Jonathan Murrell

Preliminary Matters

Application for hearing in private

1. Mr Coniah on behalf of the Registrant applied to hear the facts stage of the hearing in private in the interest of justice.

2. Mr Micklewright on behalf of the HCPC did not object to the application.

3. The Panel referred to Rule 10(1)(a) of the Conduct and Competence Committee (Procedure) 2003 Rules, which provides that:

"The proceedings shall be held in public unless the Committee is satisfied that, in the interests of justice …the public should be excluded from all or part of the hearing".

4. The Panel was mindful that it was agreed by the parties that it was in the interest of justice to hold the factual stage of the hearing in private. The Panel agreed with the submissions of Mr Coniah. The Panel therefore determined that the entirety of the facts stage of this hearing should be heard in private.

[redacted]

Decision on misconduct

93. The Panel heard submissions from Mr Micklewright. He invited the Panel to find that the statutory ground of misconduct had been established. He submitted that the Registrant’s conduct in the facts found proved by the Panel fell far below the relevant standards in force at the time. He submitted that the conduct of the Registrant breached the following standards of conduct, performance and ethics applicable at the relevant time, namely 5.2, 6.1 and 9.1. He stated the Panel may also wish to consider standards 2.7 and 3.4.

94. Mr Coniah provided written and oral submissions on misconduct, in respect of misconduct he submitted the following:

“Given there was a culture of poor compliance with confidentiality at [redacted] and the fact that the Registrant was a newly appointed and inexperienced OTL with no training, in the circumstances it is difficult to see how a finding of a misconduct can be made for conduct that was widespread at the time. Whilst it is accepted that JM’s conduct in respect of the proven allegations was not in line with the rules and standards required to be followed, however, when considering the above circumstances and authorities set out above, it is submitted that the Registrant’s conduct in this case was not sufficiently serious as to amount to misconduct.”

95. The Panel accepted the advice of the Legal Assessor. Her advice included reference to the cases of Roylance v GMC [2000] 1 AC 311 and Nandi v GMC [2004] EWHC 2317 (Admin).

96. The Panel was aware that in respect of misconduct there was no burden or standard of proof and that it was a matter for the Panel’s own professional judgment. It bore in mind that breaches of the Standards did not automatically result in a finding of misconduct or impairment.

97. The Panel began by reviewing the HCPC’s Standards (2016) and considered that standards 5.2, 6.1 and 9.1 had been breached. The Registrant, in failing to maintain confidentiality and disclosing confidential information, engaged in conduct which may undermine public’s trust and confidence in himself and the profession.

98. The Panel went on to consider the Standards of Proficiency for Paramedics (2014) and found that the following had been breached:

“7.1 be aware of the limits of the concept of confidentiality

7.2 understand the principles of information governance and be aware of the safe and effective use of health and social care information”.

99. The Panel considered each of the factual particulars found proved individually in order to consider whether the conduct amounted to misconduct.

100. In respect of allegation 1a), the Panel considered that the Registrant should have asked [the Colleagues] to leave the room whilst discussing the details of the case [redacted]. However, the Panel accepted that the set-up of the hearing and the use of the OTL office on the day in question was suboptimal. The Panel noted that the Registrant was a newly appointed and inexperienced OTL and was seeking mentorship [redacted].

101. In respect of the harm or potential harm caused by the Registrant’s actions the Panel noted that there was no evidence presented of any specific harm caused and it considered the information disclosed whilst confidential was not of a highly sensitive nature, given that the individual concerned would have known the outcome of the hearing when it was announced.

102. While the Panel considered that the Registrant could have taken further steps to maintain confidentiality, it considered that the conduct itself was not sufficiently serious to amount to misconduct.

103. In respect of particular 1b), the Panel considered the disclosure of the information about Colleague 1’s support, in the presence of Colleagues, was a breach of confidentiality. However, the Panel considered, for similar reasons to those set out above, that the disclosure itself was not sufficiently serious to amount to misconduct. Whilst the information was confidential in nature it was not highly sensitive.

104. The Panel was not able to identify any harm caused by the disclosure [redacted]. The Panel considered the Registrant’s position and the fact that he was new to the role and considered in all the circumstances that the conduct was not deplorable nor sufficiently serious to amount to serious misconduct.

105. In respect of particular 1c (i) the Panel considered that its finding in respect of Colleague 10 and the fact that Colleague 10 was not the appropriate individual for the Registrant to seek guidance from. While the Panel considered that the Registrant’s conduct amount to a breach of confidentiality, as there was no reason to disclose this highly sensitive information [redacted], the Panel considered that the conduct in of itself was not misconduct.

