Mr Bradley D Poole
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Whilst registered with the Health and Care Professions Council as a Paramedic, you:
1. On or around 12 March 2017, while employed by Cornwallis Plaza Surgery, obtained the mobile telephone number of Patient A, a vulnerable person, from the EMIS clinical system without her consent and/or knowledge.
2. Between around March and May 2017, engaged in a relationship of a sexual nature with Patient A.
3. Between around March and July 2017, sent text messages and emails of an inappropriate and/or sexual nature to Patient A.
4. The matters set out at particulars 1 to 3 were sexually motivated.
5. The matters set put at particulars 1 to 4 constitute misconduct.
6. By reason of your misconduct your fitness to practise is impaired.
1. The Registrant, Mr Bradley Poole, has attended this hearing at which he has been represented by Mr Cutting of Counsel. The Presenting Officer has been Mr Dite.
2. At the commencement of the hearing Mr Cutting applied on behalf of the Registrant that the whole hearing should be conducted in private. It was submitted that the private life of the Registrant necessitated such a direction. A letter dated 7 September 2018, written by a Medical Practitioner was provided to the Panel in support of the application. The confidential information contained in that letter will not be referred to in this determination which is a public document. The HCPC opposed the application. The Panel fully considered the terms of the letter and the submissions made by Mr Cutting in private, but concluded that the grounds advanced were insufficient to displace the presumption that the hearing would be conducted in public. Accordingly, the Panel declined to make the directions sought.
3. When invited to respond to the allegations, the Mr Cutting responded as follows on behalf of the Registrant:
• Particular 1 was admitted, save as to the date.
• Particular 2 was admitted.
• Particular 3 was admitted.
• Particular 4 was denied.
• The misconduct alleged by particular 5 was admitted on the basis of particulars 1 to 3.
• Current impairment of fitness to practice was denied.
4. Before the Registrant gave evidence to the Panel, Mr Cutting requested that the Panel should conduct the case by initially making its decision on the facts and the statutory ground of misconduct. He asked that the Panel should announce its decision on those issues before the issue of current impairment of fitness to practise was addressed. He informed the Panel that it was intended that the Registrant would give further evidence relevant to the issue of current impairment of fitness to practise after the Panel announced its decision on the facts and misconduct. The Panel acceded to this application.
5. The Registrant commenced employment with the Sussex Ambulance Service (later to become South-East Coast Ambulance Service) in July 2000 as a direct entry Trainee Paramedic. He worked as a Technician from that date until April 2003, from April 2003 to May 2005 as a Paramedic, as a Clinical Team Leader from May 2005 until 2014, and then as a Paramedic Practitioner from 2014.
6. At the time relevant to the case being considered by the Panel, the Registrant was working as a Paramedic Practitioner for a G.P. practice known as the Cornwallis Plaza Surgery. Patient A was registered with that practice.
Decision on Facts
7. The Panel has throughout accepted the advice of the Legal Assessor, and read carefully the documents in the bundles, including copies of some emails and text messages exchanged between the Registrant and Patient A.
8. Before considering the specific factual particulars to be decided, the Panel first made a general assessment of the witnesses who gave evidence before it.
9. The HCPC called two witnesses to give live evidence. They were:
• Patient A. Patient A gave evidence by video link. The Panel was satisfied that the giving of her evidence in that manner was appropriate, affording the Presenting Officer a proper opportunity to elicit her evidence in chief, and for Mr Cutting to cross-examine her. The Panel found her to be a very robust witness. She was open in the sense that she was prepared to admit to behaviour that did not cast her in a good light. She also accepted that she could not remember certain matters. The Panel found her to be a credible witness whose evidence was believable.
• Mr SK, a senior employee of a company that had provided governance support to the GP Practice that employed the Registrant. He became involved in the matter when allegations concerning the Registrant’s relationship with a patient arose. Mr SK had no direct personal knowledge of the relevant matters alleged by the HCPC against the Registrant, but he was involved in some initial investigations into them. The Panel found Mr SK to be a credible witness who was prepared to acknowledge that he made an error as to the date of a consultation between the Registrant and Patient A.
10. The Registrant gave evidence before the Panel in his defence. The Panel found the Registrant to be, on the whole, a credible witness. He was also prepared to admit to matters that were not to his credit. The Panel did not find him to be deliberately untruthful, but it did find that his evidence on the issue of sexual motivation was coloured by his interpretation of those terms, an interpretation not entirely shared by the Panel.
