Jonathan Moyes

Preliminary Matters

Service

1. The Panel was provided with a Service Bundle which includes:
• a copy of the Notice of Hearing dated 20 December 2022;
• confirmation of the Registrant’s registered email address as it appears on the HCPC’s register;
• confirmation of delivery to the Registrant’s registered email address.

2. The Panel was satisfied that the Notice of Hearing had been properly served in accordance with Rule 3 (Proof of Service) and Rule 6 (date, time, and venue) of the Conduct and Competence Committee Rules 2003 (as amended).

Proceeding in Absence

3. Having determined that service of the Notice of Hearing had been properly effected, the Panel went on to consider whether to proceed in the Registrant’s absence. The Panel was advised by the Legal Assessor and followed that advice. The Panel also took into account the guidance as set out in the HCPTS Practice Note “Proceeding in the Absence of the Registrant”.
4. The Panel determined that it was fair, reasonable and in the public interest to proceed in the Registrant’s absence for the following reasons:
a) In response to the Notice of Hearing the Registrant sent an email, dated 12 January 2023 in which he stated, ‘I will not be attending and have attached a certificate’. No reason for his non-attendance was provided. The Panel noted that the Registrant did not attend the substantive hearing in July 2021, nor did he attend the first review hearing on 21 July 2022. The Registrant has also not provided the HCPC with any of the information that the last review panel indicated would be of assistance at the next review, save for a Continuing Professional Development (CPD) certificate for a course entitled “Equality and Diversity and Human Rights – Level 1”. The certificate is dated 12 January 2023. In these circumstances, the Panel was satisfied that it was reasonable to conclude that the Registrant’s non-attendance was voluntary and therefore a deliberate waiver of his right to attend and his right to participate in these proceedings.

b) There has been no application to adjourn and no indication from the Registrant that he would be willing or able to attend on an alternative date. Therefore re-listing this review hearing would serve no useful purpose.

c) The Panel recognised that there may be a disadvantage to the Registrant in not being able to make submissions or give oral evidence with regard to his current fitness to practise or his current intentions. However, he was given the opportunity to participate in these proceedings and has not taken up that opportunity. In these circumstances, as this is a mandatory review the Registrant’s interests are outweighed by the strong public interest in ensuring that the hearing proceeds expeditiously.

Background

5. The Registrant is a Paramedic who was employed by South East Coast Ambulance NHS Trust, (“the Trust”). On 16 February 2018, it was alleged that the Registrant inappropriately used a stethoscope on Colleague A. On 19 January 2019, the Registrant allegedly pushed his hands down the back of Colleague B’s trousers and pulled up her underwear and trousers, resulting in a “wedgie”. These incidents were referred to a Trust disciplinary hearing.
6. Other incidents of behaviour which allegedly caused distress to another colleague (Colleague F) later emerged as a consequence of the Trust’s internal investigation.
7. On 8 July 2019, the Registrant referred himself to the HCPC, stating that he had been suspended under investigation for harassment and use of sexualised words, as well as for failing to follow Trust procedures. It was alleged that the Registrant smacked and/or poked and pushed Colleague F and used inappropriate and sexually suggestive language towards her.
8. The substantive hearing panel concluded that its factual findings amounted to misconduct and with regard to the issue of impairment stated:

“99. The breaches identified by the Panel’s findings are all of a type that are capable of being remedied. However, when the Panel considered whether they had in fact been remedied, the Panel had little information before it to conclude that this was the case.

100. Inappropriate and unwanted behaviour is something that the Registrant appears to regret. This is evidenced in part by a Reflective Piece from him, albeit it is scant in its content. While it identifies an online course that may be undertaken for remediation there is no evidence that this has been completed. Accordingly, there is a risk of repetition. The Panel also took into account that the misconduct related to three different colleagues spanning a significant period of time and that different kinds of unwanted behaviour were directed to each colleague.

101. The Registrant’s conduct carried with it a risk of harm to the mental wellbeing of the three complainants who have given evidence. That risk of harm graduated to actual harm in some instances. The impact on Colleague F and the emotional account she gave make this clear. Her enthusiasm for her work was eroded over time. Her mental wellbeing disintegrated to the point where she required medical intervention. It also caused harm to Colleagues A and B also who detailed the short and long term effects on them caused by the Registrant’s behaviour.

