impaired by reason of her misconduct. Conviction 43. The Tribunal next considered whether Dr Scerif’s fitness to practise is currently impaired by reason of her conviction. 44. The Tribunal notes that although the conviction relates to an offence of dishonesty, albeit, a strict liability offence, it is related to conduct which this Tribunal has found amounts to serious misconduct. 45. Accordingly, the Tribunal determined that Dr Scerif’s fitness to practise is impaired by reason of her conviction. Determination on Sanction - 01/11/2019 1. Having determined that Dr Scerif’s fitness to practise is impaired by reason of her misconduct and conviction, the Tribunal now has to decide, in accordance with Rule 17(2)(n) of the Rules, on the appropriate sanction, if any, to impose on her registration. The Evidence 2. The Tribunal has taken into account evidence received during the earlier stages of the hearing where relevant to reaching a decision on sanction. In addition, the Tribunal received further evidence at Sanction stage, namely a defence bundle



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(D4) which included a number of documents relating to Dr Scerif’s fine and collection order, correspondence regarding these proceedings, documents relating to her recent application for speciality training including her speciality training number. Submissions On Behalf Of The GMC 3. Ms Johnson commenced her submissions by addressing the Tribunal on the documents contained in the defence sanction bundle. She stated that Dr Scerif started her specialty training in September 2019 and has produced documents to demonstrate that she has disclosed these proceedings prior to commencing the post. Ms Johnson submitted that Dr Scerif has been extremely limited in that disclosure, maintaining her use of the pass was unintentional. Further, there is no reference to show that she has provided the actual allegation, the determination or even a summary of the Tribunal’s findings. Ms Johnson submitted that the written account of Dr Scerif minimises the seriousness of the allegation and referred the Tribunal to an email sent from Dr Scerif on 31 August, submitting that Dr Scerif has not been entirely open in that email as she did not disclose the findings of facts made. Ms Johnson invited the Tribunal to consider carefully the emails, which she submitted demonstrate that Dr Scerif has no insight into the seriousness of her position. 4. Ms Johnson observed that the document at page 29 of bundle D4, has been produced because it demonstrates that there is a possibility that Dr Scerif’s training number may be withdrawn. She submitted that it would still be open to Dr Scerif to reapply following a period of suspension. 5. Ms Johnson referred the Tribunal to the Sanctions Guidance (February 2018) (the SG) and submitted that SG makes it clear that in its consideration of sanction, the reputation of the profession as a whole should be at the forefront of the Tribunal’s mind. 6. Ms Johnson reminded the Tribunal that any sanction imposed should be proportionate, weighing the interests of the public against Dr Scerif’s interests. She invited the Tribunal to take account of the aggravating and mitigating factors and to bear in mind paragraphs 51-53 of the SG. She reminded the Tribunal that Dr Scerif is at an early stage in her career having only qualified in 2017 and she has the benefit of positive testimonials and no previous history of complaints. Ms Johnson submitted that Dr Scerif has apologised but only in limited terms given her maintenance that her actions were unintentional. She reminded the Tribunal that Dr Scerif does not accept that her actions were dishonest and that the Tribunal is entitled to take more serious action given the dishonesty found. 7. Ms Johnson then addressed the Tribunal as to the range of sanctions available to the Tribunal, starting with the least restrictive. She submitted that there



