Mr Darrel J Dimond
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Whilst registered as a Paramedic and employed by South Central Ambulance
1. Between 3 January 2016 and March 2016, in relation to Patient A, a vulnerable adult, breached professional boundaries in that you had an inappropriate relationship of an intimate and/or sexual nature with her.
2. In or around January 2016, inappropriately gave Patient A your work mobile number.
3. On or around 8 and 20 January 2016, used your work email address to exchange photographs of an inappropriate nature with Patient A.
4. Between approximately 8 February 2016 and 23 March 2016 exchanged WhatsApp and/or text messages with Patient A which were of an inappropriate nature.
5. On or around 29 and 30 May 2016, inappropriately sent Patient A a text message
6. The matters set out at particulars 1 to 4 were sexually motivated.
7. The matters set out at particulars 1 to 6 constitute misconduct.
8. By reason of your misconduct your fitness to practice is impaired.
1. The substantive hearing of the HCPC’s allegations against the Registrant, Mr Darrel Dimond, was scheduled to take place between 22 and 25 January 2018. At the commencement of that hearing, the Registrant was represented by Counsel, but he did not attend.
2. The fact that the Registrant was represented had the consequence that the Panel was not required to consider an application that the hearing should proceed in the absence of the Registrant. However, two issues of a preliminary nature were considered by the Panel at that hearing, namely the HCPC’s application to amend some elements of the factual particulars of the allegation and whether it was appropriate for the evidence of Person A to be given solely by a written witness statement.
Amendment of the particulars to the allegation.
3. Notice of an intention to amend the hearing was communicated to the Registrant by a letter dated 18 May 2017, and, save in one respect, the application made at the hearing accorded with the notice that letter provided to the Registrant. The one respect in which the application did not reflect the terms communicated to the Registrant was that when the application was made it was submitted that the contention that Patient A was a vulnerable witness advanced by the original allegation should be maintained. No objection was raised by Counsel on behalf of the Registrant to any of the proposed amendments. The Panel was satisfied that they were appropriate in the sense they reflected the case the HCPC proposed to advance and they did not depart from the “case to answer” decision of the Investigating Committee. Crucially, the Panel was satisfied that, if allowed, they would not result in any prejudice to the Registrant. Accordingly, the Panel acceded to the application and permitted the amendments sought. The allegation as amended is set out at the beginning of this document.
The evidence of Patient A.
4. When an assessment of Patient A’s ability to give evidence had been undertaken in 2017, it was recorded that she would consider giving evidence by video link if she was not required to see the Registrant and could be supported by her Care Co-ordinator. However, as the hearing scheduled to commence on 22 January 2018, approached, no consideration was given either to seeking permission for the witness to give evidence by video link or to the making of arrangements for her to do so. The Case Summary included in the hearing bundle represented that Patient A would attend the hearing to give evidence, but in the event the HCPC sought to rely on her written witness statement alone. The Panel concluded that fairness to the Registrant demanded that efforts should be made to ensure that Patient A should give her evidence in a manner which would enable her to be questioned, whilst fairness to Patient A required that she should be offered special measures in order to be able to give her best evidence. Accordingly, after hearing the evidence of the other witness upon whose evidence the HCPC wished to rely, the Panel adjourned the hearing with directions enabling Patient A to give evidence by video link.
5. Subsequently, the HCPTS Scheduling Team listed the reconvened hearing to take place between 11 to 14 June 2018.
The resumed hearing commencing on 11 June 2018.
6. When the adjourned hearing recommenced on 11 June 2018, the Registrant did not attend and on this occasion he was not represented.
7. The Panel was satisfied that the letter dated 14 May 2018 sent to the Registrant at his HCPC Registered address informing him of the date, time and location of the reconvened hearing had provided a valid notice of hearing.
8. On 23 May 2018, the Solicitors who had instructed Counsel on behalf of the Registrant at the January 2018 hearing sent an email to the HCPC confirming that they were still representing the Registrant. However, when the HCPC Case Manager telephoned the Solicitors on the morning of the first day of the reconvened hearing, 11 June 2018, she was informed that they were no longer representing the Registrant and that the Registrant had informed the Solicitors that he would not be attending the hearing until Thursday 14 June 2018.
