Mr Steven Watkins

Preliminary Matters

Service

1. The Panel was satisfied that a Notice of the Hearing had been sent to the Registrant by an email dated 20 November 2020. The Notice was sent to the Registrant’s postal address registered with the HCPC and to two email addresses held by the HCPC. These gave notice of the hearing date and informed the Registrant that the hearing was to be a virtual hearing. The Panel had sight of a confirmation of delivery email and a confirmation of posting.
 

2. The Panel was satisfied that there had been proper service of the notice of hearing in accordance with the requirements of Rule 6 of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”).
 

Application to proceed in the absence of the Registrant

 

3. Mr Tarbert applied on behalf of the HCPC to proceed with the hearing in the absence of the Registrant.
 

4. The Panel had sight of an email from the Registrant dated 7 February 2021 and timed at 01.42 in which he stated that he would not attend the hearing. It was also established that the Registrant had earlier completed an HCPC hearing proforma response to the Notice of Allegations stating that he would not attend the hearing and that he admitted the facts alleged. Mr Tarbert submitted that the Registrant had clearly decided not to attend and that an adjournment would not serve any useful purpose. It was in the interests of the public and of the HCPC witnesses who were ready to give evidence that the matter should proceed and be resolved today.
 

 

5. The Panel considered the submissions on behalf of the HCPC. It accepted the advice of the Legal Assessor. The Panel was referred to the HCPTS Practice Note of September 2018, Proceeding in Absence, which sets out guidance from the cases of R v Jones (Anthony) [2004] 1 AC 1HL and GMC v Adeogba and GMC v Visvardis [2016] EWCA Civ 162. Applying that guidance, the Panel was careful to remember that its discretion to proceed in absence is not unfettered and must be exercised with the utmost caution and with the fairness of the hearing at the forefront of its mind.
 

6. The Panel was satisfied in accordance with Rule 11 that the HCPC had made all reasonable efforts to inform the Registrant of the details of the hearing scheduled for today and to inform him of his right to participate in the hearing and be represented. In the Notice of Hearing he was informed of the Panel’s power to proceed in his absence and of the sanctioning powers available to the Panel, should the allegation be found proved. The Registrant had twice indicated his decision not to attend this hearing. The Panel concluded that an adjournment to a future date would not serve any useful purpose. The Panel was satisfied that the Registrant had voluntarily absented himself from the hearing and waived his right to attend.
 

7. The Panel was mindful of the public interest in the fair and expeditious resolution of disciplinary cases, as described in the case of Adeogba, and of the readiness of the HCPC’s witnesses to proceed today. The Panel was satisfied it was fair and in the public interest to proceed with the hearing in the Registrant’s absence.
 

8. The Legal Assessor reminded the Panel of its duty in the absence of the Registrant to ensure that the hearing was as fair as circumstances permit. In considering the evidence the Panel should raise any issues which were reasonably evident from the evidence and might have been asked by the Registrant.
 

Documents

 

9. The Panel received a pdf of the HCPC hearing bundle which comprised 462 pages (C1), a small bundle of service documents (C2) a HCPC Hearing Proforma Response completed by the Registrant (C3) and emails from him dated 19 January 2021 (C4) and 7 February 2021.
 

Application to amend the allegation

 

10. Mr Tarbert applied to amend the particulars of the allegation. The allegation, showing the proposed amendments, is set out below:
 

Whilst registered as a Paramedic with the Health and Care Professions Council and whilst employed at West Midlands Ambulance Service NHS Foundation Trust, you:

 

1. On or around 20 February 2018, you sent an inappropriate and/or unprofessional text message to Person A in that you stated “I still think you’re just sexy” or words to that effect.

 

2. Between 26 and 28 March 2018, you sent inappropriate Facebook messages and/or text messages of a sexual nature to Person C, specifically you stated:

a) “you can still do as you are told or does it mean I have to spank you” or words to that effect;

b) “I won’t leave a bruise (winking emoji)” or words to that effect;

c) “I love how you tease me” or words to that effect;

d) “I could can still look” and you would not I just won’t tell the GF what you . xx your girlfriend” or words to that effect;

 e) "13 things that made EMS sounds dirty” sent as a picture message;

 f) “how’s naughty” or words to that effect;

 g) a picture of yourself laying on a bed topless to Person C;

h) “…..mmmm pull your top down a little lower and send me again (winking emoji)” or words to that effect;

 i) “…..sometimes getting sweaty is fun” or words to that effect;

 j) “you’ll have to give me your suggestions” or words to that effect;

 k) “so what are your suggestions for sweaty?” or words to that effect;

 l) “Naughty student” or words to that effect;

 m) “need me to give you a massage” or words to that effect.

