Mr Dean P Carey

Preliminary Matters

Service
1. The Registrant was present and represented and accepted that the HCPC had complied with the rules in respect of service in this case.

Background

2. The Registrant is a paramedic who qualified in 2012 and by June 2020 had been employed by East Midlands Ambulance Service (EMAS) for many years. On 28 June 2020, just before 04:00, the Registrant was on duty by himself in an ambulance car and attended at Service User A’s home address in response to a 999 call made by her partner. Service User A’s partner had called for an ambulance because he was concerned that Service User A was having difficulty breathing.

3. Service User A accepted that she was very drunk and that she had not wanted a paramedic to attend. She initially refused permission for the Registrant to accompany her into the house. She complained of tightness in her chest and the Registrant treated her for hyperventilation caused by a panic attack. He conducted two rounds of observations. He offered to perform an Electrocardiogram (ECG) which was declined by Service User A. Service User A explained that she no longer had chest pain.

4. The Registrant was at Service User A’s house for a little over two hours, much of which was spent bringing her breathing back to normal and providing reassurance. Treatment took place in the sitting room of the home where Service User A’s partner was present throughout, either sitting next to her or standing beside her, as she sat on the sofa. Service User A’s brother was also present at times.

5. As part of his treatment, the Registrant asked Service User A what had caused her panic attack.

6. At 16:47 the same day the Registrant found Service User A on Facebook and sent her a direct message on Facebook Messenger which said; 'Hey. Hope your well and not feeling too bad! I forgot to mention last night are you aware of the fb group for… parents and children? They give advice and arrange days etc. Hope you don't mind the message x'.

7. Service User A replied at 22:00 thanking the Registrant for the information.

8. This led on to a period of at least nine weeks when the Registrant and Service User A exchanged multiple messages, some of which were personal, and which included the Registrant sending to Service User A photographs of his naked upper body and his erect penis. There were occasions when they spoke by video call. Although there was mention of meeting up, the Registrant and Service User A never had a face-to-face meeting in person. Contact ended when Service User A’s partner discovered the messages and her intention to meet the Registrant, and he sent the Registrant a message warning him off and threatening to report him to his employer. As a result, the Registrant blocked Service User A and there was no further contact between them. Service User A volunteered that she had not wanted the relationship to end and that she had tried but failed to find other ways to contact the Registrant.

9. Service User A spoke first to her counsellor about what was happening and then later made a formal complaint to EMAS. In July 2022, following a disciplinary hearing, the Registrant was dismissed from his employment.

10. On 2 August 2023, the Registrant started employment in an Emergency Medical Technician (EMT) role with Ambulance Response Services Ltd who have local contracts providing patient transport services, high dependency services and event cover. He joined the high dependency team, becoming the senior clinician transporting cardiac patients who require treatment at different hospitals.

Decision on Facts

11. Particular 1 alleged that; on or around 28 June 2020 having attended Service User A in your capacity as a paramedic, you used Service User A's name to find her on social media. This Particular was admitted and found proved.

12. Particular 2 alleged that; between around 28 June 2020 and 20 September 2020 you did not maintain appropriate professional boundaries in relation to Service User A, in that you:

a. sent Service User A messages of a personal and/or sexual nature; and/or

b. engaged in video calls with Service User A of a personal and/or sexual nature.

13. Particular 2 of the allegation was admitted and found proved.

14. Particular 3 alleged that; “between around 28 June 2020 and 20 September 2020 you engaged in video calls with Service User A at times when you were at work as a paramedic and speaking on the radio with the control room”. Particular 3 was admitted to the extent that the Registrant engaged with at least one video call, but he denied doing so while also speaking on the radio to the control room.

15. Particular 4 alleged that; “on or around 28 June 2020 you suggested to Service User A that you should carry out an ECG on her when this was not clinically indicated”. The Registrant accepted that he had suggested an ECG but denied that it was not clinically indicated.

16. Particular 5 alleged that; “your conduct in relation to allegations 1 and 2 was sexually motivated”. The Registrant admitted that his conduct in respect of Particular 2 was sexually motivated but denied that it was sexually motivated in respect of Particular 1.

Application to amend the allegation

17. In her witness statement, Service User A had stated that there was more than one video call during which the Registrant was on duty, and she was able to hear him speaking on the radio with the control room. However, during her oral evidence in chief, Service User A said that she could now only remember one such occasion and gave a detail that she remembered, which was that the patient concerned had an issue with bile. She was no longer able to be sure that there had been more than one video call during which she had been able to hear the Registrant speaking with the control room.