9. In these circumstances the Presenting Officer applied on behalf of the HCPC for a direction that the hearing should proceed in the absence of the Registrant. In considering this application, the Panel heeded the advice it received from the Legal Assessor that a decision to proceed with a case in the absence of a registrant is one to be taken with great care. However, having considered the matter carefully, and having fully taken into account the HCPTS Practice Note on the topic, the Panel decided that the case should proceed in the absence of the Registrant. The reasons for this decision were as follows:
• The Registrant had knowledge of the dates of the reconvened hearing.
• The Registrant’s decision, communicated by his former Solicitors in the circumstances already described, not to attend the hearing until 14 June 2018 was one that was not said to be based upon an inability to attend before that day. It therefore followed that any absence from the hearing amounted to a voluntary waiver of his right to attend.
• There was no application for an adjournment.
• The case concerned events that occurred over two years ago and the hearing had commenced some five months earlier. Furthermore, Patient A was due to give evidence by video link at the commencement of the second day of the reconvened hearing, and a decision not to proceed with the case would result in considerable inconvenience and anxiety for her. An adjournment with the consequential need for the evidence of Patient A to be re-scheduled on a future occasion would be likely to have a significant negative impact given her particular vulnerability.
• All of these factors resulted in the Panel concluding that the case should proceed notwithstanding the absence of the Registrant.
Patient A’s evidence given in private.
10. Although it was a decision made at the commencement of the evidence of Patient A on the second day of the reconvened hearing, it is convenient to explain in this introductory section of the determination that the Panel directed that she should give her evidence in private. As the allegations against the Registrant are of a sexual nature and Patient A is an alleged victim, the special measures provided for by Rule 10A of The Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”) were available. From the commencement of her interaction with the Panel by the video link it was clear that Patient A was very nervous and that the quality of the evidence she would be able to give would be likely to be adversely affected by that nervousness. The degree of her nervousness was likely to be increased by knowledge of the presence in the hearing room watching her on the video link of people unconnected with the conduct of the case. Accordingly, the Panel directed that in order to ensure that she should be given the opportunity to give the best evidence possible, a direction was required under Rule 10A(3)(e) of the Rules that her evidence should be given in private.
11. The Registrant was employed with the Accident and Emergency Operational Department of the South Coast Ambulance Service (“SCAS”) as a Band 6 Team Leader.
12. On 27 May 2016 the SCAS Safeguarding Lead received an email from a Senior Nurse Practitioner who was Patient A’s Care Co-ordinator. The information received was that following an occasion in January 2016, when in his role as a Paramedic the Registrant had attended Patient A at home, he had given the patient his telephone number and an intimate relationship had followed. It was claimed that in March 2016, Patient A had stopped responding to the Registrant’s calls and that at the end of March 2016, when the patient was in hospital, when she had telephoned the Registrant he had abruptly ended the call.
13. After the SCAS Safeguarding Lead became involved, it is alleged by the HCPC that the Registrant again communicated with Patient A, albeit that it is acknowledged that he did not know that his earlier involvement with the patient had been reported by her to her Care Co-ordinator.
Decision on Facts
14. The Panel began its deliberations on the facts by making a general assessment of the witnesses who had given evidence. The HCPC called two witnesses to give evidence, namely, Mr SW, a Senior Paramedic employed by SCAS who had undertaken an internal investigation into the matter, and Patient A.
15. The Panel found Mr SW to be a careful witness who undertook a thorough investigation. The value of his evidence was necessarily limited by the fact that Mr SW had no personal knowledge of any of the relevant matters. However, to the extent that recorded matters were relevant to the decisions made, the Panel was confident that the evidence of Mr SW could be safely relied upon.
16. The Panel had the opportunity to assess the reliability of Patient A. She was clearly nervous when giving evidence. However, the Panel was impressed by her as a witness, finding her account of the relevant events given in her oral evidence to be consistent with earlier accounts she had given. Her replies to questions were considered and measured, and, when she could not remember something, she did not hesitate in saying so. The conclusion of the Panel was that she was a credible and reliable witness whose evidence could be accepted.
