Mr Mark Burnage

Profession: Paramedic

Registration Number: PA39150

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 05/11/2018 End: 17:00 13/11/2018

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

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

 

While registered as a Paramedic and during your employment with South Central Ambulance Service you:

 

1. Spoke to Colleague A in an inappropriate and/or offensive manner in that you:

 

a. On or around 13 November 2015 stated:

 i. “don’t you ever do that again” or words to that effect;

 ii. “that really pissed me off and it would piss other people off if you did that again to anybody else” or words to that effect.

 

b. On 14 November 2015:

 i. shouted at Colleague A whilst they were driving;

 ii. made unfounded allegations as to disciplinary action and patient complaints against Colleague A.

 2. On 24 December 2015, recorded incorrect and/or misleading information on the continuation sheet for Patient B stating that observations were not required at a GP’s request.

 3. On or around 24 December 2015 spoke to Colleague C in an inappropriate and/or offensive manner.

 4. On 26 December 2015 spoke in an inappropriate and/or offensive manner to Patient D in that you:

 a. stated that you “could only treat emergencies” or words to that effect;

 b. threatened to call the police when challenged as to your behaviour.

 5. On 19 May 2016 in respect of Patient E:

 a. spoke in an inappropriate and/or offensive to the patient in in that you said:

 i. “Please explain to me your thinking: you felt a little bit ill so you made … how many phone calls? I have never felt ill and thought, hang on, I need to ring someone” or words to that effect;

 ii. “sit up and talk to us like an adult” or words to that effect;

 b. Incorrectly recorded that Patient E refused observations;

 c. recorded findings from a gastro-intestinal assessment on Patient E without undertaking an abdominal examination.

 6. On or around 20 August 2016, while wearing your Paramedic uniform you spoke in an inappropriate and/or offensive manner to Person F, in that you stated “hello … hello … hello …Can you speak?” or words to that effect.

 7. On or around 24 September 2016 behaved in an inappropriate and/ or offensive manner towards the family of Patient G in relation to transporting the patient to the hospital.

 8. On or about 5 October 2016 behaved in an inappropriate and/ or offensive manner when attending Patient H.

 9. Your actions as described in paragraphs 2 and 5c were dishonest.

 10. The matters described in Paragraphs 1 to 9 constitute misconduct.

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

Finding

Preliminary Matters

Service

1. The Panel heard that notice in respect of this hearing was sent by first class post and email to the Registrant’s registered address on 10 July 2018 in accordance with Rules 3 and 6 of the Conduct and Competence Procedure Rules 2003.

2. The Panel heard and accepted the advice of the Legal Assessor and determined that the notice had been served in accordance with the Rules.

Proceeding in the absence of the Registrant

3. Ms Ryan, on behalf of the HCPC, invited the Panel to proceed in the absence of the Registrant. She informed the Panel that nothing had been heard from the Registrant since 21 May 2018. Ms Ryan drew the Panel’s attention to a note of a telephone conversation between the Registrant and his HCPC Case Manager on that date. In this, the Registrant indicated that the process had “taken so long that he is not sure about whether he has the strength to carry on any longer as he has lost his job and is now homeless…MB explained that the current address…on the system…is correct…however he is not staying there and stays at different friends’ homes at different times so he would also prefer to receive future correspondence via email.” The telephone note also recorded that there was some discussion concerning the HCPC bundle of documents, and that “MB explained that it would be too distressing for him to go through the docs again and that he does not think that he can cope.”

4. Ms Ryan referred the Panel to the guidance contained in the HCPTS Practice Note on Proceeding in the Absence of the Registrant and submitted that it was appropriate for the Panel to exercise its discretion to proceed on the basis that the Registrant had chosen not to attend the hearing and had waived the right to appear. She pointed out that although there had been no request from the Registrant for an adjournment, he had made clear in May that the address he had provided was correct but that he also wished to receive communications by email. Ms Ryan reminded the Panel that the notice of hearing had been sent both by mail and email. She submitted that the Panel could be satisfied that Mr Burnage is aware of the hearing. Ms Ryan further submitted that the public interest in expeditious disposal of the allegation outweighed any disadvantage to the Registrant in proceeding in his absence.

5. The Panel heard and accepted the advice of the Legal Assessor who reminded it of the guidance provided in the cases of R v Jones [2002] UKHL5, Adeogba v the General Medical Council [2016] EWCA Civ 162 and Davies v HCPC [2016] EWHC 1593 (Admin).

6. The Panel recognised that the discretion to proceed in the absence of a Registrant is one which must be exercised with the utmost care and caution and that its decision should be guided by the overarching objective to protect the public. It noted that it would run counter to that objective if a practitioner could effectively frustrate the process by deliberately failing to engage.

7. In reaching its decision, the Panel had regard to the nature and circumstances of the Registrant’s behaviour in absenting himself; in particular, whether the behaviour was voluntary and so plainly waived the right to be present. The Panel balanced the public interest in the timely disposal of the Allegation with the disadvantage to the Registrant should the hearing proceed in his absence. It also noted the inconvenience to the witnesses scheduled to give oral evidence if the hearing were not to proceed today.

8. The Panel had no reason to believe that, if it were to adjourn the hearing, the Registrant would attend on the next occasion. On the basis of the information before it, the Panel concluded that the Registrant had deliberately absented himself and waived the right to be present. It determined that it would be fair and in the interests of justice to proceed in the absence of the Registrant.
 
Application to Amend Particulars

9. At the outset of the hearing, Ms Ryan applied to amend Particular 5
a) in order to correct two typographical errors. These were the omission of the word “manner” and the repetition of the word “in”. Ms Ryan submitted that the proposed amendments would cause no change to the overall strength of the Allegation and would not disadvantage the Registrant.

10. The Panel heard and accepted the advice of the Legal Assessor.

11. The Panel was satisfied that the proposed amendments would correct two minor typographical errors, would cause no change to the overall strength of the Allegation and would not disadvantage the Registrant. The Panel allowed the application.

Background

12. At all material times, the Registrant worked with the South Central Ambulance Service (SCAS) NHS Foundation Trust as a registered Paramedic. He joined SCAS as an Emergency Care Assistant in August 2010. He progressed to Paramedic in September 2015. In June 2016 witness BK was asked to investigate a number of complaints relating to the Registrant. The allegations relate to eight separate incidents in which the Registrant is alleged to have behaved in an offensive or intimidating manner. Three of the incidents (particulars 6-8) occurred following the Registrant being issued, on 4 August 2016, with a final written warning for his behaviour and being placed on an Action Plan. Subsequent to the investigation, in about December 2016, the Registrant ceased work with the Trust and the matter was referred to the HCPC.

