Mr Dominic Barone

Preliminary Matters

Application to amend the Allegation

1.    Ms Sheridan for the HCPC applied to amend the Allegation. She submitted that the proposed amendments were intended to better reflect and to clarify the evidence which the HCPC would call. She submitted that there was no unfairness or prejudice to the Registrant. The Panel was shown a letter dated 9 December 2019 from the HCPC which was sent by first class post to the Registrant’s registered address in which the majority of the proposed amendments were set out. Ms Sheridan also sought to make a further amendment of which The Registrant had been given notice at this hearing. The Panel notes that the Registrant has not objected to the proposed amendments.

2.    The Panel has decided to grant Ms Sheridan’s application. It has considered each proposed amendment separately. It has concluded that each amendment is one of form rather than substance, so as to better reflect the evidence which the HCPC expects to call. The Panel is satisfied that the Registrant will not be prejudiced by any of the proposed amendments and there is no unfairness caused to him by granting the application.

Background

3.    The Registrant is a paramedic who was employed by the Welsh Ambulance Service NHS Trust (“the Trust”) until 19 November 2018.

4.    On 19 January 2018, the Registrant submitted an Adverse Incident Investigation Report (DATIX) stating that he had sustained an injury to his left shoulder while attending Patient A. The Registrant reported that the stretcher he used to transport Patient A from his home to the ambulance was not fully kitted, causing him to injure his shoulder. On 12 March 2018, the Registrant submitted a personal injury claim to the Trust relating to the same injury.

5.    An investigation into the DATIX was completed by ST, Investigating Officer. Concerns were raised as to the veracity of the DATIX when Patient A, Person B and Person C were interviewed at part of the investigation.

6.    On 16 October 2018, the Registrant made a self-referral to the HCPC regarding the matter.

Decision on Facts

Evidence

7.    The Panel heard evidence from one witness called by the HCPC and had written statements from two other witnesses who were not called to give live evidence. The Panel also heard evidence from the Registrant. Both parties submitted documentary evidence which the Panel has carefully considered. The HCPC’s documents included hearsay evidence. Within the hearsay evidence were statements from CI, a colleague of the Registrant who had accompanied him on 19 January 2018 when attending Patient A. CI stated that she had no reliable recollection of events and so the Panel placed no weight on her evidence. The Panel has received and accepted legal advice as to how it should approach such evidence with care. The Registrant’s documents included a number of testimonials given by former and current colleagues and from some of the people he has mentored.

8.    At the relevant time, ST was employed by the Trust as an Ambulance Operations Manager. ST was appointed in June 2018 to conduct an internal investigation into concerns regarding the Registrant. The Panel found ST’s evidence was inevitably somewhat limited as she was reporting on documents, or producing as exhibits, notes or statements of people she had interviewed as part of her internal investigation. The Panel considers ST to be a credible and reliable witness who was open, honest, and fair to the Registrant in her answers.

9.    PG is employed by the Trust as a Claims Manager and Solicitor. Her witness statement which was accepted in evidence was in effect a production statement in relation to documentary exhibits.

10. Patient A made a witness statement in which he produced the statement he had provided to ST as part of the internal investigation. Patient A was not called to give evidence. In light of the Registrant’s admissions and evidence, the Panel has accepted Patient A’s statement as being credible and reliable.

11. The Panel considers that it is to the Registrant’s credit that he made full admissions at the start of the hearing and then gave evidence in which these were repeated. The Registrant faced difficult questions which he answered without hesitation. The Panel found the Registrant’s evidence to be capable of belief and that he was a credible witness who was open and tried to answer fully all the questions he was asked.

