Julian Cotton

Preliminary Matters:

Service

1. It was advanced by the HCPC that the Panel had before it evidence that a Notice of Hearing Letter had been sent to the Registrant on the 11 November 2024, by email, to the email address retained by the HCPC for the Registrant. The information contained in that letter was correct in referring to the date, time and mode of hearing and had been sent twenty-eight days ahead of the hearing.

2. The HCPC relied upon the Practice Note relating to ‘Proceeding in the Absence of the Registrant’, which referenced the case of GMC v Adeogba, a Court of Appeal case, in which it was established that the HCPC’s obligation was to send notice of the proceedings using the address registered by a registrant with their regulator. The Panel had evidence within the Service Bundle that the Notice of Hearing Letter had been so sent and that service of that Letter had been in accordance with Rule 6 of the Conduct and Competence Rules.

3. The Legal Assessor advised that under the Health and Care Professions (Coronavirus)(Amendment) Rules 2021, the HCPC was able to serve documentation upon a registrant by way of email. She stated that the core provisions set out in the 2023 Order, required proof of sending, but not proof of receipt. The adoption in 2021 of the email service process provided the Panel with further information relating to receipt. She advised that if the Panel was satisfied that the correct information had been sent in sufficient time in advance of the hearing, namely twenty-eight days, to the Registrant’s registered email address, it may accept that there has been good service.

4. The Panel noted that the email sent to the Registrant had been successfully delivered according to the HCPC electronic process of acknowledgment. It was noted that the Registrant’s email host had not issued an electronic receipt. The Panel however had supporting information that the Registrant had received this notice of hearing email in that there had been an email trail in recent days in which the Registrant had confirmed his position in relation to his attendance at the hearing.

5. On the evidence placed before it the Panel was able to conclude that there had been good service in accordance with the rules.

Proceeding in the Registrant’s absence

6. The Registrant was not in attendance and so the HCPC made an application for the Panel to exercise its discretion to proceed in the Registrant’s absence in accordance with Rule 11 of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003.

7. The Panel was invited to give consideration to the HCPTS Practice Note on “Proceeding in the Absence of the Registrant” (June 2022 edition). The HCPC maintained that the Panel should balance fairness to the Registrant against the interests of the HCPC and the wider public interest. The HCPC submitted that the wider public interest lies in protecting the public.

8. The HCPC has secured four witnesses who are ready to give evidence. Further, this is now a case that dates from facts arising three or four years ago and further delay in the matter being heard would serve no purpose. Arguably any delay would not result in any benefit to the Registrant, a registrant who has stated clearly his intention to not engage in this hearing process.

9. Additionally, three of the HCPC witnesses involved are “victims” of the conduct that forms the subject matter of these charges. There has already been a very significant delay that, if extended further, may undermine the cogency of their evidence and will prolong this, doubtless unwelcome episode in those witnesses’ lives.

10. The Registrant has not engaged with the HCPC fitness to practise proceedings. There is no application from the Registrant to adjourn the matter. There is no indication that the Registrant would attend any adjourned hearing, and the very reasonable assumption would be, that he will not.

11. The HCPC therefore advanced the view that the Registrant had voluntarily waived his right to attend. The Registrant has been notified that the hearing may proceed in his absence. For all the reasons given, the HCPC submitted that it is fair, and in the public interest, to proceed with the hearing in the Registrant’s absence.

12. The Panel sought the Legal Assessor’s advice in which she stated that the Conduct and Competence Rules do provide the Panel with the power to proceed in the absence of a Registrant, but that is not an unfettered power. In line with the case of Tait v Royal College of Veterinary Surgeons [2003] UKPC 34, the Panel’s power to proceed in a registrant’s absence, was a discretionary power, and should be exercised with caution. The leading case of R v Jones and Hayward identified the circumstances where a criminal trial should not proceed in a defendant’s absence. The guidance given on when to adjourn or not, was relevant in this regulatory arena. Those matters which indicated the circumstances when it was appropriate to grant an adjournment were set out in the HCPTS Practice Note, and included matters such as, lack of legal representation and absence due to illness. In the absence of any such ground to support an adjournment, the Panel was advised that it could proceed.

13. The Panel decided that it would proceed today. It accepted all of the bases put forward by the HCPC as being grounds supporting the hearing proceeding. In reaching this decision, the Panel noted that not only had the Registrant not taken the opportunity to attend; he had failed to provide the Panel with any representations to be considered in his absence. His engagement with the HCPC had been minimal. It could be assumed that should there be an adjournment the level of non-engagement by the Registrant would continue. Further, it cannot be assumed that the three witnesses, previously described as victims, would continue to be willing to attest to the facts of the allegations if there is further delay.

Amendment of Particular 3(b) at the start of the hearing

14. During the reading of the Allegation into the record, it became apparent that as a result of alterations made to the Allegation by the Conduct and Competence Committee on the 19 September 2024, some continuity had been lost within Particular 3(b). The Panel noted that in relation to the alterations made to this limb of Particular 3 it failed to make sense due to four words inadvertently being left in. The deletion of ‘on the’ before the word ‘bottom’ was no longer required, nor was the ‘and/or’ at the end of that limb of the Allegation.

15. The Panel sought the Legal Assessor’s advice as to whether it was able of its own volition to correct these errors and was advised that it could, provided that the Panel was content that in so doing so it did not cause the Registrant any prejudice.

16. The Panel considered that no prejudice was caused to the Registrant as the substance remained the same. However, the continued inclusion of these four words made a nonsense of the phrasing and conjunction, and so they should be deleted.

Further amendment of Particular 3(b)

17. At the start of her testimony, Colleague A stated that the description within paragraph 10 of her HCPC witness statement made in February 2024, was not accurate. She stated that it was not a ‘squeeze’ but more of a ‘caress’. The HCPC accordingly made an application to amend this limb of the Particular so that it better reflected and accorded with her evidence. It was suggested that this limb of the Particular would be better if phrased as ‘touched and/or caressed and/or stroked Colleague A’s bottom with your hand’.