106. The Panel noted that Colleague 10 was a member of the team [redacted]. While it was unclear why the Registrant did not go to Colleague 7 to discuss his concerns, his actions were not such that they fell significantly short of what was expected of him as a professional. The Registrant’s actions in seeking guidance from Colleague 10 were inappropriate as they breached confidentiality. However, the Panel considered that this conduct, in of itself, was not deplorable and did not amount to serious misconduct in the context of the Registrant’s role and Colleague 10’s position within the department.

107. In respect of particular 1c (ii) the Panel considered that this conduct amounted to misconduct in that the Panel found that the Registrant shared the names of some of the individuals involved in respect of the drug allegations. [redacted].

108. In respect of the harm or potential harm caused by the Registrant’s actions, the Panel noted that the actions of the Registrant had the potential to cause serious harm and reputational damage [redacted].

109. The Panel’s view was that this unauthorised disclosure of sensitive information which was conduct that fell significantly short of what was expected of the Registrant as a professional. The Panel considered that this conduct was deplorable and amounted to serious misconduct.

110. In respect of Particular 1c (iv) the Panel also considered that this conduct amount to misconduct. The Panel considered that this information was highly sensitive [redacted].

111. In respect of the harm or potential harm caused by the Registrant’s actions the Panel noted that the actions of the Registrant had the potential to cause serious harm and reputational damage [redacted]. The Panel considered that this unauthorised disclosure of sensitive information was conduct which fell significantly short of what was expected of the Registrant as a professional. The Panel considered that this conduct was deplorable and amounted to serious misconduct.

112. In respect of particular 1d) the Panel also considered that this conduct amounted to misconduct. The Panel considered that the personal health information in respect of Colleague 2 was highly sensitive. The Panel noted its conclusions that the conversation with a Colleague amounted to an unnecessary disclosure of Colleague 2’s suicidal ideations and this disclosure occurred without reasonable justification.

113. The Panel considered that the disclosure by the Registrant was conduct which fell significantly short of what was expected of him as a professional. The Panel considered that this conduct was deplorable and amounted to serious misconduct.

114. In respect of Particular 2, the Panel considered that this did not amount to misconduct. The disclosure itself was not sufficiently serious to amount to misconduct. Whilst the information was confidential in nature it was not highly sensitive and related to the Registrant himself.

115. The Panel considered that the disclosure by the Registrant, although inappropriate, was not conduct which fell significantly short of what was expected of him as a professional. The Panel considered that this conduct was not deplorable and therefore did not amount to serious misconduct.

116. All of the matters which have been found by the Panel to constitute misconduct a breach of standard 9.1 relating to a failure to uphold and maintain the public’s trust and confidence in the profession. Members of the public would be rightly concerned at the Registrant’s behaviour. The Panel decided that the Registrant’s conduct in particulars 1c(ii), 1c(iv) and 1(d) fell far below the standards of a Paramedic and were sufficiently serious to amount to misconduct.

Decision on Impairment

117. The Panel was invited by Mr Micklewright to consider whether, in its judgment, the Registrant’s fitness to practise is impaired, and to consider all the relevant factors. Mr Micklewright submitted that the Registrant has not fully remediated his misconduct and not attended specific training in respect of confidentiality. He also submitted that the Registrant was impaired in respect of the public component in that given the nature of the Allegation and the facts found proved, public confidence in the profession and how it is regulated would be undermined if there were to be no finding of impairment.

118. In his submissions Mr Coniah reminded the Panel that the test is whether the Registrant’s fitness to practise is currently impaired. He submitted that the Registrant’s conduct took place several years ago, and that there has been no replication of the conduct. Mr Coniah also referred to the Registrant’s reflection and submitted that the Registrant has demonstrated considerable insight. Mr Coniah also referred the Panel to the testimonials which he stated were likely given in the knowledge of these proceedings despite not stating that within them. Mr Coniah invited the Panel to conclude that there will be no repetition of similar conduct, and he submitted that the Registrant was not impaired on either the personal or public component.

119. The Panel recognised that its findings in relation to misconduct did not necessarily mean that the Registrant’s fitness to practise is impaired.

120. The Panel accepted the advice of the Legal Assessor and took account of the guidance in the HCPTS Practice Note on ‘Fitness to Practise - Impairment’.

