Mr Christopher J Preston

Profession: Paramedic

Registration Number: PA11665

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 13/10/2020 End: 17:00 13/10/2020

Location: Virtual Hearing

Panel: Conduct and Competence Committee
Outcome: Caution

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Allegation

While registered as a Paramedic with the Health and Care Professions
Council:

1. On 15 April 2019, at Wigan and Leigh Magistrates Court you were
convicted of;

a. Assaulting Person A, contrary to section 39 of the Criminal Justice
Act 1988

b. Assaulting Person B, contrary to section 39 of the Criminal Justice
Act 1988

2. By reason of your conviction, your fitness to practise is impaired.

Finding

Preliminary Matters

Legal argument in relation to the hearing being conducted remotely and for the hearing to be adjourned.

1. In light of the Government’s advice on containing the current Covid-19 pandemic, the HCPC has suspended all public hearings to protect the health and safety of its registrants and stakeholders. This hearing was convened remotely, with the Registrant, his legal representative, the HCPC’s Presenting Officer, the members of the Panel, the Legal Assessor and the Hearings Officer all participating via video-link.

2. Mr Harries, on behalf of the Registrant, invited the Panel to find that the HCPC’s Remote Hearing Protocol of July 2020 (the Protocol) mandated “an approach that directs the Panel to act in a way that is ultra vires”, and was unlawful. Mr Harries reminded the Panel that Rule 6(1) of the HCPC (Conduct and Competence) Committee (Procedure) Rules 2003 (the Rules) assumes that the hearing would be in-person, requiring as it does notice “of the day, time and venue for the hearing” being sent to the parties. He submitted that Rule 6(1) did not conceive of the hearing being “virtual”.

3. Mr Harries contended that the Protocol comprised a set of rules for the Conduct and Competence Committee in relation to the listing of substantive hearings and that the HCPC had not followed the procedure set out in the Health Professions Order 2001 (the Order) for the creation of such rules. He contended that the Protocol unilaterally imposed remote final hearings in all cases, save for exceptional ones. He submitted both that the HCPC did not have the power to create such a Protocol and that the Protocol itself was not capable of conferring a power on this Panel (or any other panel) to direct that a final hearing could be heard remotely.

4. If the Panel were not with him on that point, Mr Harries also applied for this final hearing to be adjourned on the basis that it was not a case that was suitable to be conducted by way of remote hearing. He addressed the Panel in relation to relevant caselaw including SC v University Hospital Southampton NHS Foundation Trust (Rev 2) [2020] EWHC 1445 (QB) in which the “general undesirability of hearing some cases remotely” was commented upon. Mr Harries pointed out that it was crucial, in the particular circumstances of this case, that the Registrant be afforded “proper facility and opportunity to give evidence about a number of vitally important factors the Panel will wish to consider as central to its decision as to whether impairment is established and, if so, the sanction to impose.”

5. Mr Lloyd, on behalf of the HCPC, opposed both applications. He also provided lengthy written submissions for the Panel’s consideration. Mr Lloyd submitted that this was a “renewed application”, already decided upon by the Chair as a preliminary decision, and that, “at its heart” this was an application by Mr Harries to adjourn the hearing. Mr Lloyd invited the Panel to think carefully as to whether it had the power to make a decision around the legality of the Protocol or indeed whether it was necessary for it to do so.

6. Mr Lloyd submitted that the Protocol was guidance and did not constitute a set of rules to be followed. He submitted that the legality of the HCPC’s listing process was not a matter for this Panel. He submitted that listing a hearing as a remote hearing did not mandate that a case must proceed to be heard remotely and that the right way to oppose the listing would be to make an adjournment application in order for the hearing to be held in person.

7. The Panel took into account the submissions of both parties and accepted the advice of the Legal Assessor. She advised the Panel that these were fresh applications made by Mr Harries today, for the Panel of three members to determine. She advised the Panel in relation to the HCPC’s own legislation conferring powers on panels, relevant caselaw and the HCPTS Practice Note on Adjournments.

