James Hughes

Preliminary Matters

Application to amend the charges

1. Mr Bridges made an application to amend the header of the Particulars. The Registrant had not been put on notice of the proposed amendments given that it was not appreciated until the start of the hearing that such an application was required. He submitted that the proposed amendments did not change the substance of the allegation against the Registrant, but merely ensured that the header to the allegation better reflected the statutory grounds relied upon.

2. The proposed amendments are set out above.

3. Mr Hughes did not object to the proposed amendments.

4. The Panel accepted the advice of the Legal Assessor and carefully considered the HCPC’s application to amend the Particulars. The Panel concluded, after reviewing each of the proposed amendments, that it would agree to the Particulars being amended for the following reasons:

a) the proposed amendments do not materially widen the scope of the allegation, but merely seek to ensure that the header reflects the pleaded statutory grounds referred to at Particular 10 of the Allegation; and
b) the Registrant has not objected to the proposed amendments.

5. The Panel concluded that the proposed amendments of the paragraphs did not materially affect the nature or seriousness of the allegation. In all the circumstances, there was no likelihood of unfairness or injustice to the Registrant. The Panel therefore agreed to the proposed amendments.

Application to hear part of the hearing in private

6. The Panel heard that matters relating to the Registrant’s health may be referred to during the course of the hearing. Mr Bridges submitted that it was appropriate that those parts of the hearing be held in private. The Registrant supported the application.

7. The Panel accepted the Legal Assessor’s advice and it noted Rule 10(1)(a) of the Rules whereby matters relating to the health of the Registrant, the complainant, any person giving evidence or of any patient or client should be heard in private. The Panel therefore agreed that those parts of the hearing where reference was to be made to the Registrant’s health should be heard in private.

Application to adjourn the hearing
The Registrant’s submissions

8. At the outset of the hearing, the Registrant, who was unrepresented, stated that he had not been given adequate notice of the evidence in this case and that he had been unable to adequately prepare for the hearing. The Panel therefore treated the Registrant’s application as an application to adjourn the hearing.

9. The application was based on the following grounds:

Inadequate notice of the evidence

10. The Registrant stated that he had only received the HCPC’s evidence 13 days before the commencement of this hearing. He submitted that as a result, he had not been given the 42 days’ notice of the evidence as required by the HCPC’s Standard Directions which states:

“The Council shall, no later than 42 days before the date fixed for the hearing of the case, serve on the health professional a copy of the documents which the Council intends to rely upon at that hearing.”

11. After the hearing date was cancelled from its original hearing date of 5 June 2023, the Registrant stated that he believed that the whole process would be restarted and that he would receive the bundle 42 days before this hearing. He stated that the papers were only uploaded on 27 November 2023 but was informed that the pagination had changed. He stated that he had not looked at the recently uploaded bundle.

Legal representation sought

12. In addition to having had less than the required 42 days to consider the evidence, the Registrant stated that he needed more time to be legally represented. He stated that he was not legally trained and that he had no support to assist him to prepare for this hearing. He said that he had tried to get representation, but in response to questions put to him by the Panel, he conceded that he had been trying to get representation for approximately two years.

13. He stated that he knew the hearing was coming up but because he only received the bundle 13 days ago, he had not been able to secure legal representation. He stated that he had been signposted to a law centre and a charity law firm, but that there was insufficient time to prepare for this hearing and he had not been able to speak to anybody over the phone.

14. As a result, he felt unprepared, stressed [redacted], and that he wanted time to give himself the best chance.
HCPC’s submissions
15. Mr Bridges opposed the application.

16. He stated that this matter was originally listed for hearing on 5 June 2023, but the hearing had to be adjourned due to the panellist unavailability. However, the evidence bundle was uploaded on 16 August 2022 and was viewed by the Registrant on 31 August 2022. Even though the papers were uploaded again on 27 November 2023, the bundle was the same, albeit that the pagination had been made clearer. There was, he stated, no change to the substance of the allegation.

17. He therefore submitted that the Registrant had had sight of the evidence since August 2022, more than 42 days before the original listing date.

18. Mr Bridges also informed the Panel that on 25 July 2023, the Registrant was emailed the listing details for today’s hearing. The email stated: ”If you have not received the case documents 42 days in advance of the hearing please contact the HCPC and Kingsley Napley LLP immediately at…..”. He stated that the Registrant did not raise the issue of non-service of the papers in response to that email.

19. Mr Bridges noted that the HCPC had not been put on notice of this application. He reminded the Panel that the Registrant had had access to the papers for over a year. He stated that there was no suggestion that if the case was adjourned, the Registrant would be able to secure legal representation given that two years had elapsed since the Registrant was made aware of the allegation yet he still had not managed to secure representation.

20. He reminded the Panel that there was a public interest in cases being heard expeditiously and that two witnesses had made themselves available to give live oral evidence and that they would be inconvenienced if this hearing was adjourned.

Decision

21. The Panel has heard and accepted the advice of the Legal Assessor. It has also considered the HCPC’s Practice Note on ‘Postponement and Adjournment of Proceedings’.

22. In considering the application, the Panel has borne in mind the need to strike a proper balance between fairness to the Respondent and the public interest in the fair, economical, expeditious and efficient disposal of proceedings, having regard to the whole history of the proceedings. It is mindful that an adjournment is “not simply there for the asking”: Hussain v General Pharmaceutical Council [2018] EWCA Civ 22 and that applications for an adjournment, and any supporting evidence, should be subject to proper scrutiny: Awan v Law Society [2002] EWCA Civ 1969. It has borne in mind that the onus is on the applicant for an adjournment to prove the need for an adjournment: Teinaz v Wandsworth London Borough Council [2002] ICR 1471 CA.

23. The Panel refused the Registrant’s application for the following reasons:

⦁ So far as having had notice of the evidence is concerned, the Panel noted that this case was originally fixed for 5 June 2023, the papers being uploaded on 16 August 2022 and viewed by the Registrant on 31 August 2022. The Registrant has therefore had more than 42 days’ notice of the evidence on which the HCPC intended to rely. The Panel did not therefore accept that the Registrant had only had 13 days’ notice of the evidence the HCPC proposed to adduce;
⦁ If the Registrant was concerned about the lack of time to prepare for this hearing, it was open to him to have raised his concerns with the HCPC as suggested in their email dated 25 July 2023, but he did not avail himself of that opportunity in the intervening five months. Instead, he has chosen to raise the issue of a lack of preparation time on the morning of the hearing;
⦁ The Registrant was served with a notice of hearing on 22 November 2021 and has therefore had over two years to seek representation, yet has been unable to arrange that. The Registrant should have been prepared for this hearing on the basis that it proceeded as originally fixed in June 2023. He has had the benefit of an additional six months, yet has not arranged representation. The Panel therefore concluded that, two years having elapsed since he first became aware of the allegations, there was no reasonable prospect of him securing legal representation if the hearing was adjourned today;
⦁ There was a public interest in this matter being heard expeditiously, particularly given that this was not the first listed date for the hearing, and two witnesses had made themselves available to attend to give oral evidence, albeit remotely;
⦁ The Panel recognises that being subject to regulatory proceedings is stressful and difficult, particularly where a Registrant is unrepresented. However, that did not, in the Panel’s view, justify adjourning the hearing. Regretfully, those pressures would remain irrespective of whether the hearing proceeded today or at some future date.

