Dominic Barone

Preliminary Matters

Service

1. The Panel noted that in accordance with the HCPTS’s Protocol relating to the COVID-19 pandemic, the mode of today’s hearing is by remote visual media. Similarly, in accordance with that Protocol all Notices of Hearing are currently being served upon a registrant by way of email only.

2. The Panel had before it a copy of the email dated 24 June 2021 which informed the Registrant of the details of today’s hearing. The Panel was satisfied that the electronic Notice of Hearing contained accurate and complete information relating to the hearing and had been sent to the email address identified as being retained on the HCPC’s Register for the Registrant.

3. The Panel having accepted legal advice has concluded that the HCPC has taken all reasonable steps to inform the Registrant of today’s hearing and he is in fact aware as indicated in an email received from him timed at 09.04hours this morning. The Panel has decided that on the evidence before it there has been good service.
Proceeding in the Registrant’s absence.

4.    The HCPC applied to have this matter heard in the Registrant’s absence and the Panel was referred by the HCPC to Rule 11 of the Conduct and Competence Committee Procedure Rules, in relation to the Panel’s power to do so.

5.    In relation to the matters which the Panel should take into consideration, the HCPC emphasised the following:

• The Registrant was put on Notice of this hearing on 24 June 2021.
• On 15 July 2021, the HCPC followed up that letter of Notice with a further email in which they reminded the Registrant of the recommendations of the previous reviewing Panel and invited him to make submissions.
• The Registrant emailed the HCPTS today informing it that he would not be attending and providing a statement for the Panel.
• In light of this email of today’s date, it was evident that the Registrant has voluntarily absented himself from attending the hearing, and deliberately waived his right to attend.
• No adjournment application has been made to date.
• In the circumstances of this case, an adjournment is unlikely to result in the Registrant’s future attendance.
• This is a mandatory review of the current Order (due to expire on 01 September 2021), it is in both the Registrant’s interest and in the public interest for a review of the current order to take place as scheduled. 

6. The Panel has considered the HCPC’s submissions and given careful consideration to the information before it, including that from the Registrant which indicated that he would not be attending the hearing. The Panel appreciated that when taking the decision to proceed in the Registrant’s absence, it was balancing fairness to the Registrant with fairness to the HCPC and the interests of the public.

7. The Panel concluded that it would proceed in the absence of the Registrant. There was no information before the Panel to indicate that an adjournment was appropriate in this instance. There is public interest in this mandatory review proceeding and in the Panel’s view that public interest in this instance outweighs that of the Registrant.

Background

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

9. On 19 January 2018, the Registrant submitted an Adverse Incident 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.

10. 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 as part of the investigation.

11. On 16 October 2018, the Registrant made a self-referral to the HCPC regarding the matter. That referral led to the final hearing which was held on 2-4 November 2020 at which the above allegation was considered. At that hearing the Registrant appeared, but was not represented, and he made full admissions to all the factual matters, including dishonesty.

12. The Final Hearing Panel found all the particulars proven by way of evidence and admission. The Panel decided that the factual matters found proven and numbered 1-4 within the Allegation were intended to mislead, and were dishonest.

13. The Final Hearing Panel concluded that those matters found proven were, in its judgment serious misconduct. In reaching its decision the Final Hearing Panel concluded that the Registrant’s conduct fell far below the high standards to be expected of a Paramedic and were in breach of the following section of the HCPC Standards of Conduct Performance and Ethics (2016 edition).

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.

14. The Final Hearing Panel had noted that the Registrant's dishonest conduct had 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 had chosen to maintain it, embellish it and when caught out, provide a different account which was also untrue.

15. In reaching its decision on impairment, the Final Hearing Panel had noted that this was not a case in which patients had been placed at unwarranted risk and there was no evidence of concerns as to the Registrant's clinical competence as it relates to patients.

16. The Final Hearing Panel was satisfied that dishonestly putting forward factually incorrect information in three different documents and in an interview, which was part of an internal Trust investigation, had brought the Paramedic profession into disrepute.

17. The Final Hearing Panel had also concluded that the Registrant has developed insight into his misconduct. It had accepted the Registrant's evidence that he wished now that he had not behaved as he had and it was 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 Final Hearing Panel considered 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.

18. The Final Hearing Panel considered that the misconduct was in this case capable of being remedied and recognised 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, could in that Panel’s view, in some cases amount to remediation. The Final Hearing Panel further noted that in his evidence the Registrant had not recognised that his account to the Trust's disciplinary hearing had been an attempt to minimise events. The Final Hearing Panel concluded that there remained a risk of repetition although it was not high.

19. The Final Hearing Panel was satisfied, that 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. It considered that a reasonable and informed member of the public would be very concerned if there had been 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.