Particular 1 was found proved

12. The Panel has accepted evidence that the Registrant sustained an injury to his shoulder, but it is unclear as to how or precisely when he did so. The Panel is satisfied that the Registrant submitted an Adverse Incident Investigation Form (“DATIX”) on or around 19 January 2018. It has seen the DATIX which is in the Registrant’s name and suggests it was submitted either on 19 January 2018 or shortly thereafter, and that it purports to relate to events on a shift on 19 January 2018 involving Patient A. The Panel accepts the evidence of Patient A and the hearsay evidence of Person B (Patient A’s wife), and Person C, (a neighbour of Patient A and Person B) that at no time was Patient A taken on a stretcher from his home address to the waiting ambulance which was parked some distance away. The Panel accepts that Patient A walked from his home address to the ambulance. The Panel is therefore satisfied that the Registrant gave a factually incorrect account in the DATIX when he stated that his shoulder injury was sustained “while moving patient on the stretcher over rough ground and without the correct push bars fitted to the Stryker stretcher (as these had been lost and reported as lost by another crew and not replaced), this caused my left shoulder to be in an awkward position as over rough ground the stretcher has to be in it’s (sic) lowest position to stop the risk of the patient and the stretcher toppling over. This awkward slightly bend over pulling position caused a tearing feeling within my left shoulder”. The Panel is satisfied that the shoulder injury was not caused in this way as no stretcher was ever used to move Patient A from his home to the ambulance.

13. In reaching its decision, the Panel has also accepted the Registrant’s admission in relation to Particular 1 which he gave at the outset of the hearing and repeated in his evidence. The Panel therefore finds Particular 1 proved.
 
 
Particular 2 was found proved

14. The Panel is satisfied that on or around 12 March 2018, a Personal Injury Claim which had been completed on his behalf by his then legal representative, was submitted by the Registrant. The Panel has seen the Personal Injury Claim form which makes clear that it has been completed by a legal representative who is acting on the Registrant’s instructions. The Personal Injury Claim Form purports to make a claim in respect of a work-related injury sustained to the Registrant’s shoulder when he was moving Patient A on 19 January 2018 from his home to the ambulance.

15. The Panel has already accepted the evidence of Patient A, the hearsay evidence of Person B and Person C and the admission and evidence of the Registrant at this hearing that the shoulder injury was not caused by moving Patient A into the ambulance prior to taking him to hospital. The Panel is therefore satisfied that the Personal Injury Claim Form was factually incorrect in stating that the shoulder injury was sustained in the following way “The Claimant was carrying the patient out of the aforementioned location on a stretcher. Because the ground was cobbled the patient had to be on the lowest setting to stop any falling hazard for the patient. The Claimant had to bend down to pull the stretcher over the cobbles and apply force the Claimant felt his left shoulder tear”.

16.  Accordingly, the Panel finds that Particular 2 is proved.

Particular 3 was found proved

17. The Panel has seen an email dated 20 March 2018 from the Registrant to DW who was his line manager and who was, at that time, investigating the DATIX which the Registrant had submitted which purported to refer to a work-related injury when moving Patient A on 19 January 2018. In the email, the Registrant refers to an attached statement relating to the injury. The Panel has also seen an unsigned copy of a statement from the Registrant relating to the incident on 19 January 2018. The Panel is satisfied that this is the statement which the Registrant submitted to DW on 20 March 2018. The Registrant in his evidence confirmed this and the Panel accepts this evidence.

18. The Panel has considered the contents of the statement and is satisfied this contained factually incorrect information as to how the Registrant’s shoulder injury was sustained. In the statement, the Registrant expanded on what he had stated in the DATIX and in his Personal Injury Claim Form, as to how his shoulder injury had been sustained. He referred to risk assessing the condition of the lane leading from Patient A’s home to the ambulance and he set out more details of how he and CI, a colleague who was with him at the time, had moved Patient A on the stretcher to the ambulance.

19. The Panel has already accepted the evidence of Patient A, the hearsay evidence of Person B and Person C and the admission and evidence of the Registrant at this hearing that the shoulder injury was not caused by moving Patient A into the ambulance prior to taking him to hospital. The Registrant stated in evidence that in this statement he had embellished on what he had said in the DATIX. The Panel is therefore satisfied that the statement was factually incorrect as to how the shoulder injury had been sustained. Accordingly, the Panel finds Particular 3 proved.

Particular 4 was found proved

20. The Panel accepts the evidence of ST that on 1 August 2018 as part of her investigation, she interviewed the Registrant. The Panel has seen two documents which refer to that interview. First, it has seen a document which sets out typed questions to be put to the Registrant and handwritten entries which summarise the Registrant’s responses. Second, it has seen a document in which the Registrant’s responses have been typed. This second document was sent to the Registrant on 10 August 2918 so that he could check its accuracy and the Panel notes that the Registrant signed this on 20 August 2018 confirming that the document was an accurate reflection of his account.