24. The Panel therefore concluded that, in all the circumstances that there was no unfairness in the hearing proceeding and therefore refused the Registrant’s application.

Background

25. The Registrant is a registered Paramedic (PA22651) and was employed by Great Sutton Medical Centre (the Employer) as a Band 7 Paramedic, from December 2019 until April 2021.

26. On 6 February 2018, the Registrant was convicted of driving a motor vehicle whilst being over the exceeded prescribed limit of alcohol at Liverpool Knowsley and St Helens Magistrates’ Court, contrary to section 5(1)(a) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988. As a result, the following penalties against the Registrant were imposed:

a) A fine of £100;
b) The payment of a surcharge to fund victim services of £30;
c) The payment of costs of £85 to the Crown Prosecution Service;
d) A Collection Order; and
e) Disqualification from holding or obtaining a driving licence for 18 months, subject to a reduction of 137 days if, by 21 January 2019, the Registrant satisfactorily completes a course approved by the Secretary of State.

27. In relation to the conviction concerns as set out above, it is also alleged that the Registrant failed to advise the HCPC of the conviction. Further, on 29 June 2020 it is alleged that when completing a readmission form to the HCPC, his registration having lapsed, the Registrant did not indicate that he had received the above conviction, as he failed to tick the correct box on the form disclosing this information.

28. In July 2020, concerns were raised by the HCPC’s Registrations Department regarding the Registrant’s conduct. Namely, it was alleged that the Registrant continued to work as a Paramedic whilst he was not registered with the HCPC, between 7 February 2020 and 24 July 2020.

29. As a result of the HCPC’s investigations into the above matters, the Employer raised concerns that the Registrant had failed to disclose to the Employer that he was not registered with the HCPC, between the relevant time set out above. The Employer subsequently conducted an internal investigation into these matters.

30. In addition to the above, on 29 June 2020, it is alleged that when completing his readmission form to the HCPC, the Registrant did not tick the box on the form to indicate that he had been disciplined by a regulatory body or his employer.

31. Further, concerns regarding the Registrant’s health also came to light as a result of the above matters. These health concerns were raised with the Employer in June 2020. During this time, the Registrant had experienced a couple of periods of sickness absence [redacted]. The Registrant’s health concerns led the Employer to refer him to Occupational Health, sometime in November 2020.

32. Subsequently, Kingsley Napley LLP (Kingsley Napley) was instructed by the HCPC to investigate the Registrant’s fitness to practise and to assist the HCPC with preparing this matter for a Final Hearing.

33. On 13 January 2022, the Registrant raised concerns regarding his health to Kingsley Napley during a phone call with LZ, Legal Assistant at Kingsley Napley. Subsequently, Kingsley Napley obtained an updated copy of the Registrant’s medical records, from 15 April 2021 to 26 April 2022. Within these records, it appears that the Registrant has suffered from [redacted] during this time (April 2021 to April 2022).

34. At its meeting on 11 November 2021, the Investigating Committee (IC) of the HCPC determined that there was a case to answer in relation to an allegation of impairment of the Registrant’s fitness to practise. The Panel referred the case to the Conduct and Competence Committee as set out above.

35. It was submitted that as this Panel is constituted as a Conduct and Competence Committee, it only has jurisdiction to decide substantively on the conviction and misconduct allegations.

36. At the outset of the hearing, the Registrant admitted factual allegations 1, 2, 3, 4, 5 and 6. Particular 7 was denied.

Panel’s Approach

37. The Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything and the individual particulars of the allegation could only be found proved if the Panel was satisfied that that was the case on the balance of probabilities.

38. In reaching its decision, the Panel took into account the oral evidence of the HCPC witnesses, namely:

⦁ SM: Practice Manager at Great Sutton Medical Centre (“the Practice”);
⦁ AM: Registrations Manager at the HCPC.

39. The Committee has also received documentary evidence provided to it, including a written statement from VO, Legal Assistant at Kingsley Napley LLP.

40. The Panel has also had sight of various documentary exhibits which include, but are not limited to:

⦁ Email correspondence between the Registrant and the HCPC;
⦁ Screen shot of payment rejection notices dated January 2020;
⦁ The Registrant’s application for readmission dated 29 June 2020;
⦁ Memorandum of conviction dated 6 February 2020;
⦁ The Registrant’s medical records for the period June 2020 – April 2021;
⦁ Notice of disciplinary decision and order dated 14 December 2009; and
⦁ Notice of disciplinary decision and order dated 2 July 2013.

41. It has also taken into account the oral submissions made by Mr Bridges on behalf of the HCPC and those of the Registrant and has accepted the advice of the Legal Assessor.

Particular 1

42. The Panel found the facts of Particular 1 proved for the following reasons.

43. The Panel heard and accepted the evidence of SM which the Panel found to reliable and consistent with the documentary evidence exhibited by her.

44. In her statement, she stated that the Registrant was employed by the Practice as a Band 7 Paramedic from December 2019 until 19 April 2021. He worked within the Advanced Nurse Practitioner Team ('ANP'). In his role with the Practice, the Registrant was responsible for telephoning and treating triaged patients suffering from acute illnesses who had phoned up the Practice on a given day. The Registrant’s role was based at the Practice. For any patients that needed to be seen, the Registrant would be responsible for bringing them to the Practice to be booked in to see a practitioner. In addition, he was required to attend to patients on home visits. The type of patients he attended to included patients of all ages, who were suffering from colds, coughs, earaches etc. she stated that the Registrant worked at the Practice from Monday to Friday from 9:30am to 5:30pm.

45. She stated that, as set out in the timeline of the Registrant’s employment, that he did not have valid registration for the period between 7 February 2020 and 24 July 2020. She confirmed that he used the title 'Paramedic' and that he was seeing patients between 7 February 2020 and 9 June 2020 at which time he went on sick leave. She confirmed that the Registrant was not on the HCPC register during this time period.

46. SM’s evidence was consistent with that of AM. He confirmed that the Registrant was first registered with the HCPC on 26 March 2007. He stated that the Registrant had renewed his registration on the following dates:

⦁ renewed 06/08/2019 – for registration cycle 01/09/2019 – 31/08/2021;
⦁ renewed 21/08/2017 – for registration cycle 01/09/2017 – 31/08/2019;
⦁ renewed 16/07/2015 – for registration cycle 01/09/2015 – 31/08/2017;
⦁ renewed 20/08/2013 – for registration cycle 01/09/2013 – 31/08/2015;
⦁ renewed 08/07/2011 – for registration cycle 01/09/2011 – 31/08/2013;
⦁ renewed 25/06/2009 – for registration cycle 01/09/2009 – 31/08/2011; and
⦁ renewed 04/07/2007 – for registration cycle 01/09/2007 – 31/08/2009.

47. He stated that the Registrant renewed his HCPC registration application on 6 August 2019 by way of a direct debit instalment payment. In January 2020, he was required to make the second instalment payment for the period 1 September 2019 till 31 August 2021. However, the direct debit payment was rejected.