 

3. On or around 26 April 2018, you displayed inappropriate and/or unprofessional behaviour of a sexual nature towards Person B, specifically you:

 

a) tickled the base of Person B’s spine when she bent forward speaking to a patient;

b) brushed your hands across Person B’s lower back;

c) put your arm around Person B’s waist;

d) stroked Person B’s back in a circular motion with your hands when she was taking a patient’s pulse in the ambulance;

e) brushed your hands across Person B’s right breast and/ or chest

f) grabbed Person B’s left arm and pulled her towards you;

g) grabbed Person B’s bum cheeks and squeezed them;

h) said to Person B “unbutton on your shirt….” or words to that

 

4. On or around 26 April 2018, during your shift you sent one or more inappropriate text messages of a sexual nature to Person B whilst she was attending to patients, specifically your including a messages which stated “Bend over…. Oooh a bit further” or words to that effect.

 

5. On 26 April 2018, you did not provide patients with adequate care and / or treatment, in that you sent several text messages to Person B whilst assigned to two
   
   
6. On or around 26 April 2018 you sent inappropriate text messages of a sexual nature to Person B, in that you said:

 

a) “Yeah the sunshine’s out of your cute bum” or words to that effect;

b) “LOL cake v sex” or words to that effect;

c) “depends where I’m eating it from” or words to that effect;

d) “I’m sticking to my assessment of your bottom button x” or words to that effect;

e) “you forgot I like your arse the way it is” or words to that effect;

f) “And I’m right about your bum” or words to that effect.

 

7. On 26 April 2018, you displayed unprofessional behaviour towards Person B, in that you hugged her in front of a patient when she was attending to the

 

8. On or before 28 June 2018, you displayed inappropriate and/or unprofessional behaviour of a sexual nature towards Person J, specifically you:

 

a) put your left hand on Person J’s right hip;

b) touched her left breast; and/or

c) asked her to send you pictures of when she was

 

 

9. Your conduct in paragraphs 1, 2, 3, 4, 5, 6, 7, and/or 8 was sexually motivated

 

10. The matters set out in paragraphs 1 to 9 constitute

 

11. By reason your misconduct, your fitness to practise is

 

11. The Registrant was given notice of the HCPC’s proposed amendments in a letter dated 13 February 2020. The HCPC had received no comment on, or objection to, the proposed amendments from the Registrant.

12. The Panel took advice from the Legal Assessor. The Panel considered that the amendments sought were to remove words, to make the particulars more specific or to make minor clarifications or corrections. The amendments did not substantively change the allegation or extend its scope. The Panel was satisfied that no unfairness or prejudice would be caused to the Registrant, who had been given ample notice of the application and had not notified the HCPC of any objection. Two other minor amendments relating to purely typographical errors were made.

13. The Panel therefore determined that it was appropriate for the amendments to the allegation to be made.
 

Background

14. The Registrant was employed by West Midlands Ambulance Service NHS Foundation Trust (“the Trust”) as a Band 6 Paramedic.
 

15. On 6 May 2018, the Registrant referred himself to the HCPC. He informed the HCPC that he was the subject of an investigation by the Trust concerning alleged inappropriate conduct towards four members of staff, identified as persons A, B, C and J.

 

The HCPC’s evidence

Evidence of Person B

 

16. Person B confirmed the truth of the matters contained in her signed witness statement dated 23 January 2020 and gave oral evidence before the Panel.
 

17. At the relevant time Person B was a Student Paramedic since September 2017, alongside her role as a Phlebotomist.
 

18. Person B’s evidence related to Particulars 3,4,5,6 and 7. She worked one 12-hour shift with the Registrant on 26 April 2018. This was during her second clinical placement in her first year as a student Paramedic. The Registrant was in charge of the crew and also on shift was another paramedic, TC. After this shift Person B reported her concerns about the Registrant. She wrote a letter of complaint to the Trust (Exhibit 1, 4b) in which she detailed her concerns.
 

19. Person B told the Panel that her decision not to continue her Paramedic training was as a result of these events and she is now working in the District Nursing team.
 

Evidence of Person J

 

20. Person J confirmed the truth of the matters contained in her signed witness statement dated 26 January 2020 and gave oral evidence before the Panel. Person J’s evidence related to Particular 8.
 

