Stuart R Gwilt

Profession: Paramedic

Registration Number: PA01916

Hearing Type: Final Hearing

Date and Time of hearing: 09:00 04/07/2016 End: 16:00 05/07/2016

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

1. On 5 August 2015 at Cannock Magistrates’ Court you were convicted of Assault by beating, contrary to section 39 of the Criminal Justice Act 1988.
2. By reason of your conviction as set out in paragraph 1 your fitness to practise as a Paramedic is impaired.

Finding

Background:
1. The Registrant is a Paramedic registered with the HCPC. He began working in Patient Transport Services in 1993 and gained his paramedic qualification shortly afterwards. He made progress throughout his career and reached the position of Clinical Team Leader and Hospital Ambulance Liaison Officer. In December 2014 he became a Patient Flow Manager at The Royal Wolverhampton Hospital.
2. On 5 June 2015 the Registrant was involved in a domestic violence incident with his wife at the family home. The police were called to the home address by the Registrant’s wife. The police arrested the Registrant on 5 June 2015 and he was interviewed and charged by the police on 6 June 2016 with the offence of Common Assault.
3. On 5 August 2015, the Registrant entered a guilty plea. He was later sentenced at Cannock Magistrates’ Court on 28 August 2015 to 14 weeks imprisonment suspended for 24 months. A 24 month Rehabilitation Activity Requirement was attached to his suspended sentence and a restraining order was also imposed upon the Registrant prohibiting further contact with his wife. In addition, he was also ordered to pay £80 victim surcharge, costs of £85 to the Crown Prosecution Services, and a criminal court charge of £150.
4. The Registrant self-referred himself to the HCPC on 6 August 2014 and has engaged with the HCPC process.
Preliminary matters:
Amendment of the Allegation:
5. Mr Chalmers, on behalf of the HCPC, applied for the Allegation to be amended. Mr Chalmers applied to correct the date of the conviction from 28 August 2015 to 05 August 2015. This was not opposed by Dr Van Dellen on behalf of the Registrant.
6. The Panel also made a minor amendment to the numbering in the Allegation. The Panel considered that the amendments were minor and did not change the substance of the Allegation but served to clarify the Allegation. The Registrant would not be prejudiced by the amendments. The Panel therefore allowed the amendments to be made. The Panel amended allegation as set out above.
Admissions:
7. At the start of these proceedings, the Registrant admitted paragraph 1 of the Allegation.
8. The Registrant admitted that his fitness to practise was impaired as a result of his conviction.
Decision on Facts:
9. The Panel has before it, the document entitled ‘MEMORANDUM of an ENTRY in the REGISTER of the Central and South West Staffordshire Magistrates’ Court LJA’. It sets out clearly the conviction and the sentence imposed upon the Registrant. It is in accordance with the Registrant’s admission and therefore the Panel finds paragraph 1 of the Allegation proved.
Decision on Impairment:
10. The Panel then went on to consider, on the basis of the matters found proved, whether the Registrant’s fitness to practise is currently impaired by reason of the conviction.
11. In reaching its decision, the Panel had regard to all the evidence before it. It took account of the submissions of Mr Chalmers on behalf of the HCPC, and by Dr Van Dellen on the Registrant’s behalf.
12. Mr Chalmers outlined the background to the case and submitted the Registrant’s fitness to practise was impaired in that the conviction was a serious matter and the Registrant is still subject to a suspended sentence as the operative period lasts until 27 August 2017. He referred the Panel to the case of CHRE v NMC and Grant [2011] EWHC 927 (Admin) and Cohen v GMC [2008] EWHC 581. He submitted that the relevant considerations in this case are the seriousness of the charge, the nature of the sentence, the public perception of domestic violence, and the poor judgement of the Registrant.
13. Dr Van Dellen reminded the Panel that the Registrant is not contesting that his fitness to practise is impaired. He contended that the conviction is not indicative of any deep-seated attitude on the part of the Registrant, nor was there any suggestion that the Registrant’s behaviour was a culmination of ongoing problems. He highlighted that the Registrant cooperated fully with the police and made full admissions at the earliest available opportunity.
14. The Panel then went on to consider whether by reason of his conviction, his fitness to practise is currently impaired. For this purpose, the Panel took into account the approach formulated by Dame Janet Smith in her 5th report of the Shipman inquiry, and which was cited with approval in the case of CHRE v NMC & Grant, as follows, by asking itself the following questions:
“Do our findings of fact in respect of the Registrant’s conviction show that his fitness to practise is impaired in the sense that he:
a) has in the past acted and/or is liable in the future to act so as to put patient or patients at unwarranted risk of harm; and/or
b) has in the past brought and/or is liable in the future to bring the paramedic profession into disrepute; and/or
c) has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the paramedic profession?”
15. The Panel also considered whether the conviction is such that the need to uphold professional standards and public confidence in the profession would be undermined if a finding of impairment were not made.
