Mr Sachin Pandya

Preliminary Matters

Service of Notice of Hearing 

1.This hearing has been conducted by video conference and the Registrant has participated in the hearing. There were no issues regarding service of the notice of hearing.

Background

2.Mr Sachin Pandya (“the Registrant“) is registered with the Health and Care Professions Council (“HCPC”) as a Paramedic. At the times referred to in the Allegation he was working, on a self-employed basis, for the British Emergency Ambulance Response Service (BEARS) which is a company supplying services to NHS Trusts. The HCPC case is that on 26 July 2018, BEARS conducted random drugs tests on some workers in accordance with their employment contracts. The test in respect of the Registrant was positive for cannabis.  By a letter dated 31 July 2018 the Registrant was placed on unpaid leave pending an investigation into the circumstances. It is said by the HCPC that on 2 August 2018 the Registrant telephoned his line manager, Person B, to say that he had been in contact with a representative of the HCPC who had told him that it “wasn’t bothered” that he had had a positive test for cannabis. The HCPC maintains that BEARS then reported the circumstances to the HCPC and, during the following period running for more than a year, the Registrant sent offensive and/or threatening text messages and emails to persons working for BEARS as those events are referred to in the Allegation.

3.Prior to the hearing, the Panel received a bundle of documents from the HCPC and some testimonials from the Registrant. The Registrant provided some further documentation during the hearing being representations and a statement sent on his behalf in March 2019 to an Investigating Committee of the HCPC.

4.The Panel heard evidence in support of the HCPC case from: (i) Person B, the Registrant’s line manager, (ii) Person C, Managing Director of BEARS and (iii) Person D, Head of Business within BEARS who all appeared in person by video conference. The Panel also received witness statements from Person A, Clinical Governance Manager within BEARS and MW, a Case Manager within the Health and Care Professions Council.

5.The Panel heard video evidence from the Registrant.

6.At the commencement of the hearing, the Registrant admitted the following Particulars: 1, 3, 4, 5, 6, and 8. He denied Particulars 2 and 7.  Ultimately, it is the responsibility of the Panel to determine whether or not the Particulars of the Allegation are made out but the Panel has taken into account those admissions when making its findings.

Decision on Facts

7.The Panel’s assessment of the witnesses who gave evidence in person is as follows:

(i) Persons B and C – straightforward, credible and consistent.
(ii) Person D -   this witness had limited relevant evidence to give but was credible.
(iii) The Registrant - credible and honest.

8.The Panel received witness statements from Person A and MW. Those statements were accepted as reliable and, so far as the statement from Person A was concerned, the statement was consistent with other evidence.
 
9.The Panel made the findings of fact below on the balance of probabilities.

Particular 1

10.On 26 July 2018, the Registrant was required, along with other workers, to provide a random urine sample for drug testing. The Registrant has, in these proceedings, disputed the reliability of the claimed form of consent that he is said to have provided to BEARS in this respect. However, in the workplace and after initially protesting, he agreed to provide the requested sample. That sample showed the Registrant to have THC, (a constituent part of cannabis) in his body.  The Panel has taken into account the sample result which confirmed cannabis to be present in the Registrant’s body. The Panel is satisfied that the sample in question had been provided by the Registrant. The Registrant has admitted this particular. The Panel finds this particular to be proved.

Particular 1 is proved

Particular 2

11.After the positive drug test on 26 July 2018, the Registrant was told by Person A that he was to remain away from the workplace on unpaid leave pending an investigation of the circumstances.  On 2 August 2018, at about 7.30pm to 8pm, the Registrant telephoned to Person B whilst Person B was off duty and at home. The evidence of Person B has been that the Registrant “said that he had spoken to the HCPC regarding his positive urine drugs test for THC and that they ”wasn’t bothered”, that they were only interested in his conduct as a paramedic and that his positive result had nothing to do with this”.

12.The Registrant’s account has been that he and his partner had made a telephone enquiry with the HCPC regarding the positive drug test.  He maintained that it was his partner who had, on his behalf, conducted the discussion with the person at the HCPC. The Registrant’s evidence has been that his partner was told that the HCPC would have to carry out an investigation into the circumstances and, until that had been done, there was no restriction on the Registrant acting as a paramedic.