21. At the relevant time, Person J was a Trainee Technician/Technician/Student Paramedic. She is now an HCPC registered Paramedic. Person J told the Panel that she is now a “Freedom to Speak” Officer for the Trust.
 

22. Person J told the Panel that she knew the Registrant from April 2017 and worked with him on one occasion prior to the incident in question. She could not recall the date of the incident she described in her evidence. Person J described her concerns, as now reflected in particular 8(a) to (c). Person J said she made a written complaint to the Trust but this had been lost when she asked for a copy. This is confirmed by documents from the Trust seen by the Panel.
 

 

The HCPC’s application to admit hearsay evidence in respect of Person C and Person A.

 

23. Mr Tarbert applied for the Panel to admit into evidence the signed HCPC witness statement of Person C. Her evidence related to Particular 2(a) to (m). Particular 1 related to Person A. Mr Tarbert applied for the Panel to admit in evidence a document within the hearing bundle marked as Exhibit 1, Appendix 6, said to be a copy of several text messages sent between the Registrant and Person A.
 

24. In respect of Person C, Mr Tarbert explained that Person C is unable to attend this hearing as she is currently home-schooling four children (as a result of the COVID 19 pandemic), one of whom is disabled. She and the children have access to one device between them. As a result, it is impracticable for Person C to attend the hearing and this situation will not change in the foreseeable future. An email from Person C dated 21 January 2021 was produced confirming this information. A further email was produced from the HCPC’s solicitors, dated 4 February 2021, giving the Registrant notice of the position and offering him the chance to comment on the HCPC’s application. No comment was received.
 

25. In respect of Person A, Mr Tarbert said that she has not given a witness statement for the purpose of the HCPC case. Efforts have been made by the HCPC to trace Person A using a tracing agent, but without success. The report of the tracing agent appeared in the hearing bundle. The Trust investigation documents showed that Person A did not attend the Trust’s disciplinary hearing due to ill health. The Trust documents indicated that a copy of the text messages relating to Person A had been obtained during its investigation. This was the document which the HCPC sought to admit in evidence. Mr Tarbert told the Panel that no formal hearsay notice had been served in relation to the Patient A text messages, but submitted that notice had been given to the Registrant at the time when all the HCPC case papers were served. The letter sending the documents informed the Registrant that the HCPC intended to rely on all the hearsay material contained in the hearing bundle. There had been no comment from the Registrant in response.
 

26. Mr Tarbert applied to admit the relevant documents as the hearsay evidence of Person C and A. He referred to the to the evidential provisions of the Rules and the principles to be applied in considering such an application in the case of Bonhoeffer v GMC [2011] EWHC 1585 (Admin).
 

Panel decision on hearsay application

 

27. The Panel took advice from the Legal Assessor, who referred to the Panel to Rules 10(1)(b) and (c) and in addition to the case of Bonhoeffer, to the guidance in the cases of El Karout v NMC [2019] EWHC 28 (Admin) and Thorneycroft v NMC [2014] EWHC 1565 (Admin). Applying this guidance, the Panel first considered whether the documents were properly admissible.
 

28. The Panel was of the view that particulars to which the evidence of Person C and Person A related were serious and it was mindful of the potentially serious consequences for the Registrant if they were found proved.
 

29. In respect of Person C, the Panel took into account that Person C had provided a formal, signed witness statement to the HCPC. The reason for her inability to attend the hearing in person had been investigated by the HCPC. Person C had previously engaged with the HCPC process and had been expected to give evidence. In the view of the Panel, the reasons given for her non-attendance, the significant issue being childcare difficulties, were valid reasons. Formal notice of the hearsay application had given to the Registrant in the email of 4 February 2021 and he had made no comment or objection. The Panel also bore in mind that the Registrant had indicated admissions to the allegation as a whole and that as a result of his decision not to attend the hearing, there would be no cross-examination of Person C.
 

30. Taking into account all these factors, the Panel was satisfied that the statement of Person C was properly admissible under Rule 10(1)(b) and (c). The Panel would be mindful of the weight to be attached to it when considering the facts.
 