121. The Panel firstly considered the personal element of impairment. It considered whether the misconduct is remediable. The Panel was of the view that the misconduct in this case was remediable and noted that this was accepted by the HCPC in their submissions.

122. The Registrant has taken some significant steps to address his past misconduct. He has provided evidence that he has completed significant training on topics which centre around confidentiality. The Registrant also included, in his reflections on his conduct, acknowledgment of the impact of breaches of confidentiality on public confidence in the profession. The Registrant acknowledged his faults.

123. The Panel’s assessment was that the Registrant has demonstrated significant insight within his statement and in his evidence to the Panel.

124. The Panel was of the view that the Registrant had fully reflected and acknowledged the issues in respect of maintaining confidential information. It was clear that he had been working for several years since the concerns were raised without incident.

125. In its assessment of the risk of repetition the Panel considered, given the lapse of time since the concerns and the lack of repetition and on the basis of the Registrant’s insight, there was no risk of repetition.

126. The Panel therefore decided that the Registrant’s fitness to practise is not impaired on the basis of the personal component.

127. The Panel next considered whether, given the nature, circumstances, and gravity of the Registrant’s misconduct, public confidence in the Paramedic profession and the HCPC would be undermined if there was no finding of impairment. The Panel also considered whether it would be failing in its duty to declare and uphold proper standards of conduct and behaviour if there was no finding of impairment in this case.

128. The gravity of the Registrant’s conduct is that he disclosed highly sensitive confidential information on multiple occasions in respect of his colleagues. In respect of the drug allegations, this could have had significant consequences for the individuals involved. The Panel considered a finding of impairment is required to mark the Registrant’s departure from professional standards.

129. The Panel also considered the impact of the Registrant’s behaviour on public confidence in the profession. The ability to maintain confidentiality is fundamental to the role of a Paramedic, and the Panel considered a Paramedic’s failure to maintain confidentiality in respect of highly sensitive information would undermine public confidence in the profession. The Panel therefore concluded that public confidence in the profession would be undermined if a finding of impairment were not made.

130. The Panel therefore concluded that the Registrant’s fitness to practise is impaired on the public component.

Decision on Sanction

[redacted]

131. [redacted] Mr Micklewright took the Panel through the available sanction options and noted that the HCPC’s position was that the sanction to be imposed was a matter entirely for the Panel’s own judgement.

132. Mr Coniah provided the Panel with oral submissions. He highlighted the mitigating factors in the case namely that the Registrant was at the time of the allegations a newly appointed and inexperienced OTL. He received no training in that role as an OTL or in respect of conducting disciplinary hearings. [redacted] He submitted that the Registrant has worked with other employers since the Allegation and there have been no concerns.

133. Mr Coniah noted that the Registrant’s reflective statement was positive and highlighted the fact that there had not been any further concerns. He noted that the Registrant has fully reflected on the concerns and noted the Panel’s finding that there was no risk of repetition, given the passage of time between the incidents and these proceedings. In those circumstances he invited the Panel to consider taking no action in this case. He submitted in the alternative that the Panel should consider a caution order for the minimum period necessary. Mr Coniah noted that Conditions of Practice would not be appropriate given the Panel’s findings in respect of the personal component. He further submitted that a suspension would be disproportionate given the nature of the allegations in this case and the findings made. He noted that any action other than a caution may result in the Registrant losing his job.

134. [redacted]

135. The Panel took into account the HCPC Sanctions Policy and accepted the advice of the Legal Assessor.

136. The Panel bore in mind that sanction is a matter for its own independent judgement and that the purpose of a sanction is not to punish the Registrant but to uphold the public interest. Further, any sanction must be proportionate, so that any order it makes is the least restrictive order that would uphold the public interest.

137. The Panel took into account the Registrant’s reflections and testimonials.

138. The Panel was of the view that the following were mitigating factors:

i. The Registrant was a new manager with limited training;

ii. [redacted]

iii. The Registrant has shown insight and remediation;

iv. There are positive testimonials which speak highly of the Registrant;

v. There has been a sustained period spanning several years since the incident in which no further concerns have been raised as to the Registrant’s ability to keep matters confidential.
139. The Panel was of the view that the following were aggravating factors:
i. Breach of trust, [redacted];

ii. [redacted].

140. The Panel took into account all of the evidence and the submissions before it, as well as the mitigating factors.

141. The Panel considered its previous finding in respect of the Registrant’s insight and remediation and its determinations that there was no risk of repetition in this case. The Registrant has worked for several years without concerns and continues to be held in high regard by his colleagues.