20. In its consideration of the mitigating and aggravating factors the Final Hearing Panel noted in relation to the mitigating factors that:

• there had been no previous regulatory proceedings;
• the Registrant had made admissions to this hearing;
• the Registrant had developed insight, but not yet complete insight, into his misconduct;
• he had shown proper remorse and had apologised for his dishonest behaviour; and
• that there had been personal circumstances at play in the background, certainly at the start of the Registrant’s dishonest conduct.

21. In relation to aggravating factors the Final Hearing Panel noted that:

• the Registrant had taken an active role in the dishonest conduct which, in this case could not be considered a single act;
• the dishonest conduct was motivated by the potential for personal gain;
• the dishonesty had persisted over a period of at least 8 months; and
• he had not made early admissions of dishonesty.

22. The Final Hearing Panel had taken into account the positive and supportive testimonial evidence, and had noted the Registrant's genuine remorse and apology, which suggested that he was likely to be able to remedy his failings given sufficient time to gain full insight by further reflection. The Final Hearing Panel had therefore decided that a Suspension Order was the appropriate and proportionate sanction. This was for a period of 9 months to allow the Registrant sufficient time in which to properly reflect on his misconduct and achieve full insight.

23. The Final Hearing Panel had found that the Registrant’s developed insight and his engagement with those proceedings showed that he is not unwilling to resolve matters. It noted that there has been no repetition of the misconduct since the Registrant left the Trust. The Panel had therefore decided that a striking off order would be too harsh and disproportionate a sanction.

24. The Suspension Order imposed would be reviewed before it expired and the Final Hearing Panel had indicated 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 at the hearing to assist the reviewing panel in relation to insight.

Fresh information received by HCPC since the Final Hearing in November 2020.

25. On the 5 March 2021, by way of email, the HCPC received a referral from the Welsh Ambulance Services NHS Trust (WAST). In that referral the HCPC was informed of a matter which had come to light relating to the sale of two WAST owned AED’s (Automated External Defibrillator) in an online sale. The seller had been identified as the Registrant.

26. The following factual information had been gathered by WAST and passed to the HCPC:

• In August 2020 it had been brought to the attention of the Counter Fraud Section of WAST, that Prestatyn Town Council had been in contact with WAST as a Zoll AED in its possession required some batteries
• The Zoll AED in the possession of the Prestatyn Town Council (serial X14C657519) was identified as having been purchased by WAST in 2014 and had been on an ambulance in the Gwent area. This machine had been received by Prestatyn Town Council from the charity Welsh Hearts.
• From information supplied by Welsh Hearts it was established that Person A had donated these two units to them.
• Person A was able, through provision of copies of screenshots from his mobile telephone, to provide evidence that the AEDs had been purchased from the Registrant around the 23 November 2017 via a Facebook page. The Registrant had been employed at that time by WAST and continued to be so employed until the time of his dismissal in November 2018.
• In the screenshots provided by Person A was the following:
  
  • The identify of Dominic Barone was accompanied by the information that he was also a member of Buy And Sell First Aid Training Equipment And First Aid Supplies (uk), Event Medical Staff Required (UK) and 4 other groups.
  • That Person A had seen the advert and offered £500 plus postage for both units. The offer was accepted by the Registrant who in his response identified that £40 would cover postage and suggested using PayPal as a means to protect both parties
  • In explanation of the postage cost the Registrant stated:
    
    ‘It sounds a lot but to post one is £19 as I’ve sold a few of these now and I don’t use couriers as I don’t trust that they’ll actually deliver the goods in a safe way….’

• Welsh Hearts were able to provide a serial number for the second AED purchased by Person A and it was discovered that this had been purchased by WAST and had been on an ambulance based in Newtown Station.
• The theft of the two AED units was reported to Dyfed Powys Police in September 2020 with crime reference number 198/01/09/2020 issued. Witness statements were gathered and supplied to the Police. The Police were also provided with the details of the fraudulent personal injury claim and details of the then forthcoming HCPC hearing.
• The Police initially had difficulty in contacting the Registrant however he was eventually interviewed by the Police on the 17 February 2021 at Newtown Police Station. Following further consideration, the Registrant was issued with a Conditional Caution for theft. The Police have not disclosed the terms of that Conditional Caution.
• In interview with the Police the Registrant is reported to have stated ‘that he had borrowed the units for his private ambulance work with the intention of returning them when he could afford his own, however he was dismissed and needed the funds, so he sold them on.’
• It was established that the Prestatyn Council had been granted funding for purchase of a defibrillator machine and as this unit had been donated the Council would not be financially disadvantaged by its restoration to its rightful owner. The unit that was in the possession of Prestatyn Town Council was therefore reclaimed by WAST.

