Proof of Service
1. The Panel accepted the advice of the Legal Assessor. The Panel was provided with a copy of a letter dated 13 October 2021 and sent to the Registrant at the prison where he is currently residing. The letter notified the Registrant of the hearing time, date and that it would be conducted by video conference. Information was included about how the Registrant could join the video conference, if he wished to do so, and the Panel’s power to proceed in his absence in the event that he did not participate. The Panel was provided with a service number and corresponding Royal Mail Track and Trace number for the letter, together with confirmation from the Royal Mail that the letter was delivered on 22 October 2021.
2. The Panel also had sight of an email dated 13 October 2021 sent to the Registrant at his registered email address, giving notice of today’s hearing. There was notification that the email had been delivered. The Panel was thus satisfied that service had been complied with in accordance with the Health and Care Professions Council (Conduct and Competence Panel) (Procedure) Rules 2003 (as amended due to the Covid 19 Pandemic).
Proceeding in absence
3. The Registrant did not attend the hearing and Ms Sheridan made an application to proceed in his absence.
4. The Panel heard and accepted the legal advice from the Legal Assessor, who referred it to the case of the GMC v Adeogba  EWCA Civ 162, and the principles to be considered when deciding whether or not to proceed in the absence of the Registrant. The Panel had in mind the need to exercise its discretion to proceed with the utmost care and caution, particularly because the Registrant was not represented.
5. The Panel noted that the Registrant had not responded to the Notice of Hearing, or indeed any of the correspondence sent to him by the HCPC in connection with these proceedings. His only contact with the HCPC was to self-refer on 4 September 2018, following his arrest.
6. The Panel was thus satisfied that the Registrant, by his non-engagement, had deliberately and voluntarily waived his right to be present and his right to be represented at this hearing. The Panel noted that the Registrant faced very serious allegations and there was a clear public interest in the matter being dealt with expeditiously. The Panel considered an adjournment would serve no useful purpose and the Registrant had not requested one. The Panel concluded that it was in the interests of justice that the matter should proceed notwithstanding the absence of the Registrant. The Panel would draw no adverse inference from the Registrant’s non-attendance.
Application to amend the Allegation
7. At the outset of the hearing, Ms Sheridan made an application to amend the Allegation in two small details. Particular 2 made reference to “by reasons” plural rather than “by reason” singular and “convictions” plural when in fact there is one conviction, albeit concerning a number of separate offences. She thus applied to amend Particular 2 to refer to “reason” and “conviction” singular. She submitted that such amendments would not prejudice the Registrant in any way.
8. The Panel heard and accepted the advice of the Legal Assessor that it could amend the Allegation at any stage prior to the findings of fact provided it was fair to do so and the amendment could be made without injustice. It was clear to the Panel that the proposed amendments were necessary in order to reflect the fact that the Registrant is subject to one conviction and that such amendments would not in any way prejudice the Registrant. Accordingly, the Panel allowed the requested amendments.
9. The Registrant is, and was at all material times, registered as a Paramedic with the HCPC.
10. On 4 September 2018 the Registrant notified the HCPC that he had been arrested and was currently on bail pending further investigation. The Registrant was investigated for historic sexual offences of rape and sexual touching of a minor.
11. On 11 January 2021, the Registrant was convicted, following trial, of the offences set out in the Allegation above.
12. On 12 February 2021 the Registrant was sentenced to a total of 21 years in prison, in addition to being placed on the Sex Offender Register for life.
13. In his sentencing remarks, the Judge said:
“… Andrew Wheeler was convicted by the jury of counts 12, 13, 15, 16, 17 and 18. He falls to be sentenced today. I’ve read the pre-sentence report, two character references uploaded on behalf of Mr Wheeler and helpful sentencing notes produced by both prosecution and defence teams. I’ve also read and indeed have read [Person B1]’s victim personal statement and I’ve read that of [Person D1]. Both of those women describe the profound and long-term effect that this type of offending inevitably causes. The date of the convictions, the 11th of January of this year, means that the Sentencing Act 2020 applies.
