Mr Simon T Standen

Preliminary Matters:

Conflict of interest
1. At the outset of the hearing, the chair indicated that 2 members of the Panel had raised matters which might give rise to a conflict of interest.

2. Ms Bainbridge made the following disclosure:
“I am currently employed by North East Ambulance Service as a paramedic. I am aware that PAF is also currently employed by North East Ambulance Service as a consultant paramedic, PAF was appointed as the leading fact finding officer in Allegations against the Registrant in 2018. I have not worked directly with PAF, I am aware of his role within North East Ambulance Service.”

3. Dr Brown made the following disclosure:

“I worked at Yorkshire Ambulance Service as Head of Corporate Affairs and then Head of Assurance, retiring in 2012. In those roles I managed variously legal matters - complaints, claims, inquests - and I may well have been involved in cases where a registrant was referred to the HCPC.

I do not know the Registrant and had left before he was employed by the Trust in 2016. The incident in question was in 2018 - so six years after I left.

I recognise the name of the senior HR adviser - LH - but do not know her and can not recall working with her.

I recognise the name of JM, Divisional Commander, who was the commissioning manager for the external investigation. I worked with him a little. There is no other reference to him in the papers.

I recognise the name of Dr JM, Medical Director - I did work with him but he is simply mentioned in the papers as signing off the PGDs - which is to be expected of the medical director.

I have had no contact with the Trust since I retired, other than naming it as a referee on occasion. I have not done this since 2016.”

4. Dr Brown confirmed that she had no continuing relationship with the Yorkshire Ambulance Service and was not likely to ask the service for a reference in the future.

5. Mr Corrie drew the Panels attention to the relevant law including the test set out in Magill v. Porter [2001] UKHL 67 and the guidance given in Suleman v GOC [2023] EWHC 2110. The Panel was assisted by Mr Corries’ submissions and deals with the authorities in its decision.

6. Mr Corrie submitted that there was no dispute about the evidence of PAF and accordingly no issue where Ms Bainbridge could appear biased to a “fair minded and informed observer”.

7. With regard to Dr Brown, he submitted that that no apparent bias arose because Dr Brown had ceased to be employed by the Yorkshire Ambulance Service in 2012, had no continuing relationship with the Yorkshire Ambulance Service, and had no expectations of a future relationship with that service.

8. The Registrant indicated that he had no objection to either member of the Panel hearing this case.

9. The Panel heard and accepted the advice of the Legal Assessor, which it has followed in its approach set out below.

10. The Panel bore in mind the test in Magill v. Porter (above) “The court must first ascertain all the circumstances which have a bearing on the suggestion that the judge was biased. It must then ask whether those circumstances would lead a fair-minded and informed observer to conclude that there was a real possibility, or a real danger, the two being the same, that the tribunal was biased."

11. In the case of Ms Bainbridge, the Panel noted that Ms Bainbridge now worked in the same ambulance service as PAF, who was the leading fact-finding investigator in the Yorkshire Ambulance Services NHS Trust ("the Trust") investigation into the matters giving rise to Particular 1 of the Allegation. The Panel found this was a large organisation and there was no suggestion that Ms Bainbridge knew him personally or worked closely with him. In addition, the Panel noted that PAF is not a witness of fact and his evidence is not in dispute.

12. Accordingly, the Panel decided that there was no conflict of interest or question of apparent bias in respect of Ms Bainbridge.

13. With regard to the position of Dr Brown, the Panel bore in mind the importance, highlighted by the court in Suleman v GOC (above), of ascertaining how long ago she had been employed by the service, the extent of her continuing link to the service and the likelihood of her having a relationship with the service in the future.

14. The Panel found that the length of time that had passed since Dr Brown had left the Ambulance service and the absence of any continuing relationship or hope of future benefit to her, meant that no conflict of interest or question of apparent bias arose in respect of Dr Brown. In addition, the names recognised by Dr Brown were not witnesses in this matter.

Application to hear part of the hearing in private

15. The Registrant indicated that part of the evidence in this case related to his heath and applied for those parts of the evidence to be heard in private.

16. Mr Corrie did not object to the application.

17. The Panel accepted the advice of the Legal Assessor, which it incorporated into the decision set out below.

18. The Panel took into account the HCPTS Practice Note entitled “Conducting Hearings in Private” and had regard to Rule 10(1)(a) of the Health and Care Professions Council (Health Committee) (Procedure) Rules 2003, which provides that “proceedings shall be held in public unless the Committee is satisfied that, in the interests of justice or for the protection of the private life of the Registrant, the complainant, any person giving evidence or of any patient or client, the public should be excluded from all or part of the hearing.”

19. The Panel concluded that it should hear in private those parts of the case that relate to the Registrant’s health but that all other evidence and submissions should be heard in public.

Amendment

20. The Panel heard an application to amend the Allegation as set out above. The Panel granted that application for the reasons set out in Annex A.

Hearsay

21. The Panel heard an application to admit the evidence of Colleagues 1, 2 and 3 by admitting the records of their interviews during the Trust investigation. The Panel granted that application for the reasons set out in Annex B

Admissions

22. After the preliminary matters had been dealt with, the Chair invited the Registrant to indicate whether he wished to make any admissions in respect of the Allegation.

23. The Registrant indicated that he admitted Particulars 1a) in relation to midazolam, 1b), 1c), Particular 2 in its entirety and Particular 3.

Background and matters not in dispute:

24. The Registrant is registered with the HCPC as a Paramedic. The Registrant was employed by Yorkshire Ambulance Services NHS Trust ("the Trust") as a Consultant Paramedic between 01 July 2016 and 28 July 2021.

25. On 25 March 2021, the HCPC received a referral from the Trust raising concerns, that:
a) On 13 April 2018 the Registrant had administered medication whilst on duty, outside of a patient group directive, and
b) On 5 October 2021, the Registrant had been convicted of two offences: Offering to Supply a Class A drug between 1 March 2021 and 31 July 2021, (both dates corrected to 2020) and Possession of a Class A drug, on 20 July 2020.

26. The first part of the referral gives rise to Particulars 1, 3 and 4 of the Allegation.

27. There is no dispute that, on 13 April 2018, the Registrant was on duty and attended a road traffic accident to support an ambulance crew and solo responder. A 60 year old man (Patient A) had been knocked to the road and suffered a significant head injury.

28. The Registrant, ambulance crew and solo responder formed the view that Patient A needed to be taken to hospital as soon as possible because of his head injury. However, they encountered considerable difficulties because the patient appeared agitated and “combative”. The Registrant formed the view that he needed to administer midazolam and ketamine to the patient in order to facilitate his safe transfer to hospital.

