Simon David Drew

Profession: Paramedic

Registration Number: PA15614

Interim Order: Imposed on 06 Dec 2019

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 31/01/2022 End: 17:00 31/01/2022

Location: This hearing will be held virtually

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

As a registered Paramedic (PA15614) your fitness to practise is impaired by reason of conviction and/or health. In that: 

1. On 1 December 2020, you were convicted at Buckinghamshire Magistrates’ Court to the effect that;

  • a)You had in your possession a quantity of Diamorphine, a controlled drug of class A in contravention of section 5(1) of the Misuse of Drugs Act 1971; Contrary to section 5(2) of and Schedule 4 to the Misuse of Drugs Act 1971.
  • b) You had in your possession a quantity of Pethidine, a controlled drug of class A in contravention of section 5(1) of the Misuse of Drugs Act 1971; Contrary to section 5(2) of and Schedule 4 to the Misuse of Drugs Act 1971.
  • c) You stole a quantity of various controlled drugs, of classes A, B and C, of a value unknown belonging to Buckinghamshire Healthcare NHS Trust; Contrary to section 1(1) and 7 of the Theft Act 1968.
  • d) You had in your possession a quantity of Ketamine, a controlled drug of class B in contravention of section 5(1) of the Misuse of Drugs Act 1971; Contrary to section 5(2) of and Schedule 4 to the Misuse of Drugs Act 1971.
  • e) You had in your possession a quantity of Diazepam, a controlled drug of class C in contravention of section 5(1) of the Misuse of Drugs Act 1971; Contrary to section 5(2) of and Schedule 4 to the Misuse of Drugs Act 1971.
  • f) You had in your possession a quantity of Tramadol, a controlled drug of class C in contravention of section 5(1) of the Misuse of Drugs Act 1971: Contrary to section 5(2) of and Schedule 4 to the Misuse of Drugs Act 1971.
  1. You have a physical and/or mental health condition as set out in Schedule A.

 

  1. By reason of your conviction and/or health your fitness to practice is impaired. 

 

Schedule A

1. REDACTED

  • a) REDACTED
  • b) REDACTED
  • c) REDACTED

 

  1. REDACTED

 

  1. REDACTED

Finding

Preliminary Matters

Service

1.Evidence was provided to the Panel that Notice of this hearing was emailed to the Registrant to his registered address 4 January 2022. This was an email address that had previously been used for correspondence with the Registrant during the current pandemic. The Panel accepted that this evidence met the requirement of the rules that require the Registrant to be notified and deemed that good service had been effected.

Proceeding in the Absence of the Registrant

2. The Panel took into account the HCPC application to proceed in the absence of the Registrant and the legal advice provided. It found the following factors to be relevant:

a. The Registrant had not engaged with the HCPC or Kingsley Napley since 29 November 2021 when he consented to electronic service;

b. The Registrant had not indicated a reason for his absence;

c. There is no indication that an adjournment would serve any useful purpose and secure the Registrant’s attendance on a future occasion;

d. That the Registrant had not asked for an adjournment;

e. The passage of time since the conviction of the Registrant;

f. General public interest in expeditious disposal of cases

3. Given the nature and circumstances, the Panel determined that the Registrant’s absence is voluntary and that it was fair and in the interests of justice to proceed in the Registrant’s absence.

Amendment of the Allegation

4. The HCPC applied to amend the Allegation so that the stem is changed. The change requested is that the date of “11 January 2021” is changed to “1 December 2020”. This change is being requested because it is factually wrong as it does not reflect the memorandum of conviction. The change is indicated as reflected above.

5. It is important that Panels give critical scrutiny to the drafting of allegations put before them, to ensure that they are fit for purpose and constitute a fair and proper representation of the HCPC’s case. If a Panel varies or extends an allegation to a material degree, the registrant concerned should be given a further opportunity to make observations on the revised allegation. The Panel was of the view that this was not a change to a material degree but was a transcribing error of dates. No prejudice to the Registrant was deemed to occur from this change given that the Registrant would know when he entered guilty pleas and when he was sentenced.

Private

6. The HCPC applied to hear some parts of the hearing in private where these involved the health of the Registrant. The Panel accepted the advice of the Legal Assessor and exercised its discretion to allow those parts of the hearing that involved the health of the Registrant to be heard in private to protect the Registrant’s private life.

