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During the course of your employment as a Paramedic with Yorkshire Ambulance Service:
1. On 3 September 2013 you obtained a telephone number from a Patient Report Form (PRF) for the purpose of making contact with persons present at the scene for non-work related purposes;
2. You used the number from the PRF to send text messages to the Patient and the Patient’s mother for non-work related purposes;
3. The matters set out in paragraphs 1 and 2 constitute misconduct;
4. By reason of that misconduct, your fitness to practise is impaired.
Facts Proved: 1, 2
Fitness to Practise Impaired: Yes
Sanction: Caution (5 years)
Proceeding in absence
1. Mr Barraclough apologised for the absence of the Registrant, who was absent for personal reasons but had instructed his representative to represent him and did not wish there to be any adjournment.
Application to amend the allegation
2. Mr Orpin-Massey, on behalf of the HCPC, requested an amendment to the allegations, as set out above. Mr Barraclough did not object to this amendment. The Panel considered that there was no prejudice to the Registrant, and that the suggested changes simply provided clarity. Accordingly, the amendment was permitted.
3. Mr Barraclough, on behalf of the Registrant, admitted particulars 1-3 of the Allegation.
4. The Registrant was employed as a Paramedic by Yorkshire Ambulance Service NHS Trust (the Service). He had worked with the Service since March 2000, initially as a technician, but thereafter qualified as a paramedic in September 2011.
5. On 3 September 2013, the Registrant attended Patient A’s home address with Witness B, who was staffing the ambulance with him at the time. This was following an emergency call-out. Patient A was there with her friend (Patient A’s Friend). Another paramedic also attended the scene, who was stationed in a Rapid Response Vehicle that day. Patient A was conveyed to hospital by the Registrant, with Witness B and Patient A’s Friend also travelling in the ambulance. On arrival at the hospital, the Registrant and Patient A’s Friend booked Patient A into A&E together.
6. Patient A was aged 20 at the time of the allegations and was a frequent visitor to hospital owing to problems with her kidneys.
7. Later on in the shift, the Registrant looked at Patient A’s Patient Report Form (PRF) and used it to try and obtain the number of Patient A’s Friend. The Registrant used the number under “next of kin”, which in fact was the phone number of Patient A’s Mother. He sent text messages to Patient A’s Mother, and subsequently to Patient A attempting to contact Patient A’s Friend. Patient A’s Mother did not know the number of Patient A’s Friend and therefore passed the Registrant’s number to Patient A. Patient A contacted the Registrant solely to ascertain the identity of the person who had been texting her mother in order to make contact with Patient A’s Friend. Therefore, the allegation is that the Registrant used the PRF to obtain a mobile telephone number deliberately for a non-work related purpose.
8. The Registrant admitted using Patient A’s PRF to try to obtain Patient A’s Friend’s phone number, and to sending text messages to both Patient A’s Mother and Patient A in order to try and effect contact with Patient A’s Friend.
9. Witness A was appointed Investigating Officer and interviewed Patient A, Patient A’s Mother, Patient A’s Friend, the Registrant and Witness B. The Registrant was suspended from his position on 3 October 2013 and subsequently self-reported to the HCPC. On 3 December 2013, he was dismissed from his post following a disciplinary hearing.
10. At the hearing today, Mr Barraclough, on behalf of the Registrant, maintained the Registrant’s position that he used Patient A’s PRF to try to obtain the phone number of Patient A’s Friend, and that he sent text messages to Patient A’s Mother and Patient A’s Friend. The Registrant admitted that these facts amount to misconduct and that he was impaired at the time of the incident in 2013. However, he disputed that his fitness to practice is currently impaired.
Decision on Facts
11. The Panel applied the principles that the burden of proving the facts is on the HCPC, that the Registrant does not have to prove anything and that the case is only to be found to be proven if the Panel are satisfied on a balance of probabilities.
12. The Panel was read statements from Patient A, Patient A’s Mother and Witness B.
13. The Panel also heard live evidence from Witness A, called by the HCPC.
Particular 1 – found proved
14. The Panel accepted the hearsay evidence of Patient A, Patient A’s Mother, Patient A’s Friend and Witness B; this evidence was not challenged on behalf of the Registrant, save to challenge one inconsistency between the evidence of Witness B and the evidence of Patient A’s Friend as to the nature of the interaction between the Registrant and Patient A’s Friend.