29. The Registrant was not in a position to prescribe the medication himself, relying solely upon his judgment, because, although he was registered with the NMC as a nurse and had completed his qualification as a prescriber, he was not authorised to carry out this role whilst working for the Trust as a Consultant Paramedic. Accordingly, he needed to satisfy himself that he was authorised to administer the medication by a Patient Group Direction (PGD) and/or that he had authorisation from a Medical Incident Commander (MIC).

30. The Registrant made a telephone call to the Trauma desk at approximately 10:49 to try and make contact with an MIC but was unable, initially, to do so. After a short delay, of approximately five minutes, the Registrant started administering firstly the ketamine to Patient A, followed by midazolam shortly afterwards, titrating the dose and observing with his colleagues, Patient A’s vital signs whilst doing so.

31. At 11.10 the MIC telephoned the Registrant who started to explain the position and his opinion that the medications set out above were required. The MIC indicated that he would not sanction the administration of midazolam, but he would leave that to the Registrant who would have to justify his decision in due course.

32. When this was said, the Registrant terminated the telephone call and returned to Patient A. He did not tell the MIC that he had already started to administer midazolam (or ketamine) to Patient A.

33. In accordance with established practice, where medication is administered without the authorisation of either a PGD or an MIC, the matter was referred to a Clinical Case Review (CCR) by the Trust. The Panel deals below with the evidence collected by that investigation.

34. On 20 July 2020 police attended the Registrant’s home address and recovered 431g of methylamphetamine, a controlled drug of Class A.

35. The police examined a large number of messages exchanged by the Registrant, on a social networking and online dating application, including, but not limited to those on a fake account set up by a former partner.

36. The significance of the messages is that they show that on a number of occasions, over a five-month period, the Registrant offered to supply methylamphetamine to people he intended to meet and have sex with. On more than one occasion he offered to inject the drug.

37. On one occasion, in a message on the fake account he offered to inject the person he was messaging, and said he had done so before and added, “yes (I'm also a paramedic so needles in the veins are key skills lol.). The Panel noted that the Registrant also made reference to being a paramedic in another message to a different individual on 16 July 2020.

38. There is no suggestion that the Registrant actually supplied drugs for money and no evidence that he actually provided the drug or injected anyone.

39. These matters form the basis of Particular 2 of the Allegation.

The evidence before the Panel

40. An investigation report was produced within the Trust on 22 August 2018 based in large part upon a number of interviews carried out between 12 July and 15 August 2018 with the Registrant, the MIC, (referred to throughout these proceedings as Colleague 2) as well as the other ambulance personnel present at the scene. The Panel saw a heavily redacted copy of that report.

41. The Panel saw the following documents created during that investigation:
a. An interview dated 12 July 2018 of Colleague 1, (an ambulance technician) present at the incident of 13 April 2018;
b. An interview dated 12 July 2018 of Colleague 2, the MIC referred to above;
c. An interview dated 12 July 2018 of Colleague 3, an ambulance paramedic present at the incident of 13 April 2018;
d. An interview dated 15 August 2018 with the Registrant.

42. The Panel also saw a number of other documents which came into existence between the time of the incident on 13 April and the investigation:
a. An undated document entitled Specialist Paramedic Emergency Care Clinical Practice Audit Form (practice audit form).
b. A statement by the Registrant dated 23 April 2018.

43. The Panel also saw copies of PGDs relating to the administration of both midazolam (dated June 2019) and ketamine (dated September 2018).

44. With regard to Particular 2 of the Allegation, the Panel saw the Memorandum of Conviction from the Magistrates’ Court and the evidence assembled and summarised by the police. The Memorandum of Conviction showed that on 5 October 2021 the Registrant pleaded guilty and was sentenced to 12 months imprisonment suspended for 12 months with a Rehabilitation Activity Requirement.

45. The Panel also saw two written statements by the Registrant and a number of documents related to his life since he was sentenced by the Magistrates’ Court. The Panel heard the Registrant give evidence.

46. The Panel deals with the Registrant’s evidence when considering each Particular of the Allegation. Nonetheless, it is right to record that the Panel compared his evidence with the contemporaneous documents relating to Particulars 1, 3 and 4 of the Allegation and found that there were no significant discrepancies between the Registrant’s evidence and those documents. The Panel found that the Registrant’s account in his written statement and tested in cross examination was a consistent and credible account and the Panel accepted his evidence.

47. The Panel heard submissions from Mr Corrie and the Registrant. It deals with those submissions, where necessary when dealing with each particular of the Allegation.

48. The Panel accepted the advice of the Legal Assessor which it followed in its approach set out below.

The Panel’s approach

49. The Panel bore in mind that, at this stage, the burden of proving each Particular of the Allegation rests upon the HCPC. The Registrant does not have to prove anything. It reminded itself that the standard of proof is the civil standard, that is to say the balance of probabilities.

50. There is no provision in the rules that matters admitted are automatically found proved. However, the Panel should give appropriate weight to any admissions when considering each Particular of the Allegation.

51. The Panel bore in mind that misleading is an ordinary English word meaning giving the wrong idea or impression. It is an objective test that does not depend upon the intent of the Registrant or proof that anyone was actually mislead.

52. In respect of the allegation of dishonesty, the Panel had regard to the test laid down by the Supreme Court in Ivey v Genting Casinos (UK) Ltd 2017 UKSC 67
a. “When dishonesty is in question the fact-finding tribunal must first ascertain-(subjectively) the actual state of the individual’s knowledge or belief as to the facts.
b. The reasonableness or otherwise of his belief is a matter of evidence (often in practice determinative) going to whether he held the belief, but it is not an additional requirement that his belief must be reasonable; the question is whether it is genuinely held.
c. Once his actual state of mind as to knowledge or belief as to facts is established, the question whether his conduct was honest or dishonest is to be determined by the fact-finder by applying the (objective) standards of ordinary decent people. There is no requirement that the defendant must appreciate that what he has done is, by those standards, dishonest.”

53. The Panel also bore in mind the direction given to Panels by the High Court that a finding of dishonesty must be based on “solid ground” or “cogent evidence”. (Fish v General Medical Council [2012] EWHC 1269 (Admin) and Lawrence v General Medical Council [2015] EWHC (Admin). This has been repeated most recently in Nigeria v PID Limited [2023] EWHC 2638 (Comm) in which the court set out the need for “convincing evidence”, to support a finding of dishonesty.