Background

7. The Registrant was a registered Paramedic at all relevant times.

8. On 28 October 2019, the Registrant was working via an agency, at the Buckingham Healthcare NHS Trust (the Trust). The Registrant was working in the resuscitation area of the emergency department (A&E) of the Stoke Mandeville Hospital. It was noted in the early hours of 29 October 2019 that a large number of controlled drugs were missing.

9. The Registrant attended work on 29 October 2019, where he was asked to empty his bag and the missing drugs were found in the possession of the Registrant. The Trust reported this to the Police.

10. On 1 December 2020, the Registrant attended Wycombe Magistrates Court, and pleaded guilty to the offences as detailed above in the allegations. The Registrant was sentenced on 11 January 2021, and received a community order, a fine of £120 and ordered to pay a victim surcharge and the crown prosecutions service costs.

11. The HCPC did not call any witnesses to give live evidence.

Decision on Facts

12. The HCPC presented a certified copy of court records which indicate that a plea of guilty was indicated on 1 December 2020 and that sentencing took place on 11 January 2021. The Registrant was sentenced to a 12-month community order, with a rehabilitation requirement and ordered to pay: a £85 victim surcharge, a £120 fine, and £85 prosecution costs, totalling £290, to be paid at £20 per month, with the first payment to be paid by 28 January 2021.

13. The Legal Assessor commended to the Panel the HCPTS Convictions and Cautions Practise Note. It sets out that within Rule 10 is reference to: “where the registrant has been convicted of a criminal offence, a certified copy of the certificate of conviction… shall be admissible as proof of that conviction and of the findings of fact upon which it was based;”. The rules also provide that, evidence is admissible before a Panel if it would be admissible in civil proceedings before the appropriate court in that part of the UK where the Panel is sitting.

14. The Panel finds the fact proved on the basis of the evidence that the Registrant has been convicted of offences, which is admissible in civil proceedings as proof that the person concerned committed that offence.

Grounds

15. Having found the facts proved, this satisfies the statutory ground of conviction. By virtue of Rule 10(1)(d), the Panel has seen the certificate of conviction and found that the grounds are made out.

Impairment

16. The Panel took into account the submissions made by Ms Sheridan for the HCPC. She submitted that the Registrant was impaired on both the personal component given the absence of up to date about the current position of the Registrant and on the public component, given the need to protect the public and the public interest which includes confidence in the profession. It also had regard to the emails sent by the Registrant on 12 and 13 November 2019 which provide context to the offending and were provided to the Panel as being relevant and is the only indication of the Registrant’s position, albeit these are not a formal response to the Allegation for the purposes of this hearing. The Panel also considered the HCPTS Practice Note “Finding that Fitness to Practise is Impaired”. It also heard and accepted the advice of the Legal Assessor in coming to its decision.

17. The Panel was required to determine whether the Registrant’s fitness to practise is impaired as at today’s date. The Panel’s task was not to punish the Registrant for past acts. However, the Panel may take into account past acts and omissions in order to make an informed assessment as to whether the Registrant’s fitness to practise is currently impaired.

18. The Panel took into account:
• the ‘personal’ component: the current competence, behaviour, etc of the Registrant, including any evidence of insight and efforts towards remediation; and
• the ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

Personal component
19. In respect of the personal component, the Panel applied the following test formulated by Dame Janet Smith in her “Fifth Shipman Report” and applied by the High Court in Council for Healthcare Regulatory Excellence v Nursing and Midwifery Council and Grant [2011] EWHC 927 (Admin), paragraph 76, to the extent relevant to the facts of the case:

“Do our findings of fact in respect of the [Registrant’s] misconduct, deficient professional performance, adverse health, conviction, caution or determination show that his/her fitness to practise is impaired in the sense that she/he:

a) has in the past acted and/or is liable to act in the future so as to put a patient or patients at unwarranted risk of harm; and/or

b) has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or

c) has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or d) has in the past acted dishonestly and/or is liable to act dishonestly in the future?”

20. The Panel also took into account the guidance provided in Cohen v General Medical Council [2008] EWHC 581 (paragraph 65). The Panel considered:

(i) whether the Registrant’s conduct was easily remediable;
(ii) whether it had been remedied; and
(iii) whether it was highly unlikely to be repeated.

