Robin John Williams

Profession: Paramedic

Registration Number: PA02583

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 13/12/2016 End: 17:00 14/12/2016

Location: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

During the course of your employment as a Paramedic at South East CoastAmbulance service (SECAmb) you:

 

1. Worked as a Duty Paramedic/Paramedic at Brands Hatch Race Circuit whilst on long term sick leave from SECAmb during the period May - November 2012, including the following dates;

 

a. 26-27 May 2012

b. 02-03 June 2012

c. 0 8 - 11 June 2012

d. 13 June 2013

e. 16-17 June 2012

f 24 June 2012

g. 26 June 2012

h. 30 June 2012

i. 01 July 2012

j . 08 July 2012

k. 11 July 2012

I. 16 July 2012

m. 19 July 2012

n. 21 - 2 2 July 2012

0. 16 August 2012

p. 18-21 August 2012

q. 23 August 2012

r. 25 August 2012

s. 2 7 - 2 8 August 2012

I 11 September 2012

u. 15-18 September 2012

V. 20 September 2012

w. 22 - 23 September 2012

X. 25 September 2012

y. 26 - 27 September 2012

z. 01 - 0 3 October 2012

aa. 05-06 October 2012

bb. 08 October 2012

cc.24 November 2012

 

2. On 29 January 2013, worked at Brands Hatch Race Circuit although instructed by SECAmb on 18 January 2013 not to take alternative work while suspended by SECAmb.

 

3. Your actions in paragraphs 1- 2 were dishonest

 

4. The matters set out in paragraphs 1 - 3 constitute misconduct.

 

5. By reason of your misconduct your fitness to practise is impaired

Finding

Preliminary matters:

Proof of Service

1. The Panel was provided with a signed certificate as proof that the Notice of Hearing had been sent in a letter, dated 24 August 2016, to the address shown for the Registrant on the HCPC register.  The Panel was satisfied that Notice had been properly served in accordance with Rule 3 (Proof of Service) and Rule 6 (date, time and venue) of the Conduct & Competence Committee Rules 2003 (as amended).


Proceeding in Absence

2. Having determined that service of the Notice of Hearing had been properly effected, the Panel went on to consider whether to proceed in the Registrant’s absence, as permitted by Rule 11 of the Conduct & Competence Rules. The Panel was advised by the Legal Assessor and followed that advice. The Panel also took into account the guidance as set out in the HCPC Practice Note “Proceeding in the Absence of the Registrant”.

3. The Panel determined that it was reasonable and in the public interest to proceed with the hearing for the following reasons:

a)The Registrant having been properly served with the Notice of Hearing, stated in his letter, dated 25 November 2016, ‘I was going to be represented by a solicitor, but due to funding problems this will not be happening. Due to my poor health and mobility problems I will not be able to attend.’ The Panel noted that in response to that letter the HCPC wrote to the Registrant on 2 December 2016. In view of the health matters the Registrant had raised, the HCPC offered him the opportunity to participate by telephone subject to the Panel’s approval. On 5 December 2016, the Registrant sent an email to the HCPC, in which he clearly stated:

(i) he did not wish to participate by telephone;
(ii) he would not be submitting further submissions to the Panel;
(iii) he did not want to make a request for an adjournment.
In these circumstances the Panel was satisfied that the Registrant’s non-attendance was voluntary and therefore he had deliberately waived his right to attend.

b) The Registrant made it clear that he had no intention of making an application to adjourn and there was no indication that even if the case were to be adjourned that he would attend on any future date.

c) It was in the interests of the witnesses who had attended that their evidence was given as soon as possible and whilst matters were still relatively fresh in their minds.

d) Although there was a disadvantage to the Registrant in not being present to make oral submissions or give evidence, the Panel was satisfied that this was mitigated to some extent by the written representations made by the Registrant and outweighed by the strong public interest in ensuring that the Final Hearing commenced and proceeded expeditiously.