18. In support of this position the Panel’s attention was drawn to the notes of Colleague A’s interview meeting with the Investigating Officer held on 8 June 2021, and the written statement she had prepared in advance and presented to the Investigating Officer at that meeting. Colleague A’s evidence at this HCPTS hearing accorded with her descriptions in those earlier recordings of events in June 2021. From this it was clear that the suggestion that the Registrant ‘squeezed’ Colleagues A’s bottom could not be supported. The proposed wording however did encapsulate Colleague A’s descriptions of the Registrant’s actions.

19. The Registrant has been aware of the nature of the allegations made against him since the end of March 2021, and has been provided with the Trust’s Investigation Report and the documentation upon which the HCPC was basing its case. The Registrant was therefore fully aware of the nature and extent of the allegations made and had been so for some years. The wording proposed by the HCPC did not change the substance of the allegation. Further, the original wording of the allegation made it clear that the action alleged was inherently sexual in nature, and this is still the position.

20. The HCPC directed the Panel to the case of PSA v HCPC & Doree [2017] EWCA Civ 319, and the dictum of Lord Justice Lindblom, where he determined that it was appropriate in the wider public interest to amend an allegation even after a finding of fact has been made. It was important to ensure that there was no under prosecution arising out of failure of the evidence to support an allegation in its drafted format.

21. It was appreciated that this Panel has not reached the conclusion of the fact-finding stage, but it was appropriate, in line with the case of Doree, for the proposed amendment to be made to ensure that it better reflected the evidence. Further, the revisions do not make the allegation any more serious, and it was in the wider public interest for the Panel to so amend.

22. The Legal Assessor reminded the Panel that the HCPC rules were silent on the issue of amendment of the Allegation. This was a different position from other regulators and was a matter that was first addressed in the case of HCPC v Ireland and Ma [2015] EWHC 846, in which there was an obiter statement that there was a common law principle that would support such a course of action. That common law principle was further considered and endorsed in the case of Doree, which it was argued would support an amendment even up to the Sanction stage. It was a matter that the Panel should consider as to whether the proposed wording did fully address the evidence of Colleague A. The Panel could propose and adopt its own alternative wording, if it chose.

23. The Panel noted that the evidence given by Colleague A better accorded with her statements made closer to the events, namely, ten weeks after 23 March 2021. In the note of the meeting with the Investigating Officer and in Colleague A’s pre-prepared written statement she does not describe the Registrant’s action as a ‘squeeze’. The only reference to that term is in the much later statement of February 2024, which the witness, at the hearing, wished to amend. The Panel was content that the oral evidence and statements made in June 2021 were the more accurate descriptions of the Registrant’s action of moving his hand down to her bottom and her various descriptions at the hearing of his hand motions when on her bottom. The wording proposed by the HCPC encapsulated those descriptions. The proposed amendment was therefore approved.

Amendment of Particular 1(c)

24. Following the evidence of Colleague D, the HCPC made an application to amend this particular, so that it better accorded with the evidence of the Witness. It was clear that Colleague D did not support the description of the Registrant having ‘grabbed’ her bottom, when giving her evidence. It was suggested that ‘touched and/or held and/or cupped’ encapsulated the description given by Colleague D.

25. As with the previous application to amend, the HCPC maintained that this further amendment would not cause the Registrant any prejudice as he had been aware of the nature of the allegation for some years. The law applicable to this application was the same.

26. The Legal Assessor confirmed that her previous advice was appropriate and so the Panel may change the particular if this is supported by the evidence. In this regard she reminded the Panel that it could suggest an alternative wording should it consider it better described the Registrant’s actions in touching Colleague D.

27. The Panel noted that Colleague D was quite clear and consistent in respect of the nature of the touching. That evidence was similar to the evidence she had provided to the Investigating Officer at the time. The wording proposed described the continuum motion which this witness had identified of sliding his hand down, lingering and cupping her buttock in his hand.

Background:

28. The Registrant is registered with the HCPC as a paramedic and was employed in that capacity by South East Coast Ambulance Service NHS Foundation Trust (the Trust). The Registrant has over thirty years’ service as a paramedic.

29. On 24 March 2022, the HCPC received a referral from a member of the public informing the HCPC that the Registrant had been dismissed on 21 October 2021 following disciplinary proceedings. The HCPC had not received a referral from the Registrant or the Trust informing it that the Registrant had been suspended and thereafter dismissed.

30. The HCPC’s enquiries established that the Trust had commenced an investigation into the Registrant's alleged actions in June 2021. The Trust subsequently provided a copy of that Investigation Report to the HCPC.

31. The Investigation Report confirmed that allegations were initially raised against the Registrant by two female junior trainee colleagues, Colleague A and Colleague B. Both alleged that, in March 2021, the Registrant inappropriately touched their bottoms whilst at work.

32. Following those initial allegations coming to light, further concerns were raised by other female members of staff, and one of those was Colleague D.

33. The complaints raised by Colleagues A, B and D form the basis of the Allegation set out above.

Submissions on facts

34. The HCPC considered that it had provided the Panel, with clear, cogent and consistent evidence through the testimony of the three female witnesses of fact who could be considered as ‘victims’ of the Registrant’s behaviour towards them. They were very good witnesses, who had come up to proof on their evidence and who had done their upmost to tell the truth and assist the Panel. They had clear recollections of the incidents that led to the allegations. These were three young females who had been adversely affected by what had happened to them and were wholly believable. The HCPC submitted that the evidence fully supported the allegations as now amended.

35. The HCPC drew the Panel’s attention to the fact that there is clear evidence that the Registrant has consciously decided to opt out of the hearing and abrogate his role in the fact-finding process. The Registrant’s non-attendance should therefore be balanced against the evidence of the three HCPC witnesses. The Panel was able to draw an adverse inference from his decision to not attend, in line with the Supreme Court decision in the case of the Royal Mail Group Limited v Efobi [2021] UKSC 33, in which Lord Leggatt stated at paragraph 41:

So far as possible, tribunals should be free to draw, or to decline to draw, inferences from the facts of the case before them using their common sense without the need to consult law books when doing so. Whether any positive significance should be attached to the fact that a person has not given evidence depends entirely on the context and particular circumstances. Relevant considerations will naturally include such matters as whether the witness was available to give evidence, what relevant evidence it is reasonable to expect that the witness would have been able to give, what other relevant evidence there was bearing on the point(s) on which the witness could potentially have given relevant evidence, and the significance of those points in the context of the case as a whole.