54. The Panel also reminded itself that the Registrant is a person against whom there has been no previous finding of dishonesty. It bore in mind that this cannot be a complete defence to an allegation of dishonesty but it is something it should take into account in the Registrant’s favour when deciding if he has been dishonest and what weight it should give to his evidence.

Decision on Facts:

Particular 1a)

Proved in relation to midazolam only.

55. With regard to midazolam the Panel had regard to the PGD for midazolam put before the Panel, which showed that midazolam was not indicated for patients with significant head injury. The Panel noted that this PGD was dated 2019. Nevertheless, the Registrant accepted in his evidence that the PGD applicable at the time contained the same exclusion and that is why he had sought the authorisation from the MIC.

56. The Panel also noted the Registrant’s evidence that he was not authorised to prescribe within the Trust although he was a nurse prescriber. The Panel also had regard to the Registrant's admission to this part of the Allegation.

57. Accordingly, the Panel found Particular 1a) proved in relation to midazolam.

58. Turning to the administration of ketamine, the Panel found that the position was far less clear. The Panel noted that the PGD relating to ketamine which was put before it was dated September 2018 and that document did allow for the administration of ketamine in the circumstances in which it was administered.

59. The Panel heard and accepted the evidence of the Registrant that when he attended the scene and administered ketamine, he believed he was authorised to do so by the PGD. The Panel also noted that Colleague 2 (the MIC), when interviewed by the Trust investigation on 12 July 2018 confirmed that his conversation with the Registrant was limited to obtaining permission to administer midazolam.

60. The Panel also heard and accepted the evidence of the Registrant, which was not contradicted by any evidence of the HCPC, that there was considerable confusion about which PGD to follow. In respect of ketamine, the Registrant explained that there was a previous PGD but that had expired in 2014. The Registrant was responsible for drafting PGDs at the Trust and a new draft of the ketamine PGD was ready for approval but had not yet been formally signed off. However, the Registrant told the Panel that the air ambulance service and the Hazardous Area Response Team (HART) were already using that new draft PGD because it was based on current best practice. The Panel accepted the Registrant's evidence that at the time he was the clinical lead for those services. In respect of midazolam, the Registrant accepted that his use of the medication fell outside any PGD at that time.

61. The Panel noted that on the practice audit form the Registrant had completed shortly after the events of 13 April 2018, he had put that he had administered ketamine outside the PGD. Nevertheless, it accepted his explanation that he had thought he was applying the correct PGD on 13 April 2018 but when filling in the audit form he had looked on the website and found only an old PGD which would not have authorised the administration of ketamine. In those circumstances he felt it safer to put in the practice audit form that he had administered ketamine in breach of the PGD.

62. Taking all these matters together and reminding itself that the burden of proving this Allegation rested on the HCPC, the Panel was not satisfied that the Registrant had administered ketamine without authorisation from the PGD. To make that finding the Panel found it would have to reject the Registrant’s explanation, which it did not.

63. Accordingly, the Panel found Particular 1a) not proved in respect of ketamine.
Particular 1b)
Found proved

64. The Panel had regard to the account given to the Trust investigation by Colleague 2 (the MIC) which indicated that he had not being made aware that any medication had already been administered. The Panel also had regard to the Registrant's statement to the investigation, his interview by the Trust investigation and his evidence to the Panel. At all times, the Registrant was clear that he had not informed Colleague 2 (the MIC) that medication had already started to be administered. The Panel in particular noted his explanation that Colleague 2 (the MIC) had said that if he went ahead he would have to justify his decision at a later date. He was confident that he could do that and ended the call because he had a patient to care for and “I didn't want to get into a long debate”.

65. In those circumstances the Panel was satisfied that, whatever his reasons were, the Registrant had in fact withheld the information from Colleague 2 (the MIC).

66. Accordingly, the Panel found Particular 1b) proved.

Particular 1c)
Found proved

67. The Panel read for itself the practice audit form referred to in Particular 1c) and was satisfied that the entries on that form did not state that the Registrant had administered drugs prior to the discussion with the MIC.

68. Accordingly, the Panel found Particular 1c) proved.

Particular 2
Found proved in its entirety.