11. At all times the Panel remembered that the factual elements of the HCPC’s allegation against the Registrant were to be proved by the HCPC, the standard to which they were to be proved being the balance of probabilities.
Particular 1 – On or around 12 March 2017, while employed by Cornwallis Plaza Surgery, obtained the mobile telephone number of Patient A, a vulnerable person, from the EMIS clinical system without her consent and/or knowledge.
12. It has already been recorded that the Registrant admitted this particular save as to the date. In his closing submissions, Mr Cutting submitted that the Panel should not find the particular proved on the basis that the incident did not occur “on or around 12 March 2017”. On the basis of the admission made at the commencement of the hearing as well as on the basis the oral evidence of the Registrant, the Panel is satisfied that, while employed at the Surgery he obtained Patient A’s telephone number from the electronic system used by the Surgery for the storage of patient records. The fact that Patient A did not consent to the Registrant obtaining the number was supported by Patient A’s own evidence. The Panel is also satisfied that Patient A was a vulnerable person; she was a patient of the G.P. practice and she was consulting the Registrant concerning a number of emotional difficulties that resulted in her being referred to counselling and prescribed anti-depressant medication. The Panel is satisfied that it was not on 12 March 2017 that the Registrant obtained the telephone number, that day being a Sunday. On the basis of all the evidence the Panel finds that the occasion was very likely to have been in late February 2017, a date that satisfies the term “on or around 12 March 2017” in the allegation. In any event the Panel took the view that the precise date was not essential to the mischief against which the particular is directed.
13. Particular 1 is proven.
Particular 2 - Between around March and May 2017, engaged in a relationship of a sexual nature with Patient A.
14. That there was a sexual relationship between the Registrant and Patient A in the period March to May 2017 was confirmed by the evidence both participants gave to the Panel.
15. Particular 2 is proven.
Particular 3 - Between around March and July 2017, sent text messages and emails of an inappropriate and/or sexual nature to Patient A.
16. The Panel has had regard to the documentary exhibits presented to it in making its decision. The Panel is satisfied that in the alleged period both text messages and emails of an inappropriate nature were sent in this period, the inappropriateness being of the personal nature of them and signed off “X” (i.e. by a kiss). The Panel does not find that in the same period that there were emails of a sexual nature sent, but it does find that there were text messages of sexual nature sent. An example of such an email was one in which the Registrant said that he wanted to make love to Patient A. Another example was of one in which he described aspects of her body.
17. Particular 3 is proven.
Particular 4 - The matters set out in particulars 1 to 3 were sexually motivated.
18. The Panel was satisfied that in order to make a decision on this particular, it was necessary to consider the sexual motivation alleged separately in relation to each of particulars 1 to 3. The Panel has construed “sexual motivation” as conduct done either in pursuit of sexual gratification or in pursuit of a future sexual relationship. The Panel does not consider that it is necessary for the sexual motivation to be the only motivation, although it would need to be a significant element.
19. So far as particular 1 is concerned, the Panel considered the real issue is whether the HCPC has discharged the burden of proof in demonstrating that the Registrant obtained Patient A’s mobile telephone number with the idea of a future sexual relationship as a reason for doing so. The Registrant told the Panel that the reason he obtained Patient A’s telephone number was to check on her wellbeing. The Panel finds that the HCPC has demonstrated on a balance of probabilities that a significant element of his motivation was to pursue the possibility of a future sexual relationship. The reasons for this finding are as follows:
• The Panel noted the Registrant’s evidence that he had not obtained the telephone number of any other of his patients about whose welfare he was concerned.
• Before he obtained her mobile telephone number, the Registrant had perceived Patient A’s attitude towards him to be flirtatious
• During the consultation immediately preceding his obtaining the telephone number, Patient A had expressed dissatisfaction with her then partner and stated that she was considering having an affair (for the avoidance of doubt, it not being suggested that at that stage her statement about a contemplated affair was one with the Registrant).
• Before the Registrant obtained the telephone number, the relationship between him and Patient A had strayed from the purely professional. In his witness statement prepared for the present proceedings, the Registrant stated in relation to the period before he obtained the telephone number, “I felt a connection with Patient A and felt empathy for her domestic situation. I felt that there was a reciprocal connection between us…..”
• The consultation immediately preceding the Registrant obtaining the telephone number ended with physical contact. The Registrant gave Patient A a hug, something he had not done with any other patient.
20. So far as particular 2 is concerned, the Panel finds that sexual gratification on the part of the Registrant explained his engagement in the sexual relationship with Patient A. He admitted that sex took place and that he enjoyed it.