Application to Amend

4. At the outset of the hearing Ms Mond-Wedd, on behalf of the HCPC, made an application for Particular 1(n) of the Allegation to be amended. The Registrant had been put on notice of the proposed amendment in a letter, dated 24 August 2016, and no objection had been raised at that time or since.  

5. The Panel determined that Particular 1(n) should be amended by deleting the number ‘22’ and replacing it with the number ’23’ so that it reads ‘21-23 July 2012’. The Panel was satisfied that the amendment was minor in nature and did not materially alter the substance or meaning of the Allegation as originally drafted.

6. The Panel was also satisfied that no injustice would be caused to the Registrant by making this amendments as it more accurately reflected the HCPC case. In forming this view the Panel took into account the fact that the Registrant had been put on notice of the HCPC’s application in advance.


Background

7. The Registrant was a band 5 paramedic at South East Coast Ambulance Service (‘SECAmb’). He worked at SECAmb for 20-30 years and was based at the Dartford Ambulance Station at the time the allegations were made.

8. On 18 January 2013 an investigation was commenced by Witness 1 (Staffing Centre Manager at SECAmb) in relation to the Registrant.  The allegations were the Registrant had been working at Brands Hatch Race Circuit (Brands Hatch) during a period of sickness absence from SECAmb.  Witness 2 was the Circuit Manager at Brands Hatch and he was responsible for the operation of the venue on a daily basis and had responsibility for staffing.
 
9. For the purposes of the investigation, Witness 1 interviewed Witness 2 and Ms KD, Group HR Officer at Brands Hatch. 

 

Decision on Facts

Panel’s Approach

10. The Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything. Although the Registrant made certain ‘admissions’ in writing prior to the hearing, the individual particulars of the Allegation could only be found proved, if the Panel was satisfied, on the balance of probabilities.
 
11. The Panel accepted the advice of the Legal Assessor.

12. In reaching its decision the Panel took into account the written and documentary evidence, including the internal employer investigation as well as the oral submissions of Ms Mond-Wedd, on behalf of the HCPC.

13. The Panel noted that the Registrant made certain ‘admissions’ in his oral responses during the internal employer investigation and in his written representations. However, he has not fully engaged with the hearing process and the Panel proceeded on the basis that none of the allegations were admitted.

14. The Panel drew no adverse inferences from the Registrant’s absence.


Assessment of Live Witnesses

15. The Panel assessed the evidence of each witness as follows:

Witness 1 – Staffing Centre Manager at SECAmb

16. The Panel found Witness 1 to be a credible and reliable witness. He did his best to assist the Panel and readily accepted that in his witness statement he had not made it clear that he was not aware of which employment policies may have applied when the Registrant joined the organisation. However, he went on to clarify how changes to any policies are brought to the attention of staff members through access to hard copies within the station, access rights via the intranet and team briefings. Witness 1’s evidence was balanced throughout and the Panel had no reason to doubt the veracity of his evidence. 
Witness 2 – Brand’s Hatch Circuit Manager

17. The Panel found Witness 2 to be both credible and reliable.  The Panel had no reason to doubt that Witness 2’s evidence was anything other than a genuine and honest recollection of the work carried out by the Registrant.

Particular 1 (a) – (cc) Found Proved (in its entirety)
‘Worked as a Duty Paramedic/Paramedic at Brands Hatch Race Circuit
whilst on long term sick leave from SECAmb during the period May -November 2012, including the following dates;

a.26-27 May 2012 – cc. 24 November 2012 (see above)

18. The Panel accepted the evidence of Witness 1 that the Registrant was on sick leave from SECAmb during the period May-November 2012. Witness 1 had overall responsibility for all HR related issues, sickness management, complaint investigation and general management of Accident and Emergency front line staff. The Panel was provided with the Registrant’s individual sickness absence record, which confirmed that he was on sick leave from 21 May 2012.  The Panel also accepted the evidence of Witness 1 that when he interviewed the Registrant on 18 January 2013, the Registrant was still on sick leave. On the basis of this evidence the Panel was satisfied that the Registrant was on sick leave during the relevant period.