8. The Panel noted that the HCPC’s own legislation, in which the Panel’s powers are set out, namely the Order and the Rules, did not make reference at all to hearings being conducted remotely. It also noted that no temporary amendments had been made to the HCPC’s legislation in light of the COVID-19 pandemic. The Panel considered that the Protocol did not form part of the HCPC’s legislation and decided that it was not necessary for it to make a decision as to whether it was lawful or not. Regardless of whether the Protocol was lawful or valid, the Panel had the inherent jurisdiction to determine whether or not the final hearing of this case should be held using remote conferencing methods or use its discretionary power under Rule 10(1)(f), to adjourn the hearing to be held on a future date in person. In coming to its decision, the Panel applied the principles of fairness and proportionality.

9. The Panel bore in mind its statutory obligation to conduct fitness to practise proceedings expeditiously (Article 32(3) of the Order) and that it is in the interest of all parties, and the wider public interest, that allegations are heard and resolved as quickly as possible.

10. The Registrant is entitled to a fair hearing. He will be able to give evidence in real-time by video-link and can request a break at any stage. The Registrant is represented by Mr Harries in these proceedings; there is a separate breakout room available for the Registrant to discuss the case with Mr Harries during the course of the proceedings. Mr Harries may request a break at any stage (other than when the Registrant is giving evidence) in order to take instructions from his client. The Panel did not consider that the Registrant would be significantly disadvantaged by not being able to give his account to the Panel in person (as opposed to via video-link) of the matters giving rise to these charges and to address the Panel in relation to issues of current impairment and, if necessary, sanction. The Panel will still be able to hear and see the Registrant and put questions to him.

11. In relation to the likely length of an adjournment, the information before the Panel is that that, following a risk assessment carried out by the HCPC, it is not possible to open the offices in a COVID-secure manner, due to the relatively small size of the hearing rooms. The Panel was mindful that there would be at least nine people in the in-person hearing room (in fact this morning there were 12 people in the virtual hearing room) and therefore requisite social distancing would not be possible. On the information before the Panel, there are no plans for the HCPC to re-open its hearing centre; any postponement would be open ended, which is not in the public interest.

12. In light of all the information before it, the Panel determined that this was a case suitable for its final hearing to be conducted remotely. It rejected the application to adjourn this hearing.

Application to proceed in private


13. The Panel heard an application from Mr Harries for the hearing to be held partly in private, when particularly sensitive and intensely personal matters arose during the course of submissions and/or evidence, to preserve the private and family life of the Registrant.

14. Mr Lloyd adopted a neutral stance on behalf of the HCPC, noting that the Panel had already had the benefit of reading the papers in this case. He reminded the Panel though of the general principle that hearings such as this should be held in public.

15. The Panel accepted the advice of the Legal Assessor in relation to Rule 10(1)(a) of the Rules. It noted the presumption that hearings are held in public for transparency and openness in regulatory proceedings. The Panel determined to hold the hearing in public, but to go into private when hearing about intensely personal matters about the Registrant’s private and family life, so as to preserve his right to confidentiality.

Amendment to the Allegation


16. Mr Lloyd highlighted to the Panel an incorrect date in both the HCPC’s Case Summary and the Allegation, in that the Registrant was convicted of the offences on 15 April 2019 rather than 2 May 2019 as currently drafted. Mr Lloyd clarified to the Panel that the offences took place on 14 April 2019, the Registrant was convicted on 15 April 2019, he self-referred to the HCPC on 16 April 2019 and was sentenced on 2 May 2019. Mr Lloyd submitted that date of the Registrant’s conviction was not in dispute and applied to amend the Allegation accordingly.

17. Mr Harries did not oppose the application.

18. The Panel accepted the advice of the Legal Assessor and agreed to amend the incorrect date in the Allegation.

The Allegation (as amended)
While registered as a Paramedic with the Health and Care Professions Council:
1. On 15 April 2019, at Wigan and Leigh Magistrates Court you were convicted of:

a. Assaulting Person A, contrary to section 39 of the Criminal Justice Act 1988
b. Assaulting Person B, contrary to section 39 of the Criminal Justice Act 1988
2. By reason of your conviction, your fitness to practise is impaired.

