Roy Guest

Profession: Paramedic

Registration Number: PA16290

Hearing Type: Review Hearing

Date and Time of hearing: 12:30 01/05/2015 End: 15:00 01/05/2015

Location: Health and Care Professions Council, Park House, 184 Kennington Park Road, London, SE11 4BU

Panel: Conduct and Competence Committee
Outcome: Suspended

Please note that the decision can take up to 5 working days to be uploaded onto the HCPTS website. Please contact one of our Hearings Team Managers via or +44 (0)808 164 3084 if you require any further information.



During the course of your employment with the West Midlands Ambulance Service NHS Trust, on or around February 2013, you:

1. Posted offensive and derogatory messages directed to patients and members of the public on a social networking site, namely Facebook.

2. The matter described in paragraph 1 constitutes misconduct.

3. By reason of that misconduct, your fitness to practise is impaired.


Preliminary matters

Proceeding in Absence

1. The Panel had determined that there was good service under the HCPC’s procedural Rules of the appropriate Notice of Hearing of this Review dated 1 April 2015 sent to the Registrant’s last known registered address by first class post. The letter referred to the time, date, venue and nature of today’s hearing, being a Review of the sanction imposed by a final hearing Panel on 12 May 2014.

2. The Panel took into account the submission on proceeding in the absence of the Registrant from Ms Rapu for the HCPC and it accepted the Legal Assessor’s advice. In reaching its decision the Panel also paid regard to the HCPC’s Practice Note on Proceeding in the Absence of the Registrant. The Panel also noted that there had been no engagement by the Registrant at any time in this process and that he has not responded to the Notice of Hearing for today’s Review. Furthermore, the Registrant has not requested any adjournment.

3. The Panel also took into account the wider public interest in the prompt disposal of hearings, particularly as this is a mandatory review of a sanction, upon the expiry of which, with no other action, the Registrant would be free to return to unrestricted practice. The Panel has not heard evidence that an adjournment would not undermine public confidence in the profession and in this regulatory process. Therefore, the Panel has concluded that the wider public interest would be undermined if it adjourned this hearing to an unknown date. In the Panel’s opinion, the public interest outweighed any interest of the Registrant. In any event, there can still be a preservation of the Registrant’s interests in having a fair hearing, by the Panel and the Legal Assessor being vigilant as to that principle for him in his absence.

4. Finally, given the pattern of non-engagement to date, the Panel has also concluded that it unrealistic and unlikely that, if this hearing is adjourned, the Registrant would engage, in any form, on the next occasion. It is the Panel’s judgement that the Registrant has absented himself voluntarily.

5. Therefore, the Panel has determined that it has every reason to be confident that the Registrant is aware of the proceedings.

6. For these reasons, the Panel has determined that the hearing shall take place in the absence of the Registrant.


7. The Registrant was employed by the West Midlands Ambulance Service NHS Trust (the Trust) as a Paramedic on the Clinical Support Desk at Tollgate Emergency Operations Centre. He joined the Trust on 20 September 1999 and qualified as a registered Paramedic in 2003. Due to a medical condition, the Registrant worked on the Clinical Support Desk from 2012.

8. On 12 February 2013 the Trust was notified by BBC Radio Stoke that offensive and derogatory comments had been posted on Facebook by the Registrant. The comments related to JB, one of the founder members of the group “Cure the NHS” which had been instrumental in pushing for a public enquiry into the standards of care at Stafford District General Hospital. The comments referred to JB’s late mother and to their mother and daughter relationship. In addition one comment referred to a hope that JB would suffer a life threatening illness at night and the impact that travelling further for medical treatment would have because of the closure of her local hospital. Altogether there were five or six postings made by the Registrant over a period of some four hours of varying degrees of unpleasantness.

9. An investigation was carried out by the Trust and, following a disciplinary hearing held on 30 April 2013, the Registrant was dismissed from his position at the Trust.

10. The Registrant did not submit any response to the HCPC allegation. He did not attend the final hearing, which took place on 12 May 2014. The final hearing Panel found that the Registrant’s fitness to practise was impaired on the grounds of misconduct and imposed a sanction of 12 months’ Suspension Order. The final hearing Panel considered that the 12 month period would allow the Registrant to provide written evidence of reflection on the final hearing Panel’s findings and the wider impact of the Registrant’s misconduct upon the reputation of the profession.

11. This is the first review of that sanction Order.


12. The Panel has taken into account the submission of Ms Rapu for the HCPC. It has accepted the Legal Assessor’s advice and it has exercised the principle of proportionality. The Panel has paid respect to the previous Panel’s findings, but also, as a Review Panel, it has fully reviewed the case, without undermining any of the original findings, which this Panel has accepted.

13. In reaching its decision on impairment, the Panel has also paid regard to the HCPC’s Practice Notes on Fitness to Practise.

14. The Panel noted that there has been no information about the Registrant, either from him, or through any other means. Therefore, the Panel has no information to establish whether the Registrant’s fitness to practise remains impaired, whether he has undertaken any further remediation so as to fully understand the consequences and seriousness of his actions in February 2013, whether there is a likelihood of recurrence in the future and if he has full insight and any further remorse or regret.