48. In his statement dated 23 May 2022, he confirmed that the Registrant was removed from the register on 7 February 2020 for the non-payment of fees. As a result of this, he was required to cease working as a Paramedic from 7 February 2020 and to apply for readmission immediately. He stated that the Registrant was readmitted to the register on 24 July 2020.

49. The Panel has also taken into account that the Registrant admitted the facts of Particular 1.

50. In the circumstances, the Panel concluded that the Registrant worked as a Paramedic for the period in question and that, at that time, he was not registered with the HCPC. The Panel therefore finds the facts of Particular 1 proved.

Particular 2

51. The Panel found the facts of Particular 2 proved for the following reasons.

52. The Panel heard and accepted the evidence of SM. She stated that at no point during the Registrant’s employment with the Practice, did he inform the Practice that his registration with the HCPC had lapsed. Following contact with the HCPC regarding this matter in October 2020, she stated that the Practice spoke to the Registrant on his return to work in February 2021 about the lapse in his registration, and that he told them that there was no lapse as he usually pays by direct debit, but the payment failed, so he sent a cheque and assumed that this had cleared.

53. SM stated that the Practice was notified that the Registrant’s registration had lapsed on 6 October 2020 by the HCPC, not by the Registrant.

54. The Panel has also taken into account that the Registrant admitted the facts of Particular 2.

55. In the circumstances, the Panel therefore finds the facts of Particular 2 proved.

Particular 3

56. The Panel found the facts of Particular 3 proved for the following reasons.

57. The Panel has had sight of the Registrant’s exhibited application for registration dated 29 June 2020. In section 3 of that form, the Registrant has entered an ’X’ in the ‘No’ box in response to the question ‘Have you been disciplined by a professional or regulatory body or your employer?’ the form was signed by the Registrant at the end of the relevant declaration at Section 6.

58. The Panel has also taken into account that the Registrant admitted the facts of Particular 3.

59. In the circumstances, the Panel therefore found the facts of Particular 3 proved.

Particular 4

60. The Panel has had sight of the memorandum of conviction which confirms the Registrant’s conviction as alleged. The Panel has had regard to Rule 10(1)(d) which states:

“where the registrant has been convicted of a criminal offence, a certified copy of the certificate of conviction (or, in Scotland, an extract conviction) shall be admissible as proof of that conviction and of the findings of fact upon which it was
based;”

61. The Panel has also taken into account that the Registrant admitted the facts of Particular 4.

62. In the circumstances, the Panel therefore found the facts of Particular 4 proved.

Particular 5

63. The Panel found the facts of Particular 5 proved for the following reasons.

64. The Panel accepted the evidence of AM. He stated in his written statement dated 23 May 2022 that “There are no notes within James Hughes’ registration records which indicate that he informed the Registration department about a drink driving offence in or around 2018 or thereafter.”

65. The Panel has also taken into account that the Registrant admitted the facts of Particular 5.

66. The Panel therefore found the facts of Particular 5 proved.

Particular 6

67. The Panel found the facts of Particular 6 proved for the following reasons.

68. The Panel has had sight of the Registrant’s exhibited application for registration dated 29 June 2020. In section 3 of that form, the Registrant has entered an ’X’ in the ‘No’ box in response to the question ‘Have you been convicted of a criminal offence or received a police caution (other than a protected caution or protected conviction)?’. The form was signed by the Registrant at the end of the relevant declaration at Section 6.

69. The Panel has also taken into account that the Registrant admitted the facts of Particular 6.

70. In the circumstances, the Panel therefore found the facts of Particular 6 proved.

Particular 7

71. The Panel finds the facts of Particular 7 proved in respect of Particulars 1, 2 and 5 proved for the following reasons.

72. In considering whether the respondent acted dishonestly, the committee has applied the test for dishonesty as set out in Ivey v Genting Casinos (UK) Ltd t/a Crockfords [2017] UKSC 67:

“When dishonesty is in question the fact-finding tribunal must first ascertain subjectively the actual state of the individual’s knowledge or belief as to the facts. The reasonableness or otherwise of his belief is a matter of evidence (often in practice determinative) going to whether he held the belief, but it is not an additional requirement that his belief must be reasonable; the question is whether it is genuinely held. When once his actual state of mind as to knowledge or belief as to facts is established, the question whether his conduct was honest or dishonest is to be determined by the fact-finder by applying the objective standards of ordinary decent people. There is no requirement that the defendant must appreciate that what he has done is, by those standards, dishonest.”

73. It has also taken into account the Legal Assessor’s direction relating to the Registrant’s character.

Dishonesty in relation to Particular 1

74. The Panel having found the facts of Particular 1 proved, then considered whether the Registrant’s conduct was dishonest.

75. On 4 January 2020, the Registrant was sent a letter by the HCPC Registrations Department to the effect that his direct debit payment for the second instalment of his registration fee had not been met. It was also the HCPC’s case that the Registrant was sent a reminder letter on 24 January 2020, as shown on the HCPC electronic recording system, although a copy of that letter has not been produced to the Panel.

76. The Registrant was removed from the register on 7 February 2020.

77. The Registrant stated that he was not aware that his name had been removed from the Register until 11 March 2020 when he spoke to the Registrations Department and was given advice regarding the readmission process.

78. The Registrant stated that he had been registered with the HCPC for a number of years and stated that he believed that his removal from the register was an administrative error that could quickly and easily be resolved. In the meantime, he continued to work as a Paramedic. He stated that this was a difficult period of time given the COVID pandemic, and that his priority was not to let anyone down, and to continue to serve the public.

79. The Registrant accepted that, with hindsight, the public would regard his actions as ‘irresponsible’ and understood now how the public might perceive his actions as being dishonest. He also stated that at the time, he did not want to ask for help from others and he conceded that he had been naive.

80. The Registrant stated in his email to the HCPC dated 21 July 2020 that:

“As I have explained in numerous emails to different advisors I was totally unaware of being removed from the register in February. I sent the payment of £45 by cheque on the 10/1/20 after the payment wasn’t taken by direct debit. I was only aware that I wasn’t on the register when I was applying to enrol on my prescribing course in March. It was the University that informed me that my details did not come up when they checked the register. I have been trying to sort this mess out since and due to the COVID pandemic I have had terrible difficulty in doing this. I have done everything that has been asked of me.

I have found this an extremely stressful situation to be in and I am currently off work sick because of this whole situation.

There has been numerous mistakes and miscommunication throughout this period and I am asking to be placed back on the register so I don’t loose my job/career.

As previously communicated in numerous emails I am a husband and father of 3 young daughters and my salary is the only financial income my family has. If I lose my job because of this it will have devastating consequences for my whole family.”

81. The Panel concluded in respect of this Particular, that the Registrant, by his own admission, was aware on 11 March 2020 that his name had been removed from the register. Notwithstanding the Registrant’s well-meaning desire to continue serving the public at what was a very demanding time for healthcare workers, the Registrant knew at the time that he was not permitted to practise as a Paramedic until such time as his name was restored to the register, even if he had the expectation that that would take place sooner rather than later. His email of 21 July 2020 reflected his concern about the financial implications if he was unable to work.