69. The Panel reminded itself of Rule 10 (1) (d) which provides that: where the Registrant has been convicted of a criminal offence, a certified copy of the certificate of conviction (or, in Scotland, an extract conviction) shall be admissible as proof of that conviction and of the findings of fact upon which it was based”.
70. The Panel saw the Memorandum of Conviction and had regard to the Registrant’s admissions.
71. With regard to Particular 2a), the Panel saw the messages that the Registrant exchanged on his social media account and the admissions that he made to the police. The Panel is satisfied that these matters set out fairly summarise the findings of fact upon which the Registrant’s conviction was based and has set them out in sufficient detail in the background section above.
72. Accordingly, the Panel finds Particular 2 proved.
Particular 3
Found proved in relation to 1b) only.
73. The Panel had regard to the account of the conversation between the Registrant and Colleague 2 (the MIC), set out in the Registrant’s statement to the Trust, the accounts given by the both the Registrant and Colleague 2 (the MIC), when interviewed during the Trust investigation, and the account given by the Registrant to the Panel. The Panel found these to be broadly consistent with one another.
74. The Panel also had regard to Mr Corrie’s careful submission that the purpose of the telephone call to Colleague 2 (the MIC) was to obtain permission to administer midazolam and the question of whether or not the medication had already been administered was clearly relevant to that purpose.
75. The Panel also had regard to the Registrant's admission that by not making it clear to Colleague 2 (the MIC) that medication had already been administered, his explanation of the situation had been misleading.
76. The Panel agreed with the submissions and the Registrant's admission. It also accepted the evidence that the account he had given to Colleague 2 (the MIC) had, understandably, misled him into believing that the medication had not yet been administered when he spoke to the Registrant.
77. Accordingly, the Panel found Particular 3 proved in relation to 1b).
Found not proved in relation to 1c)
78. The Panel examined the practice audit form and had regard to Mr Corrie’s submissions. Mr Corrie submitted that the audit form was misleading because it did not show that the conversation with Colleague 2 (the MIC) took place after the administration of medication had taken place and would leave anyone reading it with the impression that the conversation took place first and that medication had been administered afterwards.
79. The Panel also had regard to the written admission of the Registrant that the audit form “could be viewed as misleading”. The Panel also noted that the Registrant had made an admission in respect of the whole of Particular 3.
80. Nevertheless, the Panel examined the evidence about the purpose of the audit report and its role in the Trust procedures. The HCPC adduced no evidence as to the purpose of the form, the role it was intended to play or even who was intended to read it. In those circumstances, the only evidence before the Panel came from the account given by the Registrant which could not be challenged and which the Panel found to be a credible account.
81. The Registrant told the Panel, and the Panel accepted, that in his role as a Consultant Paramedic he had drafted this form for the purpose of personal development and to enable colleagues to share learning experiences. The Panel noted that this document was indeed put before the Trust investigation but there is no evidence that it was prepared for the purpose of that investigation. On the contrary, the Panel saw that the Registrant prepared a statement for the Trust investigation on 23 April 2018, in which he set out the correct sequence of events.
82. In those circumstances, the Panel found that the practice audit form was not intended to be a chronological account of the events of 13 April 2018. The Panel found that it is supported in this view by the contents of the audit form which show that a number of the matters recorded in each section are not themselves in chronological order. The Panel concluded that it was likely that this document was indeed a reflective document focused on the difficulties of complying with apparently conflicting PGD's and obtaining timely support from MICs, rather than a record of the events of 13 April 2018.
83. The Panel accepted that whether or not something is misleading is an objective test but in particular when one is looking at omissions and chronology it has to consider the purpose of the document itself. The Panel was of the view that many documents may not have an accurate chronology of the events of 13 April 2018 and yet not be misleading, unless the purpose of the document required that.
84. The Panel noted that the Registrant accepted in cross examination that the document should be accurate, but that does not assist the HCPC to establish that the document is misleading in circumstances where there is no evidence that the document was required to address the chronology of events.
85. Accordingly, the Panel finds Particular 3 not proved in respect of 1c).
Particular 4
Not proved in relation to 4a).
86. The Panel reminded itself of the Registrant's evidence about the conversation with Colleague 2 (the MIC). He stated that he had tried to contact the MIC, and there had been a considerable delay before Colleague 2 (the MIC) telephoned back. The Panel accepted that the Registrant had expected to give his account somewhat earlier than he did and began by describing the circumstances in what he called his “hand over” in the same way that he had intended to do several minutes before, because he had been “caught off guard”.
87. The Panel found that there is no dispute that Colleague 2 (the MIC) did not sanction the administration of midazolam, as the Registrant had expected. He said that the Registrant could do as he chose but would have to justify it in due course. The Registrant accepted that it would have been better if he had explained at that time that he had already started to administer midazolam. The Registrant was consistent from the outset that his intention in ending the call, with the MIC, early was so that he could get back to the patient. He was responsible, with the other members of the team present, for a patient with significant head injuries, and having started the administration of the medication before Colleague 2 (the MIC) called him, he was already prepared to justify his actions at a later review. In those circumstances, he did not wish to become “drawn into a debate” which would have only distracted him from the case in hand.
88. The Panel had regard to Mr Corrie’s submissions that the Registrant knew he had administered or started to administer medication before he had the conversation with the MIC. He also submitted that the Registrant had expected his plan to be approved, and indeed the Registrant had given evidence to the Panel that he had never had a plan which a MIC had refused to sanction, and he knew that his decision would be scrutinised. Mr Corrie also reminded the Panel that others could care for the patient and support his transfer to hospital. In those circumstances, Mr Corrie submitted that the Registrant’s clear purpose was to give a false impression to the MIC.
89. The Panel considered this submission with care and concluded that it was one possible explanation of what occurred, but the evidence was not sufficient to persuade the Panel that it was the more likely explanation. On the contrary, the Panel found the Registrant’s explanation compelling and accepted it.
90. Accordingly, the Panel found Particular 4a) not proved.
Not proved in relation to 4b).
91. The Panel reminded itself that the HCPC put the allegation of dishonesty on the basis that the Registrant intended to mislead the reader of the practice audit form by giving the impression that that he had spoken to the MIC before he administered the drugs.
92. The Panel has already set out above that the HCPC did not produce any evidence regarding the purpose of the practice audit form or who was intended to read it. The Panel also had regard to the evidence of the Registrant, supported by the contemporaneous documents, that he reported to the Trust the true sequence of events in a statement dated 23 April 2018. The Registrant could not recall the exact date he had filled in the form but accepted that it was probably shortly before he made his statement. He maintained that he did not intend to mislead anybody and there would have been no point because he put the full picture before the Trust shortly afterwards.
93. Mr Corrie submitted that the practice audit form was written before the Registrant had made his statement and was a carefully drafted document and that the only explanation for its contents was that the Registrant intended to give the impression that his conversation with the MIC took place before he administered the medication.
94. The Panel concluded that Mr Corrie’s submission was one plausible explanation for what was written, but the Panel found that there was insufficient evidence that it was the most likely explanation, in particular in the absence of any evidence as to the purpose or intended readership of the practice audit form.
95. The Panel concluded that it was at least equally likely that the Registrant intended to be open and honest with the Trust investigation, as indeed he appears to have been, and that the form was simply dealing with other matters in the way the Panel has described above.
96. Accordingly, the Panel finds Particular 4b) not proved.
Decision on Grounds:
97. Having found proved the facts set out above, the Panel considered whether the Registrant’s fitness to practise is currently impaired by reason of misconduct and/or the conviction proved at Particular 2.
Evidence
98. The Panel heard evidence from the Registrant, and submissions from Mr Corrie and the Registrant. The submissions and evidence related to both misconduct and impairment, but the Panel has decided that its decision will be clearer if it deals with the issues separately.
99. There is no dispute that the Panel’s findings at Particular 2 amount to “a conviction or caution in the United Kingdom for a criminal offence” under Article 22 of the Health Professions Order 2001. Therefore, the Panel first considered whether those facts proved at Particulars 1 and 3 amounted to misconduct.
100. The Panel had regard to the written and oral evidence of the Registrant which he gave during the fact stage and further oral evidence he gave to the Panel at this stage.
101. In his evidence regarding misconduct, the Registrant acknowledged that the purpose of the PGD was to ensure a good standard of care to patients and that by acting outside it he was giving medication without authority and outside the Trust’s governance mechanism. He told the Panel that he was qualified to prescribe the medication but was not authorised to do so within this role. He also emphasised that he was acting in the best interests of the patient at the time and in accordance with national best practice.
102. With regard to his conversation with Colleague 2 (the MIC), the Registrant accepted that he had breached his obligation to share information with colleagues and reminded the Panel that he had set out the circumstances in his written submissions.
Submissions
103. The Panel also had regard to the submissions of Mr Corrie, who first set out the law relevant to a finding of misconduct. He reminded the Panel that there is no statutory definition of misconduct and drew the Panel’s attention to the judgement of Lord Clyde in Roylance and General Medical Council (No.2) [2000] 1 A.C. 311 stated at paragraph 38 that:
“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed.....in the particular circumstances.”
104. He also submitted that in order to give rise to a finding of impairment, misconduct must be “serious” and he drew the Panel’s attention to the decision of Lord Clyde in Rylands v General Medical Council [1999] Lloyd's Rep Med 139 at 149, where he described it as “a falling short by omission or commission of the standards of conduct expected among medical practitioners, and such falling short must be serious”. The adjective “serious” must be given its proper weight, and in other contexts there has been reference to conduct which would be regarded as deplorable by fellow practitioners.
105. He added that the categories of the seriousness are not closed and the appropriate standard is for the Panel to decide.
106. Mr Corrie submitted that the Panel's findings at Particular 1a) relating to the administration of midazolam amounted to misconduct that is serious. He submitted that the purpose of the PGD forms (which authorise the use of medications by paramedics) is to ensure a good standard of care to patients and that by acting outside the PGD and so outside the governance mechanism there was an inherent risk to patient safety. He submitted that this represented a breach of paragraph 3.4 of the HCPS Standards of conduct, performance and ethics (the Standards of conduct), which provides that:
3.4 You must keep up to date with and follow the law, our guidance and other requirements relevant to your practice.
107. Mr Corrie submitted that this was more than a technical breach even if the Registrant was acting in the best interests of the patient as he saw them.