18. At the end of the evidence and after submissions to the Panel on the facts, the HCPC applied to amend Particular 3 of the allegation to “one or more video calls” to reflect both Service User A’s witness statement and her oral evidence to the Panel. The Registrant opposed the application, on the basis that it would be unfair to amend the allegation now to accommodate the change in her evidence in light of criticism made by the HCPC in cross examination of the Registrant, that he had tailored his account to suit the evidence given during the hearing.

19. The Panel accepted the advice of the Legal Assessor that amendment can be made at any time provided that it does not cause unfairness. The Panel had in mind that fairness works both ways; in other words, the hearing must be fair to both the HCPC and the Registrant. The Panel also considered what effect their decision would have in the mind of a fully informed objective and reasonable observer; whether the grant or refusal would bring the regulatory process into disrepute.

20. The Panel decided that it would not be unfair to the Registrant to allow the amendment because:

(i) The plural necessarily includes the singular and so the amendment did not change the nature of the allegation to which the Registrant had to respond and to which he had been aware from the outset,

(ii) The proposed amendment simply adds the possibility that the Panel might find that there was only one incident instead of more than one which would be to the Registrant’s advantage,

(iii) The amendment reflects the oral evidence which was given in the hearing and the Registrant did not suggest that he would have presented his case differently if this part of the allegation had been worded at the outset to include the singular as an alternative to the plural, and

(iv) It is in the public interest for the Panel to consider and make a decision on this part of the allegation rather than have it fall away as a result of the way in which the allegation had been drafted.

Decision on Particular 3 as amended

21. Particular 3, as amended, alleged that; “between around 28 June 2020 and 20 September 2020 you engaged in one or more video calls with Service User A at times when you were at work as a paramedic and speaking on the radio with the control room.”

22. The Panel noted that there was no documentary evidence to support this part of the allegation that the Registrant engaged in video calls with Service User A at times when he was at work as a paramedic and speaking on the radio with the control room. There were neither screen shots nor a call list showing the dates and frequency of video calls. Therefore, the Panel was presented with the competing memories of Service User A and the Registrant as to what had taken place.

23. Service User A made a witness statement to the HCPC dated 4 November 2022, therefore more than two years after the events had taken place. She said; “I regularly spoke to Dean over Messenger video call. Every time this happened, Dean was parked up in his ambulance at work; he would not video call me at home in case his partner heard. I knew he was at work when he video called me, as I could always see that he was sat in his ambulance or car and wearing his uniform. Sometimes I would hear him talking on the radio, being told about jobs he would be attending – he would keep me on the video call but tell me to be quiet whilst he was speaking on the radio. I remember hearing the details of the incidents he was being called to, and sometimes the ages of the people involved. I could have heard addresses, although I don't really remember. I never heard the names of patients. Dean would keep me on the video call whilst he was driving to the patient's address, then would hang up when he arrived. He would often call me back after the job, so sometimes we would have several video calls in one night.”

24. Service User A’s earlier evidence to EMAS was consistent with this but contained little detail, stating only; “I heard him a few times speaking to the person on the radio”. In her oral evidence to the Panel, Service User A said that she could now only be sure that she had heard the Registrant on the radio “just once” and added some detail that she had not included in her evidence to either EMAS or the HCPC. Service User A told the Panel that the single incident she could remember was a patient with an issue with bile. The Panel was provided with no explanation why this detail had not been included in either of her written witness statements.

25. The Registrant has consistently denied continuing with a video call when simultaneously transmitting over the radio. He explained that the radio is encrypted in that nothing being transmitted to him would be audible to a bystander unless he engaged with a call by pressing a button and that therefore a third party could not accidentally overhear a call. The Panel found it inherently unlikely that the Registrant would simultaneously keep Service User A on a video call and also use the work radio because it would be easier to simply end the video call and call back once the job was complete. The Registrant explained that he would video call Service User A when on standby waiting for the next job to come through, but that in order to use the radio he would hang up because there is no mobile phone holder in the vehicle he used, so nowhere to put the phone other than on the seat where he would not be able to use it for video anyway. He also explained that he would not maintain a video call at the same time as using the navigation system in the car or when driving to an emergency call and there was no evidence to contradict this.

