Adrian M Stanley
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1. On 20 August 2015 at Dolgellau Magistrates' Court you were convicted of:
(a) On 25 June 2015 driving a motor vehicle on Beach Road, Talybont after consuming so much alcohol that the proportion of it in your urine, namely 276 milligrammes of alcohol in 100 millilitres of urine, exceeded the prescribed limit.
(b) On 28 June 2015 driving a motor vehicle on Llwyn Ynn, Talybont after consuming so much alcohol that the proportion of it in your urine, namely 124 milligrammes of alcohol in 100 millilitres of urine, exceeded the prescribed limit.
2. By reason of your conviction for the offences set out at paragraph 1, your fitness to practise as a Paramedic is impaired.
1. The Panel had sight of a letter dated 20 July 2016 sent to the Registrant at his registered address, giving notice of today’s hearing, and determined that service had been complied with in accordance with Rule 3 of the Health Professions Council Rules 2003 (“the Rules”).
Proceeding in absence:
2. Mr Newman applied to proceed in the absence of the Registrant.
3. The Panel accepted the advice of the Legal Assessor, who took the Panel to the Practice Note on Proceeding in the Absence of the Registrant, to Rule 11 and to the guidance given in the cases of Tait –v The Royal College of Veterinary Surgeons  UKPC 34, Jones (2003) 1 AC 1 and GMC –v- Adeogba  EWCA Civ 162.
4. The Panel had sight of two HCPC file notes. The first, dated 20 January 2016, recorded a conversation between a representative of the HCPC and the Registrant, in which the Registrant stated that he had no intention of working for the NHS again and was unlikely to respond to correspondence from the HCPC. The second, dated 22 July 2016, read as follows: “Mr Stanley left a message on the admin phone at 9.52 am this morning. He noted that he won’t be attending the meeting or bringing witnesses”.
5. The Panel concluded, on the basis of a perusal of the papers before it, that the Registrant was aware of the hearing and had voluntarily absented himself. He had not made an application to adjourn and the Panel believed that there was no chance that he would attend if the matter were to be adjourned. The Panel was satisfied in the circumstances that the case could proceed without risk of injustice to the Registrant. The Panel concluded that it was in the public interest for the matter to be heard expeditiously.
6. The Registrant was employed as a Paramedic by the West Midlands Ambulance Service.
7. On 25 June 2015 the Registrant was stopped by the police whilst driving a motor vehicle, and provided a positive roadside breath test, namely 139mg, in excess of the limit of 35mg. He was conveyed to police custody and a urine sample was taken. The result of this urine reading was 276mg of alcohol in 100 millilitres of urine, in excess of the limit of 107mg.
8. On 28 June 2015 the Registrant was stopped again by the police whilst driving a motor vehicle and provided a positive roadside breath test, namely 46 mg, in excess of the limit. He was conveyed to police custody and a urine sample taken. The result of this urine reading was 124 mg of alcohol in 100 millilitres of urine, in excess of the limit.
9. The Registrant entered pleas of guilty and was convicted of both offences at Dolgellau Magistrates’ Court on 20 August 2015. He was sentenced to a curfew requirement for 12 weeks, commencing on 20 August 2015 and ending on 19 November 2015, which was subject to an Electronic Monitoring Requirement and a Rehabilitation Activity Requirement, he was disqualified from driving for 24 months, and he was ordered to pay a £60 victim surcharge, £85 in costs and a £150 criminal courts charge.
10. The Panel was informed that the West Midlands Ambulance Service had confirmed that the Registrant no longer worked as a Paramedic, and that he had retired on grounds of health, his last working day being 1 July 2015.
11. The Panel was also informed that the Registrant had confirmed with the HCPC that he no longer wished to practise as a Paramedic and that since retiring last year he does not wish to engage as he feels that the proceedings are affecting his health.
Decision on Facts:
12. The Panel accepted the advice of the Legal Assessor.
13. The Panel found Particulars 1 (a) and 1 (b) proved on the basis of the memorandum of entry entered in the register of the Gwynedd Magistrates’ Court on 20 August 2015.
Decision on Impairment:
14. The Panel accepted the advice of the legal assessor who addressed the Panel on the meaning of impairment and referred to the case of Grant ([Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery council (20 Paula Grant  EWHC 927]).
15. The Panel found that the Registrant had breached the following standards of the HCPC's
Standards of Conduct, Performance and Ethics:
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 confidence in you or your profession.
16. The Panel found that the Registrant had breached the following paragraph of the HCPC Standards of Proficiency for Paramedics.