31. In respect of the text messages relating to Person A, the Panel took into account that Person A had not provided a witness statement to either the Trust or to the HCPC. The text messages document was not produced by any witness, either Person A or any officer from the Trust who might have explained formally how the document had been created and obtained. There was no evidence in the text messages confirming to whom and by whom they were sent, other than some labelling which appeared to have been added during the Trust investigation. The notice given to the Registrant was not a specific notice in relation to an application to admit and rely upon this piece of evidence. This piece of evidence was central to the HCPC’s case on Particular 1, as there was no statement from Person A. Whilst the Panel bore in mind that formal efforts had been made to trace Person A via a tracing agent, the general admissions made by the Registrant and the fact that the question of cross-examination did not arise, the Panel was not satisfied that the document was admissible under Rule 10(1)(b), nor that it was otherwise necessary to admit the document in order to protect the public under Rule 10(1)(c), given the scope of the other particulars and other evidence available.
 

32. The Panel rejected the HCPC’s application to admit the text messages document relating to Person A.
 

Evidence of Person C

 

33. The Panel had sight of Person C’s witness statement dated 21 January 2020. She was the witness in respect of Particular 2.
 

34. At the relevant time, Person C was a student Paramedic. She worked with the Registrant on the first shift of her first placement during her first year.
 

The Registrant’s case

 

35. No evidence or submissions had been received from or on behalf of the Registrant, with the exception of the completed HCPC Pro Forma where he admits to the allegation as a whole.
 

Legal Advice at the facts stage

 

36. The Legal Assessor advised the Panel that the burden of proof is upon the HCPC. The standard of proof in HCPC proceedings is the civil standard, the balance of probabilities. This means in order to find a fact proved, the Panel must be satisfied it is more likely than not that it occurred.
 

37. In relation to the allegation of sexually motivated conduct in Particular 9, the Panel was referred to the guidance in the case of Basson v GMC [2018] EWHC 505 which suggested the following definition: “sexual motive means that the conduct was done either in pursuit of sexual gratification or in pursuit of a future sexual relationship”.
 

38. The Panel was also referred to the decision in Arunkalaivanan v GMC [2014] EWHC 873 (Admin) which discussed how, in the absence of direct evidence of sexual motivation, a panel may draw an inference from the primary evidence on the balance of probabilities, taking into account all the circumstances and considering any information as to the Registrant’s character.
 

Decision on facts

 

39. The Panel considered the submissions of Mr Tarbert on behalf of the HCPC. He provided detailed written submissions to the effect that there was evidence in support of all the facts alleged for the Panel to be satisfied that the facts were proved. The Panel accepted the Legal Assessor’s advice and bore in mind that the burden of proof of the facts is upon the HCPC and the standard of proof to be applied is the civil standard, the balance of probabilities.
 

40. The Panel noted the admissions made by the Registrant in the HCPC Response Proforma, in which he said that he admitted the facts, and in his email to the HCPC of 19 January 2021, in which he stated “I do not contest the facts of the case nor wish to subject those affected by my actions to any further stress by way of dispute or cross-examination”. The Panel bore in mind those admissions but proceeded to consider all the evidence presented in support of the HCPC’s case and whether it was satisfied that the particulars of the allegation were proved on the balance of probabilities.
 

 

41. In respect of the witnesses who gave oral evidence, the Panel found the evidence of Person B to be credible and clear. Where she could not recall all the details of the events, she acknowledged this and did not seek to embellish her evidence. The Panel noted that she was clearly uncomfortable giving evidence about these issues but found her to be candid and consistent. The Panel did not identify any indication that Person B had any adverse motivation to make a complaint against the Registrant.
 

42. The Panel found Person J to be credible, candid, straightforward and consistent in her evidence and to have a good recollection of events. The Panel did not identify any indication that Person J had any adverse motivation to make a complaint against the Registrant.
 

43. The Panel was satisfied it could rely upon and give weight to the witness statement of Person C. Bearing in mind the factors in Section 4 of the Civil Evidence Act 1995 to which it was referred, the Panel was satisfied that the witness statement was a formal document obtained for the purposed of the HCPC case. Patient C had previously engaged with the HCPC and there was a valid reason for Person C’s inability to attend this hearing. The statement produced her letter of complaint to the Trust which was relatively contemporaneous with the event (Exhibit 1, Appendix 5b). The Panel did not deduce any reason for Person C to conceal or misrepresent her evidence.
 

44. In her witness statement, Person C stated that she was a Student Paramedic at the time of the incident relating to the Registrant in March 2018. This took place during her first year as a student, on the first shift of her first placement. Person C’s statement described the incident, as particularised in particulars 2(a) to (m) of the allegation.
 

45. The Panel had also been provided were also a large number of documents from the Trust’s investigation. These documents included the record of an investigatory interview held by the Trust investigating officer with the Registrant on 29 June 2018. The Panel noted that the Registrant was accompanied by a union representative and that both he and the representative had signed the interview record. The Panel was mindful that this was itself a hearsay document, but observed that the Registrant did not dispute many of the issues put to him regarding the concerns of the student colleagues.
 