19. The Panel cross-referenced all the dates that the Registrant was said to have worked at the Brands Hatch Race Circuit against all of the exhibits which included diary sheets, daily attendance records, controlled drug signature sheets, activity logs and invoices. The Panel was satisfied that on each date or series of dates from May to November 2012, the Registrant was recorded as working either as a Duty Paramedic or as a Paramedic. The Panel was unable to identify any difference between the two roles and noted that on the activity log, the Registrant’s name appeared underneath the heading ‘Medical Cover’.

20. The Panel noted that the Registrant in his written representations admitted working at Brands Hatch, whilst signed off sick from work at SECAmb, but denied that this was as an ‘operational paramedic’. He suggested that the duties he performed were administrative and that he was recorded as a ‘paramedic’ as this made it easier for the finance department. This assertion was similar to the account the Registrant provided when he was interviewed by Witness 1 during the internal SECAmb investigation.

21. The Panel rejected the Registrant’s written account. The Panel preferred the evidence of Witness 2, who informed the Panel during his oral evidence, that between February to November Brands Hatch Circuit runs events almost daily and therefore medical cover would be required. Witness 2 informed the Panel that the Registrant was paid a slightly higher rate than other paramedics because he had some additional responsibilities which included preparing the rota of medics to cover medical work at Brands Hatch. The Panel accepted that alongside these administrative tasks the Registrant was available to be deployed to injured parties if there was an on track incident.  Irrespective of whether or not the Registrant was fulfilling administrative or operational responsibilities, he was in breach of the trust policy on Secondary Employment paragraphs 5.1.1.1 and 5.1.4.1 which set out the need to submit an appropriate form, have that form approved and received a written response as well as the absolute prohibition on any form of secondary employment during periods of sickness from the trust. 

22. Accordingly, Particular 1(a) – (cc) were found proved.

Particular 2 –  Found Proved
On 29 January 2013, worked at Brands Hatch Race Circuit although instructed by SECAmb on 18 January 2013 not to take alternative work while
suspended by SECAmb.

23. The Panel accepted the evidence of Witness 1 and had sight of the invoice he produced, dated 31 January 2013, which he obtained as part of his investigation. The invoice confirmed that the Registrant made a request for payment from Brands Hatch for work he carried out on 29 January 2013. This work was performed in direct contravention of the instructions the Registrant received in the letter, dated 18 January 2013, which was sent to him by Witness 1. The Registrant was told that he was suspended from duty on full pay pending the investigation into the allegation that he had been working whilst on sick leave. The letter made it clear that the Registrant was not to undertake any work for any other employer during the period of suspension, unless he had submitted a Secondary Employment Form that had been agreed and approved by the Trust.

24. The Registrant, in his written representations stated that he had filled in a Declaration of Interests form stating that he was doing other work and handed it in to his station officer. The Panel noted that the Registrant did not suggest that the Declaration of Interests form was the Secondary Employment Form or that he ever received approval to undertake work whilst on sick leave. When the Registrant was asked about his work at Brands Hatch, during the internal SECAmb investigation, his response were at times evasive.  For example, when he was asked to confirm that he had completed a Secondary Employment Form signed by the Trust agreeing hours to be worked and permission granted he replied, ‘I have completed paperwork explaining that I undertake work on a self-employed basis’. The Panel recognised that the interview record was not a verbatim transcript of the interview, but was satisfied that it gave a flavour of the questions posed and the nature of the responses the Registrant provided.  

25. The Panel was informed by Witness 1 that the Registrant was on sick leave, whilst working at Brands Hatch and from 18 January 2013 was also suspended from work. The Panel satisfied that the Registrant was on notice that he was not permitted to work whilst he was suspended.   Irrespective of the nature of the work that the Registrant undertook on 29 January 2016, it was not permitted because he was suspended and had not submitted a Secondary Employment Form which was agreed and approved by the trust as set out in the policy document. 