17. As the Registrant did not give evidence before the Panel, there was clearly no opportunity for the Panel to assess the reliability of his version of events as given in the course of the SCAS investigation. However, the Panel fully considered his version of the relevant events as recorded by Mr SW during the investigation, together with the documentary evidence provided to that investigation by the Registrant. When Patient A gave evidence, the Panel asked her questions that were informed by the account given by the Registrant.
18. The Panel has not overlooked the fact that during his interview by Mr SW, the Registrant’s colleague on 3 January 2016, Mr RM, said that he did not see the Registrant acting inappropriately towards Patient A. As it was the Registrant who was attending the patient and Mr RM was driving the ambulance, the Panel does not feel able to conclude that the fact that Mr RM did not observe untoward behaviour means that it did not occur.
19. Throughout its deliberations on the facts the Panel applied the advice it received that the burden of proving all elements of the factual particulars was carried by the HCPC, the standard of that burden being the balance of probabilities.
Between 3 January 2016 and March 2016, you had an inappropriate sexual relationship with Patient A, a vulnerable adult.
20. The Panel finds that Patient A’s vulnerability is established by factors beyond the mere fact that she was a person who was being attended by a Paramedic crew. The attendance upon Patient A by the Registrant and the Paramedic with whom he was working on 3 January 2016, Mr RM, was as a result of a 999 call that reported that the patient had suffered a seizure. The Panel received evidence about Patient A’s health condition. One manifestation of her condition was that she could exhibit disinhibited behaviour. When he was interviewed by Mr SW for the purposes of the SCAS investigation, the Registrant’s crewmate, Mr RM, said that Patient A was singing “you sexy thing” in the company of the Paramedics. Mr RM also said that getting out of the ambulance at the hospital, Patient A was quite loud, and that he and the Registrant exchanged a look that involved raised eyebrows. During the investigatory interview Mr RM told Mr SW that when they returned to their vehicle he made the comment, “Oh my God, she’s f****** mental.” The Panel does not think it necessary to conclude that the Registrant was aware of the full details of Patient A’s health that was made available to the Panel, but the Panel is satisfied that it was apparent to him that she was vulnerable.
21. The Panel accepted the evidence of Patient A that after 3 January 2016, the Registrant called at her home, and that after she made him a drink and there was some chat, they had sex. Patient A said that this occurred probably on two occasions. The Registrant also admitted during the course of Mr SW’s investigation that he had visited her at her home. The investigation conducted by Mr SW discovered that on 10 January 2016 the Registrant’s SCAS vehicle was parked near Patient A’s property for approximately two hours whilst he was on duty. The Panel found that the Registrant’s justification for being there, namely that he was collecting equipment left at the property on 3 January 2016, was not credible.
22. The inappropriateness of a Paramedic indulging in sexual activity with a patient whom he had attended is obvious. That the patient was particularly vulnerable resulted in the behaviour being particularly inappropriate.
23. Particular 1 is proved.
Between 3 January 2016 and May 2016, you breached professional boundaries in that you in or around January 2016, inappropriately gave Patient A your work mobile number.
24. The fact that the Panel has been provided with documentary exhibits containing messages exchanged between Patient A and the Registrant’s work mobile telephone is sufficient to prove that Patient A was in possession of the number. The issue to be decided in relation to this particular is whether the Registrant gave the number to Patient A (as she contends and the Registrant denies). If the Registrant did give Patient A that telephone number, it is necessary to decide if that was inappropriate and breached professional boundaries.
25. Consistent with its general finding that Patient A was a credible witness, the Panel accepted her evidence that the telephone number was given to her by the Registrant. It finds that it is inherently improbable that a patient being attended by a Paramedic would have been able to discover the Paramedic’s work mobile telephone number without the knowledge of the Paramedic. Mr SW noted in his investigation that SCAS mobile telephone numbers were not publicly available and an internet search for the Registrant’s work mobile telephone number yielded no results. Patient A’s version of events, accepted by the Panel, is supported by the fact, of which there is documentary proof, that on 8 February 2016 the Registrant gave Patient A his private mobile telephone number.
26. The giving by a Paramedic to a patient of a mobile telephone number in the absence of any clinical need to do so is, in the view of the Panel, clearly inappropriate. It constituted a serious breach of proper professional boundaries.