21. So far as particular 3 is concerned, the Panel finds that the text messages of a sexual nature were sent with the intention of pursuing, and subsequently maintaining, a sexual relationship.
22. It follows from these findings that particular 4 is proven in its entirety with respect to particulars 1, 2 and 3.
Summary of factual findings
23. It follows from the above that particulars 1 to 4 inclusive are proven. It is these facts that must be carried forward to the decision on misconduct.
Decision on Grounds
24. The sole statutory ground alleged is misconduct.
25. The Panel finds that the Registrant’s behaviour breached the following standards of the HCPC’s Standards of conduct, performance and ethics in force at the time of the behaviour, namely:
• Standard 1.1, “You must treat service users …. as individuals, respecting their privacy and dignity.”
• Standard 1.7, “You must keep your relationships with service users and carers professional”
• Standard 9.1, “You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.”
26. The Panel finds that the Registrant’s action represented a very serious falling short in the behaviour expected of him. He breached a fundamental tenet of his profession. Fellow professionals and members of the public would find his behaviour to have been deplorable in that he developed a sexual relationship with a patient while continuing to provide professional services to that patient. That Patient A was an active participant in what occurred does not minimise the seriousness of the matter because it was the responsibility of the Registrant, as the professional in the relationship, to ensure that matters remained on the right side of the professional boundary.
27. The Panel finds that misconduct to be established.
28. It will therefore be necessary for the Panel to decide if the established misconduct is currently impairing the Registrant’s fitness to practise as a Paramedic.
Decision on Impairment
29. After the Panel announced its findings in relation to the facts and misconduct the Registrant gave further evidence directed to the issue of current impairment of fitness to practise and the advocates made further submissions.
30. In considering the issue of current impairment of fitness to practise the Panel paid close attention to the HCPTS Practice Note entitled, ‘Finding that Fitness to Practise is “Impaired”’. In particular, the Panel accepted that it was necessary for it to consider both the personal and public components relevant to that issue.
31. The admissions and non-admissions made by the Registrant have already been fully described. He admitted his tangible actions, but denied sexual motivation. In part, his denial of sexual motivation may have been based upon his erroneous understanding that to admit sexual motivation would have involved him accepting that he had behaved in a predatory manner, or in accepting that sexual motivation was his only motivation. However, the Panel finds that at the commencement of the present hearing there was an element of the Registrant’s thinking that his actions were the less serious because Patient A was a willing and active participant in what occurred. The Panel credits the Registrant with some movement in his thinking in an appropriate direction during the course of the hearing, and in particular after the Panel’s decisions on the facts and misconduct were announced. However, the Panel finds that there remains an incomplete understanding on the part of the Registrant of the consequences of his actions on Patient A despite the manner in which she pursued the liaison. That being the case, the Panel finds that it cannot be said that the Registrant has achieved full insight into his actions, and the consequence of that is that the Panel finds that there is a residual, albeit not high, risk that the Registrant would fail to observe proper professional boundaries in the future.
32. For these reasons the Panel finds that the Registrant’s fitness to practise is impaired upon consideration of the personal component.
33. In relation to the public component, the Panel finds that the matter is very clear. The Registrant’s actions represented a very serious breach of a fundamental tenet of his profession. A declaration of proper professional standards so as to promote public confidence requires a finding of current impairment of fitness to practise. The Panel is satisfied that fair-minded members of the public would be appalled if behaviour of this sort did not result in such a finding, and that dismay would inevitably result in public confidence in the Paramedic profession and the regulation of it being seriously diminished.
34. The conclusion that the Registrant’s fitness to practise is currently impaired has the consequence that the Panel must proceed to consider the issue of sanction.
Decision on Sanction
35. After the Panel announced the decision that the Registrant’s fitness to practise is impaired, the Panel heard further submissions on the issue of sanction.
36. On behalf of the HCPC, the Presenting Officer reminded the Panel of the proper purpose of a sanction and urged the Panel to consider the HCPC’s Indicative Sanctions Policy when reaching its decision. He identified a number of factors that he submitted were aggravating, and, having done so, suggested that both a caution order and a conditions of practice order would not sufficiently reflect the seriousness of the case. He did not, however, submit that any particular sanction should be imposed.
37. On behalf of the Registrant, Mr Cutting submitted that the Registrant had accepted his failings and that although the matter could not be considered an isolated incident, it could properly be treated as an isolated episode. He urged the Panel to consider making a Conditions of Practice Order, the conditions of which could require the Registrant to undertake further training, to ensure that a chaperone was present and that he was effectively supervised.