21. The Panel accepts that during the interview on 1 August 2018, ST asked the Registrant to explain how he had sustained his injury. The Registrant stated “I was pulling the stretcher up and down the lane trying to find the patient’s address and felt a niggling pain and when I pulled the stretcher out of the ambulance at the hospital I felt a sharp, tearing pain. At no time was the patient on the stretcher when I pulled it up and down the lane”.

22. The Panel accepts the evidence of Patient A, Person B and Person C, none of whom recalls seeing a stretcher in the lane on 19 January 2018. The Panel also accepts the Registrant’s admission and his evidence that this account is factually incorrect in that he did not pull the stretcher up and down the lane on 19 January 2018. The Panel is satisfied that the Registrant’s account to ST on 1 August 2018 was factually incorrect as to how his injury was sustained and accordingly, finds Particular 4 proved.

Particular 5 was found proved

23. The Panel having found Particulars 1 to 4 proved, then considered Particular 5 and whether the Registrants actions in each of those Particulars were misleading and/or dishonest.

Misleading

24. The Panel has considered whether the Registrant’s actions as set out in each of Particulars 1 to 4 were misleading. The Panel has applied an objective test, namely that a person’s actions in submitting forms, providing statements and/or accounts can be misleading if these contain information that is objectively factually incorrect. The Panel has found that the documents and the account given in interview to ST, each contained factually incorrect information as to how the Registrant’s injury was sustained. The Panel is satisfied that anyone reading the documents, or hearing the Registrant’s account in interview, would be misled by his account of how his injury had been sustained, and accordingly, the Panel finds Particular 5 proved as to misleading in relation to each of Particulars 1 to 4.

Dishonesty

25. The Panel has considered the submissions of Ms Sheridan for the HCPC regarding dishonesty. It has received and accepted legal advice as to how it should approach the issue of dishonesty. The Panel has considered Particulars 1 to 4 and applied the test for dishonesty as set out in the case of Ivey v. Genting Casinos [2017] UKSC 67 (at para 74) [the Ivey test]. In applying the Ivey test, the Panel has first decided the Registrant's knowledge or belief as to the factual circumstances of his conduct as set out in Particulars 1 to 4 of the Allegation. The Panel understands that the Registrant’s belief does not have to be reasonable, so long as it is genuinely held. The Panel has then considered whether, based on the factual circumstances as it has found the Registrant believed them to be, his conduct was dishonest by the (objective) standards of ordinary decent people. The Panel understands there is no requirement that the Registrant must appreciate that what he has done is, by those standards, dishonest.

26. In relation to Particular 1: the Panel finds that the factual circumstances on 19 January 2018 when the Registrant submitted the DATIX, were that he knew his assertion as to the cause of his shoulder injury was untrue and that he had made this untrue assertion deliberately. The Registrant knew that he had not taken the stretcher out of the ambulance on that date and he also knew that Patient A had not been moved by stretcher from his home address to the ambulance. The Registrant knew that he had not sustained his shoulder injury on that night. The Panel is satisfied that it can rule out any mistake on the part of the Registrant. The Panel notes that the Registrant felt disgruntled at the relevant time due to what he perceived as lack of support by the Trust in the aftermath of a particularly traumatic incident which he had attended in October 2017 and also because an important part of the equipment for the stretcher had not been replaced despite having been verbally reported as missing. The Panel considers that while this might provide some explanation for what the Registrant did, it is no excuse for deliberately lying on an official internal form. The Panel has accepted the Registrant’s evidence that he knew that what he was doing was dishonest and would be regarded as such by the public.

27. In these circumstances, and applying the Ivey test, the Panel has no hesitation in finding that the Registrant was dishonest when he submitted the DATIX which contained the false and misleading information about the cause of his shoulder injury, and it is satisfied that an ordinary, decent person would judge the Registrant’s conduct to be dishonest.

