Mr Ashley Edward Williamson

Profession: Paramedic

Registration Number: PA43670

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 24/06/2022 End: 17:00 24/06/2022

Location: This hearing is being held virtually.

Panel: Conduct and Competence Committee
Outcome: No further action

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Allegation

As a registered Paramedic (PA43670) your fitness to practise is impaired by reason of misconduct. In that:

1. Between 1 September 2019 and 20 September 2019, you were unregistered with the Health and Care Professions Council and you practised as a Paramedic for Company A at the ‘Ride Across Britain’ event between 7 September 2019 and 15 September 2019.

2. In a statement provided to your employer South Western Ambulance Service NHS Foundation Trust in January 2020, you said that you had not worked as a Paramedic at the event and had not received remuneration, when this was not the case.

3. Your conduct in relation to allegations 1 and/or 2 above was dishonest.

4. The matters set out in allegations 1,2 and 3 above constitute misconduct.

5. By reason of your misconduct your fitness to practise is impaired.

 

Finding

Preliminary Matters

There were no preliminary matters.


Background

1. The Registrant Mr Ashley Williamson is an HCPC registered Paramedic. In September 2019, at a time when his HCPC registration had lapsed, he practised as a Paramedic for a private company at a cycling event. When asked about this by his employer, South Western Ambulance Service NHS Foundation Trust (the Trust), he told them that he had not worked as a Paramedic at the event and had not been remunerated by the company; both these statements were untrue.
2. The Registrant self-referred the matter to the HCPC on 12 October 2020. In respect of his lapsed registration, both the HCPC and the Trust had brought the issue of renewal to the Registrant’s notice. The HCPC contacted the Registrant concerning his renewal initially on 1 June 2019. This was followed up by the HCPC and the Trust. As the Registrant had not renewed his registration he worked as an Emergency Care Assistant (“ECA”). He renewed his registration with effect from 20 September 2019. The Trust subsequently became aware that the Registrant had worked as a Paramedic for a private company between 7 September 2019 and 15 September 2019 and invoiced the company for his services.

 

The substantive hearing panel’s decision

 

3. At the substantive hearing the Registrant admitted particulars 1-4 and gave evidence that he was “incredibly ashamed” of his behaviour. He said anyone who worked with him, would know how important honesty and integrity are to him. He said he was extremely disappointed in himself. He had been reckless, and had personal problems at the time, relating to his health, financial difficulties, relationship and bereavement issues. The Registrant did not feel stable and rational and did not feel ‘himself’ at that time. He held himself to high standards. His mindset at the time was not good but he had experienced a “massive learning curve” and was now a different person. He said he was disgusted in himself and how he had behaved. He said that he had a lot of difficulty at the time, had taken time off work and had financial problems.
4. The Registrant was working on three days per week, in a four partner General Practitioners’ practice with 11,000 patients. He worked with two other people in a home visiting team, including care for patients who were elderly and/or frail. Formulating care plans for Care and Nursing Home patients was also part of this role. He does additional shifts where possible and also works for the Trust part time.
5. The Panel determined that the Registrant’s behaviour fell far below the standards expected and that the statutory ground of misconduct was made out. The Registrant’s character witness CH knew the Registrant via a professional role from working at the same practice since October 2020. She said the first six months was a learning curve for the Registrant who was undertaking a new type of role. Rather than providing only emergency care, he had ongoing relationships with patients which provided continuity he clearly enjoyed. CH knew the Registrant was undertaking training and she had observed a significant positive change in his development. He was keen to learn and take on greater clinical responsibility.
6. In relation to the personal component of current impairment, the panel found there were no concerns as to the Registrant’s clinical competence. There was no evidence of any past harm to patients and there was no likelihood of harm to patients in the future.
7. The Registrant’s misconduct did not relate to a deep-seated attitudinal problem and was capable of being remedied. The Registrant had reflected on his wrongdoing and there was a low risk of repetition.
8. The panel had some residual concerns, namely: not keeping his current employers fully informed of matters in a timely manner and failing to provide evidence of targeted remediation until a very late stage.
9. The panel was concerned that the Registrant had not been entirely frank with his new employers, given that a sanction which impacted on his continued work could be imposed by the panel. This caused the panel to question whether he had developed sufficient insight.
10. The Registrant had not sought to deny what happened, taking full responsibility from the outset of the hearing. He understood the impact of his misconduct on the public and the profession and was genuinely remorseful. However, while the Registrant had developing insight into the seriousness of his misconduct, it was not yet at a sufficiently developed stage to reassure the panel that he had changed and that the risk of repetition had been sufficiently mitigated. His fitness to practise was impaired on the personal component.
11. A reasonable and well-informed member of the public would find the Registrant’s misconduct in behaving dishonestly to be unacceptable and would be very concerned if there was no finding of impairment. The Registrant acted in breach of a fundamental tenet of his profession by being dishonest.
12. A finding of impairment was required to maintain public confidence in the paramedic profession and the regulatory body and to send out a message to practitioners that proper standards of conduct and behaviour must be upheld.
13. The Registrant was capable of remedying his misconduct and making good progress towards further developing his insight. A Suspension Order for a period of three months was the appropriate and proportionate sanction. This would provide the Registrant with sufficient time to continue his progress towards fuller development of his insight and maintain public confidence in the paramedic profession and the HCPC.
14. The substantive hearing panel stated that the reviewing panel may be assisted by the following:
a) The Registrant’s attendance, in person or remotely, at the review hearing to assist the reviewing panel.
b) Evidence to show that the Registrant has reflected upon any professional ethics/ probity courses undertaken, detailing what he has learnt about dishonesty from this training.
c) A reflective piece addressing the Registrant’s understanding of the impact of his misconduct on his employers, the confidence of the public in the paramedic profession, and the upholding of professional standards.
d) Up to date references and testimonials from those who can speak for the Registrant’s character in full knowledge of this case.