102. The absence of remediation had the consequence that the Panel was driven to conclude that if the Registrant were to be permitted to practice without restriction, there would be a substantial risk of repetition with the attendant risk of harm that flowed from the shortcomings identified by the Panel in respect of the three colleagues in this case. The Panel’s findings of fact, grounds and the risk of repetition, necessitate a finding that the Registrant’s fitness to practise is impaired on the personal component.

103. In the judgement of the Panel a finding of current impairment of fitness to practise is also required with regard to the public component. So serious are the findings of the Panel that a finding of impairment is required in order to address the concern of fair-minded members of the public regarding a Paramedic who had acted as the Registrant did. Even if there were a negligible risk of repetition this would be the case, the fact that there is a significant risk of repetition makes that finding the more necessary. Furthermore, were the Panel not to make a finding of current impairment of fitness to practise it would fail in its duty to declare and uphold proper professional standards and to send a clear signal to other practitioners who might feel tempted to depart from the standards expected of them."

9. The substantive hearing panel went on to consider sanction and concluded that:
“…a Suspension Order, which would have the effect of protecting colleagues for the duration of the Suspension Order. Such an order would also protect the public interest as well as providing the Registrant with the opportunity for remediation and demonstration of this. The Panel considered that the showing of some insight when confronted at interview was an encouraging sign. It considers that the indication points towards the misconduct being remediable albeit that this has not been remedied. Accordingly, the Panel considered this to be in the interests of the Registrant, in addition to meeting the public protection and public interest requirements. No lesser order was sufficient to meet the risks identified.”

10. The review hearing panel imposed a 12-month Suspension Order and indicated that a reviewing panel would be assisted by the following:
• Attendance at the review panel;
• Evidence of his developing insight;
• Evidence of his remediation;
• Evidence of working with a mentor;
• Evidence of any courses he attends to address his previous misconduct.

11. The first review of the 12-month suspension order took place on 21 July 2022. The first review panel, having considered the issue of impairment, concluded that although much of the case found proved against the Registrant related to his attitudinal problems with vulnerable junior female members of staff, overall the issues raised by this case were remediable. However, the first review panel went on to state that:
14. "…that there was no additional information from the Registrant for today’s hearing that dealt, in full and robustly, with the issues highlighted by this case. The Registrant has not engaged to the extent of attending this hearing, despite the last panel’s recommendation to do so, indicating poor insight, in the Panel’s opinion. The Registrant’s reason for not attending were “work commitments” but there was no further information from him as to the reasons why he could not seek a readjustment to his working hours to attend this hearing, which would have been by remote platform, and thus, in principle, easier for him to attend.

15. The Panel was also concerned that the case against the Registrant that was found proved was serious and the sanction imposed was, rightly, towards the top end of the range of sanctions available. The Registrant’s case concerned sexual misconduct, harassment and inappropriate conduct towards three female junior colleagues over a period of 15 months, involving a breach of their trust in the Registrant and the Registrant’s inappropriate exercise of power over those junior colleagues. Yet the Registrant still chose not to attend today. Instead, he sent two documents for this hearing, a Reflective Statement and some CPD information, the latter of which only dealt with the bare minimum of the issues raised by this case.

16. In the Panel’s judgement, there was little or any developed insight on the Registrant’s part since last hearing and there was no evidence of full insight. In addition, and aggravating the situation today in the Panel’s judgement, the Registrant, either deliberately or through ignorance of the seriousness of this process and of his own position, provided no evidence, as recommended by the last panel, in particular, in relation to any remediation, working with a mentor or of any courses he might have attended to address his previous misconduct. The Panel was also concerned that the Registrant seemed not to have understood that his efforts at remediation would need to address his sexist and bullying attitudinal behaviour towards female colleagues in order to go to the root of the issues raised by this case.

17. To that end, the Panel concluded that the Reflective Statement that the Registrant provided for today’s hearing was of a poor and highly superficial standard. It failed to address the crux of the concept of remediation, which must include measures that will prevent repetition of the index behaviour in the future and deal with the root cause of the Registrant’s behaviour; for example, there was nothing to demonstrate that the Registrant had understood why he did what he did, the effect on his victims and the measures he would take to prevent recurrence in the future. The Panel concluded that this, together with the Registrant’s decision not to attend this hearing, demonstrated a woeful lack of insight on his part, that seemed not to have progressed from the substantive hearing period, when he had sent a brief Reflective Statement, with a five-line “action plan” and, also, when he had not attended that hearing either.