28. In relation to Particular 2: the Panel finds that the factual circumstances on or around 12 March 2018 when the Registrant submitted the Personal Injury Claim Form which had been completed on his behalf, he knew that his assertion as to the cause of his shoulder injury was untrue and he had done this deliberately. The Panel is satisfied that it can rule out any mistake on the part of the Registrant. This was now over a month since the Registrant had submitted the DATIX. He has had time in which to reflect on his dishonest conduct in submitting the DATIX and admit that it contained factually incorrect information regarding the cause of his shoulder injury. In submitting the Personal Injury Claim, the Registrant chose to continue his dishonest conduct by making a claim that were it to succeed, would have resulted in compensation being paid by the Trust which is ultimately funded by the taxpayer. The Panel has accepted the Registrant’s evidence that he knew that what he was doing was dishonest and would be regarded as such by the public.

29. In these circumstances, and applying the Ivey test, the Panel has no hesitation in finding that the Registrant was dishonest when he submitted the Personal Injury Claim Form which contained the false and misleading information about the cause of his shoulder injury, and it is satisfied that an ordinary, decent person would judge the Registrant’s conduct to be dishonest.

30. In relation to Particular 3: the Panel finds that the factual circumstances on or around 20 March 2018 when the Registrant provided a statement to his line manager, DW, in order to explain in more detail the events of 19 August 2018 when attending Patient A, were (i) that the Registrant knew that his further explanation as to the cause of his shoulder injury was untrue and (ii) that he had deliberately expanded on and embellished what he had said about this in the DATIX. The Panel is satisfied that it can rule out any mistake on the part of the Registrant. This was now some two months since the Registrant had submitted the DATIX. He has had further time in which to reflect on his dishonest conduct in submitting the DATIX and admit that it contained factually incorrect information regarding the cause of his shoulder injury. In submitting the statement, the Registrant chose to continue his dishonest conduct by “gilding the lily”. The Panel has accepted the Registrant’s evidence that he knew that what he was doing was dishonest and would be regarded as such by the public.

31. In these circumstances, and applying the Ivey test, the Panel has no hesitation in finding that the Registrant was dishonest when he submitted the statement which contained the false, misleading and embellished information about the cause of his shoulder injury, and it is satisfied that an ordinary, decent person would judge the Registrant’s conduct to be dishonest.

32. In relation to Particular 4: the Panel finds that the factual circumstances on or around 1 August 2018 when the Registrant gave an account of how his injury had been sustained to ST as part of her internal investigation were (i) the Registrant knew that ST had a statement from Patient A which contradicted his assertion as set out in the DATIX and confirmed in his statement provided to DW, (ii) knowing this, the Registrant chose to continue the lie as to how his shoulder injury had been sustained by maintaining that this had been sustained on 19 January 2918 but by telling a different lie to back this up. The Panel is satisfied that it can rule out any mistake on the part of the Registrant. This was now some seven months since the Registrant had submitted the DATIX. He has had more than sufficient time in which to reflect on his initial dishonest conduct in lying in the DATIX and then backing this up in his statement. The Panel accepts that by the time of the interview with ST on 1 August 2018, the Registrant had withdrawn his Personal Injury Claim. In evidence, the Registrant explained that he had done some research and withdrew the claim when he had realised that it was unlawful. However, the Panel notes that this realisation did not lead the Registrant to come clean and confess his dishonesty in relation to the DATIX and the statement when he was interviewed by ST. Instead, having been caught out in a lie, the Registrant attempted to maintain that his shoulder injury had been sustained on 19 January 2018 by telling a different lie to fit in with what ST now knew to be the true position. The Panel has accepted the Registrant’s evidence that he knew that what he was doing was dishonest and would be regarded as such by the public.

33. In these circumstances, and applying the Ivey test, the Panel has no hesitation in finding that the Registrant was dishonest in the account he gave to ST which contained the false and misleading information about the cause of his shoulder injury, and it is satisfied that an ordinary, decent person would judge the Registrant’s conduct to be dishonest.

34. Accordingly, the Panel finds Particular 5 proved as to dishonesty in relation to each of Particulars 1 to 4.

Decision on Grounds

35. In reaching its decision on the statutory ground of misconduct, the Panel has taken account of the submissions of Ms Sheridan for the HCPC and those of the Registrant. It has received and accepted legal advice.

36. The Panel is satisfied that Registrant’s conduct in relation each of the Particulars which it has found proved, fell far below the high standards to be expected of a Paramedic.