Decision on Facts

13. In considering the Particulars, the Panel applied the principles that the burden of proving the facts is on the Council, that the Registrant is not required to prove anything and that a fact alleged is only to be found proven if the Panel is satisfied on the balance of probabilities that it is correct.

14. In reaching its decisions, the Panel had careful regard to all the evidence put before it and to the submissions of Ms Ryan on behalf of the HCPC as well as to the written representations of the Registrant.

15. The documentary evidence before the Panel included:

• Witness statements from BK, DW, Colleague C, PT, Person I, Patient E, JW, Colleague A, Person J

• SCAS NHS Foundation Investigation Report dated July 2016

• SCAS Discipline & Conduct Policy & Procedure

• SCAS Dignity at Work Policy

• Email of concern from Colleague A dated 04.01.16.

• Colleague A’s interview notes dated 27 June 2016

• PCRs from shift with Colleague C dated 24.12.15

• PCR audit for observation completion

• Email from GP to BK regarding the incident with observations dated 07.07.16

• Email of concern from Colleague C dated 04.01.16.

• Colleague C’s Interview notes dated 08.07.16

• Complaint made by the Registrant against Colleague C.

• Response to the Registrant’s Complaint

• Email from complainant dated 26.12.15

• Event chronologies

• Registrant’s statement from Datix IR12290

• Complaint email from Patient E dated 20.05.16

• Registrant’s completed questionnaire

• JW completed questionnaires

• Incident S1605190176 ePR

• Completed questionnaire by Patient E
 
• IO Summary

• Registrant’s Year 2 Student Beginning of Year Review October 2014 including Action Plan

• Registrant’s Year 2 Student Mid-Year Review March 2015

• Registrant’s Informal Disciplinary letter dated 07.01.16

• Email of concern from Paramedic MF

• DMA shift letter by TL RD dated 15.03.16

• Managers’ statements from Clinical Mentor DH, Team Leader JS, and from CM and RD

• Registrant’s Pre-Investigation interview statement dated 28.06.16

• Registrant’s investigation interview notes dated 29 June

• Letters from JS and RD to Registrant regarding thank you letters

• Disciplinary hearing notes dated 02.08.16

• Letter from RM to Registrant confirming disciplinary hearing outcome dated 04.08.16

• Registrant’s reflection of PE5586 dated 26.07.16

• Action Plan for the Registrant

• SCAS Investigation into allegations of Gross Misconduct and Terms of Reference

• Email from SCAS staff in relation to BP incident also absent without leave allegation and allegation 4 CM H

• Statement from Person F

• Interview notes for TOR BP incident and AWOL dated 30.09.16

• Letter of complaint and Patient Experience documents

• Interview notes for TOR Patient Experience dated 30.09.16

• Patient Experience details complaint including complaint letter

• Interview notes

16. The Panel heard oral evidence from:

i. BK, Investigating Officer.

ii. DW, Investigating Officer.

iii. Colleague A, Emergency Care Assistant.

iv. Colleague C, Paramedic.

v. JW, Paramedic.

The Panel found the evidence of all five witnesses to be clear, consistent, balanced and entirely credible.


Particular 1a

1. Spoke to Colleague A in an inappropriate and/or offensive manner in that you:

a. On or around 13 November 2015 stated:

i. “don’t you ever do that again” or words to that effect;

ii. “that really pissed me off and it would piss other people off if you did that again to anybody else” or words to that effect.


Found proved.

17. The Panel had careful regard to the oral evidence of Colleague A, and to her written statement produced for the HCPC, as well as to her email of complaint dated 4 January 2016. She stated that on 13 November 2015 she and the Registrant had been working together and had attended a patient that needed to be transferred to hospital. She stated that the Registrant had wanted to place a cannula in the patient’s arm and had applied a tourniquet while doing so. Once the cannula was in situ she had stepped forward and asked the
 
Registrant if he wanted her to remove the tourniquet. He had said no and told her to complete the Patient Report Form (PRF).

18. Colleague A stated that after the patient had been handed over to hospital staff the Registrant had spoken to her as alleged in Particular 5 a) i) and ii) above. In addition, he had said “You knocked the arm of the patient and the cannula came out.” In her email of complaint in January 2016 Colleague A stated that she really didn’t feel she had acted as the Registrant had suggested. She stated that “he was shouting at me as he said this and made me feel inadequate at doing my job. It has meant that I question every move I take while working with others.”

19. The Panel recognised that in his interview with BK the Registrant had expressed concern that Colleagues A and C had both submitted complaints against him “at the same time ages after the alleged incidents”. However, it noted Colleague A’s evidence that she had reported the matters referred to in Particular 1 a) to her Team Leader and her Clinical Mentor the day after the incident. The Panel further noted that while the Registrant appears neither to have denied nor accepted Colleague A’s version of the incident, he did portray the incident in a more positive light and told BK that if there was a repetition “I would manage the incident differently regarding correcting a clinical concern after the incident.”

20. The Panel recognised that it was not part of its role to determine whether Colleague A had knocked the patient’s arm, but rather to determine whether the Registrant had spoken as alleged and if so, whether this constituted an inappropriate and/or offensive manner. The Panel accepted the evidence of Colleague A and noted the Registrant’s comment to BK that, after he had discussed the incident with other work colleagues, “we said let’s forget it but it pissed me off.” The Panel preferred Colleague A’s account to the Registrant’s more positive view of the discussion between them once the Patient had been handed over to the hospital. In all the circumstances, the Panel concluded that it was more likely than not that the Registrant had spoken to Colleague A as alleged. In the Panel’s view this constituted an inappropriate and offensive manner.

Particular 1b

Spoke to Colleague A in an inappropriate and/or offensive manner in that you:

a. On 14 November 2015:
 
i. shouted at Colleague A whilst they were driving;

ii. made unfounded allegations as to disciplinary action and patient complaints against Colleague A.

Found proved.

21. The Panel had careful regard to the oral evidence and written statement of Colleague A, as well as to her email of complaint dated 4 January 2016. She stated that on 14 November 2015 she and the Registrant had again been working together. She had been driving the ambulance when he falsely accused her of driving dangerously and then “in a loud, rude manner with a threatening tone” made a series of unfounded allegations about her conduct and told her that nobody liked her, all of which caused her to cry.