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are no exceptional circumstances in this case and that it would not be sufficient, proportionate, nor in the public interest to conclude this case by taking no action. 8. Ms Johnson submitted that it would be inappropriate to impose an order of conditions in this case. She referred the Tribunal to paragraph 81 which sets out the criteria where conditions may be appropriate and submitted that the circumstances of this case do not fall into any of those categories as there are no workable conditions that could protect the public. 9. As to suspension Ms Johnson, submitted that a robust response is required to send a message to Dr Scerif and the profession that this behaviour is unacceptable. She submitted that Dr Scerif’s registration should be suspended and that the Tribunal has the power to suspend for up to 12 months. 10. Ms Johnson submitted that the GMC does not consider that Dr Scerif’s conduct is fundamentally incompatible with continued registration and reminded the Tribunal that it has found that she has begun to develop insight into the effects of her dishonesty on the reputation of the profession and how it would be viewed by the public. She submitted that Dr Scerif however, does not have insight into her own dishonesty and therefore a period of suspension would allow her to reflect upon this. 11. Ms Johnson referred the Tribunal to paragraphs 112 to 119 of the SG that deal with conviction cases and invited the Tribunal to consider whether the doctor’s registration should be restricted to protect the public or maintain standards and the reputation of the profession as a result of the conviction. She also referred the Tribunal to paragraphs 120 to 128 which provides guidance for cases involving dishonesty. 12. Ms Johnson concluded her submissions by re-iterating that “only an order of suspension will protect the public in this case”. She had no submissions as to the length of any order or whether there should be a review, submitting that it was a matter for the Tribunal. On Behalf Of Dr Scerif 13. Ms Webster commenced her submissions by referring the Tribunal to bundle D4. She submitted that Dr Scerif had sent the declaration form alongside other documents which make clear that she was being investigated for dishonesty. She further submitted that Dr Scerif was still recruited on the training programme after emailing her future employers about her current position and despite letting them know that these proceedings ‘were not going in my favour’ and of the possibility of suspension or even erasure. 14. Ms Webster invited the Tribunal to consider the fact that Dr Scerif is at an early stage in her career and that an order of suspension would mean she will lose



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her specialist training number. She submitted that this would have a significant impact and will define her career. Ms Webster urged the Tribunal to take account of Dr Scerif’s dedication to her career in medicine and the years she has spent in studying to get to her current position. She reminded the Tribunal of the evidence of Dr Scerif’s involvement in audits and research and submitted that “she has got so much to offer and has so much potential”. 15. Ms Webster submitted that this is a case where Dr Scerif could be managed by conditions which would mean she can remain on the training programme. She submitted that any risk to patient safety could be managed by conditions. Ms Webster submitted that Dr Scerif does not need to be suspended in order to send a message as she has had a public finding of impaired fitness to practise and has a criminal conviction, so she has been punished. She submitted that conditions could be imposed for closer supervision and for her to attend ethics courses. 16. Ms Webster submitted that if the Tribunal were against her on that point then a suspension order for a period of three months would be appropriate as it would allow Dr Scerif to attend the courses she has already identified. The Tribunal’s Approach 17. The Tribunal has borne in mind the overarching objective. The Tribunal is of the view that the misconduct committed by Dr Scerif was serious, involving a course of repeated dishonesty which breached the above fundamental tenets of GMP. It considered that Dr Scerif’s actions were seriously below the standards of behaviour expected of doctors and would be regarded as deplorable by fellow practitioners. Aggravating and Mitigating Factors 18. The Tribunal considered the following to be aggravating factors to the already serious misconduct:

• Her lack of insight – Dr Scerif does not accept that her conduct was dishonest and therefore there is no evidence of remediation of that conduct.

19. The Tribunal noted the following mitigating factors:

• She is at an early stage of her career, having just been awarded a specialist training number in September 2019;

• There have been no concerns about Dr Scerif’s clinical abilities as evidenced

by the testimonials and the 360 feedback reports;

• There is no previous FtP history;



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• She has developing insight into how dishonesty can affect others; and

• There was no harm caused to patients as a result of her misconduct. 20. In the circumstances of this case, the Tribunal has taken particular regard to the following paragraphs of SG – para 120 124, 125 and 128

‘120 Good medical practice states that registered doctors must be honest and trustworthy, and must make sure that their conduct justifies their patients’ trust in them and the public’s trust in the profession.

124 Although it may not result in direct harm to patients, dishonesty related to matters outside the doctor’s clinical responsibility (eg providing false statements or fraudulent claims for monies) is particularly serious. This is because it can undermine the trust the public place in the medical profession. Health authorities should be able to trust the integrity of doctors, and where a doctor undermines that trust there is a risk to public confidence in the profession. Evidence of clinical competence cannot mitigate serious and/or persistent dishonesty.’