There can be no credit for any guilty pleas. Throughout, Mr Wheeler has shown not a shred of remorse for his actions, and that attitude continues in his engagement with the Probation Service for the purposes of producing the pre-sentence report. What he has shown in my assessment is arrogance and a belief that he was untouchable, protected, as he saw it, by his paramedic’s uniform. The three pairs of offences represent offending committed over a period of about nine years against three separate victims. In committing these crimes, Mr Wheeler has demonstrated that he is a manipulative sexual predator willing to exploit, for his own gratification, the vulnerabilities of three separate victims, including a patient and his own [Relationship A].
His offending finally came to light in September of 2018, when [Person B] disclosed what he had done to her. [Person B1] was a long standing alcoholic who lived on her own; she had a background of domestic abuse. By mid morning on the 2nd of September 2018, she was heavily intoxicated and visiting a friend, so intoxicated, in fact, that - that she collapsed and her friend then contacted the emergency services, fearing that she’d had a cardiac arrest. Andrew Wheeler, who was crewed alone attended, as did a double crewed ambulance. When it became clear to the medical technicians that [Person B1] had not suffered a heart attack, the double crewed ambulance left the scene.
It was then agreed between Mr Wheeler and [Person B1]’s friend, that he would take [Person B1] back to her home address. He entered that property with her; the two of them were alone. He orally raped her and he digitally penetrated her vagina. She had allowed him into her home, placing her trust in him, assuming, as I suspect we all would, that the man with the role of caring for her would do just that. Instead, he took advantage of her condition, his role and the opportunity that those factors presented to rape and sexually assault her. [Person B1] reported what had happened to her.
Thereafter for Mr Wheeler, things began to unravel, as the police began their painstaking investigation. [Person D1] had become aware of the defendant’s arrest due to her job at the time. She then reported what he had done to her. In late 2009, Mr Wheeler had initiated a relationship with [Person D1] and that relationship began at a time when, in my assessment, she was a sexually naïve young woman in her early 20s. Mr Wheeler made his initial advances while she was working alongside him, undertaking a placement as part of her training to become a nurse.
On the 11th of December 2009, he asked her to join him at St Ne - Neots Ambulance Station where he was working. She agreed that before she joined him at the ambulance station, she said that if he didn’t have any condoms, she made it clear that there would be no sexual intercourse. Once she arrived, they engaged in consensual sexual activity, falling short of full sex, but then at that point, as [Person D1] described it, his face changed, as did his behaviour towards her. He became aggressive. He grabbed her by the hair, pushing her over the arm of a sofa in a rear room at the ambulance station. He then went on to vaginally rape her, ejaculating inside her. Up until that moment, [Person D1] had been a virgin.
Both before and at the time of the attack, [Person D1] had clearly told Mr Wheeler that she didn’t want full sexual intercourse with him. Mr Wheeler didn’t care what she did and didn’t want, his only care was for what he wanted, a theme I am bound to say present in many of the complaints made about this defendant. [Person D1] was left shocked and bleeding. Evidence heard at trial indicated that she was inconsolably distraught throughout a training programme that she attended the following day; their relationship continued. I am satisfied that the relationship, such as it was, was conducted very much on Mr Wheeler’s terms throughout. I am satisfied that throughout that relationship, he was both controlling and manipulative.
In the spring of 2010, [Person D1] had an anaphylactic attack. Entirely coincidentally, it was Mr Wheeler who was despatched to respond to the emergency call that was made as a result of that attack. He attended with a colleague and together they took [Person D1] to hospital, the colleague driving and Mr Wheeler in the back of the ambulance with [Person D1]. On that journey to the hospital, it is clear that [Person D1] was in a very bad way; she was struggling to breath, but despite her physical condition, or rather because of it, the defendant took that opportunity to grope her breasts and make lewd comments towards her.
In late 2013 and early 2014, this defendant’s [Relationship A], [Person A1], would spend some weekends staying overnight at his house as part of contact arrangements; she was aged 10 at the time. During these visits and on at least six separate occasions, Mr Wheeler got into bed alongside the [Relationship A] he thought was asleep and placed his hands onto her thigh, albeit over clothing.
This defendant is now in his mid 40s, he has no previous convictions, cautions or reprimands. I set out the approach to sentencing and the structure that I intend to adopt. I’m going to impose concurrent terms of imprisonment for each offence within each pair of offences.
The sentence for the lead offence within the pair will effectively be aggravated by the other offence to arrive at what I consider to be a sentence for that pair, that complainant, commensurate with the overall seriousness of the offending in relation to that complainant, also concurrent to reflect, where appropriate, a single course of conduct and to ensure that the aggregate sentence is just and appropriate; in other words to abide by the totality principle.