26. Accordingly the Panel found Particular 2 found proved.
Particular 3 (Dishonesty) – Found Proved

27. The Registrant was on full pay for 6 months whilst on sick leave and was on half pay for the remaining period, at least until his suspension on 18 January 2013, when it appears that he may have reverted to full pay. During this period the Registrant undertook paid employment on numerous days between May 2012 and November 2012.

28. The Panel did not accept the Registrant’s assertion in his written representations that he formally put SECAmb on notice that he was employed elsewhere. The Panel accepted the evidence of Witness 1 that there was no documentation within the Trust to indicate that a formal application had ever been made for Secondary Employment and no documentation to suggest that it had ever been granted. 

29. The Panel also rejected the Registrant’s assertion in his interview with Witness 1 that he misunderstood the letter, dated 18 January 2013, in which he was told that he was not permitted to work for another employer whilst he was suspended.  The letter was clear.  The Registrant could not have been in any doubt that he was required to submit a Secondary Employment Form and obtain approval if he wanted to work for another employer during his period of suspension. 

30. The Panel was satisfied that honest and reasonable members of the public or the profession would consider the Registrant’s acts and omissions, in working whilst on sick leave and working whilst suspended whilst he was instructed that this was prohibited, to be dishonest.
 
31. The Panel was satisfied that the Registrant made a deliberate and conscious decision to work whilst on sick leave when he knew that this was in breach of his employer’s sickness absence policy.  The Panel was satisfied the Registrant did this in order to gain a financial advantage. Even when the Registrant was under investigation and was expressly instructed not to work for another employer whilst suspended, he chose to disregard that instruction.  Therefore, the Panel concluded that the Registrant knew that his actions were dishonest by the standards of honest and reasonable people.
Decision on Grounds

32. In considering the issue of misconduct, the Panel bore in mind the explanation of that term given by the Privy Council in the case of Roylance v GMC (No.2) [2000] 1 AC 311, where it was stated that:
“Misconduct is a word of general effect, involving some act or some 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 to be followed by a ….practitioner in the particular circumstances.  The misconduct is qualified in two respects.  First, it is qualified by the word “professional” which links the misconduct to the profession….Secondly, the misconduct is qualified by the word “serious.”  It is not any professional misconduct which will qualify.  The professional misconduct must be serious.”

33. The Panel was satisfied that the Registrant’s conduct and behaviour amounts to misconduct which was serious as described in the Roylance case. 

34. The Registrant dishonestly worked for another employer on multiple occasions whilst on sick leave.  He also worked whilst suspended from SECAmb within days of being instructed that he must not do so.  The Panel has considered the HCPC Standards of Conduct, Performance and Ethics (2012) and was satisfied that the Registrant’s conduct breached the following standards:

• 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. 

35. The Panel was aware that breach of the standards alone does not necessarily constitute misconduct.  However, the Panel was satisfied that the Registrant’s conduct fell far below the standards expected of a registered practitioner. 

 

Decision on Impairment

Panel’s Approach

36. Having found misconduct, the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired.  The Panel took into account the HCPC Practice Note:  “Finding that fitness to practise is impaired” and accepted the advice of the Legal Assessor.

37. In determining current impairment the Panel had regard to the following aspects of the public interest:

• The “personal” component: the current behaviour of the individual Registrant; and
• The “public” component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession. 


Panel’s Decision


38. The Panel found that the Registrant dishonestly undertook employment whilst on sick leave and whilst suspended.  The Registrant knew that his actions were in breach of his employer’s sickness absence policy and that he had been specifically instructed not to work for another employer whilst suspended.
 
39. The Panel considered the Registrant’s current fitness to practise firstly from the personal perspective and then from the wider public perspective.
 