22. The Panel noted its findings in respect of Particular 1 a) at paragraphs 11 and 12 above. The Panel accepted the evidence of Colleague A and concluded that it was more likely than not that the Registrant had spoken as alleged. In the Panel’s view this amounted to an inappropriate and offensive manner because of the raised voice, the words used and there inaccuracy. Colleague A ensured that she never worked with the Registrant again.

Particular 2

On 24 December 2015, recorded incorrect and/or misleading information on the continuation sheet for Patient B stating that observations were not required at a GP’s request.

Found Proved.

23. BK told the Panel that, on the continuation sheet of the PRF for Patient B, the Registrant had documented that observations were not required at the General Practitioner’s (GP) request. The Panel had careful regard to the PRF and to the written statement and supplementary statement of PT, the GP concerned. It noted that the PRF contained the entry “Doctor instructed no need for observation need [sic], no need for clinical intervention.” The Panel noted that in his written statement, PT states “I have no recollection of giving that instruction. That instruction would be highly unusual and untypical. General Practitioners are not in the habit of telling Paramedics what to do and I have not in 20 years had to instruct a Paramedic on whether or not to do observations…I can be fairly certain that I would
 
not have instructed a Paramedic whether or not to conduct observations.”

24. The Panel also noted the evidence of BK that it would be unusual for a GP to give such an instruction to a Paramedic, and that in his own 14 years of practice he had never encountered such an occasion. In all the circumstances, the Panel accepted PT’s evidence and was satisfied on the balance of probabilities that the Registrant had recorded incorrect information on the PRF.

Particular 3

On or around 24 December 2015 spoke to Colleague C in an inappropriate and/or offensive manner.

Found Proved.

25. The Panel had careful regard to the oral evidence and written statement of Colleague C, as well as to her email of complaint dated 14 January 2016 and the notes of her interview with BK. Colleague C stated that on the morning of 24 December 2015 she had been working with the Registrant. On their arrival at one scene a patient was receiving care from a District Nurse. Colleague C stated that she had asked the Registrant whether he would like her to take observations. In her written statement for the HCPC she accepted that because the patient was receiving care from the District Nurse at the time it would have been “impractical” for her to take observations. She stated that before the District Nurse had left, she again raised the subject of observations, this time asking the Registrant “whether he was going to do any observations”. She stated that “he told me no and did not provide a reason for his response. He then proceeded to ignore me for the remainder of the time we were on the scene.”

26. Colleague C stated that once the job had finished and they were back in the ambulance the Registrant “began raising his voice towards me and using inappropriate language. I do not remember specifically what he said to me. He used some obscene words and seemed angry that I had questioned him…he said I had questioned him in front of another health care professional and I had no right to do that. He said that if I could not understand that then we should return to base to speak to the Team Leader at the station and end the shift…I apologised for seeming as if I was questioning him…Once the shift ended, I raised a concern informally with JS, a Team Leader…because I felt uneasy about the shift and felt it was inappropriate the way he had spoken to me.” The Panel noted that in her interview with KB Colleague C had stated that in asking the Registrant whether he was going to do any observations her intention was “to offer to do them for him but he took it as questioning his clinical judgement and when we got into the ambulance after the job he got very angry…After he shouted at me I was shaking at the wheel and I felt belittled.”

27. The Panel noted that in his interview with KB the Registrant appears to agree with Colleague C’s account of what had occurred in the presence of the patient and the District Nurse. However, the Registrant went on to state: “After the job, not angrily I said you can’t question me in front of the patient and nurses like that.” He also told KB “We got on very well so I was surprised when I got a complaint…On Facebook after the job Colleague C apologised and said thanks for a good shift with me. I replied not to worry…”

28. The Panel again noted that in his interview with BK the Registrant had expressed concern that Colleagues A and C had both submitted complaints against him “at the same time ages after the alleged incidents”. However, it also noted Colleague C’s evidence that she had reported the matters referred to in Particular 3 to JS, a Team Leader at the time, on the same day.

29. The Panel recognised that the issue in respect of this Particular is not that the Registrant had aired a concern with Colleague C about her performance but the manner in which he had done so. The Panel accepted the evidence of Colleague C and concluded that it was more likely than not that the Registrant had spoken to Colleague C in an inappropriate and offensive manner. The Panel had no doubt that the Registrant’s conduct prevented Colleague C and himself from working as a coherent team. Colleague C explained to the Panel how fundamental it was for attending personnel to work effectively as a team to ensure save and appropriate care for service users.


Particular 4

On 26 December 2015 spoke in an inappropriate and/or offensive manner to Patient D in that you:

a. stated that you “could only treat emergencies” or words to that effect;

b. threatened to call the police when challenged as to your behaviour;
 
All Found Proved

30. The Panel had careful regard to the written statement of Person I prepared for the HCPC. Person I stated that on 26 December 2015 he had gone to visit Patient D at his home. He had found Patient D in bed and had been unable to wake him. Person I stated that he had called 111 and informed them of the situation. He said that, as a consequence, the operator had despatched a Paramedic to the home of Patient D.

31. Person I stated that when the Registrant arrived “he seemed quite anxious and aggressive and was reluctant to go upstairs, which is where Patient D was…The Registrant said that he was only on call for emergency situations and I should not have called an ambulance…His tone was aggressive and it seemed as if he was shaking with anger that we had called a Paramedic when my father had a chronic  condition. I explained to him that I did not actually call for an ambulance, it was sent from the non-emergency line.” Person I stated that his sister cried out ‘Please will you help my dad’ and the Registrant turned to her in a confrontational manner and spoke sharply to her. Person I stated that he asked the Registrant to leave and told the Registrant that he was going to call the police. He stated “I was so upset…that my mouth was dry and I was shaking…[The Registrant] was practically in tears.”

32. The Panel noted that in his email of complaint Person I had said that when confronted about his attitude the Registrant had threatened to call the police.

33. The Panel had careful regard to the written statement of the Registrant recorded on Datix. This stated that when he arrived at the home of Patient D he was greeted by the patient’s son who began to lead him up the stairs to Patient D. The Registrant stated that, as they climbed the stairs, Patient D’s son informed him that the patient “had significantly improved since he knew that an ambulance was attending and was now up from his bed and had gone to the toilet.” The Registrant stated that it was then agreed that he should wait for Patient D downstairs. He was shown into the living room where three ladies were present and began to take a history from the son who informed him that Patient D had been presenting with new symptoms which included unresponsiveness and breathing difficulty. The Registrant stated that one of the ladies interjected to say that none of these conditions were new and another lady began shouting “why don’t you just sort it out”. He stated that when he asked that lady not to shout, Patient D’s son said “don’t talk to her she got learning difficulties” and “pushed me on my left shoulder towards the exit of the living room.”