37. The Panel has had in mind the HCPC Standards of Conduct, Performance and Ethics (2016) and has concluded that the following standard is engaged and has been breached:

Standard 9 Be honest and trustworthy

Personal and professional behaviour

9.1 - You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

38. The Panel is satisfied that the Registrant’s dishonest conduct continued over a period of some 8 months during which he had ample opportunity to reflect on his initial dishonest lie in the DATIX. Instead of admitting his lie, the Registrant chose to maintain it, embellish it and when caught out, provide a different account which was also untrue. The Panel considers that the Registrant’s conduct amounts to serious misconduct. The public expects that paramedics and other health professionals are honest and trustworthy in both their personal and professional behaviour. Paramedics treat members of the public in their homes at times when they are particularly vulnerable. The importance of honesty and integrity in a paramedic cannot be underestimated. The Panel notes that to his credit, the Registrant accepts this and in evidence described his behaviour as having been “deplorable”. The Panel has concluded that because of the sustained pattern of the Registrant’s dishonest conduct, fellow practitioners and the wider public would also find his conduct to have been “deplorable”. Accordingly, the Panel finds that the Registrant’s conduct in Particulars 1 to 5 falls seriously short of what would have been proper in the circumstances and amounts to misconduct.

Decision on Impairment

39.    In reaching its decision on impairment, the Panel has considered the submissions of Ms Sheridan for the HCPC and those of the Registrant. It has had regard to the HCPTS Practice Note “Finding that Fitness to Practise is Impaired” and it has received and accepted legal advice. The Panel has borne in mind that the purpose of this hearing is not to punish the Registrant for past misdoings but to protect the public against the acts and omissions of those who are not fit to practise.
 
Personal component

40.    In relation to the personal component, the Panel first considered whether the Registrant’s misconduct has put patients at unwarranted risk of harm and whether, looking forward, the Registrant is liable to put patients at unwarranted risk of harm. It has concluded that this is not a case where patients were put at risk as a result of the Registrant’s misconduct. There does not appear to be any evidence of concerns as to the Registrant’s clinical competence as it relates to patients.

41.    The Panel then considered whether the Registrant’s misconduct has brought the Paramedic profession into disrepute. The Panel is satisfied that dishonestly putting forward factually incorrect information in three different documents and in an interview, which was part of an internal Trust investigation, can only bring the Paramedic profession into disrepute.

42.    The Panel is also satisfied that by his misconduct the Registrant has breached one of the fundamental tenets of the Paramedic profession which requires paramedics to be honest and trustworthy in their personal and professional behaviour. In this case, the Panel has found the Registrant to been dishonest in relation to his various accounts of how his shoulder injury was sustained.

43.    The Panel has also considered whether, looking forward, the Registrant is liable in the future to bring the Paramedic profession into disrepute, breach one of the fundamental tenets of that profession or act dishonestly. In reaching its conclusion on these matters, the Panel has considered evidence of insight, remorse, reflection, and the likelihood of repetition of the misconduct involved in this case.

44.    The Panel takes the view that the Registrant has developed insight into his misconduct. It accepts the Registrant’s evidence that he wishes now that he had not behaved as he did. It is to his credit that the Registrant made full admissions at the outset of this hearing which he confirmed in his evidence to the Panel. It is an indication of his insight that the Registrant described his conduct as “deplorable” and recognised that by his actions he had damaged public confidence in his profession and brought it into disrepute. However, the Panel considers that while the Registrant may have reflected on his misconduct more recently, he chose not to correct his original lie as set out in the DATIX when presented with opportunities to do so over a period of months. The Panel notes all of the positive and supportive things said about the Registrant in the many testimonials it has received in evidence. The Registrant said in his evidence that he is now a changed man and that he now has coping and support mechanisms in his life which he could turn to if he were ever to find himself in a similar situation. The Panel accepts that the Registrant believes this to be the position.

45.    The Panel considers that the misconduct in this case is capable of being remedied and recognises that it is difficult but not impossible to demonstrate remediation in cases involving dishonesty. The passage of time coupled with insight, reflection and the fact that there has been no repetition in the period since the misconduct, can in some cases amount to remediation. The Panel takes the view that there is some evidence that the Registrant has reflected on his misconduct and shown remorse. It also considers the Registrant to have developed insight into his misconduct but feels that there is room for improvement. For example, in his evidence the Registrant did not recognise that his account to the Trust’s disciplinary hearing had, in the view of this Panel, been an attempt to minimise events. Accordingly, the Panel has concluded that there remains a risk of repetition although this is not high. In these circumstances, the Panel has concluded that the Registrant’s fitness to practise is impaired on personal component grounds.