27. Particular 2(a) is proved.
Between 3 January 2016 and May 2016, you breached professional boundaries in that you on or around 8 and 20 January 2016, used your work email address to exchange photographs of an inappropriate nature with Patient A
28. Interrogation of the SCAS laptop provided to the Registrant revealed that several images had been shared between the Registrant and Patient A, the Registrant’s work email account being used for that purpose. The Registrant sent to Patient A an image which was not indecent but showed him holding a baby. A further image was exchanged on 8 January 2016. An image of Patient A sent to the Registrant resulted in him replying to her by email on 20 January 2016, “That’s very awesome! Any more with any less?” One image was of Patient A in her underwear. Another was of her wearing underwear on all fours on a bed.
29. The Panel finds that photographs were exchanged. As there should have been no personal contact between the Registrant and Patient A, even the image the Registrant sent was inappropriate, and those of the patient partially clothed were clearly inappropriate. The exchanging of the images breached professional boundaries.
30. Particular 2(b) is proved.
Between 3 January 2016 and May 2016, you breached professional boundaries in that you between approximately 8 February 2016 and 23 March 2016 exchanged WhatsApp and/or text messages with Patient A which were of an inappropriate nature.
31. The time span covered by this particular commences with the Registrant communicating to Patient A his personal mobile telephone number with the message sent at 19:07 on 8 February 2016, “Hey, this is my personal number. Darrel. X”. The period ends with the last message save for those covered by Particular 2(d). Some 40 minutes after the initial message the Registrant sent a photo image that showed his bare torso, which three minutes later was replied to by Patient A with the words, “At this moment in time I really do feel like I would want to be close to you. You handsome soul. X”. The Registrant replied, “Hey ur not so bad either – beautiful funny and very sexy. X”. A short while later the Registrant wrote, “I like ur chest! That’s prob my favourite bit – u neck and chest! Xx”, quickly followed by, “I have missed not seeing u! X”. Eleven minutes later he asked for a photograph, and when he received it he wrote, “You’re very pretty! X”, and “Too many clothes though! Lol. X”. In the period covered by this particular a great number of messages were sent. None of them were concerned with an issue that a Paramedic might legitimately discuss with a patient. In the judgement of the Panel they were of an inappropriate nature and breached proper professional boundaries.
32. Particular 2(c) is proved.
Between 3 January 2016 and May 2016, you breached professional boundaries in that you on or around 29 and 30 May 2016, sent Patient A a text message.
33. Patient A made the disclosure of the inappropriate contact she had had with the Registrant on 27 May 2016, and it was on the same day that the Safeguarding Lead of SCAS was informed. However, it is acknowledged that although the text messages that are relevant to this particular post-dated the disclosure, the Registrant was unaware of that fact.
34. After a period of approximately two months when there had been no contact between the Registrant and Patient A, after 10:00pm on 29 May 2016, the Registrant sent a text message to her that reads, “Hey, how r u? X”. Patient A did not respond to this message. At 08:18am the following day the Registrant sent a further text message that reads, “R u not talking to me. X”.
35. The documentary records prove the sending of the messages. They were not related to any professional contact between the Registrant and Patient A, and in the judgement of the Panel their purpose was to rekindle the relationship that had commenced in January 2016 but cooled by the end of March 2016. They breached proper professional boundaries.
36. Particular 2(d) is proved.
The matters set out at particulars 1 and/or 2 were sexually motivated.
37. After the Registrant and his colleague transferred the care of Patient A to the hospital on 3 January 2016 there was no legitimate reason for there to be contact between the Registrant and Patient A. The matters included in Particular 1 were self-evidently sexually motivated. It has already been stated that the messages included in the generality of Particulars 2(a) to (d) included those which were explicitly sexual in nature. The Panel finds that the totality of the messaging, including the text messages sent in May 2016, was sexually motivated as sending of the messages was an integral part of the on-going relationship between the Registrant and Patient A.
38. Accordingly, Particular 3 is proved.
Decision on Grounds
39. The requirement that health professionals observe proper professional boundaries is not an arbitrary rule without a sound justification. The requirement exists because there is a power imbalance and the failure to observe those boundaries can result in harm to the patient. It is apparent to the Panel that, despite her seemingly being a willing participant in the matter, Patient A has been adversely affected by the experience.