Documents


19. The Panel received a bundle of documents from the HCPC comprising a Case Summary, the Notice of Hearing and Exhibits. The Exhibits included the Registrant’s email of self-referral to the HCPC, the Memoranda of Conviction, the Police Report MG5 and three witness statements.


20. The Registrant submitted a bundle of documents for the purposes of this hearing, including a written reflective piece together with a CV, confirmation from the courts that the Registrant’s Community Order had been revoked, qualification and training certificates, a number of references and testimonials, including an email of support from Person A, and information regarding the Registrant’s ongoing Doctoral research. 


Background

21. The Registrant is registered with the HCPC as a Paramedic.

22. On 16 April 2019 the HCPC received a self-referral from the Registrant, in which he informed the HCPC that he had been charged with two offences contrary to Section 39 of the Criminal Justice Act 1998, following an incident that occurred on 14 April 2019.

23. On 15 April 2019 the Registrant pleaded guilty and was convicted at Wigan and Leigh Magistrates Court of two offences of common assault, contrary to Section 39 of the Criminal Justice Act 1988. He received a Community Order which included an unpaid work requirement to run until 1 May 2020 and a rehabilitation requirement.

24. In his email of self-referral the Registrant set out the circumstances leading to the offending and expressed regret and remorse. He stated that he was entirely overwhelmed by the situation and lashed out in anger, that he deeply regretted his actions and was engaging fully with the police. He said that he had accepted the accusations during the police interview, pleaded guilty at the first opportunity and said that he would continue to take responsibility for his actions.

Decision on Facts

25. In considering this case the Panel bore in mind that the burden of proving the facts rests upon the HCPC and that the standard of proof is the civil standard of the balance of probabilities. It has taken account of all the documentary evidence presented to it by the HCPC. It has also considered the submissions of both parties and has accepted the advice of the Legal Assessor, who referred the Panel to the HCPC Practice Note entitled ‘Conviction and Caution Allegations’.

26. At the outset of the hearing, the Registrant admitted, through Mr Harries, the charges as set out in Particulars 1(a) and (b).

27. The Panel confirms that copies of the Memoranda of Conviction in respect of the charges specified in Particulars 1(a) and (b) have been presented to it. Moreover, the Registrant has admitted the Particulars and the fact that he has been convicted of the offences.

28. The above documents set out clearly the offences for which the Registrant was convicted, and the sentence imposed upon him. On the basis of these documents, which the Panel determined to be reliable evidence of the convictions, and in accordance with Rule 10(1)(d) of the Heath and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003, the Panel finds that the HCPC has discharged the burden of proving that the convictions were recorded against the Registrant. Accordingly, the Panel finds the fact of the convictions, as set out at Particulars 1(a) and 1(b), proved.

Decision on Statutory Ground

29. The Panel took account of the advice of the Legal Assessor that in assessing whether the Registrant’s actions satisfied the statutory ground of Conviction, the Panel had to be satisfied that the convictions were sufficiently serious to give rise to concerns about the Registrant’s fitness to practise, since not all convictions would put his fitness to practise in jeopardy, such as very minor Road Traffic Act offences.

30. The Panel took account of the fact that the convictions in Particular 1 were for offences involving violence, always regarded as serious in the regulatory sphere. It therefore concluded that the convictions specified in Particular 1 were serious enough to engage the statutory ground of Conviction.


Decision on Impairment

31. The Panel then went on to consider whether the Registrant’s fitness to practise is currently impaired by reason of the convictions.

Submissions

32. Mr Lloyd provided written submissions to the Panel. In relation to the personal component, Mr Lloyd submitted that the key questions for the Panel to determine are whether the acts that led to the allegation are remediable, whether the Registrant has taken remedial action and whether these acts are likely to be repeated. He acknowledged the Registrant’s guilty plea, his self-referral and written reflection. He invited the Panel to assess the Registrant’s level of insight and to consider whether the Registrant understands the severity of his actions leading to criminal conviction and has taken steps to prevent re-occurrence.