36. In this case, there were points that the Registrant could have helped the Panel with and he had chosen not to. In the HCPC’s view the best evidence is that of the three compelling witnesses whose evidence had helped the Panel to formulate a picture of the Registrant; a picture which disclosed a consistent modus operandi and a casual approach to behaviour such as touching and hugging.

37. In relation to Particular 1, Colleague D was, in the view of the HCPC, a clear and compelling witness, who was able to provide full details of the incidents and able to describe how she was emotionally affected by the Registrant’s conduct. Conduct which she had told the Panel was at no point encouraged or invited by her. Colleague D was acutely aware that the Registrant was her superior and direct line manager. She was newly qualified and was fearful of the Registrant’s sphere of influence over her career. She informed the Panel that the Registrant was a ‘lazy’ manager who had a lax approach to administration and adherence to procedures and rules.

38. In relation to 1(a), the Panel had heard from Colleague D that she had to carry a heavy bag to her car which was some way away from the building. The Registrant had unusually offered to help her transport this to her car having already dismissed Colleagues D’s fellow crew member. It was whilst she was lifting this bag into her car that the Registrant took the opportunity of approaching her from the side and placing both hands around her body and putting his face next to her face. The HCPC considered that this unwanted and uninvited touching was planned and the scenario in which it could be enacted had been staged by the Registrant.

39. In relation to 1(b), the Panel was reminded of the evidence that the drug room at Lewes was far away from the station office. Lewes was the satellite station to the main Brighton hub. It was unusual for a manager to countersign medicine movements, however on this occasion the Registrant had intentionally chosen to do so. The Registrant had used his offer of countersigning to create the opportunity of being alone with Colleague D in the drug room. The Panel was reminded of Colleague D’s testimony that she had to reach up to the cupboard, which in her case, due to her height, was above head height. To reach she had to stretch up with raised arms. Whilst in this position the Registrant had put his arms around her in an embrace and in so doing had brushed against her breasts and had made no apology for doing so.

40. In relation to 1(c), the HCPC submitted that the amended allegation reflected the quality of the evidence given by Colleague D. Her testimony was clear that whilst the Registrant was providing a supportive hug the Registrant had moved his hand down her body to her buttock and stayed there for longer than would have been the case if only accidental touching had occurred. Colleague D had a vivid recollection of the nature of the movement which she considered deliberate. This uninvited embrace had come at a point in their discussion where she was particularly vulnerable, having just disclosed to the Registrant, her line manager, that there were family matters of a sensitive nature that were weighing heavily on her.

41. In relation to 1(d), this is the first of two incidents on 26 August 2021, a day when the Registrant had booked himself on a one-to-one shift with Colleague D. To achieve this, the Panel had been told that the Registrant had booked this shift on an overtime basis, something Colleague D told the Panel was contrary to policy. The HCPC submitted that this was evidence that as a senior member of staff the Registrant had sought, and had taken, every opportunity to engineer contact alone with Colleague D.

42. At this time in August, Colleague D was concerned about the Registrant’s attentions and after seeking guidance from a friend she had intentionally adopted a cold shoulder approach. Instead of the Registrant responding appropriately to this adopted cold behaviour by Colleague D the Registrant’s actions had, in the view of the HCPC, made matters worse. Whilst Colleague D was sat on the third step up to the ambulance the Registrant had approached her and after saying ‘you’re so grumpy’ proceeded to cup her face in his hands and had pressed his nose and forehead against her nose and forehead.

43. In relation to 1(e), whilst sat within the ambulance with the Registrant, Colleague D had disclosed sensitive personal family details and in response the Registrant had offered his hand to Colleague D and then taken hold of her hand and kissed it.

44. In relation to 1(f), in September, Colleague D had sought the assistance of AB, another Operational Team Leader (‘OTL’) at the Trust. This had consisted of an email AB sent to all OTL’s at the station on 10 September 2020 reminding managers about personal space and boundaries between all grades of staff. The Registrant’s response, on 25 September 2020, was to create an opportunity to be alone with Colleague D to discuss the content of the email. The Registrant then proceeded to slip his hand under a covid screen to touch Colleague D’s leg.

45. In relation to 1(g) on 2 November 2020, the aggravating factor here was, according to the HCPC, that when the Registrant was not on duty, and whilst waiting demand for the ambulance service was high, the Registrant had failed to inform ‘Control’ of his intention to make an ambulance resource unavailable for the purpose of a return-to-work meeting with Colleague D. The Registrant had used this opportunity to continue with his inappropriate conduct.

46. In the HCPC’s view, all of this indicates that the Registrant had taken no notice whatsoever of Colleague D’s attempts to deter his advances and showed a lack of consideration to her wellbeing.

Colleague B

47. The HCPC submitted that the evidence was that the Registrant, when alongside Colleague B, had turned and pulled the epaulettes on Colleague B’s jacket so that she moved closer to him and he had then smacked her on the bottom. The Panel was reminded of Colleague B’s clear evidence of the notable force with which this smack had been delivered. It was an incident of such note that Colleague B had mentioned it to Colleague A shortly afterwards.

Colleague A

48. The amendments made to Particular 3 reflect the clarity with which Colleague A had delivered her testimony. The evidence from Colleague A regarding the way in which the Registrant’s hand had moved to her bottom described a lasting caress where he stroked and caressed her buttock. Colleague A had formed the impression that the Registrant wanted to take things further and she felt most uncomfortable as a result.

KW

49. KW, who undertook the investigation on behalf of the Trust, was supportive of the three young females positions and her evidence gave additional support to their testimony, which has not changed over time.

50. In the HCPC’s view all of the matters identified in particulars 1, 2 and 3 are sexual in nature involving as they do contact with personal areas of the body.