21. With regard to the “personal” element of impairment, the Panel considered that the convictions have a very direct bearing on the Registrant’s ability to practise safely as a Paramedic. Factors that the Panel took into account were as follows:

a) the thefts occurred at work, while he was working as a Paramedic;

b) they were stolen from A&E where critically ill patients may have had need of them but could have been deprived of them because they were missing;

c) that the Panel has no up to date information about where the Registrant is currently working, his competence, or his state of health.

22. The Panel was live to the fact that Paramedics occupy a position of privilege and trust in society and are expected at all times to be professional. In the view of the Panel, the Registrant’s conduct fell well below the standards expected of members of the paramedic profession. The Registrant breached a fundamental tenet of the profession, namely the expectation that they will act with honesty, professionalism, and integrity at all times.

23. While the Panel recognised that the Registrant entered a guilty plea to the recent criminal charge and has apologised, provided context for their offending, which demonstrated a degree of insight on the part of the Registrant, the Panel considered this did not go far enough. The Panel has not seen an acknowledgement of the impact this could have had on vulnerable patients who required life-saving and pain relieving drugs or an insight into the implications of his behaviour. The Panel found that the Registrant had prioritised his own interests over those of patients and considered that there was a significant risk that the Registrant may breach fundamental tenets of the profession in the future and repeat his actions, without this insight.

24. Accordingly, the Panel found that, on the basis of the personal component, the Registrant’s fitness to practice is currently impaired.

Public component
25. The Panel went on to consider the public component and 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 maintain proper standards of conduct.

26. In addressing this component of impairment, the Panel had regard to the observations of Silber J in Cohen v General Medical Council [2008] EWHC 581: “Any approach to the issue of whether…fitness to practise should be regarded as ‘impaired’ must take account of…the collective need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour...” (paragraph 62)

27. Paramedics can see members of the public when they are at their most vulnerable. The public must be able to trust them and, to justify the trust that their position warrants. Paramedics must act with integrity and in the best interest of service users at all times. The Panel considered that maintaining professionalism and proper standards of conduct are fundamental requirements of the profession and that the public would be extremely concerned to learn of the Registrant’s conviction.

28. The Panel considered that the conviction was serious in nature. The Registrant was convicted of a number of serious criminal offences. He acted dishonestly. The Registrant stole from his employer using keys he had been given whilst his colleague was on a break. This act is an abuse of trust placed in him by his employer. The Panel was satisfied that the actions of the Registrant brought the reputation of the profession into disrepute and that he breached one of the fundamental tenets of the profession, which is to make sure that his conduct justifies the public’s trust and confidence in him and his profession.

29. The Panel took into account the responsibility of the HCPC to uphold proper standards of conduct on the part of members of the profession and to maintain public confidence in the profession. The Panel was satisfied that the wider public interest was engaged in this case.

30. The Panel considered that a fully informed member of the public who was aware of the circumstances of this case would have their confidence in the profession undermined if a finding of impairment was not made. This was because of the serious nature of the wrongdoing and the harm caused to the reputation of the profession by the Registrant’s conduct. The Panel was of the view that the need to uphold such standards and uphold public confidence would be undermined if a finding of impairment were not made in the circumstances of this case.

31. Due to the lack of up-to-date information from the Registrant directly, the Panel was unable to conclude that the Registrant had taken any significant steps to address the issues raised by the conviction, nor could it conclude that he had shown any meaningful insight. The Registrant has not placed any current evidence before the Panel to address his remediation or to reflect his current position. The Panel was therefore of the view that there is nothing to suggest that the Registrant is not liable in future to bring the profession into disrepute and breach fundamental tenets of the profession.

32. For all the reasons set out above, the Panel determined that the Registrant’s fitness to practise is currently impaired on the grounds of public protection and in the public interest.

Sanction

33. Ms Sheridan, on behalf of the HCPC, addressed the Panel on the question of sanction. She submitted that the decision as to which sanction, if any, to impose was a matter for the judgment of the Panel. The HCPC made no recommendation as to any particular sanction. However, Ms Sheridan highlighted that this was a case where there was deliberate wrong-doing, which crossed a criminal threshold, involved an abuse of his position of trust, and presents a risk of repetition. She indicated that further to paragraph 82 of the Sanctions Policy (“SP”) which makes clear that where the sentence is not completed, it is not usual for the Registrant to resume unrestricted practise. She submitted that it is not clear that the Registrant has completed all of his sentence particularly in respect of the financial component of the sentence, given the terms of payment that had been set out.