15. In the Panel’s judgement this was a serious matter of an attitudinal nature that is remediable and that had not yet been fully remediated by the Registrant in 2014, and, today, still has not been fully remediated, despite the Registrant having been given the opportunity to do so by the final hearing Panel. That Panel referred to the emotional harm to the victim of the Registrant’s acts and that the Registrant had not fully acknowledged the seriousness of his failings. This Panel agreed with the conclusions of the final hearing Panel in relation to that, although it noted his immediate public apology and some efforts at expressing his remorse, and regret.

16. However, in the absence of the last part of remediation envisaged by the final hearing Panel, this Panel has concluded that the Registrant remains impaired. He was given clear direction by the previous Panel as to how he could remediate fully in its recommendation as to what a Review Panel might wish to see at a hearing such as this. Following the previous Panel’s finding of impairment, the onus is on the Registrant to demonstrate that he is no longer impaired. Unfortunately, the Registrant has failed to comply with the recommendation of the last Panel, indicating to this Panel a lack of awareness of his position and impact on others, such as the affected victim, as well as a continuing lack of insight.

17. The Panel has determined that if the Registrant were to be found unimpaired today, this would undermine public confidence in the profession and in the regulatory process. This is because, in the Panel’s judgement, the matters raised in this case, un-remediated, could still attract the disapproval of the public and the profession.

18. For these reasons, the Panel has determined that the Registrant’s fitness to practise remains impaired by reason of the misconduct found proved.

19. In reaching its decision on how to dispose of the case on this review, the Panel took into consideration the submission of Ms Rapu and accepted the Legal Assessor’s advice. The Panel also exercised the principle of proportionality. In addition, the Panel has taken into consideration the HCPC’s Indicative Sanctions Policy and it had regard to Article 30(1) of the HCPC Order 2001, as amended, as to its powers. The Panel also took into account the general principle that sanction should not be primarily punitive. The Panel approached each of the options for sanction on review available in ascending order, but at the top end, it compared and contrasted each sanction with the next most serious one, without going to the more serious one first.

20. The Panel first considered taking no action and mediation and rejected these. The conduct of the Registrant was offensive and caused emotional harm to the victim. It was committed by the Registrant, a senior and experienced professional who should have known better. For those reasons, this Panel could not conceive that the public would not be offended if the Registrant were to be permitted to return to unrestricted practice at this time by reason of these outcomes.

21. The Panel next carefully considered imposing a Caution Order and rejected this. The Panel was of the view that the public would remain concerned that the Registrant was still not yet fully remediated and had yet to demonstrate full understanding of the impact on others of his conduct. This involved more effort on his part of demonstrating learning about the conduct and its effect on the public. Thus, public confidence in the profession and in the regulatory process would be undermined if a caution order were to be imposed.

22. The Panel next considered replacing the existing Suspension Order with a Conditions of Practice Order, but determined that, at this time and in absence of hearing anything from the Registrant, there were no workable and enforceable conditions to address the behavioural and attitudinal nature of the allegation found proved and the remaining lacuna of information on his insight and remediation identified on the last occasion.

23. The Panel next considered extending the existing Suspension Order on its expiry and determined that a short extension of 3 months to the existing order on its expiry is the most proportionate and fair outcome. The Panel is concerned that the attitudinal aspects of this case have not been fully addressed by the Registrant and as identified by the previous Panel. This period of time will give him the time and, hopefully, the wherewithal, to engage in this process and to satisfy a future Panel that he has the potential to become unimpaired and to potentially resume unrestricted practice as a registered Paramedic.

24. The Panel has taken into consideration the fact that the Registrant had made a public statement of apology, that he was ill at the time, that he had a long and (prior to this matter) a blemish-free career and that this was an isolated event (albeit taking place over a few hours). To that end, the Panel considered that a Striking Off Order at this time would be disproportionate and punitive.

25. As stated, the Panel is of the opinion that this is a remediable matter, but it is up to the Registrant, as an experienced professional, to engage with his professional body, to understand the efforts being made to help him fully remediate and to establish that he is fit to resume unrestricted practice. To achieve that, he must demonstrate that he is fully remediated in the way envisaged by the last Panel and that there is no risk of repetition of such behaviour.

26. The Panel considered that a Review Panel may find it useful to have from the Registrant, oral or written evidence, or both, of his reflection, learning and insight in respect of his actions, with particular reference to the impact of his misconduct on the victim, the public and his profession.

27. Therefore, for these reasons, the Panel has determined that, on the grounds of the wider public interest, the most proportionate and appropriate decision is an extension to the existing Suspension Order, upon its expiry, of a period of 3 months.



Order: The Registrar is directed to suspend the registration of Roy Guest for a further period of 3 months on the expiry of the existing order.


The Order will be reviewed before its expiry.

Hearing History

History of Hearings for Roy Guest

Date Panel Hearing type Outcomes / Status
29/07/2015 Conduct and Competence Committee Review Hearing Struck off
01/05/2015 Conduct and Competence Committee Review Hearing Suspended