51. The HCPC submitted that the matters identified in Particulars 1 and 3 are sexually motivated, intended as they were to obtain some sexual gratification from touching and maintaining contact with an intimate part of the body. In relation to Colleague D the Registrant’s actions were an attempt to form a personal relationship with her and so were clearly sexually motivated.

Decision on Facts:

52. The Panel heard live evidence from four HCPC witnesses who each produced a sworn statement. These included the three females identified in the Allegation, and the Investigating Officer. The Panel had been provided with a copy of the Investigating Report and its appendices, and copies of Trust’s Disciplinary Policy and procedures, and the Bullying and Harassment Policy.

53. The Panel sought the advice of the Legal Assessor as to the matters which should be considered and taken into account at this stage of the proceedings. In relation to the weight to be placed upon the documentation she advised that those records of events made closer to the incident may provide a better reflection of the actions and feelings at the time. This was of particular relevance in this case, where there had been some delay between the Investigation meetings and the preparation of the HCPC statements.

54. The Panel accepted the detailed advice it received from the Legal Assessor in relation to the issue of sexual motivation. The Panel was conscious at this stage that the onus was upon the HCPC to prove its case. The Panel appreciated that the standard to which the HCPC had to prove each and every part of the Allegation was on the balance of probabilities.

55. In relation to the Trust’s investigation, KW, the independent external Investigating Officer, told the Panel that the complaints that she was investigating had all been made by young, female junior staff members. She confirmed that there were more complainants than the three this Panel was considering. She explained that she had been invited to undertake four or five investigations for the Trust prior to her involvement with this case and that she had carried out many more since. The terms of reference had been set by the Trust and her involvement finished once she had presented her Investigation Report at the disciplinary hearing. She said that following the #MeToo campaign the Trust had shown itself to be actively involved in changing the culture within the organisation in relation to sexual harassment.

Particular 1 – all limbs and elements of limbs found proven

56. From the information before it the Panel was able to identify the following fuller chronology and steps taken by Colleague D that lie behind the allegation;

• In May to July 2020 (when allegations 1(a), 1(b) and 1(c) occurred) the Registrant is identified by Colleague D as changing his conduct and behaviour towards her. She confided her suspicion that the Registrant had a non-professional interest in her with a friend/colleague in a WhatsApp exchange.

• By August 2020 Colleague D’s suspicions had turned into experience-based concerns and following further discussions with her friend/colleague she decided to limit the degree of warmth she displayed towards the Registrant in an attempt to persuade him to change his behaviour towards her. This change of tactics did not work (when allegations 1(d) and 1(e) occurred).

• In early September 2020 Colleague D sought guidance from a female senior, AB, and following this discussion an email containing jointly agreed text was sent by AB to managers at the same level of seniority as the Registrant. In this email AB identified that there had been a report of inappropriate behaviour towards a junior female member of staff. At this time, Colleague D was advised to make a note of all previous inappropriate behaviour and to make a further note of any future incidents. The Panel has been provided with a copy of this note and the email of 10 September 2020.

• On 25 September 2020 the Registrant sought out Colleague D, and wanted confirmation that the email sent round by AB did not relate to him and wanted to know if he had done anything to upset her. This meeting was in an office chosen by the Registrant where the Registrant and Colleague D were alone. The Registrant as part of his dismissive response to the email, relating to no physical contact, made contact with Colleague D’s leg (allegation 1f) and remarked that he is not supposed to do that.

• Further to this encounter of 25 September 2020, on 14 October 2020 AB facilitated a mediation meeting between the Registrant and Colleague D at which the Registrant is informed that his attentions were uninvited and unwelcome. The Registrant is recorded by AB and Colleague D as being flippant at the meeting and not taking it seriously. At one point the Registrant is recorded as turning the conversation to the subject of his new home where he has acquired a lot of vintage furniture and he then invited Colleague D to come over to view this.

• Colleague D then sought the advice of her union as to how to deal with this situation short of making a formal complaint.

• On 2 November 2020 the Registrant had further unplanned contact with Colleague D whilst she was on duty, but he was not on duty, and this led to the substance of allegation 1(g).

• Following this further incident Colleague D sought a transfer to a different manager.

57. Colleague D gave her evidence in a calm, measured and composed way and without any hint of malice even though the events had a profound impact on her at the time. Her evidence was balanced and consistent with the records of her events recorded in her personal notes, her notes of the meeting with KW and her sworn statement.

58. Colleague D described herself as a loud and a friendly person whose voice and laughter could be heard all round the station. She would accept a hug from a colleague when they were empathising with her in a stressful scenario or when discussing her complicated family situation. Those colleagues she accepted hugs from were not senior to her. She considered it inappropriate for a manager to offer physical contact.

59. In relation to Particular 1(a), the Panel noted that the Registrant is recorded in his interview with KW as stating he had hugged Colleague D, but it was a face-to-face hug. He is recorded as not accepting that he put his face against her face. The Panel had received a fulsome account from Colleague D which the Panel had been able to explore with her. Her oral account was consistent with all previous records of the incident. The Panel prefers her evidence on this matter and so finds this allegation proven.

60. In relation to Particular 1(b) the Registrant, in his interview with KW, stated nothing about touching Colleague D’s breasts but accepted that he was there and gave her a hug. The evidence of Colleague D and her description of the physical contact with her breasts and how it happened which she attempted to reenact by physical movements was credible. The Panel accept her evidence and finds this particular proven.

61. In relation to Particular 1(c) the Registrant is recorded as accepting, in his interview with KW, that he had hugged Colleague D and it was a face to face hug. The Registrant makes no mention of any further physical contact. Colleague D accepted that she had reciprocated the hug which the Registrant had offered in sympathy and empathy following disclosure by Colleague D of personal family issues. Colleague D was able to fully describe the nature of the hug and how the Registrant had taken his hand down onto her bottom. Her description was credible and her description of the circumstances believable. The Panel therefore finds this allegation proven.