40. The factual findings made by the Panel necessarily involve that the finding that the Registrant’s actions were motivated by his desire to gratify his own sexual desires. He allowed that motivation to be put before Patient A’s best interests.
41. The matters found proved by the Panel occurred in the period when the presentation of the HCPC’s Standards of conduct, performance and ethics was being changed. In the view of the Panel, the Registrant’s behaviour fell so seriously short of the proper standards he was required to observe that it is not necessary to identify individually the promulgated standards. Both fair minded members of the public and fellow Paramedics would find his behaviour to be deplorable. The Panel finds it to be misconduct of the most serious nature.
Decision on Impairment
42. In considering the issue of current impairment of fitness to practise, the Panel has considered both the personal component and the public component.
43. So far as the personal component is concerned, the failings identified by the Panel are not of a type that are easily remedied. The findings of the Panel represent very serious attitudinal shortcomings on the part of the Registrant. He abandoned what he knew to be proper professional standards and the need to act in the best interests of Patient A in order to conduct a sexual relationship with her in the knowledge that she was vulnerable. The Panel has found that the Registrant’s sexual motivation began when he was treating her as a Paramedic and gave her his work mobile telephone number. Furthermore, his acceptance of his shortcomings has been very limited. He denied giving Patient A his telephone number, claiming that she obtained it without his knowledge, and also denied any physical sexual contact. His admissions were limited to the matters the clear documentary proof did not permit him to deny. In the judgement of the Panel all these factors lead to the clear conclusion that there has been no remediation and that there would be a real risk of repetition were the Registrant to be permitted to return to practise without restrictions. It follows that from the point of view of the personal component the Registrant’s fitness to practise is currently impaired.
44. The same finding is required to satisfy the wider public interest. The Registrant breached a fundamental tenet of his profession and is liable to do so in the future. Fair minded members of the public would be dismayed at the prospect of being attended, or knowing that a family member might be attended, by a Paramedic against whom these serious findings have been made. The Panel would be failing to declare and uphold proper professional standards if it did not reach a finding of current impairment of fitness to practise, and the wrong message would be sent out to other professionals were it not to be made.
45. The consequence of the findings made by the Panel is that the allegation that the Registrant’s fitness to practise is impaired by reason of misconduct is well founded. The Panel must therefore proceed to consider the issue of sanction.
Decision on Sanction
46. After the Panel announced its decision that the allegation is well founded and handed down its reasons for that decision, it received submissions from the HCPC Presenting Officer on the issue of sanction.
47. The Presenting Officer made submissions as to the aggravating and mitigating factors of the case. He suggested that the sustained nature of the misconduct, the grievous violation of proper professional standards and Patient A’s vulnerability were aggravating factors. He stated that the Registrant’s previous good character should be considered to be a mitigating factor. He also made submissions regarding the proper approach to the imposition of a sanction. He reminded the Panel of the importance of having regard to the HCPC’s Indicative Sanctions Policy and drew the attention of the Panel to various paragraphs of that document. The Presenting Officer did not urge the Panel to apply any particular sanction, but he did suggest that if the Panel concluded that its findings in relation to the allegation were incompatible with the Registrant’s continued registration, then a Striking-Off Order might be the appropriate outcome.
48. The Panel has approached its decision on sanction by accepting that a sanction must not be imposed to punish a registrant against whom findings have been made. Rather, the factors that can justify the imposition of a sanction are the need to protect the public and to maintain a proper degree of confidence in the registered profession and the regulation of it. It being the case that a finding that an allegation is well founded does not of itself require the imposition of a sanction, the first question any panel must consider is whether the particular circumstances of the case require a sanction. If a sanction is required, then the available sanctions must be considered in an ascending order of seriousness until one is reached that satisfies the need to protect the public and maintain the confidence already mentioned. As the finding in the present case is one of misconduct, the whole sanction range, up to and including striking off, is available.