33. In Mr Lloyd’s submission, in relation to the public component, in engaging in violent behaviour that resulted in injury and criminal conviction, the Registrant brought the profession into disrepute and breached a fundamental tenet of the profession. He submitted that “Violence is conduct which must be decried by the regulator and which, if public confidence in the profession is to be maintained, must be marked.” Mr Lloyd submitted that the public interest required that a finding of impairment be made to uphold proper professional standards and public confidence in the Paramedic profession and the regulatory process.

34. Whilst noting that a decision on current impairment is a matter for the Panel’s judgment, Mr Harries accepted, on behalf of the Registrant, that the Registrant’s current fitness to practise is impaired, but on the public component only. Mr Harries referred the Panel to the Registrant’s reflective piece and the insight demonstrated within it, particularly the fact that the Registrant acknowledged the need to mark his conduct with a finding of impairment:

“The Regulator, my profession and the public have a right to be concerned and dismayed when a Paramedic is convicted of a violent offence. Would any right-minded person want somebody who is violent in a caring and trusted position, entering people’s lives when they are most vulnerable and frightened? Despite an otherwise exemplary career I recognise that I have stepped far outside the boundary of acceptable conduct for any professional. I have undermined the trust the public places in their healthcare professionals and damaged the reputation of my profession.”

35. Mr Harries submitted that there should be no finding of current impairment on the personal component, that is considering the current behaviour of the Registrant and his response to the convictions. He submitted that it was abundantly clear that the conduct under scrutiny was completely out of character, that it was borne out of “unique personal circumstances” and that there had been no similar behaviour, previously or since. He submitted that the conduct was not only remediable but that the Registrant had demonstrated remediation. He told the Panel that the Registrant had fully complied with the terms of his Community Order and that, having completed all that he needed to, to such a good standard, the exceptional step was taken to revoke it. Mr Harries further submitted that the trigger factors that precipitated the conduct were unique, had now been removed from the Registrant’s life and that the Panel could be satisfied that the likelihood of repetition was extremely low.

Legal Advice

36. The Legal Assessor reminded the Panel that its role was not to go behind the conviction, nor was it to seek to retry the criminal case. She referred the Panel to the HCPTS Practice Note ‘Fitness to Practise Impairment’. She advised the Panel that its task was to determine whether the Registrant’s fitness to practise is impaired, based upon the nature, circumstances and gravity of the criminal offences concerned. The Panel should be mindful of the forward-looking test for impairment and the need to take account of public protection in its broadest sense, including whether the Registrant’s actions bring the Paramedic profession into disrepute or may undermine confidence in the profession.

37. The Panel was advised that it could take into consideration whether the Registrant pleaded guilty to the offences and if he did, at what stage in the criminal proceeding proceedings. A guilty plea entered at the first reasonable opportunity is indicative of greater insight on the part of the Registrant than one entered at the last moment.

38. The Legal Assessor also advised the Panel to have regard to the sentence received, but also to bear in mind that the sentence imposed is not necessarily a good indicator of the seriousness of the offences when considered in a regulatory context. This is because the prime consideration of regulatory tribunals is the protection of the public and of the wider public interest. As Dame Janet Smith noted in the Fifth Shipman Inquiry Report,

“The fact that the court has imposed a very low penalty or even none at all should not lead the [regulator] to the conclusion that the case is not serious in the context of [its own] proceedings. The role of the [regulator] in protecting [service users] involves different considerations from those taken into account by the criminal courts when passing sentence. What may well appear relatively trivial in the context of general criminal law may be quite serious in the context of [professional] practice.”
Decision on Impairment
39. The Panel recognised that there is no burden or standard of proof and that this is a matter for its independent judgment. The Panel took into account the HCPTS Practice Notes ‘Conviction and Caution Allegations’ and ‘Fitness to Practise Impairment.’ It accepted the advice of the Legal Assessor. In reaching its decision, the Panel had regard to all the evidence before it and took account of the submissions of both parties.