18. Added to this was the fact that the Restraint has had a year in which to address the issues raised by the case, and where, helpfully, he was pointed by the substantive hearing panel directly and clearly to what he would be required to do in order to commence his remediation and in order to help a reviewing panel in the future. This, the Registrant has almost entirely ignored. In the Panel’s judgement, he has not provided any development of demonstrable insight.

19. For these reasons, the Panel concluded that the risk of repetition by the Registrant of his misconduct is, and remains, high. Therefore, the Panel determined that there remains a high risk of harm to the health, safety and well being of the public. Furthermore, in the Panel’s judgement, and for the same reasons, an informed member of the public would be shocked to learn that the Registrant was not found impaired and was declared fit to practise today.

20. Therefore, the Panel determined that the Registrant is, and remains, impaired today on the grounds of public protection and in the wider public interest”.

12. The first review panel went on to consider sanction and provided the following reasons for imposing a further 6-month period of suspension:
"23. The Panel considered that the Registrant’s misconduct found proved was serious and involved the abuse of trust of vulnerable junior staff members and sexual misconduct and inappropriate behaviour that was, as yet, un-remediated. In the Panel’s judgement, this level of misconduct could easily attract a sanction at the higher end of the range of sanctions available. The Panel also has concluded that the Registrant has had a year to provide the reassurances required to enable a reviewing panel to conclude that he was a valued member of the profession who should be kept within it, rather than out of it, either temporarily or permanently. He has failed to provide that evidence.

24. The Panel concluded that, by the Registrant’s absence today, it has been unable to conclude whether this was a deliberate, careless, or even reckless, approach by him. It was clear to the Panel that the Registrant has not failed completely to engage with this process. Although he has not appeared at any hearing to date, despite a heavy hint that he should do so by the last panel, he has provided, on two occasions, a Reflective Statement and, latterly, a screenshot of mandatory CPD training, but that was not specifically aimed at the misconduct identified by this case.

25. To that end, although it was potentially possible to impose a Striking Off Order today, the Panel concluded that fairness demanded that the Registrant should be given what might be a last chance to rectify his position. In order to do this. The Registrant would need to read this determination very carefully and ascertain from it what would be required to draw him back from the ultimate sanction, but also taking into account that no future panel is bound by the decision of this Panel, of course.

26. The Panel concluded that a short extension to the existing Suspension Order would serve to provide the Registrant with another, and potentially last, chance to demonstrate remediation, whilst also representing protection for the public and also upholding the wider public interest, being public confidence in the profession and in the regulatory process and in upholding the standards of the profession.”

13. The first review panel suggested that the next reviewing panel may be assisted by:
• A new Reflective Statement, to include any comments he would wish to make in relation to any full, deep, and robust insight he might have, and how he would reduce and/or remove any risk of repetition in the future of the matters relating to the misconduct found proved. Overall, to demonstrate that he has commenced remediation relevant to the misconduct found proved;
• The Registrant’s attendance;
• Any support from others, by way of mentorship, for example:
   - References and testimonials, where those testifying know of the matters found proved;
   - Training in the aspects of the case that go to the root of the misconduct found proved.

Today’s Review

HCPC Submissions

14. Ms Navarro, on behalf of the HCPC, outlined the background circumstances and the history of this case. She referred the Panel to the information that the previous review panel suggested the Registrant may wish to provide to assist this reviewing panel. Ms Navarro submitted that the Registrant has demonstrated a lack of insight and there is no evidence of remorse or remediation. She drew the Panel’s attention to the HCPC’s email dated 11 January 2023, in which the Registrant was informed that the review panel has the power to replace the current Suspension Order with any other order including a Striking-off Order.
15. Ms Navarro invited the Panel to conclude that the appropriate outcome is a finding of current impairment and a striking-off order on the grounds of public protection and the wider public interest.