 

Substantive review hearing

 

15. The Registrant gave evidence today, stating that he has complied with the suggestions of the previous panel. He has supplied testimonials from two General Practitioners ME and PB, from CH their practice manager and WW (Paramedic). In addition, two reflective pieces and seven CPD course certificates. He has recognised the importance of the panel’s findings and acted upon them. He has acknowledged the need to be open and honest at all times with his employers and colleagues. He has developed his insight and his approach has changed. He has reflected and with hindsight his reflective pieces before the substantive hearing panel did not sufficiently reflect that he accepts full responsibility for his actions and their impact on the public interest.
16. The Registrant admitted the alleged dishonesty at the previous hearing. He has now developed an ability to deal with issues of stress and obtain support to avoid errors and when things go wrong, to be open and transparent. He has matured and developed and learned lessons. This was an isolated incident, and he is committed to the profession. The regulatory process has been an eye opening one and he takes seriously the public impact of his misconduct. He will not repeat his dishonest behaviour, he has more confidence to discuss difficult issues and would act differently now.

 

HCPC Submissions

 

17. Mr D’Alton took a neutral position on behalf of the HCPC regarding impairment. He submitted that the previous panel had highlighted the need for insight and reflection by the Registrant. The HCPC commends the progress made by the Registrant but invited the Panel to consider the depth of his remediation. His references state he is open and honest and during the course of his work he is able to learn and develop. Some of the reflective pieces are not specific as to his past misconduct. He has demonstrated more depth in his oral evidence. There are support mechanisms in place but the Panel should consider whether he has fully addressed the public impact aspect.
18. Mr D’Alton submitted that should the Panel determine that the Registrant fitness to practise is no longer impaired, it should consider allowing the current suspension to continue until it expires on 28 July 2022.
19. The reviewing Panel’s task is to “consider whether all the concerns raised in the original finding of impairment have been sufficiently addressed” (Abrahaem v GMC [2008] EWC 183 (Admin).

 

The Registrant’s submissions

 

20. Mr Hughes submitted the current Order should be revoked with immediate effect because the Registrant is no longer impaired on personal and public component grounds.