16. In the Panel’s opinion, by this conviction, the Registrant has breached a fundamental tenet of the profession, namely that it is incumbent on members of the profession not to behave in this manner and not to transgress the laws of the land.
17. The Panel noted that the Registrant is still subject to the suspended sentence and will continue to be so until 27 August 2017. The Panel determined that the public component required a finding of impairment.
18. Therefore, Panel determined that the Registrant’s fitness to practise is currently impaired by reason of his conviction.
Sanction stage of proceedings:
19. The Panel heard evidence on oath from the following witnesses:
a) The Registrant;
b) Witness 1, RT, – character witness on behalf of the Registrant; and
c) Witness 2, SM, – character witness on behalf of the Registrant.
Evidence of the Registrant
20. The Registrant gave evidence on oath. He adopted the witness statement that he had prepared for these proceedings.
21. The Registrant confirmed that he cooperated with the police from the outset. He also told the Panel that he self-referred himself to the HCPC on the 6 August 2015 after he had pleaded guilty. He told the Panel that he kept appointments with his Probation Officer and that, initially they were held more than once a month but now, they are held once a month. He told the Panel that there had been no problems in his dealings with his Probation Officer.
22. The Registrant told the Panel that once he had satisfactorily completed the course on domestic violence required as part of his sentence, his Probation Officer was happy with his progress and gradually extended the period between appointments.
23. The Registrant gave evidence of his current employment status. He told the Panel that his work is that of a normal Paramedic and that he works as part of a crew. He told the Panel that he had informed his current employers of these proceedings and that they were very understanding.
24. The Registrant told the Panel of his relationship with his new partner and how they deal with issues and problems that arise in their relationship. He outlined the strategies and techniques to give each other space, or “time out”, to resolve such issues and problems when they arise.
25. The Registrant was cross-examined and described the circumstances of the assault on his previous partner. He accepted that their children were in the house and in bed at that time. He stated that the incident lasted about 10 minutes. He outlined to the Panel what he had learnt from the course on Domestic Violence, in particular the coping strategies and how to ensure it does not happen again. He told the Panel that this sort of incident had never happened before, and has not happened again since.
Evidence of Witness 1
26. Witness 1 adopted his letter dated 14 August 2015 contained within the Registrant’s bundle as his evidence. He told the Panel that he had been the Chief Executive Officer at the Staffordshire Ambulance Service NHS Trust (“the Trust”) from 1995 to 2006. He told the Panel that during his time there he had frequent contact with the Registrant.
27. Witness 1 gave the Panel a summary of the Registrant’s employment at the Trust. Witness 1 also confirmed that he was aware of the Registrant’s conviction for common assault. He told the Panel that he considered the incident to be out of character for the Registrant and that he would not expect the Registrant to find himself in the same situation again.
Evidence of Witness 2
28. Witness 2 adopted her letter contained within the Registrant’s bundle as her evidence. She told the Panel that she had known the Registrant since December 2014 when he started work as a Patient Flow Manager. She outlined to the Panel what the role of a Patient Flow Manager entailed. She told that Panel that the role was a senior role and one that carried a great deal of responsibility. She confirmed that she was aware of the Registrant’s conviction and was aware of these proceedings. She told the Panel that the Registrant had contacted her on the day after the incident itself and he had kept her appraised of the progress of the case.
29. She stated that from her experience of the Registrant as a professional, the incident was out of character for the Registrant.
Submissions on Sanction:
30. Mr Chalmers, on behalf of the HCPC, reminded the Panel of the wider public interest in the imposition of a sanction. He submitted that any sanction must be proportionate and that it was important to note that the purpose of a sanction is not to punish the Registrant for a second time.  Mr Chalmers submitted the desirability of a Registrant continuing his service to the public must be balanced against the seriousness of the offence for which he had been convicted. He submitted that the facts of the offence were relevant to the Panel’s consideration at this stage.
31. Dr Van Dellen, on behalf of the Registrant, drew the Panel’s attention to paragraphs 12 and 14 of the Indicative Sanctions Policy of the HCPC. He submitted that it would be disproportionate to strike the Registrant’s name off the HCPC’s register. He submitted that the Registrant had demonstrated insight, had effective coping mechanisms in place to ensure that there was a low risk of repetition, and that witnesses 1 and 2 gave evidence of the Registrant’s competence as a paramedic and also of his service to the public. Dr Van Dellen submitted that to strike the Registrant’s name off the HCPC Register would not only be disproportionate but would also deprive the public of a highly skilled and competent Paramedic at a time when there was a severe shortage of Paramedics.