46. In considering each of the facts, the Panel considered whether it was satisfied to the required standard by the evidence presented by the HCPC and took into account the admissions made by the Registrant to the HCPC.
 

Particular 1 – not proved

 

47. The Panel had not accepted the application to admit the main evidence in support of this allegation concerning Person A, namely the text messages document. The Panel did not find the other documentary evidence sufficient and found the facts not proved.
 

Particular 2(a) – (m) - proved

 

48. The Panel considered the witness statement of Person C, the screenshots of messages between Person B and the Registrant, the record of the Trust’s investigatory interview with Person B on 18 May 2018 and the record of the Trust’s investigatory interview with the Registrant on 29 June 2018. The Panel took into account the admissions made by the Registrant to the HCPC.
 

49.In the light of this evidence, the Panel was satisfied that paragraphs (a) to (m) of Particular 2 were proved on the balance of probabilities.

 

Particular 3 (a) – (h) - proved

 

50. The Panel considered the oral evidence and the witness statement of Person B, the record of the Trust’s investigatory interview with Person B on 18 May 2018 and the record of the Trust’s investigatory interview with the Registrant on 29 June 2018. The Panel took into account the admissions made by the Registrant to the HCPC.
 

51. In the light of this evidence, the Panel was satisfied that paragraphs (a) to (h) of Particular 3 were proved on the balance of probabilities.
 

Particular 4 - proved

 

52. The Panel considered the oral evidence and the witness statement of Person B, the screenshots of messages between Person B and the Registrant, the record of the Trust’s investigatory interview with Person B on 18 May 2018 and the record of the Trust’s investigatory interview with the Registrant on 29 June 2018. The Panel took into account the admissions made by the Registrant to the HCPC.
 

53. In the light of this evidence, the Panel was satisfied that Particular 4 was proved on the balance of probabilities.
 

 

Particular 5 – not proved

 

54. The Panel considered the oral evidence and the witness statement of Person B, the screenshots of messages between Person B and the Registrant, the record of the Trust’s investigatory interview with Person B on 18 May 2018 and the record of the Trust’s investigatory interview with the Registrant on 29 June 2018. The Panel took into account the admissions made by the Registrant to the HCPC.
 

55. However, whilst the Panel accepted from the evidence that the Registrant sent several messages to Person B whilst assigned to patients, there was no evidence of what if any impact his actions had upon the care or treatment of the patients and whether or not it was adequate. When Person B herself was asked about this she considered she was unable to comment on this aspect as she was a student at the time. The Panel was not satisfied that there was sufficient evidence for it to find this particular proved.
 

Particular 6(a) – (f) - proved

 

56. The Panel considered the oral evidence and the witness statement of Person B, her complaint letter to the Trust, the screenshots of messages between Person B and the Registrant, the record of the Trust’s investigatory interview with Person B on 18 May 2018 and the record of the Trust’s investigatory interview with the Registrant on 29 June 2018. The Panel took into account the admissions made by the Registrant to the HCPC.
 

57. The Panel was satisfied that paragraphs (a) to (f) of Particular 6 were proved on the balance of probabilities.
 

Particular 7 - proved

 

58. The Panel considered the oral evidence and the witness statement of Person B, her complaint letter to the Trust, the record of the Trust’s investigatory interview with Person B on 18 May 2018 and the record of the Trust’s investigatory interview with the Registrant on 29 June 2018. The Panel took into account the admissions made by the Registrant to the HCPC.
 

59. The Panel was satisfied that Particular 7 was proved on the balance of probabilities.
 

Particular 8 (a) – (c) - proved

 

60. The Panel considered the oral evidence and the witness statement of Person J, the record of the Trust’s investigatory interview with Person J on 28 June 2018 and the record of the Trust’s investigatory interview with the Registrant on 29 June 2018. The Panel took into account the admissions made by the Registrant to the HCPC.
 

61. In her evidence, on paragraph 8(c), Person J referred to messages which she said the Registrant had sent her. These had not been produced in evidence and Person J was not able to provide them. She was however able to describe the content and sequence of the messages in detail in her oral evidence to the Panel.
 

62. The Panel was satisfied that paragraphs (a) to (c) of Particular 8 were proved on the balance of probabilities.
 

Particular 9 – proved in respect of 2,3,4,6,7 and 8.