82. Despite the Registrant’s hope that his removal would be short-lived, resulting from what he considered to be an administrative error, the Panel concluded that ordinary members of the public would consider that continuing to work as a Paramedic when he knew that his name had been removed from the register, would be considered dishonest.

83. The Panel therefore concluded that in relation to this Particular, the Registrant acted dishonestly. The Panel therefore finds this Particular proved in respect of Particular 1.

Dishonesty in relation to Particular 2

84. The Panel having found the facts of Particular 2, proved, then considered whether the Registrant’s conduct was dishonest.

85. The Panel has concluded in respect of this Particular, that the Registrant knew from 11 March 2020, that he was unable to practise as a Paramedic given that his name had been removed from the register. His rationale was as set out in paragraph 81 above. He also knew that he would have to go through what was a more expensive readmission process. In his email of 21 July 2020, he voiced his concern about the financial implications if he was unable to work.

86. The Panel has found that the Registrant knew that, notwithstanding that he was aware, certainly from 11 March 2020, his name was removed from the register, and yet he did not inform his employer. The Panel considered that ordinary members of the public would consider that withholding that fact from his employers, for whom he worked as a Paramedic, would be considered dishonest.

87. The Panel therefore concluded that in relation to this Particular, the Registrant acted dishonestly. The Panel therefore finds this Particular proved in respect of Particular 2.

Dishonesty in relation to Particular 3

88. The Panel having found the facts of Particular 3, proved, then considered whether the Registrant’s conduct was dishonest.

89. The Panel has had sight of two previous adverse regulatory HCPC disciplinary determinations:

⦁ Decision and order dated 14 December 2009 at which hearing the Registrant was present and represented: the Registrant’s fitness to practise was found to be impaired by reason of his misconduct in relation to the following allegation for which he was made the subject of a one year caution order:

1. In the February 2009 edition of the Ambulance UK Magazine an article was published that you wrote. This article;
a) was insulting, rude, abusive and offensive towards fellow health professionals
b) demonstrating a lack of integrity
c) demonstrated unprofessional behaviour from a registered health professional
d) referred to colleagues and fellow professionals as monkeys.
e) was age discriminatory
f) potentially damaged confidence in the Paramedic profession
g) potentially brought the Paramedic profession into disrepute

⦁ Decision and order dated 2 July 2013 at which hearing the Registrant was present and represented: the Registrant’s fitness to practise was found to be impaired by reason of his misconduct in relation to the following allegation for which he was made the subject of a five year caution order:

While registered as a Paramedic, you:
1. In May 2012, made offensive remarks on Facebook in relation to former
Colleagues as follows:

a) “Right here goes!!!! In priority order… [redacted] is a cunt!!! Anybody who grasses up his fellow workmates for a practical joke is a retard. I used 2 get on with him as well. But after his wet seat incident I lost any respect I had 4 him. TIT. There is nothing worse than grassing your fellow road staff up. He has got a head like a peanut, thinks Facebook should be called Sonicbook with all the shit he posts on here and has got an over inflated opinion of himself!!!! I’ve never seen so shit shades in my life. He is definitely the tithead off Team America. I would have told him 2 his face on Tuesday if what happened on Monday didn’t and next time I c him I definitely will. BELLEND!!!!”

b) “Right refreshed an ready 2 go!!! Number 2 …LITERALLY!!! [redacted] is a prick!!! He thinks he plays psychological warfare and he should have a massive brain 4 the size of his head but he is like the 1st monkey they sent into space. He’s in control of the shuttle but he doesn’t know what he’s doing!!! My Uncle [redacted] is running rings round him!!! I lost any respect for him the day he came 2 my house and told me not to make any waves with C because he was going down on overtime and 1st Class!!!! Totally dissed me in my own house!!!! I saw him 2day and instead of wishing me the best he called me a “Fucking Nuisance” hahahah. Cheers boss. Then he tried 2 hide my medal off the Queen. What a tit. Far 2 smart 4 him!!!! Told him I’m gonna b on double his salary in AD. NOBHEAD!!!! Got my medal eventually!!! He looks like Blofeld off James Bond!!!! Should of kicked him in the nuts”

90. It was not disputed by the Registrant that he was aware of these previous adverse regulatory findings. However, he stated that he had been registered with the HCPC for several years and that, even though he was applying for readmission due to a failed direct debit payment, the HCPC was clearly aware of his regulatory history. He stated that he genuinely believed that the question related to the findings of other regulators and he confirmed that he had not been disciplined by his employer. He stated that he therefore genuinely believed that, in the circumstances, he would not need to disclose the two previous HCPC findings on his readmission form.

91. The Panel has had regard to Standard 9.5 of the HCPC’s Standards of conduct, performance and ethics 2016 edition which refers to a Registrant’s obligation to tell the HCPC if “another organisation responsible for regulating a health or social-care profession has taken action or made a finding against you…”.

92. In the circumstances, the Panel accepts, on the balance of probabilities that the Registrant genuinely believed that he did not have to inform the HCPC of its regulatory findings as the HCPC would have been aware of them and that he had not been disciplined by another regulator or employer. The Panel considered that ordinary members of the public would not consider the Registrant’s conduct to be considered dishonest in those circumstances.

93. The Panel therefore concluded that in relation to this Particular, the Registrant did not act dishonestly. The Panel therefore found this Particular not proved in respect of Particular 3.

Dishonesty in relation to Particular 5

94. The Panel having found the facts of Particular 5, proved, then considered whether the Registrant’s conduct was dishonest.

95. The Registrant denied that he had been dishonest, notwithstanding that he accepted that he had not informed the HCPC of his conviction. He stated that it was his view that his conviction was spent and therefore he was not required to inform the HCPC.

96. The Panel has had regard to Standard 9.5 of the HCPC’s Standards of conduct, performance and ethics 2016 edition which states that: “You must tell us as soon as possible if: you accept a caution from the police or you have been charged with, or found guilty of, a criminal offence;”.

97. The Registrant was convicted on 6 February 2018. Not only did he not disclose his conviction on his readmission form, but the Registrant conceded that he did not inform the HCPC a year earlier on his registration renewal form when there would have been no reasonable ground for believing that his conviction would have been spent. The Panel noted that, in any event, the obligation is to inform the HCPC “as soon as possible” of the conviction. The Registrant stated that he did not notify the HCPC because he was not working at the time he was convicted. However, the Panel noted that the Registrant had repeatedly not done so since February 2018 when he had had ample opportunity to do so and was under an obligation to do so. Having withheld that information when his registration was renewed, prior to the conviction being spent, the Panel concluded that it was a proper inference to draw that the Registrant knew that he deliberately withheld that information knowing it had to be disclosed and that, to do so, it might have an adverse effect on his career.

98. The Panel considered that ordinary members of the public would consider that deliberately withholding that information knowing that it had to be disclosed to conceal the fact of the conviction, would be considered dishonest.

99. The Panel therefore concluded that in relation to this Particular, the Registrant acted dishonestly. The Panel therefore finds this Particular proved in respect of Particular 5.