3.1 Registrant Paramedics must understand the need to maintain high standards of personal conduct
17. The Panel concluded that the Registrant had shown no insight into the inappropriateness of his actions at the time of committing the offences. On the occasion of his second arrest, which occurred within three days of his first arrest for the same offence, the Registrant told the police officer: “I just don’t believe this, I’m going to be over again, I just knew it. Can’t you let me off?”. The Registrant showed no awareness of why driving in such a condition was improper, or of the risks that it could pose.
18. The Registrant’s activity, which led to him being convicted of two counts of driving a motor vehicle having consumed an excessive amount of alcohol, amounted to a breach of one of the fundamental tenets of his profession.
19. There was no evidence before the Panel to show that the Registrant had developed insight into his behaviour since the events. This caused the Panel concern in that the Registrant may not comprehend why the consumption of alcohol could not mix with the practice of his profession. This presented the potential for harm to service users.
20. The Registrant’s actions had at the time brought his profession into disrepute and continued to do so. The public has a right to expect its paramedics to obey the laws of the land. The absence of insight and of evidence of any attempt on the part of the Registrant to remediate his actions also give rise to a real risk of repetition.
21. The Panel found that the nature of the Registrant’s convictions was such that he presented a risk to the public and that the wider public interest demanded a finding of impairment in order to uphold proper standards of conduct and behaviour.
22. In summary the Panel found the Registrant’s current fitness to practice to be impaired on the basis that:
a. he had in the past and is liable in the future to place the public at risk of harm;
b. he had in the past and is liable in the future to bring his profession into disrepute;
c. he had in the past and is liable in the future to breach one of the fundamental tenets of his profession.
Decision on Sanction:
23. In considering what sanction, if any, to impose, the Panel accepted the advice of the Legal Assessor and referred to the Indicative Sanctions Policy.
24. The Panel bore in mind that its purpose was not to be punitive, but was to protect the public interest. It understood that it must act proportionately, balancing the interests of the Registrant with those of the public. It considered the range of available sanctions in ascending order of seriousness, starting with the option of taking no action.
25. The Panel began by identifying what it considered to be the principal aggravating and mitigating factors in the case.
26. The Panel found, by way of aggravating factors, that:
• the Registrant had committed two offences of the same description in the space of three days;
• the level of alcohol in the Registrant’s urine sample at the time of his first arrest had exceeded the prescribed limit by approximately two and a half times;
• there was an absence of any evidence of insight.
27. The Panel found, by way of mitigation:
• the Registrant’s previously unblemished record;
• the Registrant’s pleas of guilty at the criminal court;
• the unsupported evidence provided by the Registrant concerning his health.
28. The Panel then approached the ladder of sanction, beginning with the least restrictive.
29. The Panel concluded that in view of the seriousness of the case, and the risk that the Registrant presented to the public, to take no further action would be neither appropriate nor proportionate in the circumstances. It would fail to reflect the seriousness of the Registrant’s actions, and would not provide the necessary level of public protection against the risk of repetition previously identified by the Panel. Moreover, it would fail to protect the wider public interest in maintaining confidence in the profession and upholding proper standards of conduct and behaviour.
30. The Indicative Sanctions Policy observes that a Caution Order would be appropriate 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 an appropriate remedial action”. None of these factors were present in this case, leading the panel to conclude that a Caution Order was neither appropriate nor proportionate.
31. The Panel next considered a Conditions of Practice Order. However, it was unable to formulate workable conditions that would reflect the circumstances of the case given the absence of insight or engagement by the Registrant.
32. The Panel then considered a Suspension Order. The Panel concluded that a period of Suspension would provide the necessary level of public protection for its duration and would allow the Registrant an opportunity for reflection in which to both develop insight and to remediate his behaviour. As such, the Panel found a Suspension Order to be the appropriate sanction in this case.
33. The Panel next considered the appropriate length of the Suspension Order, and concluded that 12 months was the minimum period needed in which to develop appropriate insight and to demonstrate remediation.
34. Accordingly, the panel imposed a Suspension Order for a period of 12 months.
35. The Suspension Order will be reviewed prior to its expiry and the Panel conducting that review might be assisted by the following:
a. The Registrant’s attendance at the hearing;
b. A reflective piece written by the Registrant, demonstrating insight into his convictions and the real and potential consequences of his behaviour on others, and any remedial actions undertaken during the period of suspension;
c. Evidence of CPD, to maintain the Registrant’s competence as a paramedic.
The order imposed today will apply from 10 November 2016 (the operative date).
This order will be reviewed again before its expiry on 10 November 2017.