26. The Registrant explained that after a job he would often resume his contact with Service User A and sometimes she would ask what type of job he had just been on and he would explain, without breaching confidentiality. The Registrant thought that Service User A may have been mistaken in her recollection and was referring to one of these conversations. The Panel noted that Service User A supported the Registrant’s account to the extent that she said; “he would often call me back after the job, so sometimes we would have several video calls in one night.”

27. The Registrant was certain that he had never conducted a video call whilst on the radio and because of the clarity and consistency of his account the Panel preferred the Registrant’s version of events.

28. As a result, on the balance of probabilities, the Panel found this Particular of the allegation not proven.

Decision on Particular 4

29. Particular 4 alleged that; “on or around 28 June 2020 you suggested to Service User A that you should carry out an ECG on her when this was not clinically indicated”. The Registrant accepted that he had suggested an ECG but denied that it was not clinically indicated.

30. The Panel was not provided with an agreed definition of ‘clinically indicated’ and so gave the words their ordinary and natural meaning, read in their proper context. The Panel interpreted the words to mean whether the ECG offered by the Registrant could be justified as one of a range of reasonable clinical options available to him in the exercise of his professional judgement as a paramedic. In other words, the Panel asked itself if the HCPC had proved on the balance of probabilities that an ECG was an obscure or demonstrably inappropriate thing to suggest. The Panel took into account that paramedics are required to exercise their professional judgement. They have a degree of autonomy and must be able to justify the clinical decisions which they make.

31. In terms of what happened at the scene, there was no dispute that Service User A had experienced chest pain/tightness, and this was recorded by the Registrant on the patient care record. He had also recorded that he had offered to perform an ECG and that Service User A had declined it on the basis that she no longer had chest pain.

32. The Panel was referred to the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) clinical guidelines which are the national standards for health care professionals including paramedics. Specifically, the Panel had regard to the guidelines in place at the time on hyperventilation syndrome (HVS) and the guidance contained in the ‘Basic observations’ section; “if required, monitor and record a 12-Lead ECG, assess for abnormality, refer to Cardiac Rhythm Disturbance.”

33. The Panel also had regard to the flow chart and the warning that; “HVS is a diagnosis of exclusion… Differential diagnosis: Many life-threatening medical conditions can cause hyperventilation.”

34. The Registrant justified his actions by reference to the section of the JRCALC guidelines dealing with non-traumatic chest pain/discomfort in which there is specific reference to an ECG. The Panel noted the guideline recording; “there must be a high index of suspicion that any chest pain is cardiac in origin.” He also told the Panel that he was being thorough and was at pains to avoid a repeat of cases he had heard about where initially an underlying condition had not been identified.

35. In order to prove this Particular of the allegation, the HCPC relied on the evidence of LB, an experienced paramedic. The Panel took into account that he had conducted a paper-based review and that he had not been present at the scene. The Panel had no doubt that LB was doing his very best to assist the Panel and appreciated his candour in volunteering that his review was carried out after he had seen the explicit images that the Registrant had sent to the service user. In his oral evidence, LB explained that it had been difficult to remain objective having seen the messages. The Panel took the view that this was understandable but noted that as the HCPC did not allege that the Registrant’s decision to offer an ECG had been sexually motivated, it must be scrupulous to ensure that it assessed whether an ECG was clinically indicated on the basis of the clinical information alone.

36. In his oral evidence, LB was taken to Service User A’s patient care record which recorded that, at the start of the consultation, the service user had complained of chest pain/tightness. In those circumstances, LB accepted that to undertake an ECG was a valid option.

37. Based on the JRCALC guidelines, LB’s acceptance that an ECG was a valid option and the Registrant’s detailed explanation of his actions, the Panel concluded that an ECG was clinically indicated.

38. As a result, the Panel found this Particular not proven.

Decision on Particular 5

39. Particular 5 alleged that; “your conduct in relation to allegations 1 and 2 was sexually motivated”. The Registrant admitted that his conduct in respect of Particular 2 was sexually motivated and accordingly that was found proved.

40. The issue for the Panel to decide therefore was whether the Registrant’s motivation for finding Service User A’s name on social media was in order to pursue a future relationship or for sexual gratification. In order to decide whether the Registrant was sexually motivated, the Panel looked at the initial message sent on 28 June 2020. The content of the message was not sexual and the Panel discounted the fact that it was signed off with an ‘x’ as having any real significance because, whilst inappropriate, it is commonly encountered even in work communications and intended by those who use it simply as a sign of being friendly.