 

63. The Panel considered the allegation of sexual motivation in respect of the facts found proved, namely 2,3,4,6,7 and 8. The Panel could not consider this allegation in relation to particulars 1 and 5 as these facts had been found not proved.
 

64. The Panel referred to the advice and submissions it had received on the issue of sexual motivation. It was assisted by the guidance in the case of Basson as to a definition of the term sexual motivation and the guidance in the case of Arunkalaivanan. The Panel considered that the Registrant’s messages to the three Student Paramedics, as referred to in Particulars 2,4,6 and 8(f), were overtly sexualised comments, including references to intimate parts of the body, or were part of a pattern of comments comprising clear sexual innuendo. As part of its factual findings on each of these particulars, the Panel had already made findings that they were of a sexual and inappropriate nature. Given the evident nature and content of the messages, the Panel was satisfied that they were sent by the Registrant for the purpose of sexual gratification and that his actions were sexually motivated.
 

65. In respect of Particulars 3 and 7, relating to Person B, and 8(a) and (b) relating to Person J, the Registrant’s conduct involved direct, opportunistic, inappropriate and unwanted physical contact, touching intimate parts of their bodies. Both witnesses confirmed in their evidence that they perceived the intimate contact to be clearly a deliberate action by the Registrant. The Panel was satisfied that the Registrant’s actions were for the purpose of sexual gratification and were sexually motivated.
 

 

Decision on Ground – Misconduct

66. The Panel considered the submissions of Mr Tarbert and accepted the advice of the Legal Assessor in relation to whether the facts found proved amounted to the ground of misconduct. The Panel applied its own judgement in considering misconduct.
 

67. The Panel reminded itself that the particulars found proved involved findings of inappropriate, unprofessional and sexually motivated behaviour towards three junior female colleagues who at the time were student Paramedics. The Registrant was an experienced Paramedic who met these three colleagues in a professional capacity, in the workplace and had supervisory responsibilities towards them as students. As such, there was an imbalance of power between the students and the Registrant. The Panel concluded that the Registrant’s behaviour towards these colleagues was an abuse of his professional position as a more senior Paramedic.
 

68. The facts found proved disclosed a pattern of sexually motivated conduct towards the three student colleagues, which included initiating and pursuing contact with them on social media platforms, verbal comments and innuendo of an inappropriate and sexualised nature. There were unwanted physical advances in the cases of Person B and Person J. Some conduct occurred in the presence of service users. All the inappropriate face to face contact occurred in a professional setting. The Registrant’s actions caused distress to the witnesses. They were entitled to dignity and respect from the Registrant whilst carrying out their professional roles. Person B was clear in her evidence that the Registrant’s actions were the sole reason why she ended her training as a Paramedic.
 

69. The Panel was of the view that the Registrant’s actions breached the following paragraphs of the HCPC Standards of Conduct, Performance and Ethics (2016):

2.7 - You must use all forms of communication appropriately and responsibly, including social media and networking websites. 

6.2 – [insofar as it relates to colleagues] You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk

 

9 – Be honest and trustworthy

 

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

 

70. The Panel considered that The Registrant’s actions fell far short of the standards expected of a registered Paramedic and would be considered deplorable by fellow professionals. The Panel found that all the facts proved amounted to misconduct.
 

Decision on Impairment

 

71. The Panel considered the submissions of Mr Tarbert on behalf of the HCPC. His submission was that the Panel should find current impairment in relation to both the personal and public components of impairment. The Panel accepted the advice of the Legal Assessor and referred to HCPTS Practice Note, Fitness to Practise Impairment (December 2019).
 

72. The Panel considered in the light of all the information known to it whether the Registrant’s fitness to practise is currently impaired. The Panel applied its own judgment and bore in mind that not every finding of misconduct will indicate that there is current impairment.
 

73. In this case, the Panel concluded that the Registrant abused his position of trust as a senior Paramedic by repeatedly instigating inappropriate and uninvited communication of a sexualised nature with female student paramedics. In relation to Persons B and J this conduct escalated further and included inappropriate and sexualised physical contact without their consent. This conduct occurred in a professional setting whilst the Registrant was on duty and responsible for the care of service users. It caused distress to the three witnesses.
 

74. The Registrant has not engaged with the HCPC hearing, nor has he provided any evidence to the Panel to demonstrate any acknowledgment of his actions or any remorse. There was no evidence before the Panel of any attempt by the Registrant to remedy his past actions, or that they have been remedied.
 