34. The Panel received and accepted advice from the Legal Assessor. The Legal Assessor addressed the Panel on the SP and advised the Panel that in deciding what sanction, if any, to impose, the Panel should ensure that any sanction is proportionate and strikes a proper balance between the protection of the public and the rights of the Registrant.

35. The Panel took into account the SP. However, the Panel reached its own independent decision on the appropriate sanction based on the individual facts of the present case. The Panel applied the principle of proportionality by weighing the Registrant’s interests with the public interest.

36. The Panel proceeded on the basis that the purpose of any sanction is not to be punitive. The primary objective is public safety. However, other public interest objectives have a role to play. These include:
(i) the deterrent effect to other registrants;
(ii) the reputation of the profession concerned; and
(iii) public confidence in the regulatory process.

37. The Panel first considered whether there were any aggravating and/or mitigating factors to be taken into account when deciding the appropriate sanction.

38. The Panel identified the following aggravating and mitigating factors:

Aggravating

· The conviction reflects the carrying out of a deliberate act;
· It potentially deprived patients of life-saving/pain-relieving drugs with a consequent risk of patient harm;
· He placed his own interests above those of his patients
· He abused the trust that was placed in him by virtue of his professional position;
· There is no up-to-date evidence of insight since November 2019;
· There is no evidence as to the current position of the Registrant.

Mitigating

· This was a single incident;
· There is evidence of relevant personal circumstances;
· There is a causal link between the personal circumstances and the wrongdoing;
· Guilty pleas entered at the earliest opportunity at court;
· The Registrant did not attempt to blame anyone else for his wrongdoing;
· The Registrant co-operated with the Trust investigation and police;
· The Registrant has 20+ years’ experience as a paramedic with no apparent regulatory concerns;
· A degree of insight has been previously demonstrated by the Registrant in November 2019;
· The Registrant engaged with the HCPC investigation by permitting contact with his GP and providing emails containing personal details in November 2019.

39. In order to ensure that it imposed a sanction that was no more restrictive than was necessary to protect the public and the public interest, the Panel considered the sanctions available to it in ascending order of severity.

40. The Panel first considered whether to take no further action, and decided that it would not be proportionate to do so. The conviction was for a serious matter which had the potential to cause significant harm to service users. The Panel identified a risk of repetition, and the Registrant has not engaged directly with the HCPC to demonstrate any up to date meaningful insight or evidence that his efforts at remediation have continued to have effect without relapse. In the Panel’s view, taking no further action would not address the need to uphold the public interest concerns in this case.

41. The Panel also discounted a Caution Order for the same reasons. The Panel was also of the view that Mediation was not appropriate because it was dealing with a conviction case.

42. The Panel considered a Conditions of Practice Order. Such an order would be appropriate where a panel is confident that a Registrant will adhere to the conditions, is genuinely committed to resolving the issues they seek to address, and can be trusted to make a determined effort to do so. The Panel had limited evidence of insight on the part of the Registrant regarding the serious nature of the failings identified above. The Panel has no current evidence that allows it to be confident that the Registrant’s commitment to resolving his health issues has been sustained, given the nature of the condition and the possibility of relapse. Further, the Panel does not have evidence that the Registrant would be willing or able to comply with conditions, should these be formulated. Moreover, the Panel was not satisfied that it could formulate any conditions of practice that would address the concerns raised in this case and which would be workable and enforceable. The Panel concluded that such an order is not appropriate.

43. The Panel considered the SP which makes clear that a Suspension Order may be appropriate where the allegation is serious and cannot be addressed by any of the lower sanctions, but there is the potential for the Registrant to remedy their failings. The Particulars that have been found to be proved are serious. They involve a conviction for theft and possession of controlled drugs. In relation to the issue of dishonesty, the Panel considered that there are different forms and degrees of dishonesty. The dishonesty in this case relates to one issue, namely the theft of drugs. The Panel considered the duration of the dishonesty in this case to be relevant and noted that it was a single action and when the issue was discovered by the Registrant’s employer and was put to the Registrant, he acknowledged the issue and co-operated.

44. The Registrant has shown a limited degree of insight. The Registrant acknowledged his health difficulties in November 2019, he voluntarily attended a course between November 2019-March 2020. The Registrant also pleaded guilty at the earliest opportunity in the Magistrates’ Court.