13.There is a direct dispute between the Registrant and Person B as to what was actually said by the Registrant during the telephone call between the Registrant and Person B. The Panel takes into account that the Registrant, in giving his account to Person B, was acting on what he believed had been said to his partner by the person at the HCPC. The Panel has further taken into account the clear possibility of an error in interpretation and memory when a message is passed through a chain of three persons. The Panel has noted that Person B in his oral evidence stated that he made a contemporaneous written note of the conversation on the evening of the event. The following day he typed a note which set out his account of what was said and a copy of that note has been provided to the Panel. It is clear to the Panel that at the time of making the telephone call to Person B, the Registrant was not in a calm frame of mind. He was angry because he had been subjected to a drug test and told to stay away from work without pay. He did not make his own contemporaneous note of the conversation.  

14.The Panel has to make a determination on this disputed area of evidence. The Panel takes into account the contemporaneous record made by Person B and prefers his evidence on this issue. The Panel has concluded that the Registrant did say words to the effect that the HCPC “wasn’t bothered” about the positive drug test but he did so in the honest belief that that is what had been said by the HCPC to his partner. On that basis this particular is proved.

Particular 2 is proved

Particulars 3, 4, 5 and 6

15.Particulars 3, 4, 5 and 6 are all clearly supported by documentary evidence provided by the HCPC. The Panel has been given screen shots and copies of the relevant text messages and emails. There is evidence that the material was sent to the various persons shown in the Particulars. There is further evidence to show that the material was issued by the Registrant. The Panel is satisfied that each text and email referred to had at least some content that may reasonably be described as offensive and / or threatening. The Registrant has admitted each of these Particulars. The Panel is satisfied that each of Particulars 3, 4, 5 and 6 is proved.

Particulars 3, 4, 5, and 6 are proved

16.It is relevant to record below examples of the material which the Panel has found to be offensive and / or threatening. The Registrant within his text messages made various allegations against BEARS but these were not the subject of the Allegation, when making the findings above in respect of Particulars 3, 4, 5 and 6:

25.8.18  1.20am
“Ok you cunt. You want to be like that? Ok then yeah, let's be like that. You better pray to fucking God that you actually know your shit, you ignorant moron. I'm fucking coming for you. And guess what? HCPC says I’m ok to carry on working. You ignorant twat. Laters.”

16.7.19 23.41
“You are so going down. The irony in all of this is that you have done this to yourself.... You really should have known better.... Say goodbye to your poxy little fake ambulance service, and your income.
You could have very easily avoided what's about to happen next. Night night
You really are very stupid, and you are about to find yourself in a full on legal fist fight, you and all of your staff...... But mostly you…… Person C”.

17.7.19 1.44am
How fucking date (sic) you talk to me like I’m a piece of shit …. You have got in the way of me grieving for my father, impacted on my earnings, and may have contributed to my partner’s (redacted) through all the stress…… you are disgusting people and I am going to totally FUCK UP your house if you don’t comply……. Do you get me now?????????

6.11.19 00.19
“You know what dick head? If you want to go to magistrates court then yeah, let's go there. Let's bring all this shit out into the open. I was going to walk away bit now you are forcing me to go toe to toe. So yeah, let's do it. Bring it on. And the thing about your house, it was a fucking figure of speech you retarded moron. You are quite a malicious mother fucker aren't you?? Well you just messed with a kamakazi paramedic, you heartless disgusting person..... See you in the ring”.

06 November 2019 01:36:14

you are disgusting heartless people. you do not deserve to be running an ambulance service. don't be surprised if you lose your contract at Tommy's
I'm sure the papers would be interested in this little spat you moron, especially with your history/reputation, and especially as one of my best mates is a journalist for the daily mail/daily Star..... "Private ambulance company earns hundreds of thousands providing medics doing pretty much nothing". ... Nice headline.
Don't worry, your road staff will still have a job. You won't. All I asked for was a meeting, and you had to go and be a bully... It's a small world, the private ambulance service, and you are a small fish in an ocean....