49. The Panel does not propose to repeat all that it explained when deciding that the ground of misconduct was made out and that the Registrant’s fitness to practise is impaired. It is, however, necessary to repeat the Panel’s view that the Registrant abandoned what he knew to be proper professional standards and the need to act in the best interests of Patient A in order to conduct a sexual relationship with her in the knowledge that she was vulnerable. The Panel agrees that the finding is aggravated by the factors identified by the Presenting Officer. Against this, the Panel reminded itself that there has been no suggestion of any previous failings by the Registrant and that he said in the context of the SCAS investigation that at the time of the events relevant to the allegation he had personal and family difficulties. However, these latter factors do not diminish the severity of the misconduct and the risk of repetition presented by the Registrant.
50. The Panel considers that the finding is so serious it needs to be marked by the imposition of a sanction. Neither a Caution Order nor a Conditions of Practice Order would protect the public against the risk of repetition and such sanctions would not sufficiently maintain public confidence. The Panel considered imposing a Suspension Order, but the Registrant’s continued denial and very limited insight, when considered with the associated risk of repetition, resulted in the Panel concluding that a Suspension Order would not be appropriate. It would protect the public while in force, but it would not achieve a positive outcome because the risk presented by the Registrant at the end of any period of suspension would not be diminished. The conclusion of the Panel is that the only appropriate sanction in this case is one of striking off. The circumstances of the case accord with the factors identified in paragraphs 47 to 49 of the Indicative Sanctions Policy. The Registrant’s behaviour was deliberate and persistent and amounted to a breach of trust placed in him by his employer and the public. His lack of insight and denial means that there is a continuing risk and no sanction other than striking off will protect the public in the long term. Furthermore, a lesser sanction would not have a deterrent effect and would undermine confidence in the Paramedic profession and the regulation of it. For these reasons a Striking-Off Order is required and is a proportionate response to the Panel’s findings in respect of the allegation.
The Registrar is directed to strike the name of Mr Darrel J Dimond from the Register on the date this order comes into effect
The Panel makes an Interim Suspension Order under Article 31(2) of the Health and Social Work Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest.
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.
Reasons for making an interim order:
1. The Panel first considered whether it was appropriate to consider the HCPC’s application for an interim order in the absence of the Registrant.
2. The Panel concluded that it was appropriate to consider the application in the absence of the Registrant for the following reasons:
• The Registrant was informed by the notice of hearing letter dated 14 May 2018, that in the event of the Panel making a Striking-Off Order, it might impose an interim order which would restrict his right to practise with immediate effect.
• The Panel concluded that the information contained in the letter dated 14 May 2018 afforded the Registrant an opportunity of appearing and being heard on the issue whether an interim order should be made. Accordingly, Article 31(15) of the Health and Social Work Professions Order 2001 was satisfied and, subject to concluding that the matter was appropriate to be considered in the Registrant’s absence, the Panel had jurisdiction to consider the matter.
• There has been no suggestion by or on behalf of the Registrant that he wishes to make representations in relation to the possibility that an interim order might be applied for.
• In these circumstances the Panel concluded that the clear public interest in permitting the HCPC to make an application for an interim order outweighed the absence of the Registrant, with the effect that the substance of the matter should be considered at the present time.
3. The Panel approached the substance of the application by acknowledging that the default position provided for by the relevant legislation is that there will be no restriction on a Registrant’s ability to practise while their appeal rights against the making of a substantive sanction remain outstanding. It follows that positive reasons are required to justify the making of an interim order.
4. In the judgment of the Panel the risk of repetition identified in the substantive decision and the associated risk of harm that could result from repetition have the consequence that an interim order is necessary to protect members of the public. It is also required in the wider public interest.
5. The Panel considered whether there were conditions of practice that could be imposed on an interim basis that would sufficiently address the identified public protection and public interest considerations. The conclusion of the Panel was that interim conditions of practice would not be appropriate because the risks presented by the Registrant could not be managed by the imposition of conditions.
6. The result of these findings is that an Interim Suspension Order is required with immediate effect. It is appropriate to impose the Interim Suspension Order for the maximum period of 18 months in order to cover the period between any appeal by the Registrant and the conclusion of such an appeal.
History of Hearings for Mr Darrel J Dimond
|Date||Panel||Hearing type||Outcomes / Status|
|11/06/2018||Conduct and Competence Committee||Final Hearing||Struck off|