The Tribunal’s Determination 21. The decision as to the appropriate sanction to impose, if any, in this case is a matter for this Tribunal exercising its own judgement. In reaching its decision, the Tribunal has taken account of the Sanctions Guidance. It has borne in mind that the purpose of sanctions is not to be punitive, but to protect patients and the wider public interest, although they may have a punitive effect. 22. Throughout its deliberations, the Tribunal has applied the principle of proportionality, balancing Dr Scerif’s interests with the public interest. The public interest includes, amongst other things, the protection of patients, the maintenance of public confidence in the profession, and promoting and maintaining proper standards of conduct and behaviour. 23. The Tribunal has already given a detailed determination on impairment and it has taken those matters into account during its deliberations on sanction. No Action 24. In coming to its decision as to the appropriate sanction, if any, to impose in Dr Scerif’s case, the Tribunal first considered whether to conclude the case by taking no action. 25. The Tribunal considered that there are no exceptional circumstances which might justify taking no action against Dr Scerif’s registration. The Tribunal



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determined that in view of the serious nature of the Tribunal’s findings on impairment, it would be neither sufficient, proportionate nor in the public interest, to conclude this case by taking no action. Conditions 26. The Tribunal next considered whether it would be sufficient to impose conditions on Dr Scerif’s registration. It has borne in mind that any conditions imposed would need to be appropriate, proportionate, workable and measurable. 27. Ms Webster submitted that conditions are the appropriate sanction but she did not identify any conditions which the Tribunal considered would be appropriate. In any event, the Tribunal is of the opinion that a period of conditional registration would not adequately reflect the serious nature of Dr Scerif’s misconduct; nor can conditions be formulated that would be workable to address the concerns raised in this hearing. The Tribunal has, therefore, determined that it would not be sufficient or appropriate to direct the imposition of conditions on Dr Scerif’s registration. Suspension 28. The Tribunal then went on to consider whether suspending Dr Scerif’s registration would be appropriate and proportionate. 29. The Tribunal was satisfied that Dr Scerif’s misconduct was so serious that action must be taken to maintain public confidence in the profession. 30. The Tribunal had regard to paragraphs 91 and 92 of the SG which state:

’91 Suspension has a deterrent effect and can be used to send out a signal to the doctor, the profession and public about what is regarded as behaviour unbefitting a registered doctor. Suspension from the medical register also has a punitive effect, in that it prevents the doctor from practising (and therefore from earning a living as a doctor) during the suspension, although this is not its intention.

92 Suspension will be an appropriate response to misconduct that is so serious that action must be taken to protect members of the public and maintain public confidence in the profession. A period of suspension will be appropriate for conduct that is serious but falls short of being fundamentally incompatible with continued registration (ie for which erasure is more likely to be the appropriate sanction because the tribunal considers that the doctor should not practise again either for public safety reasons or to protect the reputation of the profession).’



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31. The Tribunal noted that whilst there was a serious breach of the principles in GMP, it was satisfied that suspension, in principle, could be sufficient to maintain confidence in the profession. 32. Despite the submission of the GMC that a suspension order was the appropriate sanction, in view of the seriousness of the misconduct found, the Tribunal nevertheless went on to consider whether erasure was an appropriate sanction. It determined, balancing all of the factors in this case, that erasure would be disproportionate. The Tribunal was satisfied that a reasonable person in possession of the full facts of this case would not consider that Dr Scerif’s misconduct was fundamentally incompatible with continued registration. This was also acknowledged by the GMC in its submissions on sanction. 33. In light of the Tribunal’s assessment of this case and the need to promote and maintain public confidence in the profession and to uphold and maintain proper standards of conduct, it was satisfied for all of the reasons set out above that suspension is the appropriate and proportionate sanction. The Tribunal determined to suspend Dr Scerif’s registration for a period of 8 months. 34. In deciding on the period of 8 months the Tribunal considered that it will allow Dr Scerif to develop full insight into her misconduct and it would enable her to reapply to join the specialist rotation in 2020. It recognised that she is a young doctor who clearly has potential and it would not be in the interests of the wider public, or her own interests, to impose a period longer than 8 months, the potential effect of which might be that she could face difficulty in getting back on the speciality training programme until 2021. The Tribunal also considered that 8 months suspension will send out a signal to the doctor, the profession and public about what is regarded as behaviour unbefitting a registered doctor. Review 35. The Tribunal determined to direct a review of Dr Scerif’s case. A review hearing will convene shortly before the end of the period of suspension, unless an early review is sought. The Tribunal wishes to clarify that at the review hearing, the onus will be on Dr Scerif to demonstrate how she has remediated her misconduct. It therefore may assist the reviewing Tribunal if Dr Scerif provides:

• Evidence she has fully remediated her misconduct, which can include, courses attended and a further reflective statement which addresses the misconduct and an appreciation of the impact of her actions; and

• Evidence she has kept her clinical skills and knowledge up to date.

36. Dr Scerif will also be able to provide any other information that she considers will assist. Given her relative inexperience, the Tribunal observes that she may



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benefit from being mentored by a senior colleague as she reflects on the outcome of these proceedings. Determination on Immediate Order - 01/11/2019 1. Having determined to suspend Dr Scerif’s registration, the Tribunal has considered, in accordance with Rule 17(2)(o) of the Rules, whether her registration should be subject to an immediate order. Submissions 2. On behalf of the GMC, Ms Johnson submitted that she had no instructions to seek an immediate order of suspension given the facts of this case. 3. On behalf of Dr Scerif, Ms Webster had no submissions to make on the matter of an immediate order. The Tribunal’s Determination 4. In reaching its decision the tribunal referred to the relevant paragraphs of the SG. It exercised its own judgement and had regard to the principle of proportionality. 5. The Tribunal noted the GMC submission and concluded that it was not necessary to impose an immediate order of suspension on Dr Scerif’s registration to protect members of the public, or is otherwise in the public interest, or is in the interests of the doctor. 6. This means that the substantive 8 month period of suspension will take effect on Dr Scerif’s registration 28 days from when notice is deemed to have been served unless an appeal is made in the interim. 7. That concludes this case. Confirmed Date 01 November 2019 Mr Miran Uddin, Legally Qualified Chair



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ANNEX A – 21/08/2019 – PRIVATE

APPLICATION TO ADJOURN

1. This determination will be read in private. However, as this case concerns Dr Scerif’s conviction and misconduct, a suitably redacted version will be published at the close of the hearing. 2. The Tribunal resumed today to commence the impairment stage of these proceedings. It noted that Dr Scerif was not present and invited her representative, Ms Webster to explain her absence. Ms Webster told the Tribunal that Dr Scerif had sent her an email yesterday evening following her discovery that the case had been widely reported in the press. Dr Scerif was distressed XXX following the press reporting of her case and in particular of the identification of her family members and also because her photograph had also appeared in the press coverage. XXX Ms Webster submitted that having discussed the matter with Dr Scerif and her instructing solicitors, an application to adjourn proceedings was made. She submitted that it may be that at a resumed hearing, Dr Scerif will wish to give further evidence or at least provide a reflective statement. XXX 3. Ms Johnson, on behalf of the GMC, opposed the application to adjourn. She submitted that there is all day today to deal with the matter of impairment. Ms Johnson submitted that XXX it is not enough to simply state that the doctor is upset. She submitted that Dr Scerif is not the first doctor to have findings made against her or the first to be reported in the press and the fact that she and her family are the subject of adverse press reporting is a result of her own dishonest actions. Ms Johnson submitted that there are insufficient reasons for stage two to be adjourned, and it would therefore be inappropriate to adjourn. She reminded the Tribunal that these matters had been reported in the press earlier in the week and the doctor continued to participate then. Ms Johnson invited the Tribunal to refuse the application to adjourn and stated that there is no reason for the Tribunal not to proceed in the usual way today. 4. The LQC advised that the Tribunal had a discretion to adjourn proceedings but that discretion must be exercised taking into account all of the circumstances in the case. He advised that it ought to consider the reasons for the doctor’s absence and most importantly consider whether it was fair to proceed with the hearing. Whilst there were factors that might point in either direction, the ultimate criterion is that of fairness to both the doctor and the GMC. Tribunal Decision 5. Whilst the Tribunal does not consider the matter of adverse press reporting in itself to be of relevance in its decision to adjourn, it has determined that to deprive Dr Scerif the opportunity to submit a reflective statement and to give further evidence at the impairment stage would be unfair and unjust. XXX



