Jagjit Sihota, registration number 2060836, was handed the suspension at a General Pharmaceutical Council (GPhC) fitness-to-practise (FtP) committee hearing held last month (July 5-6).

Mr Sihota, who was working as superintendent pharmacist at Al-Shafa Pharmacy in Walsall, dispensed fentanyl among other controlled drugs to a “life mentor” between January 2018 and February 2019, based on fraudulent scripts, according to the hearing determination document.

On various occasions, Mr Sihota supplied the patient with “a large amount” of medications containing fentanyl, an addictive synthetic opioid used in pain control, as well as tramadol and amitriptyline, it said.

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This supply was issued against prescriptions that were fraudulently amended, the committee heard.

Mr Sihota knew the patient as a “successful member of his community” that he held in “high regard” and he understood that their need for pain-killing drugs was explained by their involvement in a motorcycle accident, the document said.

It added that his personal and family circumstances were “extremely challenging”.

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After dispensing fentanyl to the patient several times, in around February 2019 Mr Sihota decided to report the possibility that the prescriptions were “fraudulent” to the local commissioner – the NHS Sandwell and West Birmingham clinical commissioning group (CCG) – it said.

Following his report, an investigation was launched by South Warwickshire NHS Trust’s counter fraud office and an examination of 87 prescriptions, issued by three GP practices, found that the “handwritten amendments” were not the work of the prescribers, the committee heard.

 

“Significant number of red flags”

 

According to the particulars of the allegations – all of which he admitted – Mr Sihoda had supplied the medications and “on one or more occasions” failed to investigate whether the prescriptions were “genuine”.

These prescriptions had various defects related to the dose, the amount of medication prescribed, the inclusion of additional medication, and some were expired, making them “invalid”, the GPhC said.

The committee found that Mr Sihoda had overlooked “a significant number of red flags” related to the scripts, which were electronic with “various handwritten amendments”, over an extended period of time.

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He admitted that there was “no defence” for his actions and acknowledged that he had “failed” in his duty – telling the committee that “pharmacists are guardians of the nation’s medicine cabinets” – according to the document.

In a sample of 32 scripts, the NHS fraud investigator found missing information on dosage, the name and form of the medication, and that some prescriptions had expired, it said.

The fraud investigator found that the numerous “unusual” aspects to the prescriptions should have prompted Mr Sihoda to conduct checks with the patient’s prescriber, it added.

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He “failed to consider the possibility that the prescriptions…being produced by [the] patient might have been forged to support an addiction to or misuse controlled drugs”, it said.

The committee felt that Mr Sihoda’s misconduct – the “uncontrolled supply” of addictive drugs – could have caused “serious harm” to the patient who was “potentially vulnerable” or disrupted the care plan put in place by their GP, it said.

It found that he should have communicated with the patient’s prescribers instead of accepting the patient’s explanations “without question”.

 

“Manipulated”

 

But the committee noted that Mr Sihoda was himself the person who had reported the suspicious prescriptions to the NHS in the first place and that the patient was now subject to “criminal proceedings” as a result.

Mr Sihoda had subsequently displayed “full insight” and “expressed genuine shame and remorse” for his misconduct, it said.

Among “extensive” remedial actions, he has become professionally involved with a Walsall substance misuse team, it added.

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He said that he was “manipulated” and “betrayed” by the patient, a person he considered a “life mentor” and was “in awe of”, and that the nature of the relationship led him to “cloud his professional judgment”, according to the hearing document.

It added that it “is a measure of the personal and professional trust” he placed in the patient that he felt “angry that he was duped” and that he now realised that the trust “was misguided” and “derived from cultural norms such as respect for community elders”.

 

“Significant family events”

 

The committee heard that Mr Sihoda had been facing “significant family events that caused him and his wife considerable emotional upset and continue to do so”.

He “believed he could improve his own circumstances” under the patient’s “mentorship” and “allowed his relationship with [them] to compromise his professional judgment”, according to the document.

It said that his wife’s career – also as a pharmacist – was “on hold because she was the primary carer for their son” and that she would be unable to give up this role “due to her family’s circumstances”.

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The committee also found that Mr Sihoda’s “otherwise unblemished career” and “many positive references and testimonials” were mitigating factors.

He is “is a caring pharmacist who is proud of his role as a pharmacist and his work…is undoubtedly valued within his community”, it said, adding that there was “minimal risk of the misconduct being repeated”.

Nevertheless, the committee felt that the public would see Mr Sihoda as having “failed in his responsibility” as a pharmacist to make certain that the prescriptions were legitimate.

It decided to suspend him from the register for six months but decided not to impose interim measures.

Read the determination in full here