75. The Panel was mindful that insight is a critical part of remediation and assessment of future risk and that is difficult for a Panel to assess this where the Registrant has not engaged in the hearing process. The Panel took into account the comment by the Registrant in his email to the HCPC of 19 January 2021, in which he stated “that he did not contest the facts or “wish to subject those affected by my actions to any further stress by way of dispute or cross-examination”. Whilst the Panel considered this comment might indicate some developing reflection and insight on the part of the Registrant, it was very far from sufficient to satisfy the Panel that there was no risk of repetition of his past behaviour. The Panel therefore concluded that there remained a risk of repetition of such harm in the future. The Panel found the Registrant’s fitness to practise is currently impaired in respect of the personal component.
 

76. Considering the guidance in the case of CHRE v NMC and Paula Grant [2011] EWHC 927 (Admin), and the Practice Note, the Panel was mindful that it must consider the wider public interest considerations. The Registrant’s actions brought the profession into disrepute and breached a fundamental tenet of the profession. The Panel concluded that members of the public would be concerned if the fitness to practise of a Registrant who had acted in this manner were not found to be currently impaired. The Panel took the view that public confidence in the profession and the regulatory process would be undermined if a finding of impairment were not made in this case and found impairment in respect of the public component of impairment. 

77. The Panel therefore concluded that the Registrant’s fitness to practise is currently impaired in respect of both the personal and public components of impairment.

Panel decision on sanction

78. Mr Tarbert addressed the Panel on the issue of sanction and provided written submissions. The HCPC did not propose a particular sanction in this matter, but referred the Panel to relevant sections of the HCPC Sanctions Policy of March 2019. There were no submissions on sanction from the Registrant.

79. The Panel received and accepted the advice of the Legal Assessor. The Panel were mindful that the purpose of a sanction is not to be punitive, though a sanction may have a punitive effect. The Panel bore in mind that its primary function at this stage is to protect the public, while reaching a proportionate sanction, taking into account the wider public interest and the interests of the Registrant. The Panel referred to the HCPC’s Sanctions Policy and applied it to the Registrant’s case on its own facts and circumstances.

80. The starting point for the Panel was that the Registrant’s misconduct was serious. The Panel has found that he engaged in a pattern of deliberate, sexually motivated behaviour towards three junior student Paramedic colleagues. His actions are likely to undermine confidence in the Paramedic profession in the eyes of service users and the public. The Registrant has not engaged with this hearing or provided any submissions or mitigation evidence. The Panel has no indication that he has undertaken any reflection or remediation, nor has he demonstrated any meaningful insight. He has provided no up to date information about his current employment or personal circumstances.

81. The Panel proceeded to consider the mitigating and aggravating factors present in the case.

82. The Panel identified the following mitigating factors:    

• The Registrant made written admissions to the factual allegations for the purposes of this hearing;
• The Panel has seen no information indicating that the Registrant has been the subject of any previous regulatory findings;
• The Panel noted at the impairment stage that the Registrant’s admissions in connection with this hearing suggested he may have begun to develop some degree of insight. The Panel acknowledges this again in relation to mitigation, but to a very limited extent, given the lack of any meaningful engagement with the HCPC proceedings.

83. The Panel identified the following aggravating factors:

• The Registrant was a qualified Paramedic and his conduct towards junior student colleagues was an abuse of his position;
• The conduct found proved involved a pattern of sexualised and inappropriate behaviour to three different junior colleagues and was deliberate;
• The failure of the Registrant to engage substantively with the HCPC hearing process means that there is no information by way of acknowledgement, remorse, remediation or insight before the Panel.

84. The Panel referred to the HCPC Sanctions Policy (March 2019) in deciding what sanction, if any, sanction should be applied. This included reference to the guidance where sexual misconduct towards colleagues has been found, at paragraphs 76-77. Paragraph 77 states that because of the gravity of a finding of impairment by reason of sexual misconduct, a panel is likely to impose a more serious sanction.

85. The Panel took a proportionate approach and considered the available sanctions in ascending order of seriousness:

 

Mediation

This was not appropriate, as the issues found proved were too serious to be addressed by means of mediation and because the Registrant was not engaging with the HCPC;

 

No Further Action

Given the risk of harm to the public and the public interest as a result of the finding of sexually motivated conduct, the matter was too serious for no further action to be appropriate;

 

Caution

The factors indicating that a Caution Order may be appropriate were not present. This was not an isolated incident, nor was it minor in nature. The Panel had no evidence of insight or remediation and was not reassured that the risk of repetition was low. The Panel also considered that a Caution would be insufficient to mark the seriousness of the findings and to maintain the confidence of the public and the profession.