34. The Registrant stated “At this point I felt very uncomfortable as I was now being shouted at by two people and…had been physically pushed…I could not finish any of my attempts to speak as I was just shut down instantly by the aggressive and defensive male…I asked the male to calm down…as I was there to help and that if he continued I would have to involve the police. This slightly calmed the situation and I was shown upstairs to the patient who was now back in bed.” The Registrant stated that he examined Patient D who was visibly well and alert and was very pleasant. “He could see i was visibly shaken and upset and said ‘please don’t be upset, don’t worry about him ill [sic] sort him out’.”

35. The Panel noted that in their respective accounts both the Registrant and Person I complained about the aggressive attitude of the other and each reported their threat to the other to call the police. However, the Panel noted that this was one in a series of unrelated incidents involving the Registrant where his conduct has been characterised by complainants as angry, aggressive and threatening. In those circumstances the Panel considered that there was clear evidence of a pattern of behaviour in which the Registrant had spoken in an inappropriate and offensive manner to colleagues, patients and their families. For this reason the Panel concluded that the matters alleged were more likely than not to have occurred.

Particular 5 a)

On 19 May 2016 in respect of Patient E:

a. spoke in an inappropriate and/or offensive manner to the patient in that you said:

i. “Please explain to me your thinking: you felt a little bit ill so you  made…how many phone calls? I have never felt ill and thought, hang on, I need to ring someone” or words to that effect;

ii. “sit up and talk to us like an adult” or words to that effect;

All Found Proved

36. The Panel had careful regard to the written statement of Patient E prepared for the HCPC and to her email complaint dated 20 May 2016, the day after the incident complained of, as well as her responses to questions from BK. The Panel noted that Patient E’s account of the incident as set out in her statement was consistent with the account set out in her email of complaint. Patient E stated that on 19 May 2016, she returned home from a medical appointment arranged by the non- emergency 111 service in response to a query from her concerning ongoing vomiting and an inability to keep water down. She stated that she took the tablets which had been prescribed for her but could not keep them down and noticed that she was starting to vomit blood. She called 111 and was told that they had despatched an ambulance. She stated that “at no point was I consulted about whether I needed an ambulance nor did I request one.”

37. Patient E stated that when the Registrant arrived she found him to be very dismissive and some of the comments he made were derogatory and rude. In particular she stated that he had made the remarks alleged at Particular 5 a) i) and ii). In respect of 5 a) ii) she stated that she had been “sitting bent over because I was in a lot of pain…His tone was mocking and dismissive. He seemed to be quite irritated.” The Panel noted that in her email complaint dated 20 May 2016 Patient E had stated “I have never felt so disrespected, dismissed, bullied and intimidated in my entire life…”

38. The Panel noted the written statement prepared for the HCPC of JW, then a student Paramedic, who accompanied the Registrant on this occasion. He stated that Patient E “did not seem critically unwell, but she did seem unwell…[The Registrant] came across as quite frustrated with Patient E. He seemed confused as to why he had come out via
111. It seemed that in his mind the incident was not really serious enough to warrant an ambulance.”

39. In his written statement JW said in respect of Particular 5 a) i) “I do not recall [the Registrant] using those words specifically, however, I would not have been surprised to have read that in a transcript of the conversation.” In respect of Particular 5 a) ii) JW stated “I do recall [the Registrant] saying this. It was said in a frustrated tone. I would not have said that Patient E was being particularly difficult, perhaps only in response to [the Registrant’s] attitude.” The Panel noted that in his response to a questionnaire from BK, JW had stated of the incident “I felt that it could have been handled better in terms of communication…[The Registrant] asked me if I agreed with the patient that he had been rude and I said that I believed he had been very clear.” JW confirmed all these points in his oral evidence to the Panel.
 
40. The Panel had careful regard to the Registrant’s response to questions about the incident during his Trust Disciplinary Hearing. The Registrant stated “I asked her early on why she had asked for an ambulance…I pointed out to her that she wasn’t as ill as she thought she was…We were there for quite a long time for someone that I didn’t think was that unwell…I can see how I have exacerbated the situation and how she could have perceived me as being rude.” The Panel noted that when it was put to the Registrant that JW had said the Registrant told Patient E to act like an adult his response was “I don’t remember using those exact words.” The Panel also noted that when the Registrant was asked whether he denied saying “Please explain to me your thinking: you felt a little bit ill so you made…how many phone calls?”, his response was “The lady has taken a lot of this out of context.”

41. In light of the evidence set out above, the Panel was satisfied that the Registrant had spoken in an inappropriate and offensive manner to the patient as alleged.

Particular 5 b)

On 19 May 2016 in respect of Patient E:

Incorrectly recorded that Patient E refused observations;

Found Proved

42. The Panel had sight of the Ambulance Handover Report in respect of this incident. It noted that this indicated that Patient E had refused observations. It was signed by the Registrant.

43. The Panel noted that the questionnaire from BK concerning the incident asked whether any observations of Patient E were undertaken and that the Registrant’s response had been “I asked…would it be ok if we took a set of routine observations. The patient declined these…”

44. The Panel received oral evidence from JW. It had careful regard to his written statement produced for the HCPC and to his responses to the questionnaire from BK. It noted his clear evidence that he did not recall the Registrant offering to examine Patient E and that the patient did not refuse to have observations taken. Further, the Panel noted JW’s evidence that he had offered to undertake observations himself but the Registrant had told him not to bother.

45. The Panel had careful regard to Patient E’s written statement produced for the HCPC and to her email complaint dated 20 May 2016 as well as her responses to questions from BK. The Panel noted that in her written statement Patient E stated that she did not refuse observations at any point. The Panel also noted that the questionnaire from BK asked Patient E “Did the crew try or ask to take any observations on you? For example blood pressure and pulse.” Her response was “No, they did not attempt to examine me at all.”

46. In light of the evidence set out above, the Panel was satisfied that the Registrant had incorrectly recorded that Patient E refused observations.

Particular 5 c)

On 19 May 2016 in respect of Patient E:

a. recorded findings from a gastro-intestinal assessment on Patient E without undertaking an abdominal examination.