41. The Registrant explained that his sole motivation for making contact was to share details of a support group. That explanation was supported by the content of the initial messages on 28 June 2020, which contained information solely related to that topic. The next message that the Panel was provided with was not until 14 July 2020 and Service User A was unable to be sure if there had been other messages in between, let alone what they said.

42. The Panel’s task was made more difficult because the screenshots that it had been provided with by the HCPC were incomplete and not all were dated. The Registrant no longer had access to the messages and so was unable to fill the gaps. Service User A said that; “from memory, the messages became flirtatious and playful almost from the start. I remember Dean calling me 'cheeky' after only a few messages had been exchanged”. In oral evidence she was unable to identify precisely when the messaging had become sexual, or to show the Panel the messages that she was referring to.

43. As a result, the Panel finds, on the balance of probabilities, that this Particular of the allegation is not proven.

Decision on Grounds

44. The Panel accepted the Legal Assessor’s advice on the definition of misconduct. In particular, the Panel paid regard to the definition given by Lord Clyde in Roylance v General Medical Council (No.2) [2000] 1 AC 311: “Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances…”

45. The Panel had in mind that the misconduct must be serious and had regard to the guidance in Nandi v GMC [2004] EWHC 2317, where Collins J suggested that misconduct could be defined as: “conduct which would be regarded as deplorable by fellow practitioners…”.

46. The Registrant accepted that he had breached several of the standards of conduct required by a registered paramedic. The Registrant accepted that he had breached;

(i) Standard 1.7 you must keep relationships with service users and carers professional,

(ii) Standard 2.7 you must use all forms of communication appropriately and responsibly, including social media and networking websites and

(iii) Standard 9.1 you must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

47. The Panel had no doubt that contacting a service user via social media using details obtained through their treatment of them as a paramedic is inappropriate behaviour in itself and without more. In this case, the Registrant went further by then misusing that information to send explicit images to the service user. The Panel decided that an objective and fully informed observer would consider that behaviour to be deplorable and, therefore, the Panel finds that it is correctly categorised as misconduct.

Decision on Impairment

48. The Panel had to consider whether the Registrant’s fitness to practise is currently impaired, in light of the misconduct proven against him. The Panel had regard to the HCPTS Practice Note ‘Finding that Fitness to Practise is Impaired’ and has accepted the advice of the Legal Assessor. The Panel has also exercised the principle of proportionality.

49. The Panel is mindful of the forward-looking test for impairment. The Registrant gave evidence and was cross-examined on the issue of impairment. The Panel also heard oral character evidence from the Registrant’s current employer, SR. The Panel heard submissions on impairment from the HCPC and on behalf of the Registrant.

50. The HCPC submitted that:

i. With regard to the personal component of impairment, the Registrant had disregarded professional boundaries, and this was not an isolated incident in that explicit images had been sent and explicit exchanges had continued over a period of months. Therefore, there was a high risk of repetition.

ii. With regard to the public component, it was submitted that a member of the public would be shocked and troubled to learn that the Registrant was allowed to practice without restriction.

iii. It was open to the Panel to find that the Registrant was impaired on both the personal and public components.

51. The Registrant submitted that:

i. There was no question about the Registrant’s clinical competence and no risk of repetition.

ii. The Registrant had made admissions both to EMAS and the HCPC. He had acknowledged his behaviour was wrong and had shown remorse. He had reflected on what he had done wrong and what he should have done differently and had demonstrated insight. For example, he would have provided the information about the support group to Service User A in a different way. He understood the impact upon Service User A in terms of his behaviour diminishing her view of the healthcare profession.

iii. With regard to remediation, the Registrant had undertaken CPD courses around professional boundaries and lone working and had adapted his practice in light of what he had learnt, for example, by being conscious of his body language and manner when he was with service users. There had been no concerns about his behaviour since and he was working as an EMT which meant having contact with the public. The Panel’s attention was drawn to the positive testimony from SR that the Registrant was fantastic to work with and well respected. The Registrant understood the breach of professional boundaries and, in light of all the circumstances, an informed member of the public would understand why his ability to practice was not impaired. Indeed, it would be contrary to the public interest for the panel to find that he was impaired.

52. The Panel reminded itself that the misconduct admitted by the Registrant included sending at least nine sexually explicit photographs and at least one sexually explicit video to Service User A over a period of eleven weeks. The Panel took into account that Service User A consented to the exchange of images and that it had seen screenshots of messages in which she confirmed that she had not felt pressured to do so and that she had sent the first picture message to which the Registrant had then responded.