40. The Panel was not satisfied that the Registrant, in his written representations, had demonstrated any insight. The Registrant’s continuing employment at Brands Hatch whilst he was on sick leave demonstrates a failure to understand and take seriously his professional obligation to be trustworthy at all times.  There was also no evidence before the Panel that the Registrant had reflected on the impact of his behaviour on SECAmb, which had a legitimate expectation that as an employee the Registrant would be honest.
 
41. The Panel recognised that demonstrating remediation following a finding of dishonesty is particularly difficult, as probity issues are reliant on attitude, which can only be inferred from conduct.  The Registrant’s dishonest conduct relates to a discrete set of circumstances, which may be capable of remediation. However, the Panel was not satisfied that there was any demonstration insight and therefore it concluded that the risk of repetition is high.  The Panel concluded that for these reasons the Registrant’s fitness to practise is currently impaired based on the personal component.
 
42. In considering the public component, the Panel had regard to the important public policy issues, which include the need to maintain confidence in a profession and declare and uphold proper standards of conduct and behaviour. 

43. In the Panel’s view members of the public would be concerned by the prospect of a Paramedic working whilst on sick leave.  It is critically important that sickness absence policies and suspension procedures have integrity.

44. A significant aspect of the public component is upholding proper standards of behaviour.  The Registrant’s conduct fell far below the standard expected of a registered practitioner and it is not acceptable for a registered paramedic to dishonestly work whilst on sick leave and whilst suspended.  The Panel considers that the Registrant’s persistent lack of insight demonstrates that in the future he is liable to breach a fundamental tenet of the profession, bring the profession into disrepute and act dishonestly.  The Panel concluded that public confidence in the profession and the regulatory process would be undermined if a finding of impaired fitness to practise was not made, given the seriousness of the Registrant’s dishonest conduct and behaviour.

45. The Panel concluded that the Registrant’s current fitness to practise is impaired on the basis of both the personal component and the wider public interest.  Therefore, the HCPC’s case is well founded. 


Decision on Sanction


Panel’s Approach

46. The Panel accepted the advice of the Legal Assessor. The Panel was mindful that the purpose of any sanction is not to punish the Registrant, but to protect the public and the wider public interest. The public interest includes maintaining public confidence in the profession and the HCPC as its regulator and by upholding proper standards of conduct and behaviour. The Panel applied the principle of proportionality by weighing the Registrant’s interests with the public interest and by considering each available sanction in ascending order of severity.

47.The Panel had regard to the Indicative Sanctions Policy (ISP) and took into account the submissions made by Ms Mond-Wedd, on behalf of the HCPC and the written representations made by the Registrant prior to the commencement of the hearing.

48.The Panel identified the following aggravating factors:

• The dishonesty was repeated on numerous occasions and persisted for a significant period of time;
• The Registrant’s actions were in breach of his employer’s trust;
• The absence of any insight.

49. The mitigating factors identified by the Panel were as follows:

• Partial admissions were made during the Trust investigation;
• There has been some engagement by the Registrant in the regulatory process.


Panel’s Decision


50. The Panel first considered taking no action. The Panel concluded that in view of the nature and seriousness of the Registrant’s dishonest behaviour and in the absence of exceptional circumstances, to take no action on his registration would be wholly inappropriate. Furthermore it would be insufficient to protect the wider public interest, in maintaining public confidence and upholding the reputation of the profession.
 
51. The Panel then considered a Caution Order.  The Panel noted paragraph 22 of the ISP which states:

“A caution order is an appropriate sanction for cases, where the lapse is isolated, limited or relatively minor in nature, there is a low risk of recurrence, the registrant has shown insight and taken appropriate action.  A caution order should also be considered in cases where the nature of the allegation means that meaningful practice restrictions cannot be imposed but where the registrant has shown insight, the conduct concerned is out of character, the risk of repetition is low and thus suspension from practice would be disproportionate.  A caution order is unlikely to be appropriate in cases where the registrant lacks insight.”