06 November 11.48

Don't worry, those emails were sent when I was blind drunk and were intended for [Person C]
You as a company have dealt with me in a very nasty malicious way. I clearly asked for a meeting right at the beginning of all this. You have been malicious and at times down right dishonest. Your actions have impacted substantially on my mental health. You as an employer are an absolute disgrace. I shall cease all communications with BEARS PTS and any further communications made shall be via an authorized legal body.

Particular 7

17.On the advice of the Legal Assessor the Panel has taken into account the guidance given by the Supreme Court in the case of Ivey v Genting [2017] UKSC 67 at paragraph 74 of the judgment:

“When dishonesty is in question the fact-finding tribunal must 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. 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”.

18.As is recorded above in the context of Particular 2, the assessment made by the Panel regarding the telephone call between the Registrant and Person B on 2 August 2018 was that the Registrant gave to Person B an account which he believed to be true. On that basis the Panel has concluded that the Registrant did not act dishonestly and this particular is not proved.

Particular 7 is not proved

Decision on Grounds

19.The Panel has taken into account the definition of misconduct as that is given in Roylance v GMC (No 2) [1999] UKPC 16 
‘Misconduct is a word of general effect involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a practitioner in the particular circumstances.’

Acts and omissions have to be sufficiently serious before they can be considered as misconduct.

20.The Panel has considered each of the particulars individually and deals first with Particular 2. The assessment of the Panel is that this amounted to a misunderstanding on the part of the Registrant as to the information given by the HCPC to his partner. The Registrant’s action in this respect did not amount to wrongdoing on his part and, in any event, was not serious enough to amount to misconduct.

21.With regard to particular 1 the Registrant, in taking cannabis, had committed a criminal offence. That was serious enough to amount to misconduct.

22.In respect of particulars 3, 4, 5, and 6, the Registrant has told the Panel that he was experiencing considerable personal difficulties at the time, including grief at the death of family members. He was also upset by the way he had been treated by persons at BEARS by being told to take leave after the positive drug test and the speed with which BEARS had reported the drug test event to the HCPC. 

23.The Panel has taken into account that on 7 March 2019, a solicitor acting on behalf of the Registrant submitted representations and a statement by the Registrant which were intended to be considered by an HCPC Investigating Committee that was considering these matters. In that material it was said that the Registrant “apologises sincerely” to Person A about sending the texts. It was further said that the Registrant was not thinking clearly at the time and that his actions were completely out of character and, further, that the Registrant was seeking counselling. In his statement the Registrant said that texts sent to Person A had been issued in anger and after drinking alcohol. The Registrant accepted that his messages had been unacceptable, unprofessional and out of character. He gave his apologies to Person A.

24.However, the Panel takes the view that the texts and emails now being considered were not isolated events. They were sent over a period of 16 months with most of them being sent after the March 2019 material sent for the benefit of the Investigating Committee in which the Registrant had already recognised his actions to be unacceptable and unprofessional. The Panel’s assessment is that the texts and emails were clearly threatening and offensive. Those actions amounted to serious misconduct on the part of the Registrant. If the Registrant had a complaint regarding any actions on the part of BEARS’ employees or workers those should have been submitted through appropriate grievance channels.

25.The Panel finds that particulars 3, 4, 5, and 6 were serious failures on the part of the Registrant and each of them individually amounts to misconduct.

Decision on Impairment 

26.The Panel has considered the guidance in the HCPTS Practice Note on Fitness to Practise Impairment. The Panel’s task is to assess current fitness to practise.

27.The Panel has taken into account the references provided by the Registrant.

28.In determining fitness to practise allegations, Panels must take account of two broad components: the ‘personal’ component and the ‘public’ component:

29.The personal component is the current competence, behaviour etc. of the registrant concerned. The public component refers to protecting service users; declaring and upholding proper standards of behaviour; and maintaining public confidence in the profession concerned.

30.The key questions which need to be answered are:
• are the acts or omissions which led to the allegation remediable?
• has the Registrant taken remedial action?
• are those acts or omissions likely to be repeated?