62. In relation to Particular 1(d), the Registrant accepted, in his interview with KW, that he had cupped Colleague D’s face and pressed his face against Colleague D’s so that they were nose to nose and forehead to forehead. Colleague D was clear that she had not said anything before this happened on the ride out on 26 August 2020, to encourage such a degree of intimacy. Colleague D was able to give a detailed account of the degree of contact. The Panel accepts Colleague D’s evidence on this, and the Registrant’s acceptance of Colleague D’s account, at his interview with KW, and therefore finds this allegation proven.

63. In relation to Particular 1(e), this event was also whilst the Registrant was on the ride out on 26 August 2020 with Colleague D. The Registrant is recorded, in notes of his investigatory interview with KW, as not recalling taking Colleague D’s hand and kissing it. Colleague D gave a full description of the incident and the context within which it had occurred. The Panel accepts Colleague D’s evidence and so finds this allegation proven.

64. In relation to Particular 1(f), the Registrant is recorded as being unable to recall having a discussion with Colleague D about AB’s email. Colleague D was able to recount the circumstances and the positioning of herself and the Registrant when this touching of her leg happened. The Panel found Colleague D’s evidence consistent with her previous recording of this incident. The Panel accepts Colleague D’s evidence and finds this allegation proven.

65. In relation to 1(g), the Panel noted that the Registrant was off duty but visited the station and was alone with Colleague D. The Registrant’s position on this incident is not recorded. The Panel accepts Colleague D’s description of what happened during this encounter. The Panel accepts her evidence and so finds this allegation proven.

Particular 2

66. In relation to Particular 2 the Registrant is recorded as denying this happened but recalled the day the new mural went up on the wall at the new joint ambulance facility and that there had been lots of people milling around looking at it. Colleague B stated that she had only met the Registrant when she and her partner had been shown around the new joint ambulance facility. She had been looking at a mural made up of a collage of photos of personnel.

67. Colleague B gave a consistent, compelling and believable account of the circumstances of this incident which had started with the Registrant, who standing alongside her, asking where he was in the mural, and she had jokingly pointed to someone far older. The Registrant had responded by turning, grabbing her jacket epaulette and then smacking her on the bottom. Colleague B was able to give a fulsome description of the Registrant’s actions and had a clear and precise recall of the pressure of the smack on her bottom. The Panel accepts her evidence and so finds this allegation proven.

Particular 3

68. The Registrant is recorded as saying that Colleague A is a ‘huggy’ person and cites incidents of seeing her accepting and giving hugs. He gives no evidence in relation to his hands slipping down and lingering on her bottom during this incident. Colleague A told the Panel that she was a huggy sort of person but that hugging was limited to those with whom she had some form of relationship, such as friends. She would not expect to be hugged without some form of consent first and not by a senior member of staff. The Registrant was an indirect senior manager to her.

69. Colleague A told the Panel that she had been in the station on her own waiting for another paramedic to look at her ears as she was encountering problems with her hearing. When she told the Registrant this, he had responded that there was ‘nothing between the ears’ and then extended his arms to give her a hug. Whilst doing so he had moved his hand down to her bottom and whilst there had lingered, stroked and caressed her bottom. The Panel also noted that Colleague A had disclosed this incident to Colleague B on 24 March 2021 which was corroborated in Colleague B’s evidence. Colleague A had made her own notes of the incident in preparation for the interview with KW. Colleague A’s evidence was consistent with that contemporaneous note and the interview notes of her meeting with KW. The Panel found her evidence credible, consistent and believable and so finds this allegation proven.

Particular 4

70. In relation to Particular 4, the allegation that the matters found proven at Particulars 1, 2 and 3 are ‘sexual in nature’, the Panel had to consider all three allegations individually. It has done so as follows:

• In relation to Particular 1, the Registrant admits that his actions were intentionally directed towards Colleague D and he stated that he believed that he was advancing what he considered to be the early stages of a relationship. In the Panel’s view all of the elements of this particular are individually and collectively sexual in nature, the context providing support for this conclusion.

• In relation to Particular 2, Colleague B stated clearly that she considered the Registrant’s actions as sexual harassment and sexual assault. The Panel noted that this action would be considered to constitute sexual assault. The Panel noted that KW in her investigation of these cases identified a good number of people affected by the Registrant’s laid-back approach to such behaviour. In this instance, there was a deliberate touching of Colleague B’s bottom, rather than a slap on the back in jocular response. Pulling her jacket was not in itself sexual but as part of a continuum of the actions of admonishment for her cheeky remark this was one intentional action. In the Panel’s view this movement of pulling her closer and making contact with an intimate part of the body took it beyond the threshold and into being an action which was sexual in nature.

• In relation to Particular 3, the Panel considered that the action of moving his hand, to Colleague A’s bottom and lingering there whilst caressing and stroking it was, in the Panel’s view, inherently sexual in nature.

Particular 5 – sexual motivation in relation to 1 and 3.

71. In relation to Particular 1, the Panel concluded that the Registrant’s actions were all focused upon creating a sexual relationship with Colleague D. His actions showed a pattern of behaviour that increases and intensifies even though Colleague D took a series of steps to dissuade him. The definition of sexual motivation includes in the pursuit of a sexual relationship which the Panel concluded was the Registrant’s intent. The Panel therefore find this series of actions demonstrates behaviour that is sexually motivated.

72. In relation to Particular 3, Colleague A stated that she did not want to believe that his hand moving to her bottom was intentional, but she knew it was. Her description of how it happened and how long it took and then ended without any explanation had made her feel extremely uncomfortable. Colleague B considered that this was inappropriate and beyond a hug. This Panel concluded that the Registrant’s actions were intentional and of an inherently sexual nature and therefore were to obtain some form of sexual gratification and so find that this action was sexually motivated.

Decision on Grounds:

73. Having found all factual particulars, (including the alternatives within limbs 1(c) and 3(b)) proven, the Panel moved on to consider whether the nature of the Registrant’s conduct constituted serious misconduct, and a breach of the standards expected of a professional practitioner in his field.

74. The Panel’s deliberations took into account the fact that breaches of the Standards expected of a practitioner were not conclusive in relation to the issue of whether that conduct would support a finding of serious misconduct or constitute conduct which fellow practitioners would consider as deplorable. Those matters were to be determined by the Panel applying its professional judgement.