52. In view of the Panel’s findings that the Registrant has demonstrated no insight into his misconduct, the risk of repetition is high and given the serious nature of his conduct and behaviour, the Panel concluded that a Caution Order would be inappropriate and insufficient to meet the public interest.

53. The Panel went on to consider a Conditions of Practice Order. The Panel noted that the ISP states:
‘Conditions of practice are unlikely to be suitable in situations where problems cannot be overcome, such as serious overall failings, lack of insight, denial or matters involving dishonesty..”.

54. The Panel concluded that dishonestly working whilst on sick leave and whilst suspended is not amenable to conditions, as the basis for this type of misconduct, is an attitudinal failing. The Panel noted that the Registrant considers himself to be retired. He stated in his written representations that he has no intention of working for the health service again or any employment which requires him to be registered. As a consequence the Panel concluded that it would not be possible to formulate workable conditions. In any event, the Panel took the view that conditions would not adequately address the serious nature of the Registrant’s misconduct and so would undermine public confidence in the profession and undermine the need to uphold standards of conduct and behaviour.

55. The Panel next considered a Suspension Order. A Suspension Order would send a signal to the Registrant, the profession and the public re-affirming the standards expected of a registered Paramedic. However, the Registrant has demonstrated no insight into his wrongdoings. Furthermore, he has not remediated his previous misconduct or demonstrated any willingness to remediate and, therefore, the Panel concluded that the risk of repetition is high. In these circumstances a Suspension Order would not be sufficient to maintain public trust in the profession and the regulatory process and would not have a sufficient deterrent effect on other registrants.
 
56. Having concluded that a Suspension Order does not meet the wider public interest the Panel determined that the Registrant’s name should be removed from the Register.  A Striking Off Order is a sanction of last resort and should be reserved for those category of cases where there is no other means of protecting the public or the wider public interest. The Panel decided that the Registrant’s case falls into this category because of the nature and gravity of his misconduct, his persistent lack of insight and the high risk of repetition. The Panel was particularly concerned that following the Registrant’s interview with Witness 1, as part of the investigation process, the Registrant went on to work on a further occasion at Brands Hatch. The Registrant was expressly made aware that working for another employer was prohibited. This behaviour demonstrated a blatant disregard for the high professional standards expected of Paramedics and is fundamentally incompatible with continued registration. As a consequence, the Panel was satisfied that any lesser sanction would undermine public confidence.

57. In reaching its decision the Panel balanced the wider public interest against the Registrant’s interests. In doing so, the Panel took into account the fact that the Registrant considers himself to be retired and the consequential personal and reputational impact a Striking Off Order would have on the Registrant, but concluded that his interests were significantly outweighed by the Panel’s duty to give priority to the significant public interest concerns raised by this case.
 
58. With regard to the Registrant’s non-engagement during the hearing the Panel noted the judgment in NMC v Parkinson [2010] EWHC 1898:
“A [practitioner] who has acted dishonestly, who does not appear before the Panel either personally or by solicitors or counsel to demonstrate remorse, a realisation that the conduct criticised was dishonest, and an undertaking that there will be no repetition, effectively forfeits the small chance of persuading the Panel to adopt a lenient or merciful outcome and to suspend for a period rather than to direct [A Striking Off Order].”

59. In this case the Registrant has disengaged from the hearing stage of the regulatory process. Although he provided written representations in advance of the hearing he has failed to demonstrate any remorse or insight. In doing so, he has not provided the Panel with any opportunity to exercise leniency.

60. The Panel decided that the appropriate and proportionate order is a Striking Off Order.



 

Order

The Registrar is directed to strike off the name of the Registrant Mr Robin John Williams from the register. 

Notes

 The Panel imposes an Interim Suspension Order to cover the appeal period. 

 

Hearing History

History of Hearings for Robin John Williams

Date Panel Hearing type Outcomes / Status
13/12/2016 Conduct and Competence Committee Final Hearing Struck off