108. Turning to the Panel’s findings at Particulars 1b) and 3, Mr Corrie submitted that this also amounted to misconduct that was serious. He submitted that this represented a breach of paragraph 2.6 of the Standards of conduct which provides that,
2.6 You must share relevant information, where appropriate, with colleagues involved in the care, treatment or other services provided to a service user.
109. Mr Corrie submitted that the Panel should bear in mind that the purpose of the Registrant’s telephone call to the MIC was to discuss medication, and by omitting the information that he had already started to administer medication and giving a misleading impression to the MIC, he made the MIC’s input less useful.
110. Mr Corrie did not invite the Panel to find that Particular 1c) amounted to serious misconduct.
111. The Panel also heard and accepted the advice of the Legal Assessor, which it followed in the decision set out below.
The Panel’s decision
112. The Panel then considered whether the matters proved at Particulars 1 and 3 amounted to misconduct. The Panel reminded itself that misconduct is an ordinary word reflecting behaviour that falls below the standard expected of a registrant in the circumstances in which he was carrying out his duties.
113. The Panel had regard to the Standards of conduct and reminded itself that only misconduct that is serious can give rise to a finding of impairment.
114. The Panel found that the matter found proved at Particular 1a) amounted to misconduct. The Registrant was outside of the PGD and although acting in the individual patient’s best interests there was a breach in the Standards of conduct because he stepped outside the protections of the Trust’s clinical governance. This constituted a breach of 3.4 of the Standards of conduct.
115. The Panel then went on to consider whether its findings amounted to misconduct that was serious. It concluded that it did not for the following reasons: although the Panel found that the Registrant was acting outside the PGD, the Panel accepted that he was acting within his knowledge, skills and qualifications and acted in the best interests of a patient. The Registrant administered the medication after he had telephoned for authorisation and waited for a reply. The Panel notes that the decision to administer midazolam was one that subsequently the MIC had refused to sanction remotely, and the MIC told the Registrant that if the Registrant decided to administer the medication then the Registrant would have to justify that decision.
116. With regard to its findings at Particulars 1b) and 3, the Panel found that the Registrant did breach paragraph 2.6 of the Standards of conduct and that the truncated telephone call did mislead the MIC. The Panel was satisfied that this falls below the standard of conduct expected of a Registrant and amounts to misconduct.
117. The Panel then considered whether this amounted to misconduct that was serious. The Panel reminded itself that it had found that the Registrant did not mislead the MIC deliberately but had prioritised returning to care for the patient in the knowledge that he would have to account for his decisions in due course. This was a decision he made on the spur of the moment in a difficult situation at the scene of an accident. In those circumstances, the Panel concluded that a finding of serious misconduct was inconsistent with its decision on facts.
Decision on Impairment
118. In light of those findings, the Panel then went on to consider whether, the Registrant’s fitness to practise is impaired by reason of the conviction found proved at Particular 2.
Evidence and submissions
119. The Panel heard evidence from the Registrant. He told the Panel of the circumstances in which he had committed the offences giving rise to the conviction. He reminded the Panel that this occurred during the period of Covid lockdown when he had become socially isolated but was also under significant pressure at work including, the great distress he suffered having to decide to leave people at home who would normally have been taken to hospital. The Registrant also gave evidence that he contracted COVID-19 and was treated in a High Dependency Unit (HDU). This coincided with a period in which his own personal relationship was breaking down in circumstances of significant acrimony. Further, he told the Panel that he helped care for his elderly mother.
120. This had produced, he said, a uniquely stressful situation in which he had turned to methylamphetamine as a “crutch”.
121. In his written and oral evidence, the Registrant told the Panel that he understood he had acted in a way that brought the profession into disrepute and was wholly inappropriate for someone in his position. He acknowledged fully that the decision to act as he had done was his alone.
122. The Registrant wrote this: “whether on duty or off duty, I have a moral, ethical and professional obligation to uphold the standards of conduct expected of me as a registered health professional and recognise the potential negative impact that my behaviour may have on the reputation of the profession more generally, with regards to public confidence.”
123. The Registrant told the Panel of the work he had done since his conviction to ensure that he would never behave in this way again. He had worked with his probation officer. The Panel saw a testimonial from his probation officer indicating that she was impressed by the efforts he had made. In a testimonial dated 12 October 2023 she wrote that the Registrant had ”completed his order to a very high standard”. She also wrote that the Registrant had undertaken additional work outside their sessions and completed work connected with healthy behaviour and “different thinking strategies”. She concluded that the Registrant was “extremely unlikely to make a mistake of this kind again”. She concluded that his actions had been “very out of character”.
124. He told the Panel that he had achieved abstinence by the end of 2021 and drew the Panel's attention to a letter which confirmed this.
125. The Registrant told the Panel that he had been abstinent since the end of 2021.
126. In the context of the Registrant's evidence, the Panel also saw a significant number of testimonials from people who had worked with the Registrant over a number of years. These included the clinical director of a major trauma centre and a consultant in emergency medicine at the air ambulance service. Their descriptions of the Registrant and his commitment to professionalism and hard work, were in the Panel’s view, powerful evidence that the events leading to the Registrant’s conviction were indeed out of character.
127. The Registrant told the Panel that he had been working for St. John’s Ambulance since March 2022 as a clinical information manager. He had been working on modernising their record keeping systems. The Panel saw a communication from the deputy chief executive of St. John’s Ambulance. He set out that the Registrant had made a full disclosure about his conviction at the time of his application and said that the Registrant had proved to be “dependable and trustworthy in his role”. He concluded that “this project would not have been delivered without Simon’s expertise and approach.”
128. In answer to questions, the Registrant acknowledged that he had not had an opportunity to test his recovery in the context of a clinical setting but told the Panel that the stresses that had led him to take drugs and commit the offences arose from stresses that were exceptional and far beyond those he met in normal practice.
129. He had, nonetheless discussed with his employer the possibility of returning to clinical practice in due course and they had discussed with him the support that might be available to him as it would be to anyone returning to clinical work after a significant period of absence.
Submissions
130. Mr Corrie again drew the Panel’s attention to the relevant law, to which the Panel refers below.
131. He acknowledged that the Registrant had made significant efforts to ensure that he did not reoffend but invited the Panel to remember that he had not yet been able to test that recovery in a clinical setting.
132. He submitted that nonetheless a finding of impairment was necessary in the wider public interest (described in the HCPC guidance as the public component of impairment) in order to maintain public confidence in the profession and uphold proper standards of conduct.
133. The Panel heard and accepted the advice of the Legal Assessor which it has followed in the decision set out below.
The Panel’s approach
134. The Panel is aware that impairment is a matter for its own professional judgement. In reaching its decision, the Panel had regard to the Registrant, nature, circumstances and gravity of the conduct giving rise to his convictions and the critically important public policy issues, in particular the need to maintain confidence in the profession as well as declaring and upholding proper standards of conduct and behaviour for the profession.
135. The Panel also bore in mind that it was concerned with whether the Registrant’s fitness to practise is currently impaired and focused on the need to protect the public and the wider public interest in the future.
136. The Panel bore in mind that a finding of impairment is separate from the finding of a conviction and not all convictions will lead to a finding of impairment.
137. The Panel had at the forefront of its mind that over three years have elapsed since the Registrant’s conduct leading to his conviction and there is no evidence that the Registrant has offended in this way either before or since the matters proved.
138. On this issue, the Panel noted in particular the observations of Silber J in Cohen v GMC [2008] EWHC 581 (Admin):
“There must always be situations in which a Panel can properly conclude that the act of misconduct was an isolated error on the part of a medical practitioner and that the chance of it being repeated in the future is so remote that his or her fitness to practice has not been impaired. Indeed the Rules have been drafted on the basis that once the Panel has found misconduct, it has to consider as a separate and discreet exercise whether the practitioner’s fitness to practice has been impaired.”
139. The Panel also bore in mind that in deciding whether the Registrant’s fitness to practise is still impaired it should follow the approach of Dame Janet Smith endorsed by the High Court in CHRE v NMC and P Grant [2011] EWHC 927 (Admin): "Do our findings of fact in respect of the (Registrant’s) misconduct, deficient professional performance, adverse health, conviction, caution or determination show that his/her fitness to practise is impaired in the sense that s/he:
a. has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or
b. has in the past brought and/or is liable in the future to bring the …..profession into disrepute; and/or
c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or
d. has in the past acted dishonestly and/or is liable to act dishonestly in the future."
140. The Panel also had regard to the passage from the Cohen case above and cited by Cox J which reminds panels that there may need to be a finding of impairment in the public interest, even if the misconduct can be characterised as an isolated incident:
“Any approach to the issue of whether a doctor's fitness to practise should be regarded as 'impaired' must take account of 'the need to protect the individual patient, and the collective need to maintain confidence [in the] profession as well as declaring and upholding proper standards of conduct and behaviour of the public in their doctors and that public interest includes amongst other things the protection of patients, maintenance of public confidence in the (profession)'(sic).
141. The Panel also had regard to the direction given to panels by the High Court that they must have regard to all three aspects of the overarching objective, to protect the public, when reaching a decision.
142. It also reminded itself that the overarching objective involves acting:
a. to protect, promote and maintain the health, safety and wellbeing of the public
b. to maintain public confidence in the profession
c. to promote and maintain proper professional standards and conduct for members of that profession."
143. The Panel also had regard to the HCPC practice note on Fitness to Practise Impairment dated February 2022. It reminded itself that a finding of fitness to practise must be focused upon the need to protect the public. In accordance with the guidelines, it considered the personal component of impairment which focuses on the likelihood of the Registrant repeating his behaviour and also the public component which is focused upon the need to maintain public confidence in the profession.
The Panel’s decision
144. The Panel considered the questions set out in the case of Grant referred to above. The Panel concluded that the Registrant had acted in a way that brought the profession into disrepute and breached a fundamental tenet of the profession. The Panel was satisfied that there was no indication that the Registrant had put patients at risk and, in light of the Panel’s findings, the question of the Registrant’s honesty does not arise.