53. The Panel noted that Service User A had attended counselling (for matters predating the Registrant’s misconduct) and through discussing the relationship with her counsellor, she had come to realise that the Registrant’s behaviour was inappropriate. She told the Panel about the impact on her of the misconduct which included a fear of being treated by male health care professionals, something which had never been a concern to her before meeting the Registrant.

54. Service User A also told the Panel that she worried that she and her family might not receive the treatment they needed if the Registrant was on duty when they needed emergency care and he felt unable to attend. She also worried about the effect it would have on her if he did attend.

55. The Panel first considered the private element of impairment and asked itself if the Registrant’s acts which led to the allegation are remediable and whether they have been remedied. The Panel was satisfied from the evidence it had seen that the Registrant had remedied his misconduct and that the risk of repetition was very low for the following reasons;

i. The Panel saw evidence in the form of certificates establishing that he had successfully completed several courses addressing professional boundaries and working alone.

ii. The Registrant had written a timely letter of apology, albeit that his employer had declined to give it to Service User A. The Panel noted her surprise that she had not been allowed to decide for herself whether she should read the apology.

iii. The Panel accepted as genuine the Registrant’s evidence that he had applied what he had learned from the training and implemented it into his current practice. For example, he was less talkative and more aware of how his body language could be misinterpreted. He also told the Panel that he would consider ensuring that there was a chaperone present if it was felt desirable.

iv. Although the misconduct had persisted for 11 weeks, it related to a single service user and had occurred at a time in the Registrant’s life when he was exposed to a unique combination of challenges, including the isolation caused by the global pandemic.

v. The misconduct represented an aberration in an otherwise unblemished career with the ambulance service for 19 years, and as a qualified paramedic since 2012. The Panel was provided with a number of impressive testimonials addressing both the Registrant’s general character and his current working practices.

vi. The Registrant had shown acceptable insight into the effect of his misconduct on Service User A and the damage done to the profession and the public’s trust in the profession.

56. The Panel had regard to the public component of impairment and concluded that a reasonably well-informed member of the public would be shocked to learn that the Registrant’s current fitness to practise had not been found to be impaired, given the nature of his misconduct and the sexual misconduct.

57. The Panel concluded that the Registrant’s actions have brought the reputation of the paramedic profession into disrepute, and that he has breached a fundamental tenet of the profession. The Panel also had regard to the need to uphold proper standards of behaviour and concluded that the public component of impairment is clearly established. The Panel had no doubt that confidence in the paramedic profession would be undermined if there was no finding of impairment given the nature of the misconduct which has been identified.

Decision on Sanction

58. The Panel has heard submissions on sanction on behalf of the HCPC and on behalf of the Registrant.

59. The HCPC identified the following aggravating features;

(i) The pattern of unacceptable misconduct went on for 11 weeks,
(ii) There was a significant number of messages, including explicit sexual content,
(iii) The Registrant abused his professional position to obtain Service User A’s contact details and
(iv) Service User A was vulnerable as a result of her pre-existing health issues and the fact that she was having counselling.

60. The Panel also had regard to submissions from the Registrant, in relation to sanction;

(i) The Registrant had lost his employment as a paramedic in July 2022,
(ii) In September 2022 he was made subject to an interim order of suspension following the HCPC’s application for an interim order, and therefore has been suspended for 16 months already,
(iii) The Registrant has been successfully employed since August 2023 as an Emergency Medical Technician (EMT) and his employer, SR, gave evidence to the Panel of the high regard in which he is currently held,
(iv) Although the misconduct represented a course of conduct over 11 weeks, it was a three-month period of misconduct in an otherwise unblemished career with the ambulance service for 19 years, and as a qualified paramedic since 2012,
(v) Although the misconduct had persisted for 11 weeks, it related to a single service user and had occurred at a time in the Registrant’s life when he was exposed to a unique combination of challenges, including the isolation caused by the global pandemic.
(v) He again expressed remorse and apologised, and,
(vi) The Panel has found that the risk of repetition is very low.

61. The Panel has had regard to the HCPC Sanctions Policy and has accepted the advice of the Legal Assessor. The Panel paid particular attention to the principal of proportionality and the need to strike a careful balance between the protection of the public interest and the rights of the Registrant.

62. The Panel has also reminded itself that the purpose of fitness to practise proceedings is not to punish registrants but to protect the public and to maintain high standards amongst registrants and public confidence in the profession concerned.