75. The Panel noted the submissions of the HCPC that the matters found proven were very serious examples of misconduct. The HCPC had emphasised that all three victims were young women. In the case of Colleagues A and B, the Registrant was a senior practitioner of many years’ experience, and on occasion the Registrant was their immediate manager when on duty. There was a huge imbalance of power between their trainee status and his managerial position. In relation to Colleague D, she was newly qualified, and the Registrant was her direct line manager. The HCPC maintained that there was clear evidence that the Registrant had manipulated processes so that he could be alone with Colleague D. In relation to all three colleagues his actions had been inappropriate, unwanted and sexual in nature. All three victims had described the Registrant’s actions as making them uncomfortable.

76. The Panel noted in regard to Colleague D that the Registrant had arranged overtime for himself so that he could take Colleague D out on a two person shift; he had taken Colleague D off active duties to speak to her about the AB email; on a non-rota day the Registrant had appeared at a single vehicle ambulance station where the only available resource was Colleague D and a crew member. In respect of the Registrant taking Colleague D off duty at a time when Control had eleven calls queueing during a period of high demand, would, in the Panel’s view, have put service users at greater risk of harm.

77. The Panel noted that in relation to the Registrant’s actions towards Colleague D, they appeared predatory and premeditated. Offering to take a bag to a car parked some way away in a remote car park. Arranging to be in a small ambulance station which only has a single crew present. Offering to countersign medicine movement in a room that is some way down a long corridor. These all deliberately created situations where Colleague D would be alone with the Registrant and feel vulnerable and ill at ease.

78. The Panel noted that the Registrant had denied his actions in relation to Colleagues A and B suggesting that he had no recollection of such matters. In relation to his conduct towards Colleague D, he had offered as a reason for his behaviour that he believed it was the start of a personal relationship. This reason was in itself a basis for desisting in such a course of action. The Panel observes that the pursuit of this inappropriate relationship within the workplace was continued by the Registrant after warnings that his conduct was unprofessional and uninvited.

79. In relation to the Standards of Proficiency the Panel considered that Standards 3.1 and 9.2 were applicable in this instance. Those were:

3.1 ‘understand the need to maintain high standards of personal and professional conduct’.

9.2 ‘understand the need to build and sustain professional relationships as both an independent practitioner and collaboratively as a member of a team.

80. In relation to the Standards of Conduct, Performance and Ethics, the Panel was of the view that a trainee would fall within the category of a service user in that a trainee was dependent upon the organisation for their training and so a user of the services of the Paramedic Profession. On this generally accepted interpretation the Panel considered that Standards 1.1 and 1.7 applied, and the Registrant’s conduct had been in breach of those standards. These state:

1.1 ‘You must treat service users and carers as individuals, respecting their privacy and dignity.’

1.7 ‘You must keep your relationships with service users and carers professional’

81. The Panel also considered that Standard 9.1 of the Standards of Conduct Performance and Ethics applied and had been breached. This states:

9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.’

82. The Panel heard from Colleague D how much she loved her profession and how it had come to the stage where the Registrant’s behaviour had made her dread going into work. She described her fear and her vulnerability at being accessible and controllable by the Registrant the whole time. She said that the Registrant always knew where she was; he could change her rota shifts; and, ultimately, he could adversely influence and impact upon her future career.

83. The Panel noted the steps which Colleague D had adopted to ensure that the matter had not been formally escalated at the time. She had initially sought the support of a female friend and colleague. She had then sought the advice of a senior female paramedic who had firstly sent an email to all OTL’s at the station and thereafter facilitated the mediation meeting. Colleague D had then sought the advice of her union. Ultimately, she requested reassignment to another manager rather than make a formal complaint because alone she felt her complaints would not be taken seriously. She told the Panel that she had previously reported inappropriate behaviour and not only had she not been believed but she had professionally suffered as a result of making that complaint. On this occasion she had waited till there had been other complainants before joining her concerns about the Registrant’s behaviour to the investigation undertaken by KW.

84. The Panel noted that all three women had expressed concern about making complaints. The Panel was mindful that there were other complaints and that as identified by AB, there had been previous issues and concerns which had been treated at that time ‘as innocent’. The concerns raised in 2021 were recorded after the #MeToo campaign and completion of in-house training on where the boundaries were in relation to sexual harassment within the working environment. Those 2021 concerns had therefore been taken seriously and investigated. The Panel noted that being involved in that process had not been easy for those three colleagues and that difficult process was continuing until the conclusion of this case.

85. All three women had expressed how they felt after the incidents. They felt embarrassed, abused and undermined. They were all acutely aware of their junior status and felt unable to personally address the matter. In relation to Colleague D, the complained of behaviour had been repeated by the Registrant after he had been made fully aware of the inappropriateness of his conduct. Furthermore, the sexually inappropriate behaviour had then been repeated with two other female colleagues within a few months. This continued pattern of inappropriate behaviour would, in the Panel’s view be considered by fellow professionals as deplorable. The Panel therefore concludes the Registrant’s actions are very serious, impacting as they did on these colleagues mental, physical and emotional wellbeing. The Panel has therefore concluded that the Registrant’s behaviour as found constitutes, individually and collectively, serious misconduct.

Decision on Impairment:

86. The Panel received and accepted the HCPC’s representations in relation to the question of impairment. It was submitted that the Registrant’s actions had brought the profession into disrepute. There was a significant power imbalance between him and Colleagues A, B and D. His systematic and premeditated pattern of sexual behaviour was totally inappropriate. The HCPC maintained that the Registrant had provided no evidence to demonstrate to the Panel that he had done anything to address and remedy his conduct and so there was nothing to support the position that as of today there was no current impairment.

87. The Panel sought and accepted the detailed advice of the Legal Assessor whose advice included that at this stage it was considering the two components of impairment, the personal and the public. In relation to the personal component, the Panel was to consider whether the evidence before it supported a conclusion that the Registrant’s conduct was remediable, had been remediated and so in the future there was little or no likelihood of a repetition. In relation to the public component, notwithstanding that there may have been full remediation, are the matters which have been found proven such, that members of the public in full possession of all the facts, would consider that the Registrant had brought his profession into disrepute and had undermined the public’s confidence in the profession.