Decision on Sanction:
32. The Panel accepted the advice of the Legal Assessor. He advised the Panel that the full range of sanctions is available to the Panel as this is a case that involved a criminal conviction. He reminded the Panel that they were not to go behind the conviction. He advised the Panel that it should bear in mind its duty to protect members of the public and also the public interest which includes maintaining and declaring proper standards of conduct and behaviour, maintaining the reputation of the profession, and maintaining public confidence in the profession and the regulatory process.
33. He advised that, whilst the Panel were entitled to take into consideration the sentence the Magistrates Court imposed upon the Registrant, the sentence imposed is not necessarily a good indicator of the seriousness of the matter in the context of regulatory proceedings. That was because different considerations apply in regulatory proceedings, amongst which were:
a) Reputational harm to the profession.
b) Public confidence in the profession and the regulatory process.
c) Relevant professional standards of behaviour and the seriousness of any departure from those standards.
34. The Legal Assessor drew the Panel’s attention to the case of CHRE v GDC and Fleischmann (2005) EWHC 87 and the general principle articulated therein that where a practitioner had been convicted of a serious criminal offence, he should not be permitted to resume his practice until he has satisfactorily completed his sentence. The Legal Assessor advised the Panel that as such it was entitled, and should, take into consideration the facts of the offence in question and determine whether or not it was a serious criminal offence. He advised that the seriousness of a criminal offence is not necessarily determined by the type of offence, but can also be determined by the circumstances of the offending behaviour. These are factors that can affect the reputation of the profession.
35. The Legal Assessor also drew the Panel’s attention to the case of D v NMC [2014] EWHC 1298 (Admin), and reminded the Panel that it was entitled to take into consideration factors that it considered to be aggravating and mitigating circumstances of the domestic incident when deciding what sanction would be sufficient in the public interest.
36. The Legal Assessor advised the Panel that any sanction it imposes must be the least restrictive sanction that is sufficient to protect the public and the public interest. He reminded the Panel that the purpose of a sanction is not punitive, although it may have that effect. The purpose of a sanction is to protect members of the public and the wider public interest, weighing the Registrant’s interest against the public interest. 
37. The Panel had close regard to the HCPC’s Indicative Sanctions Policy document in reaching its decision on sanction. The Panel reminded itself that the purpose of a sanction is not to punish. Rather, a sanction should only be imposed to the extent that it is required to protect the public, to maintain a proper degree of confidence in the profession and the regulatory process, and to declare and maintain proper standards among fellow professionals. To ensure this approach the Panel reminded itself to first consider whether the findings require the imposition of any sanction. If they do, then the available sanctions have to be considered in an ascending order of seriousness until the sanction that satisfies the factors already identified is reached. The Panel confirms that it has followed this approach in the present case.
38. The Panel has had regard to the oral evidence of the witnesses, all the documentary evidence presented, and to the submissions of both parties.
39. The Panel did not find the Registrant’s evidence with regard to his insight convincing. He failed to answer satisfactorily the question as to what triggered his behaviour on this occasion. In particular he did not fully demonstrate insight into why, after having gone to his child’s bedroom and calmed her down, he then returned to his wife in their bedroom and assaulted her again.
40. The Panel found witnesses 1 and 2 to be credible and believable. However, their evidence was, quite understandably, limited to the ability and character of the Registrant as a Paramedic with whom they had worked. They were unable to gainsay whether or not the risk of repetition was low, only that the incident was, as far as they knew, out of character for the Registrant.
41. The Panel also had regard to the HCPC’s Indicative Sanctions Policy. The Panel first considered what the aggravating and mitigating factors in this case to be. Most of the aggravating factors are contained within the Police Report (MG5), which was before the Panel today.
42. The Panel considered the aggravating factors in this case to be:
a) The seriousness of the offence. This was an offence of violence within a domestic setting. It was an unprovoked and prolonged assault with children present on the premises, one of whom witnessed part of the incident. There were pauses during the assault, during one of which the Registrant took time to comfort and calm down the child in another room, but then he returned to his partner and continued the assault. In addition, the Registrant had taken a knife from the kitchen in the presence of the victim, and threatened to harm himself and the dog.
b) Harm was done to another person. Children present in the house were also at risk of harm.
c) It was a serious departure from the standard of behaviour expected of a Paramedic. Paramedics should not engage in such behaviour and are expected to keep the laws of the land.
