Mrs Sonya Wheatley
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During the course of your employment as a Paramedic for Yorkshire Ambulance Service:
1. On 06 April 2015, you:
a. Displayed inappropriate behaviour towards Person A in her mother’s home, in that you asked Person A in an inappropriate tone:
i. “Why did you call emergency services?”, or words to that effect.
ii. “Well are you going to the pharmacy, they will give you a drink or something to sort your mother?”, or words to that effect.
b. Displayed inappropriate behaviour at Harrogate District Hospital, in that you approached Person A and stated:
i. “You reported me, because of you I will be suspended”, or words to that effect.
ii. “I was nothing but professional this morning at your mother’s. I gave you two options. Go to the pharmacy or out of hours”, or words to that effect.
c. Displayed inappropriate behaviour at Harrogate District Hospital in that you guided Person A out of the waiting room, despite Person A’s request to stay with her mother.
2. On 24 September 2015, you attempted to influence the testimony of a witness for your disciplinary hearing.
3. The matters described in paragraphs 1-2 constitute misconduct.
4. By reason of that misconduct your fitness to practise is impaired.
Proof of Service
1. On 9 February 2018, the HCPC sent the notice of this hearing by first class post to the Registrant’s registered address. A copy of the notice was also sent to the Registrant by email. The notice contained the required particulars.
2. Having heard and accepted the advice of the Legal Assessor, the Panel was satisfied on the documentary evidence provided, that the Registrant, had been served notice of this hearing in accordance with the Rules.
Proceeding in the absence of the Registrant
3. Mr Stockling, on behalf of the HCPC, applied for the hearing to proceed in the Registrant’s absence. The Panel heard and accepted the advice of the Legal Assessor, who advised that the discretion to proceed in a Registrant's absence should only be exercised with the utmost care and caution.
4. The Panel noted that no communications have been received from the Registrant since she referred herself on 25 October 2015. She did not attend the substantive hearing between 6 and 8 March 2017, nor did she attend the first review on 31 August 2017. She had not engaged with the HCPC since she referred herself in 2015. It follows that the Registrant has not applied for an adjournment, nor has she submitted any representations.
5. The Panel was satisfied that the HCPC had fulfilled its obligations and taken all reasonable steps to serve the notice on the Registrant in accordance with the Rules.
6. The Panel, therefore, concluded that the Registrant had voluntarily waived her right to attend and there was no evidence that she would attend an adjourned hearing. The Panel also considered that it was in the public interest for the hearing to take place, as this was a statutory review of a substantive order due to expire.
7. The Registrant was employed as a paramedic at Yorkshire Ambulance Service (YAS) between 29 July 1999 and 21 October 2015. She was responsible for attending on patients as part of the 999 emergency response service.
8. On 6 April 2015, Person A telephoned the NHS “emergency” 111 number for an out of hours doctor, as her elderly and vulnerable mother, Patient A was in pain. At around 09:49, an ambulance crewed by the Registrant and Witness 3, at that time an Emergency Care Assistant, arrived at the home address of Patient A. Person A, the daughter of Patient A was also present. Witness 3 conducted observations on Patient A at around 09:50. Patient A was not conveyed to hospital.
9. During this attendance, the Registrant was rude to Person A and displayed inappropriate behaviour towards Person A, by asking questions in an inappropriate tone, namely questioning why an ambulance had been called, and asking if Person A was going to the pharmacy.
10. After the Registrant and Witness 3 had left the home address of Patient A, Person A re-dialled 111. During her conversation with the 111 call handler, Person A complained about how the Registrant had behaved towards her. As a result of the call to 111, Person A took Patient A to see a doctor at the out of hours clinic located in Harrogate Hospital (the Hospital). Following this consultation, the doctor referred Patient A to the Accident and Emergency Department (A&E) within the Hospital.
11. Later the same day, whilst at the Hospital, the Registrant and Witness 3 were told that a complaint had been made about an ambulance crew. They subsequently realised that the complaint was by Person A and concerned the Registrant.
12. Whilst Patient A and Person A were waiting in A&E, the Registrant and Witness 3 attended the same A&E with a different patient. The Registrant, on seeing Person A, displayed inappropriate behaviour, in that she approached Person A and said words to the effect of ‘You reported me, because of you I will be suspended’ and to the effect that she had been nothing but professional to Person A’s mother that morning. She also displayed inappropriate behaviour by guiding Person A out of the waiting room, despite Person A’s requests to stay with her mother, to a separate waiting area where she continued to speak to Person A about the complaint.
13. Within days of the incident Person A submitted a written complaint to YAS about the behaviour of the Registrant. Witness 1 was assigned the matter to investigate either at the end of April 2015 or the beginning of May 2015.
14. On 24 April 2015, Witness 3 provided a statement for the investigation. On 24 September 2015, the Registrant telephoned Witness 3 and attempted to influence his testimony at the forthcoming disciplinary hearing. During the telephone conversation on 24 September 2015, the Registrant told Witness 3 that he had not included certain information in his witness statement, that she would lose her job if the information was not included, and that he had ‘condemned her’.