31.The Panel considered all four limbs of the test set out by Dame Janet Smith in the fifth Shipman Report which were re-stated in Grant (CHRE v NMC (1) and Grant (2) (2011) EWHC 927 (Admin)), namely:-

“Do our findings of fact in respect of the doctor's misconduct, deficient professional performance, adverse health, conviction, caution or determination show that his/her fitness to practise is impaired in the sense that s/he:
1.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
2.has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or
3.has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or
4.has in the past acted dishonestly and/or is liable to act dishonestly in the future.”

32.The Panel has taken into account the honest evidence from the Registrant is still taking cannabis daily, albeit on his evidence, at a reduced rate and with the intention of ceasing altogether in time. He is still drinking alcohol, albeit that he now drinks beer rather than wine or spirits. The Panel acknowledges that during his evidence the Registrant gave a full and frank apology for his actions to Person D.

33.With regard to the personal component, the Panel has concluded that the Registrant has not yet developed full insight into his failings. There is considerable work that the Registrant needs to do to fully understand the negative and damaging impact on others that would be caused if the Registrant were to commit similar failings in the future. That work may involve further counselling and/or treatment arranged through his general practitioner. In this respect the conclusion of the Panel is that the Registrant has so far taken little action to develop insight and remediation.  Therefore, there is a high risk of repetition of harm to others if there were not to be a finding of impairment.

34.With regard to the public component the Panel is satisfied that, having regard to the findings and conclusions above, if the Panel were to make no finding of impairment members of the public would be shocked. They would take into account that the Registrant had attended for duty as a paramedic when he had cannabis in his body. They would consider it to be deplorable if a paramedic were to attend the home of their family member and treat that family member whilst the paramedic had cannabis in his body. The public would be shocked in all the circumstances of this case, and there would be damage to the reputation of the paramedic profession and this regulatory process, if no finding of impairment were made.

35.The Panel has concluded that the fitness to practice of the Registrant is currently impaired on both the personal component and the public component.

Sanction

36.On behalf of the HCPC Mr Foxsmith said that it was not the role of the HCPC to seek a particular sanction but he invited the Panel to take into account the Sanctions Policy. He submitted that the purpose of sanctions was not to punish but to protect members of the public. The Panel should be clear about the purpose of the available sanctions and should approach consideration of those by a step-by-step approach, ensuring that the chosen sanction was proportionate and adequately upheld professional standards and the interests of members of the public. The Panel may find there were mitigating circumstances in this case in that the Registrant had been subject to these proceedings for an extended period of time, there had been no previous regulatory action taken against him, there had been expressions of insight and remorse and he had shown some reflection as to the impact of his actions on others. In respect of aggravating factors, the Panel in its Decision had already identified that the Registrant had continued his misconduct despite HCPC proceedings taking place before the Investigating Committee.

37.The Registrant regretted the fact that his misconduct continued even after the HCPC proceedings had started. He did mean the apologies that he had previously given to the persons affected by his misconduct. In his view, what had happened was that the continuing HCPC proceedings had caused him to dwell upon his past actions and to feel anger. He now realised that at that time he should have sought help but he had not been thinking clearly. He accepted that the language he had used within the various messages had been awful.

38.The Registrant had been provided with a copy of the Sanctions Policy before the Panel received submissions on sanction. The Panel asked the Registrant if he had been able to identify any particular sanction that he thought might be suitable. The Registrant said that he thought that a Conditions of Practice Order would be appropriate.

39.The Panel took into account the HCPC Sanctions Policy. The purpose of sanctions is not to be punitive, although they may have that effect. The primary purpose of a sanction is to ensure public safety. However, a Panel must also give appropriate weight to wider public interest factors which include: the deterrent effect for other registrants, the reputation of the profession concerned, and public confidence in the regulatory process. Further, a Panel must act proportionately in striking the proper balance between the interests of the public and those of a registrant.

40.In considering an appropriate sanction a Panel should impose the sanction that provides an adequate and proportionate balance between (i) public safety and the other public interest factors referred to above and (ii) the Registrant’s ability to practise his or her profession.