The sentences imposed for each pair of counts will be consecutive to those imposed for the other pairs. The lead sentence for each pair I will reduce slightly from the sort of sentence that would be imposed if I was simply dealing with each pair in isolation. Again, that reduction is made to ensure that the aggregate sentence is an appropriate one.
Dangerousness: In relation to three of these offences, the maximum sentence is life. However, whilst each of these offences, viewed individually but certainly viewed cumulatively, are exceptionally serious, they do not in my judgment meet the threshold necessary before a life sentence, a sentence of last resort, could properly be considered. In terms of the provisions of 2 - section 280 of the 2020 Act and the question of dangerousness, I am satisfied that if in 2018, Mr Wheeler had not been arrested and his activities had remained unchecked, he would at that point have satisfied the statutory test of dangerousness. In other words, at that point in time left unchecked, there was a significant risk of serious harm arising from him committing further specified offences. He will, however, spend many years in prison, where he will present no or very little risk.
It follows, it seems to me, that in deciding whether to impose an extended determinate term, I must effectively project forward and assess whether upon release from prison he would meet the statutory test of dangerousness. I bear in mind of course in carrying out that assessment that he’s been convicted of very serious offending against three separate complainants, offending committed over a significant period of time that might lead one to the view that he’s someone with entrenched attitudes in terms of his approach to women. The harm caused by those offences is unquestionably serious harm.
I’ve considered the tool based and clinical assessments made and provided by the author of the pre-sentence report. It seems to me, however, that I must balance against those matters the following factors: Firstly, the appropriate determinate sentence in this case will be a very long one. This defendant will be much older when he’s eventually released. (2), in relation to at least one of the sentences that I will impose today, his release will come only at the two-thirds point. (3), once released, he will be subject to licence and post release supervision for a very significant period. (4), he will indefinitely be subject to both notification and Sexual Harm Prevention Order requirements as well as the consequential monitoring by the Public Protection Unit. (5), the majority of these offences arose directly or indirectly as a result of his work. He will not be working in this or a similar capacity again and finally (6), he is not somebody with previous convictions. Even of course if I was to find that he would present the risks and meet the statutory test of dangerousness, this court has a discretion, and on balance I take the view that the appropriate sentence in this case can be a determinate one.
The guidelines: Dealing with matters of mitigation that apply generally, there is very little frankly that can be said on behalf of Mr Wheeler. I bear in mind the absence of previous convictions and indeed his age. I also have at the forefront of my mind the effect that the current pandemic is having upon the regime in the custodial environment. I turn now to the specific offences and the guidelines, turning, first of all, to count 12. This in my judgment is a 3B offence. It is aggravated because this defendant ejaculated inside [Person D1], leaving her concerned about the possibility of pregnancy. I do not find that the fact that it took place in the defendant’s place of work is a factor that aggravates the seriousness of what he did.
Count 13, in my assessment a 2A offence. [Person D1] was particularly vulnerable because of her physical condition in the rear of that ambulance. There is a very clear abuse of trust. This defendant chose to sexually assault his patient rather than care for her. [Person B], count 15, clearly culpability A, again a gross abuse of the relationship of trust that should exist between a patient and a paramedic. In terms of harm, I face competing submissions made by prosecution and defence. I am satisfied that [Person B1] was particularly vulnerable due to her high degree of intoxication and the fact that she found herself alone with this defendant. Her vulnerability is greater than many that fall into this category, but this factor operates to push the sentence up within the appropriate range. I do not find the extent of vulnerability here quite meets the threshold, being properly cat -categorised as extreme. I will sentence on the basis that this is a 2A offence.
There is the additional aggravating feature because it took place in her own home. It seems to me that that factor is distinct from the factors deployed to place this offence in category 2A, but of course I’m not simply dealing with a single act, a single sexual assault, because there is also count 16. In terms of the application of the guidelines to that count, similar considerations apply, although I note that the starting point for the section - the count 16 is a little lower under the guidelines than it is for count 15. Although the sentences, as I’ve indicated on counts 15 and 16 will run concurrently with each other, the lead offence, and that’s the sentence I’m going to pass on count 15, must reflect the fact that two different types of serious sexual assault were carried out by Mr Wheeler on [Person B1]. The effect of that approach is to push the sentence on count 15 to the very top of category 2A.