27. On the morning of this review the Registrant sent by email a statement which he wished to have placed before the Panel. In that the Registrant made (amongst others) the following statements:

‘I hoped that today would be a culmination of 9 months of growing and learning which it has been, even though in a very different way. But with the conviction now for previous wrongdoings which happened many years ago now and also around a period of time when I was going through a lot of personal upheaval and problems which led to me being suspended in the first place. This pattern of behaviour was for a short period of time, a period of time that I look back on with regret and disbelief.’

‘There are no excuses for my behaviour it was wrong end of, I’m not going to try and justify it, but that was a different period of my life and that person isn’t the person who I am today. Over the last 7 months I’ve moved on started my own buisness [sic] and I’m looking forward to what the future holds going forward with that. Obviously I wish today was under different circumstances but at least I know after today I can finally draw a line in the sand and move on. Lastly I’d like to apologise to the Welsh Ambulance Service for my actions and to my family that I have disappointed, put excess stress and pressure on over this period.’

HCPC submissions

28. Ms Sampson submitted on behalf of the HCPC that the Panel’s role is to review the matter on the basis of the evidence available today, and to decide whether the Registrant’s fitness to practise remains impaired, and if so, to decide what the appropriate sanction should be.

29. She reminded the Panel that under Article 30(1) of the Health Professions Order 2001, Whilst it was a matter for the Panel’s judgement, Ms Sampson stated at the outset of her submissions that the HCPC position was that a Striking Off Order was appropriate and proportionate in this case.

30. In terms of background Ms Sampson reminded the Panel of the seriousness of the matters which had previously been raised against the Registrant and which had led to the Substantive Suspension Order being put in place. She emphasised the repetition of the misleading and dishonest behaviour that had been identified within the Allegation, dishonesty that had continued over many months and which had been embellished and changed over time.

31. The Final Hearing Panel had indicated in its decision what it expected the Registrant to supply to this hearing. In terms of those recommendations Ms Sampson noted that there was no information before the Panel today of any improved insight or steps of remediation, issues which the Final Hearing Panel had considered crucial to demonstrate an ability to practise without restriction in the future. None of the information recommended by the Final Hearing Panel had been sent to the HCPC by the Registrant either before or since the HCPC letter of 15 July 2021 indicating that further issues would be placed before this Panel. There was therefore nothing to indicate that the Registrant had ever taken any steps towards remediation. In the HCPC’s view there is no evidence that would support a finding that the Registrant is no longer impaired.

32. In terms of the appropriate Sanction Ms Sampson referred the Panel to the chronology of the matters before the Panel which indicated that at the time of the Final Hearing the Registrant was aware of the matters that had been referred in September 2020 to the Police. This meant that at the time of the Final Hearing he was aware of other wrongdoing being investigated and had not disclosed this to the Final Hearing Panel.

33. Ms Sampson drew the Panel’s attention to the email from the Police in which it is stated that the Registrant had told the Police that he had sold the AEDs after he had been dismissed. This was clearly not true and demonstrated a consistent and continuing chain of dishonest behaviour. This was further clear evidence that the Registrant has not remediated his previous misconduct.

34. Ms Sampson added that from the fresh evidence the Panel will see that the Conditional Caution was imposed in February 2021. At no point since then has the Registrant taken steps to inform the HCPC of that Conditional Caution. This is a further serious breach of his duties as a registrant.

35. The Registrant’s email also indicated that he had recently made a conscious decision to ‘draw a line’ under past matters and had recently started up his own business and appeared to be pursuing a new career.

36. Ms Sampson stated that all these matters supported her submission that a Striking Off Order was now the only appropriate and proportionate measure which would maintain and uphold the Paramedic profession’s reputation and that of its regulatory body.

Legal advice

37. The Legal Assessor reminded the Panel that its purpose today was to conduct a comprehensive review to determine if the Registrant is fit to return to unrestricted practice. She referred the Panel to the approach to be adopted in relation to this review hearing. She reminded the Panel that its role was not to conduct a rehearing of the allegations nor was it to go behind the previous findings. She advised that in carrying out this assessment, the Panel must exercise its own independent judgment and in that regard must give appropriate weight to the fresh evidence the Panel had before it today. The Panel should consider all the fresh information before it today when considering the issue of whether there remains a lack of fitness to practise and any sanction to impose.

38. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired, then the Panel must go on to consider what sanction, if any, should be imposed. She reminded the Panel that any of the options under Article 30 of the 2001 Order, including a striking off order, could be exercised by the Panel today. She also advised the Panel that it should bear in mind the principles of fairness and proportionality and have regard to the Sanctions Policy document issued by the HCPTS. She reminded the Panel that any order that it makes under Article 30 should not be punitive in purpose, and that it should be the least restrictive order that would suffice to protect the public and/or would otherwise be in the public interest.