Found Proved

47. The Panel had sight of the Ambulance Handover Report in respect of this incident. It noted that the section of the form headed Gastrointestinal Assessment had been completed with responses to each of that section’s sub-headings and was signed by the Registrant.

48. The Panel received oral evidence from JW. It had careful regard to his written statement produced for the HCPC and to his responses to the questionnaire from BK. It noted his clear evidence that he did not see any physical examination taking place, nor could he recall any questions being asked regarding an abdominal assessment.

49. The Panel had careful regard to Patient E’s written statement produced for the HCPC and to her email complaint dated 20 May 2016 as well as her responses to questions from BK. The Panel noted that in her written statement Patient E stated that the Registrant did not examine her at any point. She stated that the Registrant “asked me if my stomach was soft but I was not asked to perform any sort of examination on myself.” The Panel also noted that the questionnaire from BK asked Patient E “Did the crew try or ask to undertake a physical examination on you? Her response was “No.”

50. The Panel noted that the questionnaire from BK concerning the incident asked the Registrant “Did you perform any kind of physical examination?” The Registrant’s response was “As with the observations, when asked if it was possible if could examine the patient’s abdomen she declined. At this point I felt that to persist with this line of investigation along with the observations, could add to the frustration and appear argumentative. Instead I asked the patient if she noted any changes to her abdomen, asking the questions rather than performing the assessment. Having reflected on this aspect of the incident…it would have been better to have noted this in the narrative rather than in the abdominal assessment area…” The Panel concluded that the Registrant’s position was that he had conducted a gastrointestinal assessment by asking questions of Patient E rather than by physically examining her. In the Panel’s view, the absence of any note on the form explaining this would be likely to mislead anyone reading the report into believing that the patient had been physically examined by the Registrant or his fellow crew member. The Panel has concluded that the nature of the gastrointestinal assessment detailed could not have been elicited without undertaking a physical examination.

51. In light of the evidence set out above, the Panel was satisfied that the Registrant had recorded findings in the gastrointestinal assessment section of the report in the full knowledge that he had not undertaken an abdominal examination.

Particular 6

On or around 20 August 2016, while wearing your Paramedic uniform you spoke in an inappropriate and/or offensive manner to Person F, in that you stated “hello…hello…hello…Can you speak?” or words to that effect.

Found proved.

52. The Panel had careful regard to a written statement prepared for the Trust by Person F. This referred to the incident set out above. Person F stated that he was a customer services assistant working at a petrol station at Milton Services which sold petrol and a large collection of food and household items. Person F stated that on the occasion in question an ambulance worker in uniform had asked him whether there were any expired food items left for sale. Person F stated that he had replied “No they have all been removed to the store room due to the time.” The ambulance worker asked to see the items as he felt they could still be sold. Person F stated that he informed the ambulance worker that it was company policy that the items could not be sold, and as a result had been removed. Person F stated that he was seated at this time and that the ambulance worker had stood above him and kept saying the words alleged in Particular 6. Person F stated “His demeanour was very arrogant and I felt his actions were belittling and bullying.”

53. The Panel also had careful regard to the notes of an interview of the Registrant carried out by DW, Investigating Officer, on 30th September 2016. When told of the incident involving Person F the Registrant did not dispute that he had been the ambulance worker referred to by Person F. The Registrant told DW “I asked him if he would get the expired stuff from the stock room for me to view? He went off to get it. He seemed really annoyed and returned without any items. I said is there anything for me to look at. He didn’t reply. I said hello is there anything for me to look at? He was sat down on a stool thing and I was stood next to him.”

54. The notes of interview record DW saying “It is suggested that you said “Hello 3 times, can you speak” in a belittling and bullying fashion. Is there a chance that you could have come across in this way?” The Registrant is recorded as replying “Well yes there is a chance. I thought I said it in a soft way.” The Registrant is also recorded as stating “the shop keeper was clearly in a bad mood and taking it out on me or something…why would I go into a shop and cause problems. I wouldn’t do that…”

55. In light of the evidence set out above, the Panel was satisfied that the Registrant had spoken in an inappropriate and offensive manner as alleged.

Particular 7

On or around 24 September 2016 behaved in an inappropriate and/or offensive manner towards the family of Patient G in relation to transporting the patient to the hospital.

Found Proved in respect of inappropriate manner. Found not proved in respect of offensive manner.

56. The Panel had sight of a letter of complaint from the daughter of Patient
G. In this she stated she had dialled 999 for her mother who had fallen, hit her head, was bleeding from the wound and on the verge of unconsciousness. After about an hour an ambulance arrived, staffed by a Paramedic and an Emergency Care Assistant. She stated that the Paramedic examined her mother and began to take all appropriate measures. However, the Paramedic went on to ask why Patient G’s husband and daughter had not taken her to A&E when they found her after her fall. She found this unacceptable especially as her mother had a head wound and was on warfarin. Patient G’s daughter stated that the Paramedic “continued to push for my husband and I to take my mother to hospital.” She stated that, in her opinion, he was “forceful in his attitude to accede to his request…my husband stepped in and informed him that we would not convey her. He was asked why and my husband reluctantly informed him [of his own health condition.] [The Registrant] immediately changed his attitude and stated they would take my mother to A&E…whilst I have no issue with the quality of medical service I received, in fact it was very good, I was extremely disappointed that my husband and I were put under unnecessary pressure to convey my mother to hospital when we have both been under a great deal of stress and anxiety due to my husband’s condition.”

57. The Panel heard oral evidence from Investigating officer DW. It noted that in interview with DW the Registrant had stated that he felt Patient G’s clinical presentation was stable and did not require an emergency ambulance to transport. DW told the Panel that the Registrant had said he had been surprised that the family had not taken the patient in the car earlier to save waiting for an ambulance to arrive, in light of the fact that they were situated so close to the emergency department. Further, he found the suggestion that he was “over the top, aggressive and bullying” hard to believe.

58. On the basis of the evidence set out above, the Panel was satisfied that the Registrant had behaved in an inappropriate manner towards the family of Patient G in relation to transporting the patient to the hospital. However, it was not satisfied on the balance of probabilities that he had behaved in an offensive manner and noted that there had been no suggestion of offensive words having been used.

Particular 8

On or about 5 October 2016 behaved in an inappropriate and/ or offensive manner when attending Patient H.

Found proved.

