Mr Pepper qualified with Distinction from Guy's, King's, & St. Thomas' Medical School in 2005, also completing an intercalated BSc in Radiological Sciences during this time. This was followed by Basic Surgical Training which included time in neurosurgery, general and endocrine surgery as well as ENT.

He quickly moved into ENT higher surgical training, which was undertaken in respected centres in and around London.  He was trained to a high level in each ENT subspecialty, after which he was awarded a one-year specialist fellowship in Paediatric ENT at Great Ormond Street Hospital, London. During this fellowship he gained extensive expertise in treating children's ear, nose and throat conditions, and continues to develop this in his current practice.

He became a Fellow of the Royal College of Surgeons of England in 2013, and was appointed to the GMC Specialist Register in Otolaryngology in 2015.  Mr Pepper was appointed as a full time Consultant Paediatric ENT Surgeon at the Evelina London Children's Hospital, part of Guy's and St. Thomas' NHS Trust, in 2015.  

Mr Pepper is the head of the Paediatric ENT Department at the Evelina London Children’s Hospital, and is involved in regional planning of Paediatric ENT Services.

His practice covers all aspects of children's ENT, and he looks after many children in the local area with problems such as obstructive sleep apnoea, snoring, tonsillitis, nasal obstruction, hearing problems, and ear infections.  

In addition he provides a busy regional service for children with complex airway and breathing disorders, who often have other significant medical and developmental problems.  He works closely with other specialists (including intensive care, respiratory, cardiothoracic and paediatric surgery, sleep medicine, speech and language), in a large multi-disciplinary team to offer the optimum care for each child.

Mr Pepper is also the regional lead for head and neck lumps in children.  He accepts referrals for all manner of swellings and lesions from GPs and specialists in London down to the South Coast.  These include enlarged salivary glands and lymph nodes, thyroid lumps, vascular anomalies (haemangiomas, venous malformations, lymphatic malformations), as well as other benign and malignant tumours in the neck, nose, and airway.  He is a member of the vascular anomaly multi-disciplinary team, and works closely with the Head and Neck Surgical Team at Guy's Hospital to offer this specialist service.    

He is the educational supervisor for the senior ENT trainee in the department, and is a member of the annual trainee review panel and Specialty Advisory Group.  He also trains two clinical fellows in complex paediatric ENT Surgery in the department.  His commitment to training extends beyond the hospital as the co-director of national Paediatric ENT courses for the British Paediatric Otolaryngology Course.