The Panel’s Approach

16. In undertaking this review, the Panel took into account the documentary evidence including the undated Reflective Statement and the CPD documents dated 13 July 2022, both of which were provided to the first review panel. The Panel also took into account the CPD certificate provided for this hearing dated 12 January 2023. The Panel took into account the submissions made on behalf of the HCPC.
17. The Panel accepted and applied the advice it received from the Legal Assessor as to the proper approach it should adopt. In particular that:
• The purpose of the review is to consider the issue of impairment based on the substantive hearing panel’s findings of fact, the extent to which the Registrant has engaged with the regulatory process, the scope and level of his insight and the risk of repetition.
• In terms of whether his previous misconduct has been sufficiently, and appropriately remedied relevant factors include whether the Registrant:
(i) fully appreciates the gravity of the previous panel’s finding of impairment;
(ii) has maintained or updated his skills and knowledge;
(iii) is likely to place service users or colleagues at risk if he were to return to unrestricted practise.

• The Panel should have regard to the HCPTS Practice Note: ‘Fitness to Practise Impairment’ and must take account of a range of issues which, in essence, comprise two components:
(i) the ‘personal’ component: the current competence, behaviour etc. of the individual registrant; and
(ii) the ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

• It is only if the Panel determine that the Registrant’s fitness to practise remains impaired, that the Panel should go on to consider sanction by applying the guidance as set out in the HCPC Sanctions Policy (SP) (March 2019), and the principles of proportionality which require the Registrant’s interests to be balanced against the interests of the public.

Impairment

18. The Registrant was found by the substantive hearing panel to have acted inappropriately towards three female junior colleagues over a period of around 15 months. This conduct included sexually motivated behaviour and a significant breach of trust. The Panel agreed with the observations made by the previous panels that in theory, even though the Registrant’s misconduct relates to an attitudinal deficiency in relation to vulnerable junior female colleagues, his conduct is remediable. However, the Panel noted that the Registrant did not attend the substantive hearing and did not attend the previous review hearing. Nor has he attended today’s review hearing and no reason for his absence has been provided. Therefore, there is only limited information before the Panel.
19. The Panel was particularly concerned that the Registrant has not responded meaningfully to the indication from the previous panels as to the information that was likely to be of assistance at the next review hearing. The only new information provided by the Registrant is a CPD certificate for a course entitled “Equality and Diversity and Human Rights – Level 1” from E-Learning for Health. The Panel took the view that, based on the title, the course is not directly relevant to the substantive hearing panel’s findings of fact but, in any event, attending a course is not sufficient; it is the learning that has been achieved and the registrant’s ability to demonstrate that the course objectives have or will be met to ensure that the learning is embedded into their practice which is of paramount importance. Furthermore, the CPD certificates that the Registrant provided to the first review relate to a similar course on equality and diversity and a separate course on dementia awareness. Neither of these courses directly address the issues in this case. The Panel acknowledged that the Registrant in his undated Reflective Statement accepted that what he had done was wrong. However, the Panel agreed with the assessment of the first review panel that the statement lacks depth and overall is of a poor standard.
20. The Panel noted that given the Registrant’s non-engagement with the substantive hearing and subsequent reviews (including today’s hearing), there was no evidence before the panel that he has made any further progress towards recognising the seriousness of his misconduct, or the impact on his colleagues. Nor has the Registrant taken the opportunity to demonstrate that he has adequately remedied his misconduct. In particular, there was no evidence that he understood why he had acted the way he did and the measures he has taken to ensure that this type of behaviour is not repeated. In the absence of any positive evidence of insight and remediation, the Panel was satisfied that there has been no material change in circumstances, since the first review hearing. Therefore, there remains a risk of harm to the health, safety and well-being of the public and a significant risk of repetition.
21. The Panel noted that a significant aspect of the public component is upholding proper standards of behaviour. Members of the public would be extremely concerned to learn that a paramedic that is impaired has subsequently demonstrated, an unwillingness or an inability, to take appropriate steps to acknowledge his wrongdoing and take the opportunity to persuade the Panel that he is committed to upholding the high standards expected of registered practitioners. The Panel concluded that, in these circumstances, a finding of no impairment would undermine rather than uphold and maintain public trust and confidence in the profession and the HCPC as a professional regulator.
22. Therefore, the Panel was led to the conclusion that the Registrant’s fitness to practise remains impaired based on the personal and public components.