I turn now to [Person A1] and count 17 and 18, culpability A because of the breach of trust. Harm: The vulnerability in this case does not in my judgment go beyond the sort of vulnerability that would usually be encountered in an offence of this nature. Whether youth is extreme is to be judged against the fact that an offence under section 7 can only be committed against those under 13. Indeed there are Court of Appeal authorities indicating that children as young in 5 and 6 had not properly been - sorry, had improperly been viewed as having extreme youth. Here, [Person A1] was 10.
Equally, I’m conscious that there is a real risk of factors that feed into an assessment of harm have already been accounted for in finding the abuse of trust and high culpability. I therefore approach this case on the basis of this being harm category 3, but again I’m dealing with multiple offending here and the length of sentence that I pass must properly reflect that what [Person A1] described occurred on six occasions and did so during overnight contact visits that she was paying [Relationship X].
14. The sentences the Judge passed were as follows:
• on Count 12, six years’ imprisonment;
• Count 13, 30 months’ imprisonment, concurrently;
• Count 15, 13 years’ imprisonment;
• Count 16, 10 years’ imprisonment, concurrently;
• Count 17, 15 months’ imprisonment;
• Count 18, two years’ imprisonment, concurrently with each other.
15. The Judge indicated that the sentences for the lead offences in relation to each pair of offences would run consecutively with each other, making a total of 21 years’ imprisonment. The Registrant was also made subject to the notification obligations for life and an indefinite Sexual Harm Prevention Order.
Decision on Facts
16. In reaching its decisions on the facts the Panel took into account the memorandum of conviction which, the Legal Assessor advised, is conclusive proof of the conviction. Accordingly, the Panel found the facts as set out in Allegation 1(a) and (f) inclusive proved.
Decision on Statutory Ground
17. The Panel next considered the statutory ground. Because this is a conviction case, and the Panel had been provided with the memorandum of conviction, the Panel found the statutory ground to be made out.
Decision on Impairment
18. Having found the statutory ground of conviction to be well founded, the Panel went on to consider whether the Registrant’s current fitness to practise was impaired as a result of that conviction. In doing so it took into account the submissions made by Ms Sheridan and all the documents provided. The Panel accepted the advice of the Legal Assessor.
19. The Panel had been advised by the Legal Assessor that an important factor when considering current impairment is whether the conduct which led to the allegation is remediable, that it has been remedied and that it is highly unlikely to be repeated. The level of insight shown by the Registrant is also an important factor when considering current impairment. The Registrant had not attended, nor had he provided any evidence of remediation or an understanding of what had motivated him to behave in such an appalling way towards his victims. He had denied the matters alleged and shown no insight into his offending behaviour. The Panel had in mind the Judge’s sentencing remarks about how the Registrant is a manipulative sexual predator who preyed on vulnerable victims and had not shown a shred of remorse. Much of the Registrant’s offending took place whilst working as a Paramedic and given his lack of insight and remorse, the Panel considered there to be a high risk of repetition, albeit it would be many years before he was released from prison. The Panel therefore concluded that the Registrant’s fitness to practise as a Paramedic was at the time, and remained, impaired on public protection grounds.
20. The Panel went on to consider whether this was the type of case that required a finding of impairment on public interest grounds in order to maintain public confidence in the profession and the Regulator and to uphold professional standards. The Panel was satisfied that a fully informed member of the public, who was aware of all the background to this case, would have their confidence in the profession and the Regulator undermined if a finding of impairment were not made. The Panel considered that a member of the public would be extremely concerned if the Regulator took no action in a case where a Paramedic had been convicted of such serious sexual offences, many of them committed whilst working as a Paramedic with extremely vulnerable patients that he took advantage of in the most reprehensible ways imaginable. There was clearly a need to send out the message to the profession that this sort of behaviour is wholly unacceptable and not to be tolerated.
21. The Panel also noted that the Registrant had yet to complete his sentence from the Crown Court and that, in accordance with the case of The Council for the Regulation of Healthcare Professionals v (1) General Dental Council (2) Alexander Fleischmann  EWHC 87 (Admin), he should not be permitted to resume his practice until he had satisfactorily completed his sentence.