Public component

46.    In relation to the public component, the Panel is satisfied, given the findings of fact in this case which involve dishonest and misleading factual entries in documents and in an account given by the Registrant, that public confidence in the Paramedic profession and its regulatory body, would be undermined if there was no finding of impairment in this case. The Panel is also satisfied that it would be failing in its duty to declare and uphold proper standards of conduct and behaviour in that profession if it did not find impairment in this case. It considers that a reasonable and informed member of the public would be very concerned if there was no finding of impairment in a case where a registrant’s misconduct involved dishonesty which had persisted over a period of time and involved a claim for compensation which would ultimately be funded, if successful, by the taxpayer.

47.    The Panel therefore finds, on the public component, that the Registrant’s fitness to practise is impaired.

48. Accordingly, the Panel finds, on both the personal and public component grounds, that the Registrant’s fitness to practise is impaired and the Allegation is well-founded.

Decision on Sanction

49. In considering the appropriate and proportionate sanction in this case the Panel has considered the guidance set out in the HCPC Sanctions Policy. It has had regard to the submissions of both parties. The Panel has received and accepted legal advice. The Panel is aware that the purpose of any sanction it imposes is not to punish the Registrant, although it may have that effect, but it is to protect service users and to maintain confidence in the Paramedic profession and to uphold its standards of conduct and behaviour. It has also had in mind that any sanction it imposes must be appropriate and proportionate bearing in mind the misconduct involved.

50. The Panel has considered mitigating and aggravating factors. The Panel first looked at the mitigating factors. It notes that until the 19 January 2018, the Registrant had practised as a Paramedic without there being any previous regulatory proceedings against him. The Panel also notes that the Registrant made admissions to this hearing. The Panel considers that the Registrant has developed insight, but not yet complete insight, into his misconduct. He has shown proper remorse and has apologised for his dishonest behaviour. The Panel accepts that there were personal circumstances at play in the background, certainly at the start of his dishonest conduct.

51. The Panel then looked at the aggravating factors. The Panel considers its finding of dishonesty to be an aggravating factor and has had in mind the following paragraph from the HCPC Sanctions Policy:

“57     Dishonesty, both in and outside the workplace, can have a significant impact on the trust placed in those who have been dishonest… It is likely to lead to more serious sanctions”

58       …However, panels should bear in mind that there are different forms, and different degrees, of dishonesty, that need to be considered in an appropriately nuanced way. Factors that panels should take into account in this regard include:

• whether the relevant behaviour took the form of a single act, or occurred on multiple occasions;
  
  
• the duration of the dishonesty;
  
  
• whether the registrant took a passive or active role in it;
  
  
• any early admission of dishonesty on the registrant’s behalf; and
  
  
• other relevant mitigating factors”.

52. The Panel has concluded that the Registrant took an active role in the dishonest conduct which, while it related to a single matter i.e. the cause of his shoulder injury, occurred on each of the occasions set out in Particulars 1 to 4. It could not be said that the dishonesty in this case took the form of a single act. The Panel notes that in relation to Particular 2, the dishonest conduct was motivated by the potential for personal gain and considers this to be an aggravating factor. The Panel has also concluded that the Registrant’s dishonesty persisted over a period of at least 8 months. Although the Registrant referred himself to the HCPC in October 2018 and this was prior to his disciplinary hearing at the Trust which was held in November 2018, he did not make early admissions of dishonesty. It was only at this hearing that the Registrant made full admissions and the Panel has given him some credit for these in the mitigating factors it has found.

53. The Panel has considered the available sanctions in ascending order of seriousness. The case is not one which would be amenable to mediation. The Panel has decided that to take no action or to impose a Caution Order in this case would not be appropriate or proportionate given the seriousness of the misconduct concerned which involved a pattern of dishonest behaviour. The misconduct could not be described as isolated, limited or relatively minor in nature. The Panel has found that there is a risk of repetition. In these circumstances, the Panel considers that to protect the public from that risk and to ensure public confidence in the profession is not undermined, it must consider a more severe sanction.