38. The Panel accepted the advice of the Legal Assessor as to how a decision on sanction should be made. The Panel also paid close attention to the HCPC’s Indicative Sanctions Policy. Accordingly, the Panel accepted that a sanction must not be imposed to punish the Registrant. Rather, any sanction imposed must be the least restrictive outcome consistent with the Panel’s obligation to ensure that a proper degree of public protection and public confidence is provided. To ensure that this principle is applied it is necessary for the Panel initially to consider whether the findings on the allegation require the imposition of any sanction. If a sanction is required, the available sanctions must be considered in an ascending order of seriousness until one that satisfies the proper sanction aims is reached. The Panel confirms that it has applied these principles in reaching its decision.
39. The Panel identified a number of factors that could properly be regarded in the Registrant’s favour when reaching the decision. They were:
• although the findings of the Panel cannot be regarded as a single incident, they can properly be regarded as a single episode;
• Patient A was a willing and active participant who contributed to the development and continuation of the Registrant’s misconduct;
• the Registrant was unsupported in the work environment;
• the Registrant admitted his actions with Patient A at an early stage;
• the Registrant has expressed genuine regret and remorse for his actions, and has fully engaged in the HCPC fitness to practise process; and,
• the Registrant has an unblemished career as a Paramedic over a period of approximately 17 years, and the positive testimonials presented to the Panel leads it to treat him as a competent practitioner.
40. Against these positive factors were the following:
• the fact that the Registrant engaged in a sexual relationship with a patient to whom he was currently providing services, and despite the fact that during the hearing Patient A presented as a robust individual, he knew her to be vulnerable at the time;
• the Registrant knew that his actions were wrong from the beginning of his inappropriate contact with Patient A;
• the Registrant had a number of opportunities to stop the relationship with Patient A, but did not take them; and,
• the Registrant’s insight into his actions is incomplete (albeit that it is developing).
41. In the Panel’s judgement the findings it has made require the imposition of a sanction. Furthermore, a caution order would not be sufficiently robust as it would neither sufficiently protect the public nor provide a proper degree of public confidence. The Panel also concluded that no conditions of practice could be formulated that would provide a proper degree of protection and confidence.
42. It follows from the decisions made in relation to less restrictive sanctions that the Panel considered the making of a suspension order. The Panel has already stated that the Registrant admitted his actions as well as the fact that his insight into the inappropriateness and impact of his actions, although incomplete, has developed. Having carefully considered the matter, the Panel concluded that there are grounds for believing that the Registrant will further develop his insight so as to reduce the risk of any repetition such that a return to practise could be contemplated. That being the case, the Panel concluded that the imposition of a suspension order would be appropriate and would meet the public interest elements identified below. Having tested that decision by considering a striking-off order, the Panel concluded that such an order would be disproportionate while there remains a realistic prospect that the Registrant will be able to persuade a future reviewing panel that his insight has further developed.
43. In common with all suspension orders, the order made today will be reviewed before it expires. What information the Registrant provides to that future reviewing panel is a matter for the Registrant to decide. However, the present Panel suggests that a future panel might be assisted by:
• Evidence of learning about the maintenance of appropriate boundaries with patients.
• A comprehensive reflective piece outlining the Registrant’s understanding of the inappropriateness and impact of his behaviour.
• An indication of the strategies the Registrant would put in place to prevent a recurrence of proper professional boundaries being breached.
44. As to the length of the suspension order being imposed, the Panel considers that it should be for 12 months. Suspension for that period is required not only to underline to the public and the Paramedic profession the seriousness of the findings made and the need to declare that it was unacceptable behaviour, but also to provide a proper opportunity for the Registrant to take the steps that he will need to take to demonstrate to a future panel that he has achieved a greater degree of insight.
The Registrar is directed to suspend the registration of Mr Bradley D. Poole for a period of 12 months from the date this order comes into effect.
.This order will be reviewed before its expiry.
History of Hearings for Mr Bradley D Poole
|Date||Panel||Hearing type||Outcomes / Status|
|10/09/2018||Conduct and Competence Committee||Final Hearing||Suspended|
|27/04/2018||Conduct and Competence Committee||Interim Order Review||Interim Suspension|
|31/01/2018||Conduct and Competence Committee||Interim Order Review||Interim Suspension|
|08/08/2017||Investigating committee||Interim Order Application||Interim Suspension|