22. The Panel therefore determined that the Registrant’s fitness to practise is currently impaired on public protection and public interest grounds and that the allegation of impairment is well founded.
Decision on Sanction:
23. In reaching its decision on sanction, the Panel took into account the submissions made by Ms Sheridan, together with all the written evidence and any matters of personal mitigation. The Panel also referred to the guidance issued by the Council in its Indicative Sanctions Policy (“ISP”). The Panel had in mind that the purpose of sanctions was not to punish the Registrant, but to protect the public, maintain public confidence in the profession and maintain proper standards of conduct and performance. The Panel was also cognisant of the need to ensure that any sanction is proportionate. The Panel accepted the advice of the Legal Assessor.
24. The Registrant had provided nothing by way of mitigation and the Panel was unable to identify any mitigating factors.
25. The Panel considered the aggravating factors in this case to be: very serious sexual offences; gross abuse of trust and professional position; particularly vulnerable victims; repeated, predatory behaviour over a prolonged period of time; severe service user harm; the Registrant is subject to a live sentence; a complete lack of insight, remediation or remorse; behaviour that significantly undermined the profession.
26. In light of the serious nature of the conviction, the Panel did not consider this was an appropriate case in which to take no further action.
27. The Panel next considered whether a Caution Order would adequately reflect the seriousness of the conviction. The Panel’s role as indicated by the ISP was not to punish the Registrant twice for the same offence, but to protect the public, maintain high standards amongst registrants and maintain public confidence in the profession. The Panel did not consider that such an Order would adequately mark the seriousness of the behaviour or protect the public in this case.
28. This was not a case where conditions of practice would be appropriate because of the nature of the Registrant’s conduct. The Panel considered that conditions would not protect the public or the public interest and in any event the Panel considered a Conditions of Practice Order would not adequately reflect the seriousness of the Registrant’s offending behaviour.
29. The Panel next considered whether to make a Suspension Order. The ISP states that, “Suspension should be considered where the allegation is of a serious nature but unlikely to be repeated and, thus, striking off is not merited.” The Panel reminded itself of the nature of the conviction, namely rape, sexual assault, assault by penetration and the sexual assault of a child under 13. Although a Suspension Order would provide protection to the public for its duration, having identified a risk of repetition of this behaviour and, in the absence of any information from the Registrant about remediation, the Panel decided that suspension was not appropriate. In addition, the Panel was not satisfied that it would be sufficient to maintain public confidence in the profession or the regulatory process, or to send a clear message to the profession at large that such behaviour was wholly unacceptable. The Panel determined that a Suspension Order would not be a sufficient sanction in the circumstances of this case.
30. In reaching this decision the Panel took into account paragraph 82 of the ISP which echoed the case of Fleischmann referred to above, where the High Court stated that as a matter of general principle, where a registrant had been convicted of a serious criminal offence, he should not be permitted to resume his practice until he had satisfactorily completed his sentence. This had direct relevance to this case because the Registrant had been convicted of a serious criminal offence and his 21 year sentence remained to be completed.
31. The Panel therefore looked at the guidance in the ISP on making a Striking Off Order in order to decide whether such an Order would be appropriate. The guidance states that, “Striking off is a sanction of last resort for serious, deliberate or reckless acts involving abuse of trust such as, sexual abuse, dishonesty or persistent failure.” It goes on to observe that “Striking off should be used where there is no other way to protect the public.” The Panel finds that this case is characterised by a gross abuse of trust and sexual offences of the utmost gravity.
32. The ISP goes on to suggest that a Striking Off Order may be appropriate where the nature and gravity of the allegation are such that any lesser sanction would lack deterrent effect or undermine confidence in the profession. The Panel’s earlier finding in relation to the consideration of a Suspension Order identified that a lesser sanction would indeed be insufficient to represent these wider public interest issues in the specific circumstances of this case.
33. The Panel concluded that in all the circumstances, the only appropriate sanction in this case was to make a Striking Off Order. The Panel considered that the Registrant’s abhorrent behaviour, much of it directly connected to times when he was working as a Paramedic, was fundamentally incompatible with being a registered Paramedic. The Panel took into account the impact this might have upon the Registrant, but concluded that the need to protect the public far outweighed his interests and that no other sanction would adequately protect the public.
34. Accordingly, the Panel makes a Striking Off Order and directs the Registrar to strike Andrew Wheeler’s name from the Register.