Dishonesty in relation to Particular 6

100. The Panel having found the facts of Particular 6, proved, then considered whether the Registrant’s conduct was dishonest.

101. The Registrant stated that at the time of completion of the readmission form, he believed the conviction in question was spent as his period of disqualification from the motoring offence had expired. He stated that he had no legal training, was unaware of the meaning of a ‘protected caution’. He therefore stated that the form was completed without any dishonest intent.

102. The Panel concluded on the balance or probabilities in respect of this Particular, that the Registrant held a genuine, but mistaken belief that he was not required to disclose the conviction of the readmission form. As a matter of law, by the date of completion of the form, the conviction was in fact spent. However, it was not a protected conviction which still required disclosure as the requisite 11 year period since the conviction had not elapsed. It was incumbent on the Registrant to take appropriate steps to ensure that the declarations made were accurate, but he recklessly failed to do so.

103. The Panel nevertheless concluded that, in all the circumstances, whilst his actions in failing to disclose his conviction were reckless, ordinary members of the public would not conclude the Registrant’s actions would be considered dishonest.

104. The Panel therefore concluded that in relation to this Particular, the Registrant did not act dishonestly. The Panel therefore finds this Particular not proved in respect of Particular 6.

105. In summary, the Panel therefore finds the facts of Particular 7 proved in relation to Particulars 1, 2 and 5.

Particular 8

106. This Panel being constituted as a Conduct and Competence Panel was invited not to consider this allegation, which solely related to the Registrant’s health, until the conclusion of its findings in relation to the remaining Particulars. The Panel therefore made no determination on the facts of this Particular at this stage.

Decision on Grounds

HCPC submissions

107. Given the Panel’s determination that the Registrant’s conduct in relation to Particulars 3 and 6 was not found to have been dishonest, Mr Bridges restricted his submissions regarding misconduct to those Particulars where the Registrant was found to have acted dishonestly. He submitted that those matters established that the Registrant acted in such a way which fell seriously short of that which would be proper in the circumstances and that which the public would expect of a HCPC registered Paramedic.

108. He asked the Panel to bear in mind the explanation of that term given by the Privy Council in the case of Roylance v GMC (No.2) [2000] 1 AC 311, where it was stated that: 

“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a … practitioner in the particular circumstances. The misconduct is qualified in two respects. First, it is qualified by the word ‘professional’ which links the misconduct to the profession ... Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious.”

109. He further submitted that the Registrant’s conduct had the potential to impact adversely on the reputation of the profession.

110. In his written submissions, he invited the Panel to conclude that the Registrant had breached standards 8, 9, 9.1 and 9.5 of the HCPC Standards of Conduct, Performance and Ethics (2016):

Standard 8: Be open when things go wrong;
Standard 9: Be honest and trustworthy;
Standard 9.1: You must make sure that your conduct justifies the public’s trust and confidence in you and your profession;
Standard 9.5: You must tell us as soon as possible if:
⦁ you accept a caution from the police or you have been charged with, or found guilty of, a criminal offence;
⦁ another organisation responsible for regulating a health or social-care profession has taken action or made a finding against you; or
⦁ you have had any restriction placed on your practice, or been suspended or dismissed by an employer, because of concerns about your conduct or competence.

111. He also invited the Panel to conclude that the Registrant had breached standards 2.2; 3; 3.1; 9.5 of the HCPC Standards of Proficiency for Paramedics.

Standard 2.2: promote and protect the service user’s interests at all times
Standard 3: look after their health and wellbeing, seeking appropriate support where necessary
Standard 3.1: identify anxiety and stress in themselves and recognise the potential impact on their practice

112. However, in his oral submissions to the Panel, Mr Bridges relied on Standard 9 and 9.5 of the HCPC Standards of Conduct, Performance and Ethics (2016).

113. He referred the Panel to the HCPTS’s Practice Note “Fitness to Practise Impairment’ dated November 2023 and in doing so, invited the Panel to address the personal and public components of impairment referred to in that document.

114. He referred the Panel to the judgement of Mrs Justice Cox in the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011] EWHC 927 (Admin) in reaching its decision. In paragraph 74, she said:

“In determining whether a practitioner’s fitness to practise is impaired by reason of misconduct, the relevant panel should generally consider not only whether the practitioner continues to present a risk to members of the public in his or her current role, but also whether the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment were not made in the particular circumstances.”

115. Mrs Justice Cox went on to say in Paragraph 76:

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

a. has in the past acted and/or is liable in the future to act 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”.

116. He reminded the Panel that dishonesty was difficult to remediate and that there remained a risk of repetition of the Registrant’s misconduct. As a result, he submitted that the Panel should conclude that the Registrant’s fitness to practise is impaired.
117. Mr Bridges submitted that whether the proven facts amount to impairment of fitness to practise is a matter of judgement for the Committee and the HCPC did not propose to present any separate evidence on this point.

118. However, if the proven facts are determined to constitute misconduct, Mr Bridges submitted in his written submissions that there has been a failure to accept or address that misconduct such that there was an on-going risk of repetition of it.

119. For this reason, Mr Bridges submitted that the Registrant’s fitness to practise is currently impaired.

120. Further, it was submitted that the conduct and failures in the allegation are so serious that finding that the Registrant’s fitness to practise is not impaired would undermine both the public confidence in the paramedic profession and in the regulatory process.

121. So far as the Registrant’s conviction was concerned, he submitted that it was a matter for the Panel to determine whether, in all the circumstances, the Registrant’s fitness to practise was impaired by reason of that conviction.

Registrant’s submissions

122. The Registrant stated that he had at the outset of the hearing, accepted a number of the factual allegations and that his conduct had fallen short of the standards expected of him.

123. He submitted that he had shown insight into his failings and that if he could ‘turn the clock back’ and change the scenario, he would. He expressed remorse for his actions and reminded the Panel that he had complied with the regulatory process. He apologised for his actions and for the consequences of them on his employers, his family and anybody else involved in the regulatory investigation and hearing.

124. He stated that he had reflected on his conduct over the last two to three years and stated that his failings largely arose from a miscommunication with the HCPC which he was trying to remedy, but which he had been unable to do so quickly. He accepted that he should have done things differently, but at the time was motivated to assist colleagues and patients at what was a stressful time because of the COVID pandemic.

125. He stated that he had not been dishonest before, and that he would not repeat his dishonesty. Other than the criminal conviction that has brought him before this Panel, he has not committed any other offence and there has been no repetition of his dishonest behaviour since.

126. He accepted in response to Panel questions, that he may not have been covered by professional insurance indemnity by practising as a Paramedic whilst not on the register. However, at the time, he hoped that the issue of his registration would be resolved quickly.

127. He described the personal impact of his actions on both his employment and his family. He stated that he had applied to various agencies for work, but had been unable to secure employment. As a result, he said that he had taken tentative steps towards renewing his relationship with the Professional Footballer’s Association, but that did not come to fruition.

128. He stated that he had looked online regarding courses he might usefully undertake, but as yet, he had not undertaken any.