54. The Panel has considered a Conditions of Practice Order. The Panel notes that the Registrant has engaged with the regulatory process since his self-referral in October 2018. The Panel has been told by the Registrant that since he left the Trust, he has been working, usually through an agency, in the primary care sector. The Panel has also seen evidence of the Continuing Professional Development (CPD) which the Registrant has undertaken to gain experience and the skills necessary for a paramedic working in the primary care sector. The Panel has no reason to suppose that were it to impose a Conditions of Practice Order, the Registrant would not comply with it. However, the Panel has decided that it cannot formulate any conditions of practice which would be appropriate, workable and measurable, and which would address the issue of the Registrant’s dishonesty in this case. It takes the view that even if it had been able to formulate such conditions, these would not be sufficient or appropriate to protect the public and public confidence in the Paramedic profession, or in its regulatory body. Nor would a Conditions of Practice Order send out an appropriate message to the Paramedic profession that misconduct such as the Registrant’s, will not be tolerated.

55. The Panel next considered whether to impose a Suspension Order. It has had in mind the following guidance from the HCPC’s Sanctions Policy:

“121 A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register. These types of cases will typically exhibit the following factors:

• the concerns represent a serious breach of the Standards of conduct, performance and ethics;
  
  
• the registrant has insight;
  
  
• the issues are unlikely to be repeated;
  
  
• there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings.”

56. The Panel has found the misconduct in this case to be serious. The Panel considers it to be capable of being remedied and has already noted that the Registrant has developed insight, but not yet complete insight, into his misconduct. The Panel has found that there is a risk of repetition albeit not a high one. The positive and supportive testimonial evidence, and the Registrant’s genuine remorse and apology, suggests that he is likely to be able to remedy his failings given sufficient time to gain full insight by further reflection. The Panel has therefore decided that a Suspension Order is the appropriate and proportionate sanction.

57. The Panel has decided that the Suspension Order should be for a period of 9 months. This will allow the Registrant sufficient time in which to properly reflect on his misconduct and achieve full insight. The Panel is satisfied that a Suspension Order for a period of 9 months would adequately to protect the public from the risk of repetition in this case albeit that such a risk is not a high one. The Panel is satisfied that such an Order would be sufficient to protect public confidence in the Paramedic profession and its regulatory body, while at the same time sending out a clear message to the profession that such behaviour will not be tolerated.

58. Finally, the Panel considered whether the appropriate and proportionate sanction in this case is a striking off order. It has borne in mind that such an order is “a sanction of last resort for serious, persistent, deliberate or reckless acts involving” … “dishonesty” [paragraph 130 Sanctions Policy].

59. The Panel has had in mind paragraph 131 of the Sanctions Policy:

“A striking off order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession and public confidence in the regulatory process. In particular where the registrant:

• Lacks insight;
  
  
• Continues to repeat the misconduct…
  
  
• Is unwilling to resolve matters."

60. The Panel has found that the Registrant’s has developed insight and takes the view that his engagement with these proceedings shows that he is not unwilling to resolve matters. It notes that there has been no repetition of the misconduct since he left the Trust. The Panel has decided that a striking off order in this case would be too harsh and disproportionate a sanction.

61. The Suspension Order will be reviewed before it expires and the Panel takes the view that a reviewing panel may be assisted by the following:

1. a reflective piece addressing the deficiencies in the Registrant’s insight;
   
   
2. evidence of CPD or other actions taken by the Registrant to maintain his knowledge and skills as a Paramedic;
   
   
3. references or testimonials from people for whom the Registrant may be working in paid or unpaid employment, or from other people of good standing concerning his honesty during the period of his suspension;
   
   
4. the Registrant’s attendance in person or remotely, at the review hearing to assist the reviewing panel in relation to his insight.

ORDER: That the Registrar is directed to suspend the name of Mr Dominic Barone from the Register for a period of 9 months from the date that this order comes into effect.

Interim Order

The Panel makes an Interim Suspension under Article 31(2) of the Health Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest for the reasons set out in its determination above.

This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Mr Dominic Barone