Mitigating and aggravating features

41.The mitigating features are the Registrant’s:

• personal circumstances which include bereavement
• lack of previous regulatory action
• admissions to the majority of the Particulars of the Allegation
• recognition that his misconduct had adversely impacted other persons and his regret in that respect.

42.The aggravating features are:

• the misconduct continued over a substantial period of time
• 4 colleagues were affected by the misconduct
• the owner of BEARS was put in fear for his personal safety

43.The Panel first considered an outcome of No Further Action. Such an outcome was not appropriate. The matter was too serious to be resolved in this way.

44.The Panel next considered a Caution Order, which is deemed to be appropriate where “the issue is isolated, limited, or relatively minor in nature” and “the registrant has shown good insight”. Neither of those apply. The misconduct by the Registrant was clearly not minor, limited or isolated. Further, given the serious nature of the misconduct a Caution Order would not serve to maintain confidence in the Paramedic profession or this regulatory process. A Caution Order would not, in that sense, be a proportionate reflection of the gravity of the misconduct.

45.The Panel considered a Conditions of Practice Order.   The Panel took into account that the misconduct on the part of the Registrant occurred outside of work.  The view of the Panel was that it was not practicable to identify workable and enforceable Conditions of Practice that would provide a sufficient level of protection against any repetition of this kind of misconduct. A Conditions of Practice Order is not an appropriate sanction.

46.The Panel next considered a Suspension Order and noted paragraph 121 of the Sanctions Policy:

“A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register”.

47.The Panel has taken into account that the Registrant has displayed a level of insight. However, he has a lot of work ahead of him before he has full insight and has reached the stage when his fitness to practise is no longer impaired. Given that the Panel has concluded that it is not practicable to identify conditions of practice the Panel has concluded that the appropriate and proportionate sanction in all the circumstances is one of a Suspension Order. Such an order is necessary to provide adequate public protection, to maintain public confidence in the Paramedic profession and in this regulatory process.

48.Such an Order may run for any period up to a year. The period of the sanction should itself be proportionate. The Panel has taken into account the stated resolve on the part of the Registrant to seek help. However, it is likely to take some months before such help can be effectively accessed and a further period of time before the Registrant will be able to demonstrate a sustained positive reaction to that help. For that reason, the Panel has decided that the suitable and proportionate period of the Order is 12 months.

49.As a step in checking that a Suspension Order is a proportionate and suitable sanction the Panel considered a Striking-off Order. However, this is not a case where the Registrant lacks any insight and is unwilling to resolve matters. He has positively engaged in these proceedings.  On that basis the Panel is satisfied that a Striking-off Order is not suitable and would be disproportionate.

50.This Order will be reviewed before expiry. The Registrant will be invited to attend a review hearing and this Panel recommends him to do so. This Panel cannot bind the hands of any Reviewing Panel but believes it will assist any Reviewing Panel if at that Review Hearing the Registrant produces documentary confirmation of the treatment he has received by way of counselling and from his general practitioner dealing with his issues of bereavement, anger management and substance abuse.

The Registrar is directed to suspend for a period of 12 months the name of Mr Sachin Pandya from the Register on the day this Order comes into effect.

Interim Order:

1.Mr Foxsmith applied for an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001. The Panel was satisfied that the Notice of Hearing dated 27 August 2020 had put the Registrant on notice that such an application may be made. 

2.An Interim Order may only be made if the Panel is satisfied that such an Order is necessary for the protection of members of the public or is otherwise in the public interest or is in the interests of the person concerned. It is open to the Panel to make an Interim Conditions of Practice Order or an Interim Suspension Order.

3.The Registrant did not object to such an Order.

4.The Panel decided that it was necessary to impose an interim order because not to do so would be inconsistent with the Panel’s earlier decision. The Panel was also satisfied that a member of the public would be dismayed to learn that the Registrant was permitted to continue in practise pending the outcome of the appeal period, if an interim order is not made.  Given the nature of the substantive order made by the Panel which was a Suspension Order, the only sensible type of interim order was an Interim Suspension Order.

5.The Panel concluded that an Interim Suspension Order for 18 months is necessary to protect members of the public and as being otherwise in the public interest.

6.This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Mr Sachin Pandya