40. So far as the personal component is concerned, the Panel acknowledged that the Registrant’s convictions and the conduct that led to them had no connection with his employment. The Panel, however, considered that the offences were serious; this was behaviour that fell significantly short of that which the public is entitled to expect from a registered Paramedic.

41. The Panel first considered whether the acts that led to the allegation were remediable. It considered that they were - a registrant convicted of offences relating to common assault could, with appropriate reflection, come to an understanding of why he had committed such offences and thereafter develop insight into his personality together with appropriate strategies to prevent repetition. The Panel considered the level of insight shown by the Registrant in his correspondence with the HCPC and his reflective piece.

42. The Panel considered that the Registrant had focused on a full admission of his responsibility for his actions, rather than seeking to minimise or excuse them, and appeared to accept the effect on the victims and his family; he has also accepted the damage caused to his profession. The Panel was of the view that the Registrant was able, in his written reflection, to express meaningful strategy or measures that he could take to avoid such conduct in the future, should he be put in any stressful situation again. Further, the Panel took into account that he admitted guilt at the earliest reasonable opportunity and complied fully with the criminal sentence imposed. In particular, the Panel noted the written testimonial provided by the provider of probation and rehabilitation services which stated:

“[The Registrant] was sentenced to a 12 month CO [Community Order] with 20 days Rehabilitation Activity Requirement days and 180 hours Unpaid work. [The Registrant] completed the Unpaid work successfully. He has completed the RAR days by completing offence focused work on Risk reduction, victims, healthy relationships, handling conflict without Violence. [The Registrant] has always been on [sic] punctual, his attitude has been excellent, he has shown full remorse for his offending behaviour.”

43. In light of all of the evidence presented to it, the Panel determined that this demonstrated a high level of insight on the part of the Registrant and considered there to be a low risk of repetition. After careful consideration, the Panel concluded that the Registrant had demonstrated full remediation and that a finding of current impairment was not required on the personal component.

44. In relation to the public component, it was clear to the Panel that the public’s perception of the Registrant’s actions would be negative and that such actions have harmed the reputation of the profession as a whole.

45. The Panel adopted the approach formulated by Dame Janet Smith in her fifth report of the Shipman Inquiry by asking itself the following questions:

“Does the Registrant’s conviction, and the facts relating to the conviction show that his fitness to practise is impaired in the sense that he:
a) has in the past acted and/or is liable in the future to act so as to put patient or patients at unwarranted risk of harm; and/or
b) has in the past brought and/or is liable in the future to bring the paramedic profession into disrepute; and/or
c) has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the paramedic profession; and or
d) has in the past and/or is liable in the future to act dishonestly?

46. The Panel concluded that limbs (b) and (c) above were engaged in this case. The Panel determined that by these convictions, the Registrant had breached a fundamental tenet of the profession, namely that it is incumbent on members of the profession not to behave in this manner and not to transgress the laws of the land. The Panel determined that the Registrant’s convictions, relating to offences involving violence, had clear implications in terms of the wider public interest in maintaining public confidence in the profession. The Panel determined that other practitioners would consider that the Registrant’s actions were abhorrent and would attract public opprobrium. In concluding that the public component of impairment is clearly established, the Panel also had regard to the need to uphold proper standards of behaviour. It determined that the conviction was such that the need to uphold professional standards and public confidence in the profession would be undermined if a finding of impairment were not made.

47. Therefore, the Panel has determined that the Registrant’s fitness to practise is currently impaired, on the public component only, by reason of his conviction.

Decision on Sanction

48. The Registrant gave sworn evidence to the Panel at this stage of the proceedings. He outlined his 17-year professional career to date, including the ongoing academic portion of it, and addressed the Panel in relation to his current circumstances. He recounted the events that took place on 14 April 2019 that led to the convictions and the context around his conduct that night. He said he couldn’t entirely remember the incident because “the whole world collapsed around me.” He expressed deep regret and remorse, apologising unreservedly on a number of occasions for his failings and for the convictions. He explained how, and the degree to which he, his victims and his wider family had been impacted and how he recognised that he had brought his profession into disrepute.