59. The Panel had sight of a letter of complaint from Patient H. In this he stated that during the evening of October 5th 2016 through to the morning of October 6th he had contacted the 111 service as he was experiencing extreme abdominal pains. He stated that when the crew arrived at his property they refused to come into the house until all lights were on. He stated that he is unable to bear bright lights so his house had low level lighting to help him. He said that when they entered his property he found the ambulance crew to be rude and intimidating, particularly the Registrant. Patient H complained that the Registrant asked him at least four times for an ECG printout from a previous visit by a separate ambulance crew. He also complained that the crew were disrespectful of his house during the visit. He stated that the Registrant sat on the arm of a chair and broke the castor underneath, and that his female colleague had told him that he should sit properly on the chair. Patient H also complained that “they questioned why I was not registered with a GP. They questioned me as to why I had called for an ambulance. They made me feel like a criminal in my own home…this situation did not help me and it left me feeling worse.”

60. The Panel noted that the only information it had from Colleague LD was the Ambulance Handover Report which had been signed by her and by the Registrant. The report included the following account of events:

“On arrival patient answered the front door. The house was badly lit and i asked if the lights could be turned on so reluctantly a light was switched on there was also a very strong smell of cannabis. We followed pt into the living room and began to ask what the problem was and we were told he had epigastric pain. Pt was not wanting to answer any medical questions about smh we were only told about depression and that nothing else was any of our business so no more details obtained. patient was not willing to give any details initially. Pt was very defensive and said he has had all his medical records removed as he does [sic[ want any help or dealings with Nhs. He is not registered with a GP and says he does not intend to either. Managed to obtain consent to do observations. My crew mate was talking to patient and I asked if he was happy for me to remove the ecg leads i was accused of being rude because i interrupted him then became very aggressive towards me and i felt very uncomfortable. this seemed to really annoy the patient and he started to become very aggressive and told us to get out of his home at which point we gathered our equipment together and left informing control Straight away.”

61. The Panel had careful regard to the notes of the Registrant’s interview with DW and to DW’s own statement prepared for the HCPC. It noted that in his interview with DW the Registrant had described arriving at the call location and initially thinking it was uninhabited. Further, the Registrant had told DW that he had been wary about entering the building, had felt uneasy from the outset and recalled the smell of cannabis inside the property. He had been shocked to learn that Patient H had complained specifically about him as he felt he had hardly said anything. He denied having been rude or intimidating and described the patient as having “a chip on his shoulder” and suggested the patient had an issue with the NHS in general and clearly “wasn’t right.”

62. In reference to Patient H’s letter of complaint, the Panel noted that the Registrant had told DW that the patient had said nothing to him about having “some sort of visual disturbance” and that the first he had heard of the chair castor being broken was in the Patient’s written complaint. The Registrant accepted that he had repeatedly asked for copies of the previous ECG and explained to DW why he had felt it important to do so.

63. The Panel considered that it could never be appropriate for a Registered Paramedic called out to provide assistance to a patient to be rude, aggressive, intimidating or disrespectful or to behave in a way which caused the patient to feel like a criminal in their own home. The Panel was satisfied that this was how the Registrant had behaved on this occasion and it had no doubt that his manner had been both inappropriate and offensive.

Particular 9

Your actions as described in paragraphs 2 and 5c were dishonest.

Found proved in both cases.

64. In considering the issue of dishonesty, the Panel had careful regard to the guidance provided in the case of Ivey v Genting Casinos.

65. In respect of the Panel’s finding that on 24 December 2015 the Registrant had recorded incorrect and/or misleading information on the continuation sheet for Patient B, stating that observations were not required at a GP’s request, the Panel concluded that the Registrant had deliberately made the false entry, knowing it to be so, in order to justify his failure to undertake the observations that he knew were standard practice. The Panel had no doubt that ordinary decent people provided with the information that was before the Panel would conclude that the Registrant had acted dishonestly.

66. In respect of the Panel’s finding that on 19 May 2016 the Registrant had recorded findings from a gastro-intestinal assessment on Patient E without undertaking an abdominal examination, the Panel noted its conclusion that the absence of any note on the completed form explaining this would be likely to mislead anyone reading the report into believing that the patient had been physically examined by the Registrant or his fellow crew member. The Panel also noted Patient E’s statement that she had neither been asked to undergo physical examination nor had refused any request to do so. Further, the Panel noted JW’s clear evidence that he did not see any physical examination taking place, nor could he recall any questions being asked regarding an abdominal assessment. In these circumstances, the Panel did not accept the Registrant’s explanation that the record had been made as a consequence of his assessment through questions and answers rather than physical examination. In the Panel’s view, the Registrant had completed this part of the form in order to create the false impression that he had undertaken an abdominal examination in accordance with standard practice. Further, the Panel had no doubt that ordinary decent people provided with the information that was before the Panel would conclude that the Registrant had acted dishonestly.

Decision on Grounds

67. The Panel had careful regard to the submissions of Ms Ryan and accepted the advice of the Legal Assessor.

68. Ms Ryan referred the Panel to the Privy Council case of Roylance v GMC (No2) [2001] 1 AC 311 in which Lord Clyde stated: “Misconduct is a word of general effect, involving some act or 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 required to be followed by a …practitioner in the particular circumstances.”

69. Ms Ryan submitted that the Registrant had fallen seriously below the standards expected of a Paramedic as set out in the HCPC Standards of Conduct, Performance and Ethics.

70. The Panel bore in mind that not every breach of the Standards and not every falling short of what would be proper in the circumstances will constitute misconduct; the breach must be serious, or as Elias LJ put it in R (on the Application of Remedy UK Ltd) v GMC [2010] EWHC 1245 (Admin) “sufficiently serious. that it can properly be described
as misconduct going to fitness to practise.”
 
71. The Panel found that the Registrant was in clear breach of the following Standards of the HCPC’s Standards of Conduct, Performance and Ethics, 2012 edition:

In respect of the matters found proved at Particulars 1, 2, 3, and 4:

1 You must act in the best interests of service users.

3 You must keep high standards of personal conduct.

7 You must communicate properly and effectively with service users and other practitioners.

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

In respect of Particular 2 only:

10 You must keep accurate records.

In addition, the Panel found that the Registrant was in clear breach of the following Standards of the HCPC’s Standards of Conduct, Performance and Ethics, 2016 edition:

In respect of the matters found proved at Particulars 5, 7 and 8:

1.1 You must treat service users and carers as individuals, respecting their privacy and dignity.

1.2 You must work in partnership with service users and carers, involving them, where appropriate, in decisions about the care, treatment or other services to be provided.