45. The Registrant appears to have been a Paramedic for over 20 years with no apparent regulatory concerns. No concerns have been raised with the Panel in relation to his clinical competence.

46. In the particular circumstances of this case, the Panel did not consider that the Registrant’s actions are incapable of remediation. There is the potential for the Registrant to develop insight and remediate the concerns set out above. The Panel has some information that this journey had begun by November 2019.

47. The Panel concluded that a period of Suspension would provide the necessary level of public protection for its duration. It would mitigate the risk of repetition which the Panel addressed above and the wider public interest concerns that arise in this case. It would allow the Registrant an opportunity for reflection in which he may potentially develop fuller insight into his failings and evidence his continued remediation. The Panel found a Suspension Order to be the appropriate sanction in this case.

48. In order to test the proportionality of a Suspension Order, the Panel gave very serious consideration to a Striking Off Order. This was a finely balanced decision but the Panel concluded that such an order would not be appropriate because it would be disproportionate given all of the circumstances of this case. A Striking Off Order is a “…sanction of last resort for serious, persistent, deliberate or reckless acts…” (SP, paragraph 130). While the Particulars that have been proved are of a serious nature involving a conviction.

49. The Panel did not consider that actions had been persistent or repeated such as to justify a Striking Off Order at this stage. In these circumstances, the Panel concluded that the lesser sanction of a Suspension Order would provide the correct level of public protection and maintain public confidence in the paramedic profession.

50. The Panel next considered the appropriate length of the Suspension Order, and concluded that 12 months was the necessary and appropriate period. Such a period would reflect the serious nature of the conviction that has been found. The Panel considered that a period of 12 months was required given the potential ongoing risks outlined above. A 12-month suspension would reflect the public interest concerns that arise in this case. The Panel also considered that a period of 12 months would be required in order for the Registrant to develop appropriate insight, while evidencing remediation.

51. The Panel considered a review of the Suspension Order would be required before its expiry and wishes to make clear to the Registrant that it would be in his interests to engage in future proceedings and, in particular, to attend future hearings. It would be in the Registrants best interests if he makes all of the following information available in advance of any future hearing:

a. A reflective piece concerning the circumstances leading to the Registrant’s conviction. Any such reflective piece should address the impact of the Registrant’s action on the paramedic profession and the public;

b. An indication of the Registrant’s current employment status and his future intentions in respect of returning to his profession as a paramedic;

c. Details of steps taken to keep his knowledge and skills up-to-date;

d. Testimonials and references from current and recent employers and/or voluntary organisations that he has worked for, detailing his role, responsibilities and performance in that organisation;

e. Evidence of continued interest in addressing remediation with strategies to avoid any repetition of events which concern this Panel;

f. Evidence that the criminal sentence has been satisfactorily completed;

52. The Panel therefore imposes a Suspension Order for a period of 12 months. It is of the view that this sanction addresses both the public protection and public interest issues in this case. The Panel considers that this would act as a deterrent to other Registrants, uphold appropriate standards in signalling the unacceptability of the Registrant’s behaviour and provide public confidence in the profession and its regulator.

 

Order

Order: The Registrar is directed to suspend the registration of Mr Simon David Drew for a period of 12 months from the date this order comes into effect.

Notes

Interim Order

1.Ms Sheridan offered no evidence in relation to the health matters given the determination of the Panel in relation to conviction. The Panel was content with this.

2. Ms Sheridan applied for an Interim Order Application to be heard in the Absence of the Registrant. She repeated her application and the Panel applied the same legal advice. In deciding to proceed in the absence of the Registrant, the Panel took into account the same rationale applied earlier, but added to this its findings of facts and its substantive decisions on impairment and sanction.

3. Ms Sheridan applied for an Interim Order to cover the 28 days before the substantive order took effect and indicated that this should be for 18 months to cover any period of appeal. The Panel accepted the advice of the Legal Assessor that an interim order could be imposed if it was necessary for public protection or otherwise in the public interest. The Panel imposes an interim order of suspension for 18 months to cover the period before the substantive order took effect, or any appeal period. It did so on both the grounds of public protection and public safety. It imposed an interim order of suspension, to reflect the substantive decision it has made and the reasons for this.

Hearing History

History of Hearings for Simon David Drew

Date Panel Hearing type Outcomes / Status
31/01/2022 Conduct and Competence Committee Final Hearing Suspended