15. Patient A and Patient A’s Mother reported events that were consistent with each other.
16. Witness B referred to Patient A’s Friend as being “flirty” with the Registrant, and heard Patient A’s Friend mention the words “telephone number”. Witness B said that she was told by the Registrant, on the day in question, that Patient A’s Friend had asked the Registrant for his telephone number.
17. The transcript of Witness A’s interview with the Registrant was read out. In the transcript, the Registrant made admissions as to taking information from the PRF. The Registrant acknowledged that he had obtained the phone number of Patient A’s Mother from the PRF but that he thought that the number was that of Patient A’s Friend. Patient A’s Mother gave the Registrant’s number to Patient A. Patient A contacted the Registrant and the two texted with a view to the Registrant obtaining the number of Patient A’s Friend. Patient A was trying to ascertain the identity of the person sending the texts and the Registrant was deliberately concealing his identity.
18. The Registrant admitted that he had not behaved appropriately and had breached the Service’s policy on patient confidentiality.
19. The transcript of Witness A’s interview with Patient A was also read out. Patient A reported the text messages to the Ward Sister. She was concerned that the Registrant would continue making contact with her to pursue her friend.
20. The transcript of Witness A’s interview with Patient A’s Friend was also read out. She confirmed that a message for her was sent to Patient A’s phone. She denied being “flirty” or requesting the exchange of phone numbers with the Registrant as she had a boyfriend.
21. The Panel found Witness A to be credible, straightforward and honest. The Panel believed the evidence that he gave.
22. Witness A gave evidence that his involvement in this case was that of Investigator appointed by the Service; he interviewed the Registrant, Patient A, Patient A’s Mother, Patient A’s Friend and Witness B. He provided a Report at the conclusion of his investigation. He was the Presenting Officer at the internal disciplinary hearing, the outcome of which was that the Registrant was dismissed for gross misconduct.
23. The PRF records official information, including clinical presentations and personal details, as well as other relevant information such as a patient’s General Practitioner’s name and contact details. It is a confidential document due to the personal nature of the data is contains. “Next of kin” details are recorded in one of the fields in that document.
24. Confidential information is patient-identifiable data; this includes personal telephone numbers. Information is provided for a specific purpose and should not be used for any other purpose. Misuse of confidential information is considered to be gross misconduct by the Service and the Registrant would have been made aware of this. The Registrant was dismissed for gross misconduct. He used personal details from the PRF for a non-work related purpose. The Registrant, as with all staff, would have been informed of the relevant policy as it was covered in the Registrant’s annual mandatory training. There are legal requirements to protect confidential information, as a common law duty, under the Data Protection Act and further to the Human Rights Act.
25. Witness A did not form a view on whether Witness B or Patient A’s Friend was the more credible witness as to the nature of the contact between Patient A’s Friend and the Registrant, as this was not the subject of his investigation. Witness A confirmed that the Registrant had made full admissions from the outset in breaching data protection, that he had been contrite and had referred himself to the HCPC.
26. Witness A was clear that the data protection policy of the Service had been breached by the Registrant.
Particular 2 – found proved
27. Patient A and Patient A’s Mother covered in their statements some of the texts that they had received from the Registrant. The Registrant has agreed that he sent texts and the purpose of these texts was an attempt to make contact with Patient A’s Friend for non-work related purposes.
28. From his recollection of the “next of kin” field on the PRF, Witness A said he thought that the phone number of Patient A’s Mother, Patient’s A Mother’s name and nature of her relationship with Patient A was set out. Witness A was under some confusion as to what the Registrant was saying during his interview and who he believed he was corresponding with. There appeared to be some contradictions, as are apparent in the texts below.
29. The following texts were exhibits from Patient A and Patient A’s Mother:
“This is a mesage 4r [Patient A’s Friend], u dnt me, bt I did see u at the hosp yestry with u friend, I hope she wr ok, anyway cudnt take ma eyez of u, I found a number, on sum paperwork, thnkn it was urs but I guess it wasn’t, I thnk ur mates mum? So I tx her askn 4r ur”.
30. The Registrant texted Patient A: “how cum u wr in hosp., an is [Patient A’s Friend] single”.
31. He went on to ask “Hows [Patient A’s Friend].x” and “Whats [Patient A’s Friend] number,” and the next morning: “Hi hw r u, still in hosp? Hws [Patient A’s Friend]?”