129. In relation to steps he had taken to remediate his failings, he stated that he now had people to talk to and that he would refer to the HCPC if he had any professional concerns. By looking online, he stated that he had kept up to date with NHS developments and he remained in contact with other paramedics.

130. [redacted] He also submitted that his difficult personal circumstances had improved.

131. In conclusion, he stated that there was no risk that his misconduct would be repeated. He invited the Panel to take into account the context of his dishonesty in that he was trying to do the right thing and that he did not want to let anybody down at what was a demanding time both personally and professionally. He accepted with hindsight, that the way he managed the situation was the wrong thing to do.

Decision on the statutory grounds

132. On the basis of the facts found proved, the Panel went on to consider whether the Registrant’s conduct amounted to misconduct. It took into account the submissions made by Mr Bridges on behalf of the HCPC and those made by the Registrant. It has also heard and accepted the advice received from the Legal Assessor.

133. In considering this matter, the Panel exercised its own judgement. The Panel also took into account the public interest, which includes protection of the public, maintenance of public confidence in the profession, and the declaring and upholding of proper standards of conduct and behaviour.

134. Given the Panel has found the facts of the conviction proved, the statutory conviction ground is therefore made out.

135. When considering whether the facts found proved amounted to misconduct, the Panel noted that not all breaches of the HCPC’s Standards of Conduct, Performance, and Ethics need amount to a finding of misconduct.

136. The Panel heard and accepted the advice of the Legal Assessor, which included reference to the cases of: Roylance v General Medical Council (No 2) [2000] 1 A.C. 311, Nandi v GMC [2004] EWHC 2317 (Admin), Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011] EWHC 927 (Admin) and Cohen v GMC [2008] EWHC 581, PSA v HCPC Christopher Wood [2019] EWHC 2819 (Admin), Remedy UK v GMC [2010] EWHC 1245, PSA v HCPC & Ghaffar [2014] EWHC 2723 (Admin) and Chaudhary v GMC [2017] EWHC 2561 (Admin).

137. In Nandi v GMC [2004] the Court referred to Roylance v GMC [1999], where the Court described misconduct as “a falling short by omission or commission of the standards of conduct expected among medical practitioners, and such falling short must be serious” such that it would be “regarded as deplorable by fellow practitioners”.

138. The Panel adopted a two-step process in its consideration. Firstly, the Panel considered whether the facts found proved amount to misconduct. Secondly, and only if the facts proved were found to amount to misconduct, the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired as a result of that misconduct and the conviction.

139. The Panel carefully considered all the evidence and submissions presented to it and considered the facts of the case in the round.

140. Given the Panel’s findings in relation to the facts found proved, it concluded that the Registrant breached standards 9, 9.1 and 9.5 of the HCPC’s Standards of Conduct, Performance and Ethics 2016.

141. However, the Panel was mindful that a finding of misconduct does not necessarily follow as a result.

142. The Panel carefully considered the seriousness of the Registrant’s failings. Notwithstanding the Registrant’s motives for continuing to work as a Paramedic during the COVID pandemic whilst not on the HCPC register, the Registrant nevertheless repeatedly acted dishonestly in relation to his eligibility to practise as a Paramedic, and to dishonestly conceal that fact and his conviction from his regulator and employer. The Panel noted that when confronted about his registration status at the case review meeting on 1 February 2021, the Registrant stated that his registration had never lapsed. That was patently untrue and was demonstrative of a lack of candour at that time. Failure to make relevant disclosures to his regulator has the potential to fundamentally undermine the regulator’s function.

143. The Panel recognises that honesty is a fundamental quality of a professional, and a failure to act honestly has the potential to seriously undermine confidence in the profession. Paramedics are expected at all times to act in a professional manner. They must make sure that their conduct always justifies both service users’ and the public’s trust in the profession. The public should quite rightly be able to expect that Paramedics behave honestly, and in that regard, the Registrant’s conduct fell seriously short of what was expected of him.

144. The Panel concluded that the matters found proved and subsequent breaches of the HCPC’s Standards of Conduct, Performance and Ethics were both individually and collectively sufficiently serious departures from the standards expected of a Paramedic and amounted to misconduct.

145. The Panel therefore found that the Registrant’s dishonest behaviour amounted to misconduct.

Decision on Impairment

146. In relation to the Registrant’s conviction, the Panel was mindful that this appeared to be an isolated criminal matter, which occurred almost six years ago and which has not been repeated. It has considered whether his fitness to practise is impaired in light of the HCPTS’s Practice Note ‘Conviction and Caution Allegations’ dated March 2017.

147. The conviction unquestionably does the Registrant no credit, and is justifiably worthy of significant criticism. However, it noted that the Registrant pleaded guilty to the offence and that, in the intervening period, his criminal behaviour has not been repeated. Taken in isolation, whilst the conviction is demonstrative of behaviour falling below the standard expected, given the nature of the conviction and the time that has elapsed without reoffending, the Panel did not conclude that the Registrant’s conduct was so serious that it brought the profession into disrepute or would otherwise undermine confidence in the profession.

148. In the circumstances, the Panel concluded that the Registrant’s fitness to practise is not impaired by reason of his conviction.

149. The Panel then went on to consider whether the Registrant’s fitness to practise is impaired by reason of his misconduct. The Panel heard and accepted the advice of the Legal Assessor and took into account the HCPTS’s Practice Note on “Fitness to Practise Impairment”.

150. In reaching its decision on impairment, the Panel is mindful that it does not necessarily follow that a finding of current impairment follows from a finding of dishonesty. However, any instance of dishonesty is likely to impair a Registrant’s fitness to practise and it will be an unusual case where this is found not to be the case.

151. The Panel first considered the extent of the registrant’s insight. It identified the following:

⦁ The Registrant accepted that his conduct fell below the standard expected of him and he recognised that his behaviour was irresponsible;
⦁ He apologised for his behaviour and accepted that he should have acted differently.

152. The Panel however noted that whilst the Registrant had reflected on the consequences of his actions on his employment and on his family, he failed to demonstrate meaningful insight into the impact of his actions on the reputation of the profession generally.

153. The Panel recognised that dishonesty is difficult to remediate. In considering the extent to which the Registrant had remediated his failings, the Panel identified the following:

⦁ [redacted], the Registrant has not provided any supporting evidence in relation to the nature of the help sought and provided, the frequency of that support, or the extent to which those issues have been addressed to such an extent that the Registrant would be highly unlikely to repeat his misconduct;
⦁ The Registrant has stated that he would comply with any requirements to ensure he did not repeat his dishonesty. However he has not provided tangible details of specific steps that he has taken to address his failings, other than stating that he would now seek help from others. He stated that he has looked at available courses, but to date, has only “seen some things I’d like to do”, without having undertaken any such courses.

154. In the absence of the Registrant being able to demonstrate that he had fully remediated his failings, the Panel concluded that there remained an ongoing risk of his misconduct being repeated. The Registrant had failed to demonstrate that sufficient practical steps had been put in place, or that he had developed meaningful strategies to ensure that his dishonest conduct would not be repeated if faced with a similarly stressful situation in future.