Panel’s decision

39. The Panel accepted the advice of the Legal Assessor. The Panel has also had regard to the HCPTS’s Practice Note on Fitness to Practise Impairment. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Panel took into consideration all the documentation before it, and the submissions of Ms Sampson.

40. The Panel accepted that there was a persuasive burden on the Registrant, and that this required him to demonstrate to this Panel both developed insight and remediation of his failings before being considered able to return to unrestricted practice.

41. There is no evidence before this Panel of improved insight into previous misconduct nor any evidence of steps towards remediation. On this basis it would be difficult for this Panel to conclude that the Registrant had discharged the burden upon him and was, under the personal component of its decision, fit to practise.

42. There was however also fresh evidence of further misdoings which had resulted in a Conditional Caution being imposed by the Police. In such circumstances the Panel had little difficulty in establishing that a finding of current impairment was warranted in the public interest.

43. The Panel then went on to consider what the appropriate and proportionate sanction should be, starting with the least restrictive. It bore in mind that the purpose of a sanction was not to be punitive, although a sanction may have that effect. In doing so, it took into account the HCPTS’s Sanctions Policy.

44. The Panel also bore in mind that its over-arching objective is:

• to protect, promote and maintain the health, safety and wellbeing of the public;
• to promote and maintain public confidence in the profession; and
• to promote and maintain proper professional standards and conduct for members of the profession.

45. The Panel noted, in fairness to the Registrant, that whilst the matters which had resulted in his Conditional Caution had been referred to the Police in September 2020, there was no evidence to support the view that he knew this at the time of the Final Hearing in November 2020. The Panel noted in this regard that the Police had initially had difficulty making contact with the Registrant. However, by February 2021 he was so aware and did not take any steps to inform the HCPC of this further matter.

46. The Panel has noted that the fresh evidence before it demonstrates that there had been and has continued to be a pattern of dishonest behaviour culminating in the terms in which the Registrant had responded at the interview with the Police in February 2021, responses which were clearly untrue, misleading and dishonest.

47. The Panel noted the terms of the Registrant’s letter in which he again expresses his regret and makes apology however even in this letter there is an attempt to minimise matters by saying that the events took place many years ago. However, as stated above, that was not true as the misleading and dishonest behaviour was evident only a few months previously. In the Panel’s view this further demonstrated a lack of insight into the seriousness of the Registrant’s misconduct.

48. Having made those observations the Panel turned to considering the appropriate and proportionate sanction in this case and first considered taking no action but was satisfied that the Registrant’s failings were so serious that the public interest considerations could not be met by such an outcome. The Panel was not satisfied that there would be no risk to the public, or to public confidence in the profession by taking no action.

49. Given the Panel’s findings, it was also not satisfied that mediation was an appropriate sanction given that the particular circumstances of this case make such an outcome irrelevant.

50. The Panel next considered whether to impose a Caution Order however it concluded such an order would not be sufficient to protect the public, nor would it be in the public interest given that the Registrant’s serious misconduct could not be described as minor or isolated. Such an outcome would not restrict the Registrant’s practice and would therefore not adequately protect the public or safeguard the public interest.

51. The Panel next considered whether to impose a Conditions of Practice Order but concluded that it would neither be appropriate nor proportionate given the nature of the misconduct. Misconduct which demonstrated a continuous and consistent pattern of dishonest behaviour. Further there were no conditions which would be workable in relation to this issue of repeated dishonest behaviour. Further, in the Registrant’s absence it would be inappropriate to assume that the Registrant is willing or able to comply with any conditions that may be imposed.

52. The Panel considered that a further period of suspension would not be appropriate in light of the additional material disclosed at this hearing. In addition, a further period of suspension would not, as identified in the Sanctions Policy, be appropriate as the criteria for such have not been met. The Panel has no evidence that the Registrant has gained insight. It does however have evidence that there is good reason to believe that a repetition of the misconduct may occur in the future. 

53. The Panel has therefore concluded that the Registrant’s behaviour is fundamentally incompatible with remaining on the Register. The Registrant’s misconduct has brought him, his profession and his regulatory body into disrepute. A member of the public would rightly be appalled if a registrant who has admitted openly to making a false and fraudulent injury claim which would have, if successful, resulted in public funds being used, and had also sold for his own gain publicly owned medical equipment, were allowed to remain on the Register. This Panel has therefore concluded that in all the circumstances of this case a Striking Off Order is proportionate and appropriate in this instance.

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

The Order imposed today will apply from 1 September 2021.

History of Hearings for Dominic Barone