 

Conditions of Practice Order

The Panel did not consider this was a case in which conditions of practice were appropriate. There was no indication that the Registrant would be willing to comply with conditions. Further, it was difficult to formulate conditions which could address these findings of inappropriate sexually motivated behaviour. The Panel decided that a Conditions of Practice Order would not be effective in marking the seriousness of the findings, nor would such an order protect the public or the public interest.

 

Suspension

The Panel carefully considered whether a period of suspension would be an adequate response in this case. In so doing, the Panel referred to the HCPC Sanctions Policy as to when a suspension order is appropriate, at paragraph 121. The Panel concluded that there was no satisfactory evidence that the Registrant has insight, it was not reassured that the issue is unlikely to be repeated and there is no evidence that the Registrant has taken steps to resolve or remedy his misconduct. The Panel concluded that a Suspension Order would not be sufficient or appropriate.

 

Striking off order

The Panel went on to consider whether the ultimate sanction, a striking off order, was required in this case. It was mindful that this is the sanction of last resort.

The Panel referred to the Sanctions Policy which indicates at paragraph 130 that in a case of sexual misconduct a Striking Off Order may be appropriate. Given the nature and gravity of its findings, the Panel concluded this was such a case.

In the circumstances of this case, the Panel concluded that a Striking Off Order was the appropriate and proportionate sanction which would protect the public interest and demonstrate the seriousness of the matter to the profession and the public.

ORDER: The Registrar is directed to strike the name of Mr Steven Watkins from the Register on the date this Order comes into effect.

Application to proceed in the Registrant’s absence with an Interim Order application:

 

1.    Mr Tarbert made an application for the hearing to proceed in the Registrant’s absence in order to consider an application by the HCPC for an immediate interim order. The Panel accepted the advice of the Legal Assessor.

 

2.    The Panel was satisfied that the Notice of Hearing sent to the Registrant on 20 November 2020 was served in accordance with the Rules. The Notice informed the Registrant that an application for an immediate interim order may be made by the HCPC, should the Panel decide to impose a sanction which suspended or removed his right to practise.

 

3.    The Registrant indicated in his email to the HCPC of 7 February 2021, and in the earlier Response Proforma, that he did not intend to attend this hearing. There was no change in circumstances since the Panel’s initial decision to proceed in the absence of the Registrant on the first day of this hearing. There was no new information before the Panel to indicate that at this stage the Registrant wished to attend, or sought an adjournment for any reason. The Panel was therefore satisfied it was appropriate to proceed to hear the HCPC’s application in the Registrant’s absence

 

Application for an Interim Order:

 

4.    Mr Tarbert made an application for an Interim Suspension Order to cover the appeal period on the ground that, in the light of the Panel’s substantive decision in this case, such an order was necessary for the protection of the public and was otherwise in the public interest.

 

5.    The Panel accepted the advice of the Legal Assessor. The Panel referred to the Interim Orders Practice Note and the HCPC Sanctions Policy.

 

6.    The Panel bore in mind that this was a discretion and that it must consider whether an interim order was necessary in accordance with the test set out in Article 31(2) of the Health Professions Order 2001. The Panel must act proportionately, imposing the lowest order which would adequately protect the public.

 

7.    The Panel considered the issue of proportionality and balanced the interests of the Registrant with the public interest. The Panel had determined to impose a substantive Striking Off Order. It had made findings that the colleagues, service users and the wider public were at risk of harm if the Registrant were able to continue to practise. Accordingly, and for the same reasons as set out in its substantive decision, the Panel determined that an interim order was necessary in order to protect the public and in the wider public interest.

 

8.    The Panel was satisfied, for the same reasons as in respect of its substantive decision, that an interim Conditions of Practice Order would not be appropriate. The Panel therefore directed that the Registrant’s registration should be suspended on an interim basis.

 

9.    The Panel concluded that the appropriate and proportionate duration of the interim suspension order was 18 months, as the interim order would continue to be required pending the resolution of an appeal, in the event of the Registrant exercising his right of appeal within the 28-day period. 

 

Interim Order:

The Panel makes an Interim Suspension Order 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. 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) upon the final determination of that appeal, subject to a maximum period of 18 months.

 

History of Hearings for Mr Steven Watkins

Date	Panel	Hearing type	Outcomes / Status
08/02/2021	Conduct and Competence Committee	Final Hearing	Struck off