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Allegation(as amended at the Final Hearing)
As a registered Paramedic (PA08858) your fitness to practise is impaired by reason of misconduct, in that:
1.Between 1 June 2016 and 25 June 2017 On one or more of the dates set out in Schedule 1, you made duplicate mileage and/or expenses claims to the Welsh Ambulance Service and to the College of Paramedics.
2.Your actions at Particular1 were dishonest.
3.The matters set out in particulars 1 and 2 constitute misconduct.
4.By reason of your misconduct your fitness to practise is impaired.
i. 1 June 2016
ii. 3 June 2016
iii. 7 June 2016
iv. 16 June 2016
v. 20 June 2016
vi. 4 July 2016
vii. 6 July 2016
viii. 8 July 2016
ix. 18 July 2016
x. 19 July 2016
xi. 28 July 2016
xii. 29 July 2016
xiii. 1 August 2016
xiv. 18 August 2016
xv. 2 September 2016
xvi. 6 September 2016
xvii. 7 September 2016
xviii. 12 September 2016
xix. 13 September 2016
xx. 14 September 2016
xxi. 29 September 2016
xxii. 3 October 2016
xxiii. 7 October 2016
xxiv. 20 October 2016
xxv. 21 October 2016
xxvi. 1 November 2016
xxvii. 2 November 2016
xviii. 8 November 2016
xxix. 16 November 2016
xxx. 18 November 2016
xxxi. 29 November 2016
xxxii. 10 January 2017
xxiii. 11 January 2017
xxiv. 12 January 2017
xxxv. 22 January 2017
xxvi. 23 January 2017
xxvii. 3 February 2017
xviii. 5 March 2017
xxix. 7 March 2017
xl. 8 March 2017
xli. 23 March 2017
xlii. 24 March 2017
xliii. 24 April 2017
xliv. 28 April 2017
xlv. 29 June 2017
1. The Panel has been convened to undertake a review of a substantive order of suspension imposed in respect of the HCPC registration of the Registrant, Mr Andrew Jones, a Paramedic.
2. At the time relevant to the HCPC’s allegations against the Registrant, he was employed by the Welsh Ambulance Service NHS Trust (‘the Trust”) in the role of a Band 7 Advanced Paramedic Practitioner. Following an injury at work, he was unable to carry out his substantive duties and from September 2016 to July 2017 he was placed on alternative duties. During this period, he was also carrying out duties on a voluntary basis for The College of Paramedics (“the College”), of which organisation he was a trustee.
3. In October 2017, a referral was made to the Trust’s Counter Fraud team by an anonymous member of the Trust’s staff. The following month the Counter Fraud team commenced an investigation. Subsequently, the Registrant was invited to attend an interview on 30 April 2018.
4. On 14 May 2018, the Registrant referred himself to the HCPC in which he disclosed that he was being investigated in relation to an alleged fraud relating to his mileage claims.
5. No criminal charges resulted from the matter.
The substantive hearing held in November 2021
6. At the commencement of the hearing the Registrant admitted all of the factual elements of the case, he admitted that his behaviour had been dishonest and that the admitted facts amounted to misconduct. In relation to impairment of fitness to practise he admitted that he was currently impaired in relation to the public component.
7. The substantive hearing panel (hereafter “the former panel”), heard evidence concerning the matters in issue and found all of the particulars proven. This finding included a decision that the Registrant’s behaviour was dishonest. The Registrant had admitted dishonesty at the commencement of the hearing, but his evidence included contextual matters that were to concern the former panel when it came to make its decision.
8. The former panel decided that the established facts amounted to dishonesty. A total of 45 separate duplicate claims had been made over a 12 month period, and the Panel found that this represented a pattern of dishonest conduct which fell far short of the standards expected of a registered professional. It breached the requirement imposed by standard 9.1 of the HCPC’s Standards of conduct, performance and ethics, that registrants must, “…. make sure that [their] conduct justifies the public’s trust and confidence in [them] and [their] profession.” The Panel found that the Registrant’s conduct had damaged the reputation of Paramedics and that members of the profession and the public would be shocked and appalled to learn of his actions.
9. When the former panel considered the issue of impairment of fitness to practise it stated that it was of the view that with the development of meaningful insight the Registrant’s misconduct was remediable, but it said this in paragraph 49 of its written determination:
“The Panel determined that the Registrant had not fully developed his insight into the reasons for his conduct. The Panel considered that the Registrant’s reflective piece was very academic in nature. The Panel considered that in his evidence the Registrant appeared unable or unwilling to confront the simple and basic nature of his dishonesty. The Registrant stated he had “compartmentalised” his thought process at the time and sought to put forward explanations for his thought process which were not credible. For example, his concern about exceeding his personal mileage. The Panel did not consider that the Registrant’s insight was sufficiently developed to enable him to fully explain why he could not see that his actions were dishonest at the time. The Panel considered that the Registrant, either in his reflection or in his oral evidence to the Panel, had not adequately identified or addressed the underlying reasons for his misconduct.”