15. The substantive hearing took place between 6 and 8 of March 2017. The Panel found the facts proved and that two of the allegation found proved were sufficiently serious as to amount to misconduct. The substantive panel had regard to the Practice Note on Impairment, and concluded that the Registrant’s fitness to practise at that time was impaired. In coming to this conclusion, the substantive panel noted that there was no evidence from the Registrant of an apology, remorse, or recognition of the impact of her behaviour on other professionals or on service users. Further, there was no explanation from the Registrant as to her behaviour or as to her current employment. The substantive panel concluded that it the absence of insight there remained a risk of repetition.
16. The substantive panel imposed a Suspension Order of 6 months. It said that the length was to mark the seriousness of the misconduct and was also with a view to giving the Registrant the opportunity to demonstrate to the next panel that she had reflected on her conduct and had developed insight. It set out a number of suggestions to the Registrant for information to provide which might assist a reviewing panel.
17. On 31 August 2017, the 6 month Suspension Order was reviewed before it was due to expire. That first reviewing panel concluded that the Registrant’s fitness to practise was impaired at that time. In coming to that conclusion it noted that the Registrant had not engaged with the HCPC since October 2015, and so for the same reasons as those given by the substantive panel, it concluded that the Registrant’s fitness to practise was impaired. The first reviewing panel determined to extend the Suspension Order for a further 6 months, inviting the Registrant to provide the information which had been suggested by the substantive panel to assist a review panel. The first reviewing panel set out in terms:
“The Registrant should understand that in the absence of engagement by her and should she fail to comply with the suggestions made by the Original Panel, there is a very real possibility that the next review will result in the making of a striking off order. Accordingly this Panel determines that a further 6 months suspension would be appropriate and proportionate.”
18. Mr Stockling on behalf of the HCPC submitted that the Registrant had not engaged with the HCPC since October 2015, nor had she provided any of the documentation suggested by the previous panels in respect of any remediation, insight, or whether she was keeping her skills and knowledge up to date. He submitted that in the absence of any such meaningful information, the likelihood of repetition was high. He submitted that the Registrant’s fitness to practise remained impaired and that it was the HCPC’s view, that in the absence of any engagement, the appropriate order was a Striking-Off Order.
19. The Panel heard and accepted the advice of the Legal Assessor. The Panel exercised its independent judgement in determining whether the Registrant’s fitness to practise remains impaired. It had regards to the HCPTS Practice Note on Impairment and the Indicative Sanctions Policy (the Policy).
20. At the substantive hearing, that panel had commented on the apparent deficiencies in the Registrant’s insight, the risk of repetition and the associated risk of harm to the public and to the reputation of the profession.
21. There was no new evidence before this review Panel that there had been any significant change in circumstances since the last review hearing. Accordingly, the Panel finds that the risks identified at that hearing remain live and that the Registrant’s fitness to practise remains impaired on the grounds of both public protection and the wider public interest in maintaining public confidence in the profession and declaring and upholding proper standards of conduct and professionalism.
22. In the Panel’s view, there was a need to impose a sanction that would provide public protection, reflect the seriousness of the Registrant’s misconduct and would otherwise address the public interest of maintaining public confidence in the profession and declaring proper standards of conduct and behaviour. Taking no further action would not achieve this.
23. Likewise, the Panel was of the view that a Caution Order would not restrict the Registrant’s practice and, so, would also fall short of protecting both the public and the wider public interest. As such, the Panel finds that a Caution Order would be neither appropriate nor proportionate in the circumstances of this case.
24. The Panel does not consider it possible to formulate workable conditions of practice in the circumstances of this case and, given the Registrant’s complete lack of engagement, the Panel is not reassured that the Registrant would be either willing or able to cooperate with such an Order, even if it were possible to formulate conditions.
25. The Panel acknowledged that an extension to the Suspension Order would protect the public for the period of its duration. However, the Panel was mindful that the Registrant has already been subject to two periods of suspension, and, despite clear guidance from the previous panels to re-engage with the process and provide information relevant to insight and remediation, she has not made contact with the HCPC since October 2015. It was also made clear to the Registrant by the first reviewing Panel that in the absence of any engagement, there was “a very real possibility that the next review will result in the making of a striking off order”. The Panel finds that there is no reason to believe that the Registrant would behave any differently should a further period of suspension result from this hearing. Such an outcome would not, in the Panel’s view, be in the public interest. The Panel finds that a Suspension Order is no longer an appropriate or proportionate response.
26. Next, the Panel considered a Striking-Off Order. The Panel acknowledges that this is a sanction of last resort. However, the Panel considers that the Registrant has persistently failed to engage with her regulator, and has not, to date, provided any evidence of remediation or insight. In light of this, the Panel concluded that the risks, through repetition, to the public and the reputation of the profession remain. The Registrant has not taken the opportunity to use the two periods of suspension to provide any evidence to demonstrate that she would be capable of returning to safe and effective practice as a Paramedic. Accordingly, the Panel finds that only the ultimate sanction is appropriate in the circumstances of this case.