145. The Panel considered whether there was evidence that the Registrant had developed insight into the conduct leading to his conviction and taken sufficient steps to remediate so that the Panel could have confidence that he would not repeat that conduct.
146. The Panel examined the evidence and other material set out above. It acknowledged that the circumstances in which the Registrant had committed the offences of which he was convicted were truly exceptional and went significantly beyond the mere pressures of professional practice. The Panel was impressed by the testimonials of those who have worked with the Registrant both before and since his offending and the Panel is satisfied in the light of that material that his behaviour can properly be described as out of character.
147. The Panel has also considered the work that the Registrant has done since his conviction. The Panel was impressed by his insight not only into the impact of his behaviour on himself but on the wider profession to which the Panel accepts he is genuinely committed. Having examined the testimonials of those who have worked with the Registrant both in the probation service and the drug treatment service the Panel is satisfied that the Registrant has taken effective steps to ensure that his offending behaviour is not repeated.
148. The Panel was also reassured that the Registrant has developed a proper understanding of the dangers of relapse and was reassured that he sought help at a time when he was tempted to take drugs again.
149. Taking all these matters together, the Panel is satisfied that the risk of repetition is so reduced that a finding of impairment is not required under the personal component of impairment.
150. The Panel then considered whether a finding of impairment was necessary under the public component to uphold standards of conduct and maintain public confidence in the profession.
151. The Panel bore in mind that the Registrant's conviction related to offering to supply a Class A drug to potential sexual partners, and the Panel noted that there was no evidence before it that the Registrant had in fact supplied the drug. The second conviction does, however, provide clear evidence that he was in possession of that Class A drug. This occurred outside his professional practice and fell short of those most serious drugs offences where drugs are supplied for commercial gain. Nevertheless, the Panel found that the matters giving rise to the conviction in this case were extremely serious and resulted in a custodial sentence, albeit that was suspended.
152. The Panel was satisfied that in those circumstances, right thinking and informed members of the public would be disturbed if there were no finding of impairment in this case. The Panel is satisfied that it would be failing in its duty to maintain public confidence and maintain proper standards of behaviour in the profession if it did not make a finding of impairment.
153. For these reasons the Panel has found that the Registrant fitness to practise is currently impaired on the public component alone.
Decision on Sanction
155. Having found the Registrant’s fitness to practise impaired, for the reasons set out above, the Panel considered, what, if any sanction it should impose on the Registrant.
156. The Panel heard submissions from Mr Corrie who submitted that the Panel should have regard to the importance of the role of paramedics and the importance of maintaining public trust in them. He submitted that the Registrant’s conviction in this case was particularly damaging of public trust, and it was necessary for any sanction to demonstrate that the behaviour giving rise to the conviction will not be tolerated.
157. Mr Corrie submitted that the aggravating features of this case were that the Registrant had been convicted of serious criminal offences, committed over a significant period. The mitigating features were that the Registrant had significant insight, had undertaken remediation and he had no previous disciplinary history.
158. Mr Corrie reminded the Panel that the purpose of sanction is not to punish the Registrant but to protect the public, including the wider public interest. He reminded the Panel of the importance of proportionality and of considering each available sanction in turn, starting with the least restrictive. Nevertheless, he submitted, only suspension for a period of 12 months or a striking off order would be sufficient to satisfy the overarching objective in this case.
159. Mr Corrie drew the Panel’s attention to the Case of The General Medical Council v Dr Maher Khetyar [2018] EWHC 813 (Admin) in which the court stated that “a proper conclusion that suspension is sufficient cannot be reached without reference to and careful consideration of advice in [the Guidance] that erasure may be or is likely to be appropriate where that advice is pertinent to the facts of a particular case.”
160. Mr Corrie drew the Panel’s attention to the decision of the High Court in Bolton v Law Society [1994] 1 WLR 512 in which the judge said:
i. ‘The reputation of the profession is more important than the fortunes of any individual member. Membership of a profession brings many benefits, but that is part of the price.’
161. Mr Corrie also acknowledged that the Registrant had been the subject of an interim suspension order since 10 July 2021 and the Panel should take that into account when considering the appropriate sanction to impose in the wider public interest. It was a matter for the Panel how much weight it attached to the period of interim suspension in all the circumstances of the case.
162. Mr Corrie reminded the Panel of the relevant paragraphs of the Sanctions Policy (SP) and in particular paragraph 121, which provides:
121. 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 do not require the registrant to be struck off the Register. These types of cases will typically exhibit the following factors:
i. the concerns represent a serious breach of the Standards of conduct, performance and ethics;
ii. the registrant has insight;
iii. the issues are unlikely to be repeated; and
iv. there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings.”
163. He also drew the Panel’s attention to the paragraphs relating to a Striking off Order and in particular paragraphs 130 to 131 which provide.
130. A striking off order is a sanction of last resort for serious, persistent, deliberate or reckless acts involving (this list is not exhaustive):
i. dishonesty (see paragraphs 56–58);
ii. failure to raise concerns (see paragraphs 59–60);
iii. failure to work in partnership (see paragraphs 61–62);
iv. discrimination (see paragraphs 63–66);
v. abuse of professional position, including vulnerability (see paragraphs 67–75);
vi. sexual misconduct (see paragraphs 76–77);
vii. sexual abuse of children or indecent images of children 11 (see paragraphs 78-79 and 87–89);
viii. criminal convictions for serious offences (see paragraphs 80–92); and
ix. violence (see paragraph 93).
1. 131. 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:
x. lacks insight;
xi. continues to repeat the misconduct or, where a registrant has been suspended for two years continuously, fails to address a lack of competence; or
xii. is unwilling to resolve matters.
164. Mr Corrie acknowledged that the factors set out at paragraph 121 all applied in this case. Nevertheless, the Panel must consider paragraph 130 viii criminal convictions for serious offences.
165. The Panel heard submissions from the Registrant. He told the Panel that he was deeply remorseful for what he had done. He reminded the Panel that he had committed the offences sometime before and had not committed offences either before or since.
166. He acknowledged that the period of interim suspension had not been intended to be punitive, but it had had a significant effect on him both from a financial and professional point of view. In all the circumstances, he invited the Panel to impose a sanction which enabled him to return to his profession and told the Panel that a further prolonged period away from the profession, would impact upon his ability to return without significant support.
167. The Panel also accepted the advice of the Legal Assessor and had regard to the HCPC’s Sanctions Policy (SP), which it has followed in this decision.
The Panel’s approach
168. The Panel is aware that the purpose of a sanction is not to be punitive but to protect the public and the wider public interest, which includes the deterrent effect on other registrants, the reputation of the profession and public confidence in the profession and the regulatory process.
169. The Panel also bore in mind the principle of proportionality and balanced the Panel’s duty to protect the public against the rights of the Registrant.
170. The Panel accepted the approach set out in Mr Corrie’s submissions. It also accepted that when recording the mitigating and aggravating factors it should balance them with all the other evidence and reach a conclusion about the seriousness of the conduct giving rise to the convictions in this case.
171. The Panel took into account the following mitigating factors:
i. The conduct which led to the Registrant’s conviction took place during an exceptional period coinciding with the Covid lock down. At this time, the Panel has found the Registrant was subject to a number of personal and work stresses which combined to create a situation where the Registrant was isolated and suffering from exceptional pressures;
ii. The Panel is satisfied that the Registrant’s offending can be genuinely described as out of character, it is accepted that in his long career he has been regarded by senior colleagues as “a highly professional and competent paramedic” and “an expert clinician”;
iii. There are no previous regulatory or criminal findings against him.
iv. The Registrant has worked in a related field since 2022 and made an extremely favourable impression on his employers and colleagues. The Panel has already referred to testimonials from very senior colleagues.
172. The Panel also took into account the following aggravating factors.
i. The convictions were for serious offences and his offending behaviour was repeated with different people over a period of 5 months;
ii. The convictions attracted a suspended sentence of imprisonment and were likely to bring the profession into disrepute.
173. The Panel balanced those matters when considering the gravity of the offending which gave rise to the convictions. For the reasons set out in detail below, the Panel concluded that the Registrant could be dealt with by way of a sanction less than strike off, if all the other factors in this case were sufficiently compelling to allow that course.
174. The Panel then considered the sanctions available to it in ascending order of severity.
175. The Panel considered that to take no action or to impose mediation would not be appropriate given the serious nature of the conviction. Such a course would not be sufficiently restrictive to protect the wider public interest.
176. The Panel next considered whether it should impose a caution order. The Panel had regard to paragraph 101 of the SP, which provides:
101. A caution order is likely to be an appropriate sanction for cases in which:
i. the issue is isolated, limited, or relatively minor in nature;
ii. there is a low risk of repetition;
iii. the registrant has shown good insight; and
iv. the registrant has undertaken appropriate remediation.
177. The Panel found that the facts giving rise to the convictions were confined to some five months but not were not minor and a caution order would not be sufficiently restrictive to uphold public confidence in the profession or uphold proper standards of conduct.
178. The Panel considered whether a conditions of practice order would be sufficient to protect the public. The Panel reminded itself that the Registrant’s conduct is not connected to his practice, he has significant insight, he is unlikely to repeat his offending behaviour and is likely to comply with any conditions.
179. Nevertheless, the Panel had regard to paragraph 108 of SP which provides that:
i. Conditions are also less likely to be appropriate in more serious cases, for example those involving:
ii. “• criminal convictions for serious offences”
180. Accordingly, the Panel concluded that a conditions of practice order would be insufficient to protect the public interest including maintaining public confidence in the profession.
181. The Panel then went on to consider whether a Suspension Order would be sufficient to protect the public and the wider public interest and had regard to paragraph 121 set out above:
182. The Panel found that these factors are well demonstrated in this case.
i. The Registrant’s misconduct was relatively isolated in the context of a long career and
ii. The Registrant has developed insight into the seriousness of what he has done and demonstrated this by undertaking remediation and treatment which makes it unlikely that he will repeat his offending and
iii. There is no evidence of any misconduct in the 3 years since the conduct giving rise to the conviction in this case
iv. The Registrant has the benefit of impressive testimonials from senior colleagues
183. Nevertheless, the Panel went on to consider whether a suspension order was sufficient to protect the public interest. The Panel reminded itself that paragraph 121 provides that a suspension order is likely to be appropriate where there are “serious concerns…which do not require the registrant to be struck off the register.”