For the reasons explained in this passage, the former panel did not consider that the Registrant’s insight was fully developed and that there was accordingly a residual risk of repetition. This, in turn, resulted in a finding that the Registrant’s fitness to practise was impaired upon consideration of the personal component. It was also decided that the public component required a like finding.
10. When the former panel considered the issue of sanction, it accepted that the Registrant had had a lengthy professional career and that there had been no previous regulatory concerns and that there was positive evidence concerning the Registrant’s ability as a Paramedic. It also accepted that there had been no repetition of dishonest conduct since 2017. However, in paragraphs 67, 70, 71 and 72 of its written determination, the former panel stated this:
“The Panel considered that the Registrant had not yet fully taken responsibility for his conduct and, in the Panel’s view, was unable to adequately grasp the nature and extent of the dishonesty.
“The Panel concluded that [a Suspension Order] was the appropriate and proportionate sanction in the circumstances of this case. The Panel considered that such an Order is required to maintain public confidence in the profession and to uphold professional standards. The Panel considered that the Registrant’s conduct undermined public trust in the profession and therefore a serious sanction of suspension was required. The Panel considered that the length of the Order should be for 12 months which is the maximum permitted. The Panel determined that the maximum period was required to uphold public confidence and to demonstrate to the wider profession that the Registrant’s misconduct was serious.
“Although the Panel had found that the Registrant’s insight was limited at this time, it considered that a 12 month Suspension Order would provide a further opportunity to the Registrant to reflect on his misconduct and to demonstrate that he had developed an appropriate level of insight.
“The Panel acknowledged that the Policy lists dishonesty as the type of case in which a Striking Off Order may be appropriate. The Panel considered this very carefully. The dishonesty, while serious, was not fundamentally incompatible with remaining in the profession. The Panel did not consider that the Registrant had displayed entrenched attitudinal dishonesty. The Panel noted that the Registrant had taken some steps to address his misconduct and had indicated to the Panel that he would be willing to take further steps. As the Panel had previously found, the dishonesty could be remediated with the development of insight. Having found that a Suspension Order would adequately protect the public and the public interest it considered that this was the least restrictive sanction and therefore proportionate. Taking account of all of the above the Panel was of the view that in these circumstances a Striking Off Order would be unduly punitive and would deprive the profession of a skilled practitioner.”
11. The Suspension Order for a period of 12 months was imposed on 26 November 2021. As it did not come into effect while the Registrant’s appeal rights remained outstanding, it is not due to expire until 24 December 2022. Having determined that this sanction was required, the former panel said this in paragraph 73 of its determination:
“This Panel does not seek to fetter the discretion of a future reviewing panel, but it considers that such a panel may be assisted by any information which evidences a developed level of insight. This might include an appreciation and understanding of the nature and extent of the dishonesty and a fuller appreciation of the reasons behind it. This Panel considers that a future panel would be further assisted by evidence about any personal learning the Registrant has undertaken. This Panel also considers that a future reviewing panel may be assisted by the submission of a contemporary reflective piece from the Registrant.”
The evidence of the Registrant presented to the present Panel
12. In advance of the hearing two bundles of documents prepared by or on behalf of the Registrant were presented to the Panel. The earlier in time extended to 20 pages and contained a letter dated 5 November 2022 written by the Registrant and addressed to the Panel. It also included details of, and certificates confirming, CPD undertaken by the Registrant. The latter bundle contained 11 pages and contained a Reflective Statement dated 20 November 2022 and testimonials, including one from the Clinical Director of the organisation for which the Registrant has been working as an Emergency Care Technician. The Registrant also gave oral evidence before the Panel and was cross-examined by the Presenting Officer. Further detail of the written and oral evidence will be given when the Panel explains its decision.
The submissions made to the present Panel
13. The Presenting Officer’s submissions fell into two parts. At the commencement of the case, and before the Registrant gave evidence, she explained the background of the case. After the Registrant gave evidence she made submissions on the powers available to the Panel and the approach the Panel should adopt in reaching the decision on the review. In this regard she summarised the relevant questions the Panel should consider. These submissions accorded with the approach advised by the Legal Assessor and adopted by the Panel, and therefore need not be repeated here. In relation to the outcome of the appeal, the Presenting Officer did not submit that the Panel should come to any particular decision; she submitted that the outcome of the review was a matter for the Panel’s judgement.
14. On behalf of the Registrant, Dr Graydon made submissions after the Registrant gave evidence. His submissions fell into three categories. First, he made submissions relating to the purpose of the review hearing. As these accorded with the approach suggested by the Presenting Officer and advised by the Legal Assessor, the Panel does not feel it necessary to elaborate further on them here. Secondly, Dr Graydon took the Panel to those sections of the determination of the former panel that explained the outcome of the substantive hearing was the suspension order currently being reviewed. Again, these sections have been explained above. Thirdly, Dr Graydon made submissions as to how the Registrant had satisfactorily addressed the reservations expressed by the former panel as to the Registrant’s evidence concerning his dishonesty. He submitted that the Registrant does now understand both the nature and extent of his dishonesty, and that being so, there is no risk that he would repeat such behaviour. Accordingly, it was submitted that a finding of impairment of fitness to practise is not required at the present time in relation to the personal component. So far as the public component is concerned, it was submitted that a period of suspension for 12 months sufficiently addressed that issue. Accordingly, it was submitted that the present Panel should decide that the Registrant’s fitness to practise is not impaired.