88. In relation to the personal component, the Panel noted in the investigation meeting between KW and AB, AB is recorded as saying ‘this was the most recent example I could think of but over the years there have been many of these seemingly innocent acts’. From this the Panel identified that not only had there been more complainants involved in the investigation carried out by KW in 2021, but there had been further incidents of a similar nature in previous years. This clearly supported the position that there was a patten of behaviour towards females. KW confirmed that all the complainants involved in her investigation in 2021 were young females and so it could be safely assumed also junior in life experience and professional rank. The conduct found in these proceedings therefore formed a pattern of inappropriate and unprofessional conduct of a sexual nature. The Panel noted that this pattern of behaviour had continued despite warnings not to. The Panel therefore considered that this pattern of inappropriate conduct may be a behavioural trait that would be difficult to address.

89. The Panel had received nothing from the Registrant in terms of his current position. There was nothing to indicate that he had reflected upon these events and what his current level of insight was into his former actions. There was nothing to indicate that the Registrant may now consider his actions supported the making of an apology or that he may now regret and feel remorseful for his actions. The last record of his view of these complaints is that set out in the notes of his investigation meeting with KW. In that he had denied the complaints made by A and B and whilst he had accepted his actions towards Colleague D he had offered as a defence the fact that he believed that they were in the early stages of a personal relationship.
90. The Panel has concluded from this evidence that remediation may be difficult however, in the absence of any evidence of steps to achieve remediation there is every likelihood of the behaviour complained of being repeated in the future.

91. In relation to the public component, the Panel considers the pattern of behaviour displayed towards young females within the ambit of their professional duties would be considered by members of the public as appalling. Invading these females personal space; putting them in embarrassing situations; subjecting them to behaviour of a sexual nature; undermining their confidence at an early stage in their professional career; and creating a cloud of doubt and fear over their professional future would be considered as manipulative, predatory and exploitative, given the imbalance within the power dynamics of their professional relationships. The public would be rightly concerned if such a practitioner were allowed to remain in unrestricted practice. The Panel therefore makes a finding of current impairment on the public component of its decision.

Decision on Sanction:

92. The HCPC submitted that the only appropriate and proportionate sanction in this case is one of Strike Off and the reasons for that are those which the Panel has cited in relation to the seriousness of the Registrant’s misconduct. In particular, the Registrant’s premeditated and predatory course of behaviour towards multiple young junior female colleagues within the workplace. Of note was the fact that the Registrant had not ceased to inappropriately pursue Colleague D, when given warning signs not to, such as the cold shoulder to his advances; the email that was circulated by AB; or the mediation meeting. He had persisted with his unacceptable behaviour resulting in Colleague D requesting another line manager. He then repeated his inappropriate and sexual behaviour with two further colleagues. The HCPC submitted that this level of sanction will send out the right message to the public and to fellow practitioners that this type of conduct should not be condoned.

93. The Panel was reminded by the Legal Assessor that the Panel’s task at this stage was to balance the wider public interest with those of the Registrant. Sanctions were not intended to be a punishment, but the imposition of the minimum restriction on practice that will ensure continued public protection. The Panel was reminded by the Legal Assessor to refer to and take account of the guidance contained within the HCPTS’s Sanctions Policy which she emphasised was persuasive in nature only and it was a matter for the Panel to make the decision on the appropriate and proportionate restriction to apply. The Panel appreciated that any restriction imposed should maintain the public confidence in the profession and the regulatory process as well as acting as a deterrent to fellow practitioners to act in the same way.

94. At this stage in the Panel’s deliberation there had not been any further contact with or from the Registrant. There were therefore no testimonials or references to be considered. The Registrant had been a Paramedic for over 30 years at the time of these events in 2020/2021. The Panel was informed that the Registrant had no previous cases or referrals made to his regulator.

95. The Panel was mindful of the guidance in relation to allegations of a sexual basis and their seriousness. Paragraphs 76 and 77 of the HCPTS Sanctions Policy state:

‘Sexual misconduct is a very serious matter which has a significant impact on the public and public confidence in the profession. It includes, but it is not limited to, sexual harassment, sexual assault, and any other conduct of a sexual nature that is without consent, or has the effect of threatening or intimidating someone. The misconduct can be directed towards:

• Service users, carers and family members;
• Colleagues; and
• Members of the public.’

‘Because of the gravity of these types of cases, where a panel finds a registrant impaired because of sexual misconduct, it is likely to impose a more serious sanction. Where it deviates from this approach, it should provide clear reasoning.’

96. The Panel was also mindful of the guidance within paragraphs 67 and 69 of the Sanctions Policy in relation to what would constitute a serious case. Within those paragraphs of that guidance the following are relevant to this case. Those were:

• Where there is a need to put trust in a registrant and there is an unequal balance of power in favour of the registrant. The Registrant’s actions were all targeted towards young, junior female colleagues with whom there was a large imbalance of power in his favour.

• Where a registrant has been found to have abused their professional status. The Registrant had used his position as direct line manager and indirect manager to manipulate and engineer situations.

• Inappropriate relationships which included attempts to conduct personal relationships within the workplace. The Registrant had given as a reason for his conduct towards Colleague D, his belief that his intentions to pursue a personal relationship had been reciprocated. However, that stated reason was, in itself, conduct that should have been avoided.

97. In relation to seriousness, of relevance to this case was the guidance set out in paragraphs 71 and 72 relating to predatory behaviour which stated:

A registrant’s behaviour should be considered predatory where they are seen to take advantage of others, motivated by a desire to establish a sexual or otherwise inappropriate relationship with a service user or carer. The panel should take predatory behaviour particularly seriously, as there will often be significant risk to the targeted service user or carer.

Predatory behaviour might include attempts to contact service users or carers using information accessed through confidential records (for example, visiting a service user’s home address without authority or good reason to do so), or inappropriate use of social media to pursue a service user or carer. Any evidence of predatory behaviour is likely to lead to more serious sanctions.