49. The Registrant spoke about the importance to him of his career as a registered Paramedic and that he did not regard it as “just a job.” He said that, since his convictions, he had continued to work and to contribute to the profession. He was taken to the positive testimonial in the bundle from his current employer, where the Registrant works full time hours, who referenced his exemplary professionalism in his role. The Registrant said that the only thing that he has ever wanted is to improve his profession and how it is regarded; that he could not envisage working in any other role. He spoke about the significant financial impact upon him and his personal responsibilities if he were to be suspended from the Register. He told the Panel that he would likely lose his job if he were to be suspended.

Submissions on Sanction

50. Mr Lloyd reminded the Panel of the wider public interest in the imposition of a sanction. He took the Panel through the HCPC’s Sanctions Policy (SP) document and addressed it in relation to each sanction. He submitted that any sanction must be proportionate and that it was important to note that the purpose of a sanction is not to punish the Registrant for a second time. He referred the Panel to mitigating factors of the Registrant’s early guilty plea, his admissions at police interview, his expeditious self-referral and his insight, remorse and apology. Mr Lloyd said that there were no specific aggravating factors beyond the facts of the offences themselves.

51. Mr Harries conceded that any case that involves violence is a serious one but invited the Panel to find that the offences in this case - two offences but arising from the same short, isolated incident - were at the bottom end of the hierarchy of violent offences. He asked the Panel to look at the context in which the offences took place and the Registrant’s response - contrition and remorse - demonstrated from the police interview onwards. He submitted that, in every other way, the Registrant is a credit to the profession and that an informed member of the public would recognise that his actions on that one occasion were “an aberration wholly out of character.” Mr Harries also took the Panel through the SP and submitted that the Panel’s finding of impairment was, of itself, suitable, appropriate and proportionate in this case and no sanction was required. If the Panel were not with him, however, he submitted that a Caution Order would “mark the card.” He submitted that no meaningful Conditions of Practice could be formulated to address the issues in this case and that a Suspension Order would be disproportionate.

52. The Panel accepted the advice of the Legal Assessor. She advised the Panel that the full range of sanctions was available to the Panel as this was a case involving a criminal conviction, and she reminded the Panel that it was not to go behind the conviction. She also reminded the Panel of its over-arching objective to protect the public in its broadest sense.

53. The Legal Assessor advised that, whilst the Panel was entitled to take into consideration the sentence that the criminal court imposed upon the Registrant, the sentence imposed was not necessarily a good indicator of the type of sanction that should be applied in this case.

54. The Legal Assessor advised the Panel that any sanction it imposed must be the least restrictive sanction that was sufficient to protect the public and the public interest. It should take into consideration the aggravating and mitigating factors in the case. She reminded the Panel that the purpose of a sanction is not punitive, although it may have that effect. The purpose of a sanction is to protect members of the public and the wider public interest, weighing the Registrant’s interests against the public interest.

Decision on Sanction

55. The Panel found the Registrant’s evidence to be credible and accepted that his remorse was significant and genuine.

56. The Panel had close regard to the HCPC’s Sanctions Policy document in reaching its decision on sanction. It took account of paragraph 93 of the SP which provides, “Registrants have a duty to ensure that their conduct justifies the public’s trust and confidence in them and their profession (see standard 9.1 of the Standards of conduct, performance and ethics). Where a registrant has exhibited violent behaviour, this is highly likely to affect the public’s confidence in their profession and pose a risk to the public. In these cases, a more serious sanction may be warranted.” While the Panel acknowledged the relevance of this paragraph of the SP guidance to its considerations, it reminded itself of its finding of impairment on the public component and that the Registrant did not pose an ongoing risk to the public.