15. The fundamental issue to be decided by the Panel is whether, upon the expiry of the present period of suspension, a further sanction is to be imposed, and, if it is, what that a sanction should be. In reaching this decision, the Panel has approached the matter as follows:
• The findings made by the substantive hearing Panel as to the factual particulars are to be taken as settled, as is the finding of that Panel that those facts demonstrated misconduct.
• It is part of the background to the case that the substantive hearing Panel determined that the misconduct was impairing the Registrant’s fitness to practise in November 2021, but it is for the present Panel to decide if the Registrant’s fitness to practise is still impaired. In reaching this decision, the Panel is to apply the usual considerations applicable to a decision on current impairment of fitness to practise, is to have regard to the HCPTS Practice Note entitled, “Fitness to Practise Impairment” dated February 2022. In particular, it is important for the Panel to address both the personal and public components of impairment.
• If the conclusion is that there is no continuing impairment of fitness to practise, then no further sanction will be imposed upon the expiry of the present period of suspension. The Panel also acknowledged that it had the power to revoke the current period of suspension with immediate effect if it concluded that it would be appropriate to do so.
• If, however, the finding is that there is continuing impairment of fitness to practise then the available sanctions must be considered. The HCPC’s Sanctions Guidance is to be considered in that regard. The present Panel has available to it all the sanction powers that were available to the substantive hearing Panel. It follows that as the finding in November 2021 was one of misconduct, the whole sanction range up to and including striking off is available.
16. The Panel confirms that it has applied the approach set out above. The Panel also accepted that, as knowledge of any remedial measures taken will be within the knowledge of a registrant, and not to the HCPC, when a decision is to be made as to whether remedial steps have been taken to address identified shortcomings, there is a persuasive burden on the registrant to provide evidence of any steps taken.
17. The Panel first considered the personal component impairment of fitness to practise. The Panel should state at the outset that it was very impressed by both the Reflective Statement dated 20 November 2022 and the Registrant’s oral evidence. It was very clear to the Panel that the Registrant has now fully grasped the reasons for and gravity of his dishonesty, and that his current position is very different to that demonstrated by his evidence to the former panel. Indeed, he has taken considerable steps to gain insight into his dishonesty including difficult discussions with colleagues both senior and junior about his dishonesty. He had researched into dishonesty cases with other UK Regulators and internationally and reflected on his findings. So far as the Registrant’s oral evidence is concerned, it was clearly honest, and the substance of it demonstrated that what was written in the Reflective Statement was genuine. He spoke about the process of accepting his dishonesty as being a difficult one, something the Panel can understand given the senior and respected position in which the Registrant was in the Paramedic Profession. Again, the Registrant stated that he understands that when dishonesty on the part of a professional is an issue, the impact on the professional reputation does not depend upon the value gained. His evidence was that it did not depend on whether it was five pence or five thousand pounds. Furthermore, that the Registrant now truly understands the significance of his dishonesty was underlined by his statement that patients, despite their acute vulnerability if requiring the attendance of a Paramedic, may have legitimate concerns as to whether a Paramedic who has been dishonest in the past might steal money from their home.
18. The conclusion of the Panel is that the Registrant has developed a degree of insight into his behaviour that it can safely be declared that he does not present a significant risk of repeating behaviour of the sort found against him in November 2021. For that reason, the Panel has concluded that, from the perspective of the personal component, his fitness to practise is no longer impaired.
19. So far as the public component of impairment is concerned, the present Panel is of the clear view that the dishonesty established in this case would be a serious matter for an individual. It was particularly serious for a registered health professional and the Registrant was a health professional who was both senior and respected in his profession. The public interest would not be served were it to be thought that the regulator of that profession did not treat dishonesty as a very grave matter. While acknowledging that it has the power to order the immediate termination of the suspension order, after very careful consideration, the Panel concluded that this factor requires the full length of the period of suspension imposed on 26 November 2021 to stand. For that reason, the Panel does not order the immediate revocation of the order, although it does not consider that the public interest requires the duration of the order to be lengthened.
The Registrar is directed to revoke the Suspension Order of the registration of Andrew Jones from 24 December 2022, the date this order comes into effect.
No notes available
History of Hearings for Andrew Jones
|Date||Panel||Hearing type||Outcomes / Status|
|22/11/2022||Conduct and Competence Committee||Review Hearing||Suspended|
|22/11/2021||Conduct and Competence Committee||Final Hearing||Suspended|