184. The Panel also had regard to paragraph 131 and noted that although a striking off order was more likely to be necessary in cases where the Registrant lacks insight, continues to repeat the misconduct or is unwilling to resolve matters it may also be necessary “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.”
185. The Panel noted that this may include “criminal convictions for serious offences”.
186. The Panel therefore looked at the nature of the offences in this case and weighed up the aggravating and mitigating features in order to assess the gravity of the offending.
187. The Panel was satisfied that offering class A drugs to others is always a serious matter. The Panel was also satisfied that the impact on public confidence was greater because it was done on more than one occasion to a number of people; the Registrant offered to inject them and drew attention on two occasions to him being a paramedic who knew how to administer injections.
188. Set against that, the Registrant was not offering to supply drugs for money. Nor was he offering to distribute drugs in the usual sense but rather to share them with those he met in circumstances of privacy. The Panel also reminded itself that the Registrant was not convicted of supplying drugs, much less of actually injecting anyone.
189. The Panel had regard to the areas highlighted as “serious” in SP. These include dishonesty, discrimination, abuse of professional position, predatory behaviour, sexual misconduct and violence. The offending behaviour in this case does not fall within those categories.
190. The Panel also had regard to paragraphs 80 to 92 of SP dealing with criminal convictions. The Panel noted that those paragraphs provide that a registrant may be able to return to practice after serving a custodial sentence.
191. Weighing those matters, the Panel concluded that the Registrant’s offending was serious but did not rule out dealing with him by a suspension order if all the other factors in this case pointed in that direction.
192. The Panel reminded itself of all the matters set out in its decision on impairment and which persuaded it that there was not a significant risk that the Registrant would repeat his offending. These included:
i. The evidence of his insight;
ii. The extensive remediation he had undertaken;
iii. The impressive testimonials from senior practitioners in his own profession, senior doctors (clinical directors) and a senior official at St John’s Ambulance. All of these point to the Registrant being able to make a significant contribution to the profession and the public if he returns to practice.
193. The Panel also had regard to the fact that the Registrant has been suspended since July 2021. The Panel reminded itself that it should take that period of suspension into account when deciding what was an appropriate sanction to impose in the wider public interest. (Kamberova v NMC [2016] EWHC 2955 (Admin)). The Panel noted that a period of suspension imposed now could mean that the Registrant would be suspended for a total period of three and a half years.
194. The Panel considered whether, nonetheless, it was necessary to impose a striking off order. The Panel had regard to paragraph 131 of SP which provides:

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.

195. The Panel noted that the fitness to practise process had taken over two and a half years to conclude the substantive hearing, through no fault of the Registrant. The Panel recognised that the practical effect of imposing a strike off would be that, the Registrant would be unable to practise for a total period of 7 ½ years before he could even apply to be restored to the register.
196. The Panel did not think that such an exceptionally long period was necessary to protect the public interest in circumstances where it has not found current impairment on the personal component. The Panel found that in those circumstances, a striking offer order would be disproportionate and would unnecessarily deprive the public of a good paramedic who the Panel has found is safe to practise.
197. Taking all those matters together, that is to say the Panel’s analysis of the offending which gave rise to the convictions, the exceptional mitigation and the practical effect of imposing a period of suspension after a long interim suspension, meant that a suspension order was sufficient in this case and accordingly, was the appropriate and proportionate sanction.
198. The Panel then went on to consider the length of suspension that it should impose. It concluded that the suspension had to be for a period of 12 months because no shorter period would reflect the seriousness of the Registrant’s offending and how close he had come to being struck off.
199. Accordingly, the Panel imposes a Suspension Order for a period of 12 months.
200. The Suspension Order will be reviewed before its expiry. At the review hearing the reviewing Panel is likely to be assisted by
i. The Registrant’s attendance at the review hearing;
ii. Evidence of the Registrant’s continued employment, paid or unpaid;
iii. A reflective piece demonstrating that the Registrant has continued to remain abstinent from Class A drugs;
iv. Any references or testimonials the Registrant can obtain demonstrating that he has continued to work
v. Evidence that the Registrant has maintained his CPD and skills;
vi. Any other material the Registrant can present to demonstrate that he has remained free from illicit drug use.

Order: That the Registrar is directed to suspend the registration of Mr Simon Standen for a period of 12 months from the date this order comes into effect.

The order will be reviewed again before it expiry on 19th January 2024

History of Hearings for Mr Simon T Standen