155. Applying the principle derived from the case of Cohen, the Panel was therefore unable to conclude that it was highly unlikely that the Registrant’s misconduct would be repeated. The Panel therefore determined that a finding of impairment was necessary on the personal component of impairment.

156. Given its findings regarding ‘seriousness’ in relation to misconduct, the Panel considered that limbs b, c and d of the approach in Grant were all engaged by the Registrant’s past actions. The Panel had regard to the fact that honesty is a fundamental tenet of the Paramedic profession. The Registrant had breached that core value by repeatedly acting dishonestly, by working as a Paramedic when he knew that he was unregistered, and by concealing his criminal record history.

157. The Panel also took into account the overarching objectives of the HCPC to protect, promote and maintain the health, safety, and wellbeing of the public and patients, and to uphold and protect the wider public interest, which includes promoting and maintaining public confidence in the Paramedic profession and upholding proper professional standards for members of the profession. The Panel therefore concluded, given the serious nature of the misconduct found proved and the ongoing risk of repetition, that public confidence in the profession would be undermined if a finding of impairment were not made in all the circumstances.

158. Having regard to all of the above, the Panel found that, by reason of the Registrant’s misconduct, his fitness to practise is also currently impaired on the public component of impairment.

Decision on Sanction

HCPC’s submissions

159. Mr Bridges made submissions to the Panel on sanction. He submitted that sanction was a matter for the Panel’s judgement and that he was not proposing any particular sanction. He referred to the HCPC’s 2019 updated Sanctions Policy (SP) and reminded the Panel to start from the least restrictive sanction, bearing in mind the need to act proportionately.

160. He invited the Panel to take into account any aggravating and mitigating factors. He submitted that the Panel should bear in mind the potential harm of the Registrant’s conduct on the reputation of the profession, his lack of insight and remediation and the risk of repetition. By way of mitigation, he also invited the Panel to take account of the Registrant’s admissions at the start of this hearing.

161. He reminded the Panel that case law indicated that matters of dishonesty lie at the top end of the spectrum of misconduct and that erasure was an appropriate sanction to impose for persistent dishonesty. Balanced against that, he submitted that erasure was not inevitable for every case of dishonesty.

The Registrant’s submissions

162. The Registrant stated that as a result of his conduct, he has had a very difficult time. [redacted]

163. He stated that when he had applied to potential employers, he had properly disclosed this outstanding investigation but that it had prevented him securing employment.

164. He stated that he has reflected on his conduct, he understood and regretted his actions and that his dishonest behaviour will not be repeated. He reminded the Panel that he admitted a number of factual allegations at the start of this hearing and that he had fully engaged with the regulatory process. He stated that he recognised his failings and was willing to address them and that this demonstrated insight and remorse. He was prepared to comply with any training requirements. He reminded the Panel that no actual harm was caused and that no concerns about his clinical practice had been raised.

165. He stated that he was committed to working as a Paramedic and that it would be fair and proportionate to allow him to continue practising in his chosen career. He stated that his financial debts had accumulated.

166. [redacted]

Decision on Sanction

167. The Panel accepted the advice of the Legal Assessor who referred it to HCPC’s SP. He reminded the Panel it should consider any sanction in ascending order, and to apply the least restrictive sanction necessary to protect the public and the public interest. It should also consider any aggravating and mitigating factors and bear in mind proportionality.

168. The Panel was mindful that its role was not to punish a Registrant but to protect the public and the public interest and that there was a need to balance those interests with the interests of the Registrant. It has considered the available sanctions open to the Panel in an ascending order of seriousness, not imposing any more severe a sanction than was necessary to achieve its objective.

169. In reaching its decision on whether to impose a sanction, and if so, which one, the Panel has reminded itself of its conclusions in relation to the seriousness of the Registrant’s misconduct as set out in its determination on impairment. The Panel has concluded that the Registrant continues to pose an ongoing risk of repetition of his misconduct. As such, any sanction should reflect the need to uphold the public interest and mark the seriousness of the misconduct found proved. In that regard, the Panel has had due regard to paragraphs 56-58 of the SP, noting the impact of dishonesty on public confidence.

170. The Panel considered all the information before it. In doing so, the Panel identified the following aggravating factors:

⦁ That the Registrant repeated his dishonesty over a period of several months. This, the Panel concluded, was a particularly aggravating feature;
⦁ The Registrant’s dishonesty was directed to both his employer and his regulator and had the potential to impact on his eligibility and suitability to practise as a paramedic;
⦁ Notwithstanding that the Registrant has demonstrated some insight, the Panel has recognised that it was limited;
⦁ The Registrant has demonstrated limited steps towards remediating his failings and keeping his knowledge and skills up to date;
⦁ His initial lack of candour at the case review meeting in February 2021 in which he denied that his name had been removed from the register; and
⦁ This is the third time that a disciplinary finding has been made against the Registrant. Whilst the Registrant’s two previous regulatory findings date from some years back, and were for unrelated matters, the Registrant should have had a heightened awareness of his duty to comply with his professional obligations, particularly given that the five year caution order imposed in July 2013 did not expire until mid 2018.

171. The Panel identified the following mitigating factors:

⦁ The Registrant has engaged in the regulatory process and made early admissions to the factual particulars with the exception of the dishonesty allegations at the outset of the hearing;
⦁ The Registrant has expressed remorse and apologised for his actions;
⦁ The Registrant had difficult health and personal circumstances at the time; [redacted]
⦁ The risk of direct patient harm was low;
⦁ The Registrant’s dishonesty in relation to practising as a Paramedic whilst unregistered, arose from very particular circumstances which were unlikely to be replicated, and that the Registrant believed that his registration problems, which arose following a refused direct debit payment, would be quickly resolved.

172. In the circumstances, and noting that no patient harm resulted from the Registrant’s dishonesty, the Panel concluded that the Registrant’s dishonest behaviour fell towards the lower, but not at the lowest end of the dishonesty spectrum.

173. The Panel approached the issue of sanction starting with the least restrictive first, bearing in mind the need for proportionality and to take into account the Registrant’s interests. Having done so, it concluded that taking no further action would not reflect the nature and gravity of the misconduct. The Panel concluded that taking no action would not be adequate to protect the public or the wider public interest of maintaining confidence in both the profession and the regulatory process. Such an outcome was therefore neither appropriate nor proportionate in the circumstances.

174. The Panel next considered mediation, but having had due regard to the circumstances of this case, such an outcome was inappropriate to address the issues of dishonesty. It therefore concluded that this was not an appropriate outcome.

175. The Panel then considered whether to impose a Caution Order and had regard to paragraphs 99-102 of the SP. The Panel concluded that this was also not an appropriate outcome because:

⦁ For the reasons set out in its determination on misconduct in relation to dishonesty and impairment, the Panel did not consider the Registrant’s misconduct to be minor in nature;
⦁ The Registrant’s insight was incomplete;
⦁ The Panel considered that there remained an ongoing risk of repetition given the lack of effective remediation of his failings.

176. The Panel next considered whether a Conditions of Practice Order was appropriate. It had regard to paragraphs 105-109 of the SP. It has concluded that such a sanction would neither be appropriate nor proportionate to address the nature of the misconduct proved or the public interest concerns identified. The Panel concluded that workable and appropriate conditions could not be formulated that would meaningfully address the dishonesty concerns identified.