32. Patient A emailed the HCPC indicating that the Registrant “has sent just one more saying sorry I won’t text you again”.
Decision on Grounds
33. The Panel found that the failings of the Registrant amounted to misconduct. It accepts that the texts relate to one course of conduct over 24-48 hours, but that this evidences a flagrant breach of Service confidentiality policies in obtaining personal data from Patient A’s PRF. The Registrant abused his position of trust by engaging in misconduct of a kind which falls far below the standard of conduct expected of a reasonably competent paramedic.
34. The Registrant knew what his obligations were in relation to confidentiality, having received annual mandatory training from his employer. He was in a trusted role as a paramedic. Trust and confidentiality are central to the role of a paramedic, given the personal nature of patient contact and the intimate details that need to be shared for appropriate patient care. The Panel is of the view that the Registrant abused the trust placed in him by his profession, his employer, Patient A, Patient A’s Mother and Patient A’s Friend, by his actions.
35. The Panel found that the Registrant had breached the HCPC’s “Standards of Conduct, Performance and Ethics”. In particular, it found that his behaviour was in breach of the following duties:
1. You must act in the best interests of service users.
2. You must respect the confidentiality of service users.
3. You must keep high standards of personal conduct.
13. You must behave with honesty and integrity and make sure that your behaviour does not damage the public’s confidence in you or your profession.
Decision on Impairment
36. The Panel heard submissions on behalf of the HCPC and on behalf of the Registrant. It also accepted advice from the Legal Assessor.
37. In considering this aspect, the Panel has taken into account that the purpose of these procedures is not to punish the practitioner for past misdoing but to protect the public against the acts and omissions of those who are not fit to practise.
38. The Registrant failed to follow the procedures and policies required by his employer in regard to respecting the privacy of a patient and misusing personal information for a non-work related purpose.
39. The Registrant has provided the Panel with evidence that he has insight into his behaviour, accepting that he had breached the Service’s confidentiality policy and that his behaviour was unprofessional, falling well below the acceptable standards of behaviour for registrant paramedics.
40. The Panel was presented with a number of arguments regarding the sincerity of the remorse he has expressed.
41. There has been evidence of remorse, given that the Registrant has not only apologised to the Service, but also to Patient A. The Registrant’s apology was made to Patient A after he was told by the Police not to contact her again.
42. Witness A gave evidence to the effect that, when interviewed, the Registrant’s primary concern was “worry” over his own situation; he said that “he was sorry and that it would not happen again,” but Witness A’s impression was that the apology was not “heartfelt”. Witness A’s evidence gave rise to the Panel being concerned that the Registrant had not exhibited sufficient insight into the impact of his behaviour upon Patient A, Patient A’s Mother or Patient A’s Friend in his interview. While Mr Barraclough pointed out on behalf of the Registrant that it was understandable that the Registrant would have been focused on the potential loss of his career and reputation at that time, the Panel concluded that it does not see this aspect addressed in his most recent Reflective Statement either.
43. Having improperly obtained a number from the PRF, the Registrant used the number to try and contact Patient A’s Friend for non-work related purposes. While the misconduct took place over a 24-48 hour period, the text messaging only drew to a conclusion following Patient A reporting the matter to the relevant authorities.
44. The Registrant’s behaviour was deplorable. He has let down his profession. His course of conduct demonstrates that his intention to make contact with Patient A’s Friend was deliberate and pre-meditated. While there has been a Reflective Statement, the Panel considers that the insight that it demonstrates is limited. It lacks sufficient weight in failing to reference literature read and more importantly fails to evidence an adequate understanding of the impact of his behaviour on Patient A, Patient A’s Mother and Patient’s A’s Friend, and falls short of the expectations laid out in the HCPC’s “Standards of Proficiency for Paramedics”, at paragraphs 3.4, 3.5 and 11.1. This indicates a risk of repetition where respecting patient confidentiality is involved.
45. The Panel was not persuaded that the Registrant has understood the effect of his actions on the three people impacted by his behaviour. This is especially significant given that Patient A requires regular medical assistance and was concerned that the Registrant would attend on a future occasion should she require assistance from the ambulance service.
46. The Registrant provided references that are current but none from his current employers, who would be best placed to comment on his current and recent professional performance. The references supplied are insufficient to persuade the Panel that there are no current concerns relating to his conduct.