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6. Today is the last scheduled date of the original listing. The Tribunal determined that there was insufficient time remaining to conclude matters and identified three further days to conclude the remaining stages of the hearing. 7. The Tribunal has now completed stage one of the process and handed down its determination on facts. This hearing will now adjourn part-heard, subject to Rule 29(2) of the General Medical Council (Fitness to Practise Rules) 2004 as amended (‘the Rules’), until Wednesday 30 October – Friday 1 November 2019 to conclude matters in this case. 8. The Tribunal invited the GMC, if they wished, to make any applications in the light of the determination on the facts. Ms Johnson submitted that the GMC did not wish to make an application to impose an interim order. 9. The hearing is now adjourned part-heard and will re-convene at the impairment stage at 9.30 am on Wednesday 30 October 2019.



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ANNEX B – 30/10/2019 – PRIVATE APPLICATION TO HEAR EVIDENCE VIA SKYPE OR TELEPHONE

1. This determination will be read in private. However, as this case concerns Dr Scerif’s conviction and misconduct, a suitably redacted version will be published at the close of the hearing. 2. The Tribunal resumed today to commence the impairment stage of these proceedings. It noted that Dr Scerif was not present and invited her representative, Ms Webster to explain her absence. Ms Webster told the Tribunal that Dr Scerif had intended to attend but that XXX 3. Ms Webster made an application for Dr Scerif to be permitted to give further evidence via telephone under Rule 34(13) of the General Medical Council (‘GMC’) (Fitness to Practise) Rules 2004, as amended (the Rules). XXX 4. Ms Johnson, on behalf of the GMC, submitted that that the GMC position is that the doctor should be present. XXX Ms Johnson submitted that non-attendance of a doctor would not prevent continued press interest and reporting of her case. She further submitted that Dr Scerif is currently working XXX. 5. Ms Johnson accepted that regulatory proceedings and adverse publicity are stressful but publicity is a consequence of the doctor’s behaviour. 6. Ms Johnson submitted that the GMC take a neutral stance. She added that giving evidence over a telephone is not ideal as it makes assessment of the witness more difficult. 7. The Tribunal raised the possibility of the doctor giving evidence via a skype link and neither Counsel had any objection to that suggestion. Tribunal Decision 8. The LQC referred the Tribunal to Rule 34(13) and (14) which states:

‘(13) A party may, at any time during a hearing, make an application to the Committee or Tribunal for the oral evidence of a witness to be given by means of a video link or a telephone link.

(14) When considering whether to grant an application by a party under paragraph (13), the Committee or Tribunal must —

(a) give the other party an opportunity to make representations; (b) have regard to —



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(i) any agreement between the parties, or (ii) in the case of a Tribunal hearing, any relevant direction given by a Case Manager; and (c) only grant the application if the Committee or Tribunal consider that it is in the interests of justice to do so.’ 9. The Tribunal notes Dr Scerif’s reasons for her non-attendance XXX. 10. The Tribunal is mindful that the preference is to hear witness evidence in person. It took into account the submissions made by both Counsel and in particular the GMC’s neutral stance in response to the application. The Tribunal has determined that it would be in the interests of justice to receive Dr Scerif’s evidence via a skype link or a telephone link as it will assist it to make a fuller assessment of the evidence. It therefore determined to grant the application.

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