177. In the circumstances, the Panel concluded that imposing a Conditions of Practice Order was not the appropriate sanction to impose.

178. The Panel next considered the sanction of suspension. The Panel has borne in mind that this would be an appropriate sanction to impose where, even though the allegation is serious, the conduct was not fundamentally incompatible with the Registrant remaining on the register, and hence, a Striking Off Order would not be justified.

179. The Panel considered that a Suspension Order was the appropriate sanction to impose because:

⦁ The matters found proved, as set out in the Panel’s determination on misconduct, represented serious breaches of the Standards of Conduct Performance and Ethics;
⦁ The Registrant has demonstrated some insight into his failings particularly in relation to Particular 1;
⦁ The Panel was mindful that a striking off order was appropriate for the most serious cases of dishonesty. It considered that the Registrant's failings were not so serious that they were fundamentally incompatible with remaining on the register. In reaching that conclusion, it had regard to paragraph 121 of the SP which states that a Suspension Order may be appropriate where “there is evidence to suggest that the Registrant is likely to be able to resolve or remedy their failings”. The Panel noted, as set out in the Panel’s determination on impairment, that the Registrant has developed some insight into his dishonest behaviour even though that process was not as yet complete.

180. To satisfy itself that a Suspension Order was the appropriate and proportionate sanction to impose, the Panel considered whether a Striking-off Order was justified. It had regard to paragraph 130 of the SP which states that: “A striking off order is a sanction of last resort for serious, persistent, deliberate or reckless acts” whilst setting out a non-exhaustive list of applicable circumstances. The Panel was satisfied, given the identified mitigating factors, that the facts of this case were not of such gravity so as to merit such a restrictive sanction. It concluded that the public protection, and the public interest concerns could be adequately met by the imposition of a Suspension Order which would restrict the Registrant’s ability to practise as a Paramedic until such time as a reviewing panel determined that he was fit to do so.

181. The Panel therefore imposes a Suspension Order for a period of 6 months. The Panel concluded that that was an appropriate and proportionate period of time to enable the Registrant to reflect on the nature and gravity of the misconduct found proved and to allow him an adequate period of time to address and remediate his failings.

182. So far as any future review is concerned, the Panel considered a future reviewing panel would be assisted by:

⦁ His attendance at any review hearing;
⦁ Further evidence of remediation in relation to addressing his dishonest behaviour;
⦁ [redacted]
⦁ Evidence of reflection on his conduct demonstrating meaningful insight into the impact of his dishonest behaviour on the wider profession and the public;
⦁ Up to date references / testimonials in relation to any work undertaken by the Registrant, whether paid or unpaid;
⦁ Evidence that the Registrant had kept his skills and knowledge up to date;
⦁ Any other evidence the Registrant considers would assist him to demonstrate that he is suitable to return to unrestricted practice.

ORDER: That the Registrar is directed to suspend the registration of Mr James Hughes for a period of 6 months from the date this order comes into effect.

 

Interim Order

183. Mr Bridges applied for an Interim Suspension Order in light of the Panel’s findings on the grounds that it was necessary for the protection of the public, and otherwise in the public interest to cover the appeal period. He submitted that the public would be shocked to learn that the Registrant were allowed to practise unrestricted if he were to appeal this decision.

184. The Registrant did not oppose the application for an interim order. He stated that he would not appeal this decision in any event.

185. The Panel was mindful that when a substantive sanction is imposed, a Registrant’s entitlement to practise is unrestricted whilst their appeal rights against the substantive sanction remain outstanding. The Panel concluded that in view of its determination that a substantive Suspension Order should be imposed, it would not be appropriate for the Registrant to return to unrestricted practice given the Registrant’s incomplete insight and lack of demonstrable remediation and the ongoing risk of repetition of his misconduct identified.

186. The Panel therefore decided to impose an interim order under Article 31(2) of the Health Professions Order 2001, it being necessary to protect members of the public and being otherwise in the public interest, which outweighs the Registrant’s personal and professional interests.

187. It first considered an Interim Conditions of Practice Order. The Panel concluded that such an interim order would not be appropriate given its rationale for its earlier determination on sanction. It considered that in light of that determination, an Interim Suspension Order is necessary for protection of the public and is also in the public interest. It would be wholly incompatible with the Panel’s findings and its decision as to sanction not to impose an Interim Suspension Order.

188. The Panel concluded that the appropriate length of the Interim Suspension Order should be 18 months, as the interim order would continue to be required pending the resolution of an appeal in the event that the Registrant submits a Notice of Appeal within the 28-day period. This Interim Suspension Order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) on the final determination of that appeal, subject to a maximum period of 18 months.

Referral to a Health Committee and Discontinuance of the health allegation

HCPC’s submissions

189. At the conclusion of the hearing, Mr Bridges invited the Panel to reconvene as a Heath Committee to deal with an application to discontinue Particular 8 of the Allegation which related to the Registrant’s health. He reminded the Panel of its powers under Rule 4(1) of the Rules which states:

“4.—(1) Where it appears to the Committee that an allegation which it is considering would be better dealt with by the Health Committee, the Committee may refer the allegation to the Health Committee for consideration and shall suspend its consideration of the allegation.”

190. The Registrant did not object to the application.

191. The Panel acceded to Mr Bridges’ request and referred the matter to a Health Panel pursuant to its powers under Rule 4(1) of the Rules as the one remaining health particular would be better dealt with by a Health Committee. It then reconstituted itself as a Health Panel to deal with this application.

192. Mr Bridges then applied to offer no evidence in relation to the health allegation based on the fact that the Panel had sufficient cogent evidence on the misconduct ground to find that the Registrant’s fitness to practise is impaired. In support of the application, he had provided a skeleton argument dated 5 August 2022. Specifically, the majority of the evidence obtained as part of the HCPC’s investigation related to these serious concerns. He submitted that the Panel has found these serious allegations proved and has imposed an appropriate sanction.

193. Further, he submitted that as a Suspension Order has been imposed by the Panel in respect of the misconduct allegation, the HCPC’s position is that the health allegation should fall away.

194. He submitted that an informed member of the public would understand why the health element of the case is to be discontinued. It was further submitted that the public’s confidence in the profession and in the regulatory process would not be undermined as a result of the discontinuance of the health matter, as the public interest element has already been addressed by the Conduct and Competence Panel and in its determination.

195. For the reasons set out above, Mr Bridges offered no evidence on the health allegation against the Registrant.

The Registrant’s submissions

196. The Registrant did not oppose the application.

Decision

197. The Panel has had regard to the submissions made and has accepted the advice of the Legal Assessor. It has also had regard to the HCPTS’s Practice Note on ‘Discontinuance of proceedings’ and its guidance note on ‘Approach to dual allegations’. Having done so, and having had regard to the Conduct and Competence Panel’s determination on facts, impairment and sanction, it directed that the health Particular 8 be dismissed.

History of Hearings for James Hughes

Date	Panel	Hearing type	Outcomes / Status
11/12/2023	Conduct and Competence Committee	Final Hearing	Suspended