Sanction

23. Having determined that the Registrant’s fitness to practise remains impaired the Panel went on to consider what sanction, if any, to impose.
24. The Panel first considered taking no action. The Panel concluded that, given the nature and seriousness of the Registrant’s misconduct, which has not been remedied, to take no action on his registration would be inappropriate. Furthermore, it would be insufficient to protect the public, maintain public confidence and uphold the reputation of the profession.
25. The Panel went on to consider a Caution Order. The Panel noted that a Caution Order will not restrict the Registrant’s ability to practice. As the Registrant has demonstrated no further insight into his misconduct and provided inadequate evidence of remediation, the risk of harm to the public and the risk of repetition remains. Therefore, the Panel concluded that a Caution Order would be inappropriate and insufficient to protect the public and meet the wider public interest.
26. In considering conditions of practice the Panel took into account paragraph 107 of the SP which states:
"Conditions will only be effective in cases where the registrant is genuinely committed to resolving the concerns raised and the panel is confident they will do so. Therefore, conditions of practice are unlikely to be suitable in cases in which the registrant has failed to engage with the fitness to practise process or where there are serious or persistent failings.”

27. The Panel took the view that the Registrant is either unwilling or unable to provide the information and evidence that was suggested by the previous panels. Although the Panel acknowledged that the Registrant’s failings are capable of being remedied, in the absence of engagement from the Registrant, there was no indication that the Registrant is committed to addressing the issues which led to the previous findings of impairment. In these circumstances, the Panel could have no confidence that he would comply with a Conditions of Practice Order, even if suitable conditions could be formulated. The Panel was aware that the suggestions made by the previous panel are only indicative and do not have any binding authority, unlike conditions which require compliance. However, both involve willingness on the part of the Registrant and a determined effort. In the absence of any evidence that the Registrant is willing and able to remediate his previous misconduct, the Panel concluded that there were no conditions it could devise which would be appropriate, workable and measurable.
28. The Panel next considered extending the current Suspension Order for a further period. The Panel noted that a Suspension Order would prevent the Registrant from practising during the extended suspension period, which would therefore protect the public and the wider public interest. The Panel noted that the first review panel concluded that “it was potentially possible to impose a Striking Off Order” but ultimately decided to give him what “might be a last chance to rectify his position”. The Panel is not bound by the views of the first review panel. However, the Panel noted that the Registrant has failed to take advantage of the opportunity that was presented to him to engage with the regulatory process and concluded that no useful purpose would be served by providing him with a further opportunity.
29. The Panel took into account paragraph 131 of the SP which states,
“A striking off order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process. In particular where the registrant:
• lacks insight;
…
• is unwilling to resolve matters.”

30. The Panel noted that the Registrant has not worked as a paramedic for a considerable period, had no information before it as to any work the Registrant has undertaken, and the Panel was satisfied that he had exhausted the opportunities to demonstrate that he is fit to return to practice. The Panel was also satisfied that the Registrant’s failure to demonstrate an appropriate level of insight and take sufficient steps towards remediation strongly indicated that he had no intention of doing so. In reaching this conclusion the Panel noted that the first review panel had made it very clear that this may be the Registrant’s “last chance” but despite this warning, there has still been no meaningful engagement from the Registrant.
31. The Panel concluded that the Registrant’s repeated failure to address the serious concerns that have been identified, the absence of sufficient insight and his inability or unwillingness to engage with these proceedings is fundamentally incompatible with continued registration. There can be no public interest in maintaining the Registrant’s name on the Register and subjecting him and the HCPC to a further review hearing when there is no indication that the Registrant has any intention of returning to practice or engaging with the fitness to practise procedures. In these circumstances, the Panel concluded that no sanction lower than a Striking Off Order would be sufficient to protect the wider public interest.
32. With regret, the Panel concluded that removal from the register is the only means to protect the public and the wider public interest.
33. Accordingly, the Panel concluded that the appropriate and proportionate sanction would be a Striking Off Order.

Order: The Registrar is directed to Strike Off the name of Mr Jonathan Moyes from the register.

The Order imposed today will apply from 20 February 2023.

History of Hearings for Jonathan Moyes