d) The Registrant received a sentence of 14 weeks’ imprisonment suspended for 24 months, which expires on 27 August 2017. A 24 month Rehabilitation Activity Requirement was attached to his suspended sentence, and a restraining order was also imposed upon the Registrant prohibiting further contact with his wife. The Registrant is currently subject to the conditions of the Rehabilitation Activity Requirement.
e) There was limited insight demonstrated on the part of the Registrant as to what triggered his behaviour on this occasion.
43. The Panel next considered the mitigating factors in this case. It considered them to be:
a) The Registrant self-referred himself to the HCPC following his conviction and fully engaged with the process.
b) The Registrant accepted the fact and that his fitness to practice was impaired by reason of the conviction.
c) There are no issues with the competence of the Registrant. In fact, the witnesses spoke highly of the Registrant’s competency as a Paramedic.
d) The Registrant has demonstrated some insight and remorse.
e) The Registrant’s previously unblemished record.
44. The Panel determined that the Registrant had been convicted of a serious criminal offence. Furthermore, given the lack of a full insight and reflection on why he had committed the assault on this occasion, the Panel could not be satisfied that there was a low risk of repetition.
45. In considering the matter of sanction, the Panel started with the least restrictive sanction moving upwards.
46. The Panel first considered taking no action but concluded that, given the seriousness of the criminal offence, and the lack of demonstration of full insight into his behaviour, this would be wholly inappropriate.
47. The Panel then considered whether to make a caution order. The Panel determined that circumstances of the criminal offence are such that a caution order is not appropriate for the same reasons as set out above. In addition, the lapse of judgment on the part of the Registrant was not of a minor nature.
48. The Panel next considered the imposition of a Conditions of Practice Order. However, this is not a case that is suitable for the imposition of a Conditions of Practice Order. There are no concerns with the Registrant’s practice or competency as a Paramedic. In any case, the serious nature of the criminal offence makes a Conditions of Practice Order inappropriate as a sanction.
49. The Panel then considered whether a period of suspension would be a sufficient and proportionate response to maintain a proper degree of confidence in the profession and the regulatory process, and to declare and maintain proper standards among fellow professionals. As stated above, taking the circumstances of the assault into consideration, the Panel has determined that the Registrant was convicted of a serious criminal offence and that he should not be permitted to resume his practice until he has satisfactorily completed his sentence.
50. The Panel also considered the public interest in allowing a skilled Paramedic to return to practice at the completion of his criminal sentence. It noted that there is current shortage of Paramedics nationwide, and the testimony of the references as to the Registrant’s ability and competence as a Paramedic.
51. The Panel weighed all the above considerations, and also reminded itself of the mitigating features in this case, as set out above. The Panel determined that the matter before it was so serious that a Suspension Order would not be sufficient to maintain and declare proper standards of conduct and behaviour, nor to maintain the reputation of the profession, nor to maintain public confidence in the profession and the regulatory process.
52. The Panel then went on to consider striking the Registrant’s name off the HCPC Register of Paramedics. The Panel took into account the impact that such an order would have on the Registrant in terms of his finances and his reputation. However, it concluded that this was such a serious departure from the standard of behaviour expected from a Paramedic that only a striking off order would be sufficient to maintain and declare proper standards of conduct and behaviour, to maintain the reputation of the profession, and to maintain public confidence in the profession and the regulatory process.
53. In the light of the above, the Panel are satisfied that the appropriate and proportionate response to protect the public and otherwise be in the public interest in these circumstances is to make a Striking Off Order.

Order

That the Registrar is directed to strike the name of Mr Stuart R Gwilt from the Register on the date this order comes into effect.

Notes

Application for an Interim Order:
Following the announcement of the Order (above) the Panel heard an application for an interim suspension order from Mr Chalmers on behalf of the HCPC. Dr Van Dellen on behalf of the Registrant opposed this application on the grounds that it was neither in the public interest nor necessary for the protection of the public. The Panel heard and accepted the advice of the Legal Assessor.
Interim Order:

The Panel makes an Interim Suspension Order under Article 31(2) of the Health and Social Work Professions Order 2001, on the grounds of public interest and that, it would be incongruous with the decision above not to do so. 

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.

Hearing History

History of Hearings for Stuart R Gwilt

Date Panel Hearing type Outcomes / Status
04/07/2016 Conduct and Competence Committee Final Hearing Struck off