142. While the Panel concluded that the Registrant is not impaired on the personal component, the Registrant’s actions were serious. Accordingly, this was not an appropriate case to take no further action or consider mediation, since neither sanction option would reflect the seriousness of the misconduct found proved.

143. The Panel therefore went on to consider a Caution Order. The Sanction Policy suggests a Caution Order might be appropriate in cases in which:

• the issue is isolated, limited, or relatively minor in nature;

• there is a low risk of repetition;

• the registrant has shown good insight; and

• the registrant has undertaken appropriate remediation.

144. The Panel is satisfied that the misconduct in this case was limited as it occurred [redacted]. The Registrant was also relatively unsupported in his role and had no previous disciplinary hearing training.

145. [redacted] Any breaches of confidentiality are serious and not to be taken lightly. That said, the Panel is now satisfied, following the information received throughout the hearing and its findings on misconduct and impairment, that there is no risk of repetition, as the Registrant has shown good insight and has undertaken appropriate remediation.

146. However, in light of the seriousness of the behaviour, the Panel went on to consider more onerous sanctions before coming to a decided position.

147. Accordingly, the Panel went on to consider whether to place Conditions of Practice on the Registrant’s registration. The Sanctions Policy states that before imposing conditions a Panel should be satisfied that:

• the registrant has insight;

• the failure or deficiency is capable of being remedied;

• there are no persistent or general failures which would prevent the registrant from remediating;

• appropriate, proportionate, realistic and verifiable conditions can be formulated;

• the panel is confident the registrant will comply with the conditions;

• a reviewing panel will be able to determine whether or not those conditions have or are being met; and

• the registrant does not pose a risk of harm by being in restricted practice.

148. There are no clinical concerns in this case and thus no issues that could be addressed by way of conditions. There has never been any question about the Registrant’s skills as a clinician. The Registrant has also demonstrated good insight and remediation in respect of the concerns and his handling of confidential information in the future. The Panel therefore considered that there were no Conditions of Practice which were appropriate, proportionate, realistic and verifiable.

149. The Panel therefore looked at the guidance in the Sanctions Policy about when a Suspension Order might be the appropriate sanction. This is a case in which, on its face, a Suspension Order could potentially be justified. However, in light of the good insight and remediation demonstrated by the Registrant, the Panel formed the view that such a sanction would be wholly disproportionate. A period of suspension, however short, would have a profound effect on the Registrant and his ability to work.

150. Furthermore, the context and circumstances of the misconduct had to be taken into account. This was not a case which the Sanction Policy identifies as “more serious” in accordance with paragraph 108. Further, the Registrant has since shown good insight and demonstrated remediation through CPD. The Panel has already indicated that it considers there to be no risk that he would ever behave in this way again.

151. In all the circumstances, the Panel concluded that a Suspension Order would be wholly disproportionate in this case. The Panel thus returned to the Sanctions Policy and noted the following guidance:

“A caution order should be considered in cases where the nature of the allegations mean that meaningful practice restrictions cannot be imposed, but a suspension of practice order would be disproportionate. In these cases, panels should provide a clear explanation of why it has chosen a non-restrictive sanction, even though the panel may have found there to be a risk of repetition (albeit low).”

152. The Panel considered this case fell within that guidance and that accordingly a Caution Order would be appropriate. The Panel has chosen a non-restrictive sanction because it determined that there is no risk to the public. The concerns are limited in nature and occurred when the Registrant was new to a role and working within a poor working culture. There are no concerns about the Registrant’s clinical skills and the testimonials attest to his professionalism. Importantly, there have been no concerns in the several years since these matters were raised and the Registrant has demonstrated good insight into his behaviour and the risk of repetition has thereby diminished.

153. Accordingly, the Panel determined that a Caution Order was the most appropriate order in this case. The Panel therefore makes a Caution Order.

154. The Panel considered that the order should be in place for 3 years to reflect the seriousness of the concerns and uphold the public interest. [redacted].

155. The Registrant should be in no doubt that any finding of current impairment by his regulatory body is a serious matter, and he should not take this Caution Order lightly.

Order: The Registrar is directed to annotate the register entry of Mr Jonathan Murrell with a caution which is to remain on the register for a period of 3 years from the date this order comes into effect.

Right of Appeal

The Registrant may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made.

Under Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served. The Panel’s order will not take effect until the appeal period has expired or, if appealed, until that appeal is disposed of or withdrawn.

History of Hearings for Jonathan Murrell