2.1 You must be polite and considerate.

2.2 You must listen to service users and carers and take account of their needs and wishes

2.3 You must give service users and carers the information they want or need, in a way they can understand.

In respect of the matters found proved at Particulars 5, 6, 7, 8, 9:

9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
 
In respect of the matters found proved at Particular 5 c) only,:

10.1 You must keep full, clear, and accurate records for everyone you care for, treat, or provide other services to.

72. The Panel considered that it had received ample evidence that there was a perception among colleagues at SCAS that the Registrant could be difficult to work with. There appears to have been a feeling of apprehension among some colleagues, particularly related to the Registrant being rude and arrogant. The Panel has seen no evidence to suggest that the Registrant is anything other than clinically competent and there was some evidence of him displaying compassion on occasions, the overall impression of the Panel was that he did not communicate well with colleagues, particularly with women, and that he was often perceived by patients and others as rude and intimidating. The Panel also noted the evidence of DW that the Registrant appeared unable to recognise or appropriately respond to the repetitive pattern of complaints about him.

73. The Panel’s findings on facts highlight clear and repeated patterns of unacceptable behaviour which inevitably caused distress to colleagues, patients and their families, undermined confidence in the profession and impacted on the ability of crews, on which the Registrant served, to work in a cohesive manner. The Panel has no doubt that the breaches of standards set out above are so serious as to amount to misconduct going to fitness to practise.


Decision on Impairment

74. The Panel went on to consider the issue of impairment by reason of the Registrant's misconduct. It had careful regard to all the evidence before it and to the submissions of Ms Ryan. It accepted the advice of the Legal Assessor and had particular regard to the HCPTS Practice Note on Finding that Fitness to Practise is Impaired.

75. The Panel first considered past impairment. It found that the Registrant’s misconduct had breached key standards of the HCPC’s Standards of Conduct, Performance and Ethics as set out above, had in respect of particulars 2 and 5 c) been dishonest, had brought the profession into disrepute and seriously undermined confidence in the profession. In addition, the Registrant’s misconduct had put patients at unwarranted risk of harm. In the Panel’s view, patients were put at risk of harm not only by the Registrant’s falsification of records, but also because service users need teams to work coherently and the Registrant’s treatment of his colleagues undermined their ability to work to their full potential, thereby diminishing the effectiveness of the team. Further, by his rude and aggressive and conduct towards patients he made it less easy for them to interact effectively about their assessment and care. In these circumstances the Panel had no doubt that, at the times in question, the Registrant’s fitness to practise had been impaired by reason of his misconduct.

76. The Panel went on to consider whether the Registrant’s fitness to practise is currently impaired by reason of that misconduct. In addressing the personal component of impairment, the Panel asked itself whether the Registrant is liable, now and in the future, to repeat misconduct of the kind found proved. In reaching its decision, the Panel had particular regard to the issues of insight and remediation.

77. The Panel noted that in the case of CHRE v NMC & Grant [2011] EWHC 927 (Admin) Mrs Justice Cox stated: “When considering whether or not fitness to practise is currently impaired, the level of insight shown by the practitioner is central to a proper determination of that issue.”

78. The Registrant has made no formal admissions and has not attended to give evidence before the Panel. However, the Panel has had the benefit of reading his extensive responses to the Trust in relation to individual complaints made against him by colleagues, patients and carers.

79. In the Panel’s view the Registrant has demonstrated only limited insight into the seriousness of his misconduct and its impact on colleagues, patients, their carers, SCAS and the profession. The impression gained by the Panel is that the Registrant is surprised at how he is perceived by others and finds it difficult to accept the validity of the recurrent complaints about his anger, arrogance, rudeness, dismissiveness, and belittling, bullying and intimidating behaviour. The Panel noted a tendency to deflect criticism by blaming his shortcomings on what he sees as the unreasonableness of others and on the effect of unspecified events in his past and in his private life.

80. The Panel had careful regard to Silber J’s guidance in Cohen v GMC [2008] EWHC 581 (Admin) that Panels should take account of:
 
• Whether the conduct which led to the charge is easily remediable;

• Whether it has been remedied; and

• Whether it is highly unlikely to be repeated.

81. The Panel recognised that remediation of misconduct which involves dishonesty or entrenched attitudinal problems may be less easy than misconduct involving clinical failings. However, it considered that with the development of meaningful insight the Registrant’s misconduct is remediable. It noted the Registrant’s references to steps he had taken to address his failings through treatment and also the assistance given to him by the Trust when he was placed under the care and supervision of the clinical mentorship team at SCAS. Unfortunately, despite these measures, and before his action plan could be completed, complaints continued to be received about him. The Panel has received no evidence to suggest that the Registrant has taken any further steps towards remediation since he left the Trust in about December 2016.

82. In light of its findings in relation to insight and remediation, the Panel considered that there is currently a high risk that the Registrant would repeat matters of the kind found proved. For these reasons, the Panel determined that a finding of impairment is required with regard to the personal component, including the need for public protection.

83. The Panel then went on to consider whether a finding of impairment is necessary on public interest grounds. In addressing this component of impairment, the Panel had careful regard to the critically important public issues identified by Silber J in the case of Cohen when he said:

“Any approach to the issue of whether fitness to practise should be
regarded as ‘impaired’ must take account of…the collective need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour.”

84. The Panel considered that maintaining professionalism and proper standards of conduct and performance are fundamental requirements of the profession and that the public would be concerned to learn of the Registrant’s recurrent pattern of serious misconduct. The Panel had no doubt that the need to maintain public confidence in the profession, and to declare and uphold proper standards, would be undermined if a finding of impairment of fitness to practise was not made in the  circumstances of this case.
 
85. For all the reasons set out above, the Panel determined that the Registrant’s fitness to practise is currently impaired, both on the grounds of public protection and in the public interest.

Decision on Sanction

86. The Panel next considered what, if any, sanction to impose on the Registrant’s registration.

87. Ms Ryan drew the Panel’s attention to the HCPC’s Indicative Sanctions Policy and submitted that the question of sanction is a matter for the Panel’s own independent judgment.

88. The Panel heard and accepted the advice of the Legal Assessor.

89. In reaching its decision the Panel had at the forefront of its thinking the principle of proportionality and the need to balance the interests of the Registrant with the protection of the public and the wider public interest in maintaining confidence in the profession and the HCPC, and in declaring and upholding proper standards of conduct and performance.

90. The Panel had regard to all the circumstances, including the following mitigating and aggravating features of the case:

Mitigating


• There was evidence that the Registrant is capable of showing compassion;

• There was evidence that the Registrant had been in receipt of ongoing treatment;

• There was no evidence of lack of clinical competence.