98. The Registrant’s behaviour towards Colleague D encapsulated the guidance quoted above. Colleague D told the Panel that as a result of the Registrant’s conduct she had become fearful of going to work. She stated she loved her job but due to her perception that the Registrant had unfettered access to her and was able to control her she stopped wanting to go to work.

99. In relation to Colleague A, she had been left embarrassed and fearful of making a complaint for fear of repercussions. As identified by KW, the impact of the Registrant’s conduct upon these young females had not been understood or appreciated by the Registrant. KW considered that he had no insight in this regard and had not considered that it was behaviour that required an apology.

100. As to what would be the most appropriate and proportionate restriction to impose, the Panel started its deliberations by identifying the mitigating and aggravating factors in this case. In relation to mitigating factors the Panel was unable to identify any element that could be justified as being a mitigating factor.

101. In relation to aggravating factors, the Panel identified the following:

• The Registrant had repeatedly ignored Colleague D’s attempts to reject his unwanted and uninvited advances towards her and so continued to repeat his misconduct.

• The Registrant had failed to follow directions from a fellow manager to desist in his behaviour: he had not heeded the clear messages delivered within the email and the mediation session.

• The Registrant had continued with his mode of conduct with Colleagues A and B only a few months later. There was nothing to indicate that the Registrant would not act in the same way in the future.

• The Registrant had shown no insight into the nature of his conduct or the adverse impact it had on these female junior colleagues.

• The Registrant’s conduct had relied upon a natural fear of junior staff making a complaint and so had undermined staff’s trust in management.

• The Registrant had abused and manipulated the power imbalance between him and female junior colleagues.

• The Registrant’s actions were premeditated and engineered to produce situations and outcomes for his personal gratification.

• There had been emotional, mental and psychological harm to female junior colleagues.

• There may have been indirect harm caused to service users by the Registrant’s divergency tactics of taking Colleague D off duty for inappropriate reasons when there was a high volume of 999 calls waiting.

102. The Panel appreciated that it should start its consideration of the range of sanctions available to it in ascending order. The Panel considered that taking no action was not appropriate in this case. In relation to the offer of mediation, the Panel considered that this measure could provide a process of resolution of the issues between the Registrant and the three females involved, however in terms of providing a sanction that reflected the seriousness of the misconduct it was not proportionate.

103. In terms of a Caution Order, the Panel appreciated that this level of sanction did not address matters of behaviour that have not been addressed and remedied. This level of order would also send the wrong message to fellow practitioners, in particular to the three complainants in this case, for whom the seriousness of the Registrant’s actions, had caused those colleagues’ discomfort, embarrassment, and to be fearful for their future careers.

104. In relation to the imposition of a Conditions of Practice Order, the Panel appreciated that this sanction would only be workable in circumstances where the Registrant was willing and able to comply with the conditions imposed on his practice. The Panel had no information before it from the Registrant that would assist it in this regard. As stated in paragraph 107 of the Sanctions Policy, ‘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.’

105. Further, the Panel was mindful that the mischief that required addressing in this case was behavioural conduct which included an element of the Registrant’s attitudinal approach to female colleagues and professional boundaries within the workplace. The Registrant’s actions had failed to adhere to the standards of conduct that were, and would be expected of him, in an operational setting. It was unclear to this Panel as to how that could be monitored and controlled in the future without evidence of the Registrant’s willingness to personally take responsibility for his past actions and future conduct. The Panel has therefore concluded that conditions would not be appropriate and workable in this case.

106. The Panel then moved on to consider whether the Registrant’s actions were so serious as to be contrary to fundamental principles of a professional and in breach of the tenets of his profession and whether his misconduct is fundamentally incompatible with remaining on the register. The Panel considered this principle to assist it in assessing whether the imposition of a period of suspension was appropriate, or it warranted the ultimate sanction of a striking-off order. The Panel also considered the guidance within the Sanctions Policy in relation to the circumstances when it is appropriate to impose a period of suspension. Paragraph 122 states:

‘A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which so not require the registrant to be struck off the Register. These types of cases will typically exhibit the following factors:
• the concerns represent a serious breach of the Standards of conduct, performance and ethics;

• the registrant has insight;

• the issues are unlikely to be repeated; and

• there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings.’

107. The Panel noted that the Registrant has failed to provide any evidence that he has gained insight into the events that led to him being before his regulator. There is nothing before the Panel to satisfy it that the misconduct found would not be repeated, nor that the Registrant has evidenced that he is able to resolve and remedy his failings. Therefore, the Panel concluded that as there is a high risk of repetition in this case there is little to support the imposition of a Suspension Order.

108. The Panel then considered the guidance within paragraphs 130 and 131 which states:

A striking off order is a sanction of last resort for serious, persistent, deliberate or reckless acts involving (this list is not exhaustive):

• dishonesty;

• failure to raise concerns;

• failure to work in partnership;

• discrimination;

• abuse of professional position, including vulnerability;

• sexual misconduct;

• sexual abuse of children or indecent images of children;

• criminal convictions for serious offences; and

• violence.
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;

• continues to repeat the misconduct or, where a registrant has been suspended for two years continuously, fails to address a lack of competence; or

• is unwilling to resolve matters.

109. The Panel considered the following matters in the guidance were engaged in this case as follows: The Registrant carried out repeated inappropriate sexually motivated behaviour towards vulnerable young female members of staff, abusing his professional position; he had shown no insight into his behaviour; and demonstrated a total lack of willingness to resolve matters. Accordingly, the Panel decided that the only proportionate and appropriate sanction in this case is that of a Striking-off Order.

110. In making a Striking Off Order the Panel was mindful of the impact this sanction would have on the Registrant, but it has concluded that it is the only sanction that provides the necessary degree of protection from the risk of repetition and that will maintain the public confidence in the profession and the regulatory process. Such a sanction will send out the right deterrent message to practitioners within the profession that misconduct of a sexual nature will not be tolerated.

The Registrar is directed to strike the name of Mr Julian Cotton from the register on the date this order comes into effect.

Right of Appeal:

You may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made against you.

Under Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you. The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

Interim Suspension Order:

The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest.

This 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) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Julian Cotton