57. The Panel reminded itself that the purpose of a sanction is not to punish. Rather, a sanction should only be imposed to the extent that it is required to protect the public, to maintain a proper degree of confidence in the profession and the regulatory process, and to declare and maintain proper standards among fellow professionals. To ensure this approach the Panel reminded itself to first consider whether its findings require the imposition of any sanction at all. If they do, then the available sanctions must be considered in ascending order of seriousness until one that satisfies the factors already identified is reached. The Panel confirms that it has followed this approach in the present case.

58. The Panel did not consider there to be any specific aggravating features in this case beyond the facts of the offences themselves.

59. The Panel agreed with Mr Harries’ regarding the mitigating features of this case: the Registrant’s early guilty plea; his admissions at police interview; his expeditious self-referral to the HCPC; his significant reflection; his insight, remediation and apology.

60. In this case, the mitigating factors significantly outweigh the aggravating factors.

61. In considering the matter of sanction, the Panel started with the least restrictive, moving upwards.

62. The Panel first considered taking no action but concluded that, given the seriousness of the criminal offences, this would be inappropriate and insufficient to declare and affirm proper standards of conduct and behaviour, or to maintain public confidence in the profession.

63. The Panel then considered whether to make a Caution Order and considered paragraph 101 of the SP which states as follows:
“A caution order is likely to be an appropriate sanction for cases in which:
• the issue is isolated, limited, or relatively minor in nature;
• there is a low risk of repetition;
• the registrant has shown good insight;
• and the registrant has undertaken appropriate remediation.
The Panel was of the view, and for the reasons already set out in this determination, that each of the 4 bullet points above had been satisfied.
64. The Panel further considered paragraph 102 of the SP:

A caution order should be considered in cases where the nature of the allegations mean that meaningful practice restrictions cannot be imposed, but a suspension of practice order would be disproportionate. In these cases, panels should provide a clear explanation of why it has chosen a non-restrictive sanction, even though the panel may have found there to be a risk of repetition (albeit low).”
In the Panel’s view, this is not a case that is suitable for the imposition of a Conditions of Practice Order, there being no concerns with the Registrant’s clinical practice or competency as a Paramedic.
65. The Panel then considered whether a period of suspension would be an appropriate and proportionate response. It had regard to paragraph 121 of the SP which states as follows:

“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; and
• there is evidence to suggest the registrant is likely to be able to
resolve or remedy their failings.”

The Panel balanced the public interest with the interests of the Registrant and the detrimental impact upon him of a Suspension Order. In all the circumstances and given the findings and mitigating factors, it determined that a Suspension Order would be disproportionate and contrary to the public interest, which includes the retention of a skilled paramedic who is able to make a valuable contribution to the profession and to patients.

66. Having weighed all the above considerations the Panel determined that the matter before it, although serious, could be addressed by the imposition of a Caution Order which, in the Panel’s view, was an appropriate and proportionate response to protect the public interest. A Caution Order would be sufficient to maintain and declare proper standards of conduct and behaviour, to maintain the reputation of the profession, and to maintain public confidence in the profession and the regulatory process.

67. The Panel next considered how long the Caution Order should be imposed for and bore in mind paragraphs 103-104 of the SP. It noted that “…the panel should take the minimum action required to protect the public and public confidence in the profession, so should begin by considering whether or not a caution order of one year would be sufficient to achieve this. It should only consider imposing the caution order for a longer period where one year is insufficient. Each case should be considered on an individual basis…”

68. The Panel was of the view that a Caution Order of one year was insufficient to mark the seriousness of the conduct and the resulting convictions. It determined a 2-year Caution Order was the appropriate and proportionate sanction in this case to mark the severity of the offences, while recognising the steps that the Registrant has taken with regard to remediation.

Order

Order: That the Registrar is directed to annotate the register entry of Mr Christopher J Preston with a Caution which is to remain on the register for a period of two years from the date this order comes into effect.

Notes

The Order imposed today will apply from 10 November 2020.

 

 

Hearing History

History of Hearings for Mr Christopher J Preston

Date Panel Hearing type Outcomes / Status
13/10/2020 Conduct and Competence Committee Final Hearing Caution
03/09/2020 Conduct and Competence Committee Final Hearing Adjourned part heard