Aggravating


• The Registrant put patients at unwarranted risk of harm:


Patient E asked him to leave because she was unsettled by his behaviour;
 
The Registrant created 2 false records which could have resulted in other professionals relying on misleading information

The Registrant compromised team working


• The matters found proved included 8 incidents of misconduct spanning a 2 year period

• The high risk of repetition of the misconduct found proved;

• There was a pattern of inappropriate communication with women.

91. The Panel first considered whether it would be appropriate to impose no sanction in this case. It gave careful consideration to Paragraph 8 of the Indicative Sanctions Policy. The Panel determined that in light of its findings that the Registrant has demonstrated only minimal insight and no remediation and that there remains a high risk of repetition, the imposition of no sanction would neither protect the public nor serve the wider public interest in maintaining confidence and declaring and upholding proper standards.

92. The Panel next considered the potential for mediation in this matter. It gave careful consideration to Paragraphs 26 and 27 of the Indicative Sanctions Policy. It noted that such a course may only be used if the Panel is satisfied that the only other appropriate course would be to take no further action. The Panel had no doubt that this is not such a case.

93. The Panel went on to consider the imposition of a caution order. It gave careful consideration to the factors set out in Paragraphs 28 and 29 of the Indicative Sanctions Policy. The Panel considered that the risk of repetition is high, the Registrant has demonstrated only minimal insight and no remediation, and the misconduct was neither isolated nor minor in nature. For these reasons, the Panel determined that a caution order would be inappropriate. Further, it would neither protect the public nor be sufficient to mark the wider public interest.

94. The Panel then considered the imposition of a Conditions of Practice Order. It gave careful consideration to Paragraphs 30-38 of the Indicative Sanctions Policy. In considering the suitability of a Conditions of Practice Order, the Panel kept in mind its finding that the Registrant’s misconduct is remediable and that there had been no evidence of lack of competence. The Panel noted that the Registrant has not engaged with his regulator since May of this year, and has demonstrated only minimal insight. His failings are not at the low end of seriousness; they occurred over a significant period of time; involved vulnerable patients, including on two occasions the dishonest falsification of records; and there is a high risk of repetition. Further, the Panel had received no information which might give it confidence that the Registrant is committed to remediation and would comply with conditions. For all these reasons, the Panel determined that a Conditions of Practice Order would be neither appropriate nor sufficient at this time.

95. The Panel went on to consider the imposition of a Suspension Order. It gave careful consideration to Paragraphs 39-45 of the Indicative Sanctions Policy.

96. The Panel noted that although there had been dishonesty, the Registrant had not been motivated by personal gain.

97. The Panel noted that paragraph 41 of the Indicative Sanctions Policy states: “If the evidence suggests that the registrant will be unable to… remedy his … failings then striking off may be the more appropriate option. However, where there are no … difficulties preventing the registrant from understanding and seeking to remedy the failings then suspension may be appropriate.” The Panel noted its earlier finding that “with the development of meaningful insight the Registrant’s misconduct is remediable.”

98. In all the circumstances, the Panel decided that the information currently before it is not such that it could reasonably conclude that there are difficulties which would prevent the Registrant from developing full insight and remedying his failings.

99. The Panel considered that a Suspension Order would, in the short term, protect the public and would, in the Panel’s view, also satisfy the public interest in marking the unacceptability of the Registrant’s misconduct, as well as upholding proper standards and maintaining confidence in the profession.

100.  For all the reasons set out above, the Panel considered that a Suspension Order for a period of 12 months is the proportionate and appropriate response at this time.
 
101. The Panel did seriously consider whether the circumstances are such that a striking off order might be the appropriate sanction in this case. The Registrant’s current lack of insight rendered a striking off order a very real possibility. However, the Panel noted that a striking off order is a sanction of last resort. In light of its view that, with the development of meaningful insight, the Registrant’s misconduct is remediable, the Panel considered that proportionality required he be given the opportunity to remedy his failings, and that a striking off order would be disproportionate at this time.


102. The Panel decided to impose a suspension order of 12 months duration. That order will be reviewed before its expiry.


103. The reviewing Panel will have all options open to it. It may be assisted by:

• The Registrant’s attendance;
• A report from any professional providing the Registrant with treatment;
• An up to date reflective piece completed by the Registrant, reflecting on the seriousness of his misconduct and its impact on colleagues, patients, their carers, SCAS and the profession;
• Evidence of any remedial action the Registrant has taken since leaving the Trust in December 2016;
• Details of any current employment and testimonials or references from paid or unpaid work;
• Any continuing professional development undertaken by the Registrant, including the reading of professional journals.

Order

ORDER: That the Registrar is directed to suspend the registration of Mr Mark Burnage for a period of 12 months from the date this order comes into effect.

Notes

This order will be reviewed again before its expiry on 7 December 2019.

Interim Order:


1. The Panel heard an application from Ms Ryan to cover the appeal period by imposing an 18 month Interim Suspension Order on the Registrant’s registration. She submitted that such an order is necessary to protect the public and is otherwise in the public interest.

The Panel heard and accepted the advice of the Legal Assessor.

2. It had careful regard to Paragraphs 51-54 of the Indicative Sanctions Policy.

3. The Panel noted that the Registrant had been informed by first class post and email dated 10 July 2018 that if this Panel found proved the allegation against him and imposed a sanction of Conditions of Practice or a more restrictive sanction on his practice, the HCPC may make an application to the Panel to impose an interim order to cover any appeal period. For the reasons set out in its earlier decision to commence the hearing in the absence of the Registrant, the Panel determined that it would also be fair, proportionate and in the interests of justice to consider Ms Ryan’s application for the imposition of an interim order.
 
4. The Panel recognised that its power to impose an interim order is discretionary and that the imposition of such an order is not an automatic outcome of fitness to practise proceedings in which a suspension order has been imposed and that the Panel must take into consideration the impact of such an order on the Registrant. However, the Panel was mindful of its findings in relation to the lack of insight and remediation and that there remains a high risk of repetition. In the circumstances, it considered that public confidence in the profession and the regulatory process would be seriously harmed if the Registrant was allowed to remain in practice during the appeal period. The Panel considered that, given its substantive findings and order, it would be perverse not to grant Ms Ryan’s application.

5. For the reasons set out above, 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; or, 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 Mr Mark Burnage

Date Panel Hearing type Outcomes / Status
05/11/2018 Conduct and Competence Committee Final Hearing Suspended