63. The Panel noted that a relationship between a registrant and service user or carer is based upon trust, confidence and professionalism. However, it is also a relationship in which there is an unequal balance of power, in favour of the Registrant. Whilst Registrants should endeavour to have positive relationships with service users and carers, it is essential that they remain aware of this dynamic and take care not to abuse their position.

64. The Panel considered whether the Registrant’s professional status had been a coercive factor in the relationship between the Registrant and Service User A. The Panel concluded that there was no evidence that the Registrant had used his position as a paramedic to coerce Service User A into a relationship, above the fact that he would not have encountered her but for his attendance at her home in the course of his employment as a paramedic. The Panel decided that the evidence indicated that it was their shared experience of having children that was likely to have caused the initial bond and that thereafter the attraction was mutual.

65. Sexual misconduct is a very serious matter which has a significant impact on the public and public confidence in the profession. The Panel went onto consider whether the Registrant’s behaviour could properly be described as predatory. The Panel noted the Sanctions Guidance which states that; “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.”

66. The Panel decided that the Registrant’s behaviour was not properly described as predatory because his original approach to Service User A had not been sexually motivated. The Panel had carefully considered the evidence in respect of the allegation that the motivation for his initial contact was sexual and had found it not proven. Having heard the evidence, the Panel decided that it was a genuine attempt to reach out to another parent struggling to care for a child.

67. The Panel recognised that given the unequal balance of power between registrants and service users or carers, any service user or carer accessing treatment is vulnerable to some extent. However, a service user or carer is considered particularly vulnerable if they are unable to take care of themselves or are unable to protect themselves from significant harm or exploitation. As set out in the Sanctions Guidance, this might include factors such as:

• mental illness (including dementia);
• age (for example, children under 18 or the elderly);
• disability;
• lack of capacity;
• history of abuse or neglect;
• bereavement.

68. The Panel was satisfied that none of these features applied to Service User A.

69. The Panel noted the Sanctions Guidance permits a panel deciding whether a substantive sanction is proportionate, to take into account any interim order and its effect on the registrant. In this case, the Registrant has already been suspended for a period of 16 months. The Panel considered whether that meant that it would be disproportionate to impose a further sanction but in light of the aggravating factors, and with regard to the HCPC Sanctions Policy, the Panel decided that given the serious nature of the Registrant’s misconduct, that to take no action or to impose a Caution Order would not retain public confidence in the regulatory process or have the necessary deterrent effect on other registrants. The Panel further concluded that public confidence in the profession would be undermined by imposing either of these sanctions, given the seriousness of the Registrant’s misconduct. The Panel was sure that a fully informed and objective member of the public would not think it appropriate for there to be no sanction or a Caution Order bearing in mind the sexual nature of the misconduct, notwithstanding that the Registrant has been suspended for 16 months in the interim while awaiting this hearing.

70. The Panel next carefully considered whether to impose a Conditions of Practice Order. The Panel struggled to identify any conditions which would address the need to uphold proper standards, to deter other practitioners and to maintain confidence in the profession and the regulatory process.

71. The Panel next considered whether to make a Suspension Order. The Sanctions Policy suggests that a Suspension Order is appropriate where there are serious concerns which do not require the registrant to be struck off, but where the concerns cannot be addressed by a Conditions of Practice Order. The Panel concluded that this was an appropriate sanction to address the public interest concerns which the Panel identified.

72. The Panel took account of the Sanctions Guidance that “short-term suspensions can also be appropriate in cases where there is no ongoing risk of harm, but where further action is required in order to maintain public confidence in our professions.” Having regard to the fact that the Registrant has already been suspended for 16 months, the Panel determined that the Suspension Order should be imposed for a period of six months.

73. Having arrived at an appropriate sanction, the Panel concluded that to impose the more restrictive sanction of a Striking Off Order would be unnecessarily punitive and disproportionate. The Panel noted that striking off should be reserved for cases where there is no other way to protect the public and in this case the Panel determined that the proportionate level of public protection would be achieved by the lesser sanction of a Suspension Order.

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

Interim Order

1. The Panel considered the HCPC’s application for an Interim Order, pending the coming into force of the Suspension Order.
2. The Panel makes an Interim Suspension Order, because it is necessary to protect the public interest. The Panel has found that the Registrant is currently unfit to practise without restriction but without an interim order he would theoretically be able to do so, pending an appeal and the Panel has decided that it would not be appropriate to leave that possibility open at this time.
   
   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 Mr Dean P Carey