47. Having regard to the critically important public policy issues, in the Panel’s assessment the Registrant’s current fitness to practice remains impaired. Confidence in the profession of paramedics has been undermined, as members of the public will be concerned about this breach of confidentiality. The public is entitled to expect practitioners to apply the prevailing policies and rules which are in place for the appropriate care of patients and the protection of their personal information.
48. Failing to respect patient confidentiality is a serious matter. It impacts upon the trust that patients need to have in paramedics in order to confidently share with them their personal information. Such trust can be essential in obtaining information necessary to assess and provide appropriate, and, on occasion, life-saving care.
49. There is a need to maintain confidence in the profession and to declare and uphold proper standards, send a clear message to other healthcare professionals and to maintain confidence in the regulatory process. In the Panel’s assessment, critically important public policy issues are engaged and continue to exist in this case.
50. The Panel has had regard to the HCPC’s guidance on Fitness to Practice and considered both the personal and public components in this case. There are concerns both as to the Registrant’s insight and in respect of addressing public confidence in paramedics.
51. Accordingly, the HCPC’s case is well founded. The Registrant is currently impaired.
Decision on Sanction
52. In considering what sanction, if any, to impose, the Panel has taken account of the submissions made by both representatives. This is serious misconduct and a breach of trust that has had a detrimental effect, primarily on Patient A. The Registrant’s remorse and reflection has focused on the impact that this experience has had on him, more so than on others who have been impacted by his behaviour.
53. Mr Barraclough addressed the Panel on a number of mitigating factors for the Registrant, who has had no other findings of impairment recorded against his name in the Register, and who has not had any workplace concerns regarding confidentiality or professional practice either prior to or since this incident. He has worked as a registered Paramedic for Bristol Ambulance Service for 2-3 days a week since November 2014, and also worked for Site Rescue and KFA Medical as a Paramedic on a part-time basis.
54. He lost his job as a result of his misconduct in breaching patient confidentiality and remained out of work for almost a year. The Registrant has provided recent references obtained only last month. One of the references is a personal reference but the other is from a registered Paramedic who works for Bristol Ambulance Service, and who Mr Barraclough advised the Panel in his submissions on sanction has supervisory responsibility for the Registrant. This referee was able to say that the Registrant “maintains patient confidentiality to a high standard” and that he is a trusted employee.
55. The Panel took advice from the Legal Assessor and has referred to the HCPC’s “Indicative Sanctions Policy” in arriving at a decision. In considering the appropriate sanction, the Panel has had regard to its earlier findings.
56. The Panel was concerned that although the incident did not last for longer than a day or two, there was a repetition of breaches in the Service’s policy in making each text. Further, that while the Registrant had only been registered as a paramedic for two years at the time of the incident, he had been employed for 13 years by the Service by then and would have been aware of the importance of patient confidentiality.
57. The Registrant is required to care for patients when they are at their most vulnerable and need urgent health care. His wrong-doing came to light because a complaint was made. Had this behaviour not been reported by Patient A while she was ill in hospital, the course of conduct that the Registrant was pursuing could have continued. This matter was uncovered as a result of investigations rather than the Registrant coming forward and making admissions of his own volition.
58. In view of the seriousness of the case, to take no further action would not be appropriate as it fails to address the serious issues raised. The risk to the public interest requires that action be taken.
59. Imposing a Caution was considered, given that this was an isolated lapse in the Registrant’s otherwise unblemished professional career. Although the Panel considers there to be some risk of recurrence because of the Registrant’s inadequate insight, it assesses this risk as low.
60. A Conditions of Practice Order was considered but meaningful practice restrictions to address the wrong-doing cannot be imposed in this matter. There are no verifiable, realistic or workable conditions that could be formulated. Given that the risk of repetition is low, a Caution is considered the appropriate action in this case.
61. The Panel balanced the Registrant’s right to practise in his chosen profession against the public interest. The Panel were of the view that a lengthy Caution would adequately address the identified concerns, acting as a reminder to the Registrant that it is important to keep patient data confidential, and in order to protect the public, maintain confidence in the profession and maintain confidence in the regulatory process. In all the circumstances, the Panel believes this to be a necessary and proportionate sanction.
That the Registrar is directed to annotate the register entry of Mohammed Saeed with a caution which is to remain on the register for a period of 5 years from the date this order comes into effect.
History of Hearings for Mohammed Saeed
|Date||Panel||Hearing type||Outcomes / Status|
|10/08/2015||Conduct and Competence Committee||Final Hearing||Caution|