 

Legal Assessor’s advice

 

21. The Legal Assessor advised the Panel to consider if the Registrant is fit to return to unrestricted practice. This is not a rehearing of the original allegation and the Panel cannot go behind the previous findings. The Panel has to make an assessment of the Registrant’s fitness to practise as at today’s date.
22. The Panel should take into account the HCPTS Practice Notes on “Article 30 Reviews” and “Finding that Fitness to Practice is Impaired”. If the Registrant’s fitness to practise remains impaired the Panel will need to consider what restriction, if any, should be imposed.
23. The Panel should take into account the principles of fairness and proportionality and have regard to the HCPC Sanctions Policy which states:

58. Given the seriousness of dishonesty, such cases are likely to result in more serious sanctions. However, panels should bear in mind that there are different forms, and different degrees, of dishonesty, that need to be considered in an appropriately nuanced way. Factors that panels should take into account in this regard include: whether the relevant behaviour took the form of a single act, or occurred on multiple occasions; the duration of any dishonesty; whether the registrant took a passive or active role in it; any early admission of dishonesty on the registrant’s behalf; and any other relevant mitigating factors…

24. Under Article 30 of the Health Professions Order 2001, all suspension orders must be reviewed before they expire.
25. The Panel has power under Article 30 to vary, extend, replace or revoke the existing sanction. All the sanction options including a Striking-off Order are available.
26. As the decision in Abrahaem v GMC indicates, in practical terms there is a “persuasive burden” on the Registrant, to demonstrate at the review hearing that he has fully acknowledged the deficiencies which led to the original finding, and addressed his impairment sufficiently “through insight, application, education, supervision or other achievement”.

 

Reviewing Panel’s Decision

 

27. The Panel accepted the advice of the Legal Assessor. The Panel has taken into account the relevant HCPTS Practice Notes and the Sanctions Policy.
28. The Panel has taken into account the personal component, which includes the current competence and behaviour of the Registrant, and the public component, which includes protecting service users, declaring and upholding proper standards of behaviour and maintaining public confidence in the Paramedic profession.
29. This review process requires the Registrant to demonstrate both developed insight and remediation, enabling him to safely return to unrestricted practice. There is a persuasive burden on the Registrant.
30. The Panel took into consideration the evidence, documentation and the submissions made. The Panel finds that there has been a significant change in the Registrant’s circumstances since the last hearing, as regards remediation and insight. He gave evidence to the Panel and demonstrated that he has taken the steps suggested by the previous panel.
31. The Registrant has made considerable progress since the final hearing. He has undertaken CPD courses in relation to probity, law and ethics. He has reflected upon the panel’s findings and continued to work in a health care role. The testimonials supplied speak to his honesty and integrity. He has maintained his professional skills. In his evidence to the Panel today he has accepted the importance of professional standards and demonstrated greater maturity, in complying with the panel’s suggestions.
32. Although some elements of his reflective pieces lacked depth, it was clear from the Registrant’s evidence to the Panel that he has insight and has remediated his misconduct as intended by the previous panel. He has acknowledged the impact of his misconduct in his oral evidence on the public’s confidence and the wider profession.
33. The Registrant has demonstrated a commitment to return to professional practice. The Panel concluded that his fitness to practise is no longer impaired on either the personal or public components.
34. The Panel next considered whether to revoke the current suspension order with immediate effect or to allow it to lapse on the date of expiry.
35. The Panel determined that the public interest considerations of the substantive sanction are met by allowing the current suspension to continue until it expires.
36. The Panel noted that the sanction of a Suspension Order of 3 months was the minimum period required to reflect the serious misconduct. The substantive panel had determined that a shorter period would not have sent an appropriate message as to the unacceptable nature of the misconduct. Therefore, the full term of the Order should remain in place, on public interest grounds, despite the finding that the Registrant is no longer impaired.

Order


ORDER: The Registrar is directed to allow the current Suspension Order against the registration of Mr Ashley Edward Williamson to lapse upon its expiry, namely 28 July 2022.

Notes

No notes available

Hearing History

History of Hearings for Mr Ashley Edward Williamson

Date Panel Hearing type Outcomes / Status
24/06/2022 Conduct and Competence Committee Review Hearing No further action
28/03/2022 Conduct and Competence Committee Final Hearing Suspended