Mark Titley

Preliminary Matters

Service

1.The Panel was satisfied that a valid notice of hearing was sent to the Registrant on 31 January 2024.

Proceeding in the absence of the Registrant

2. After the Panel stated that it was satisfied that there had been good service of the notice of hearing, the Presenting Officer applied for a direction that the hearing should proceed in the absence of the Registrant. He submitted that the Registrant had made clear that he did not wish to attend the hearing and that the public interest required the allegation to be determined.

3. The Panel accepted the advice of the Legal Assessor and followed the guidance contained in the HCPTS Practice Note entitled, “Proceeding in the Absence of the Registrant”. Accordingly, the Panel acknowledged that a decision to proceed with a hearing in the absence of the Registrant required more than simply being satisfied that the Registrant had been sent a notice of hearing; the Panel would need to be satisfied that it was fair in all the circumstances to proceed for directing that it should. In the present case, the Panel was satisfied that it would be fair to proceed for the following reasons:

⦁ The Registrant knew that the hearing was due to take place today.

⦁ Both before and after he was sent the notice of hearing informing him that the hearing would be held today, the Registrant had stated that he did not intend to attend a hearing:

⦁ In an email sent on 9 November 2023, the Registrant wrote, “Can I please advise you I will not be attending any meetings ….”.

⦁ In an email sent on 24 January 2024, the Registrant wrote, “….. I feel that attending any hearing would be of no or little benefit ….”.

⦁ In an email sent on 7 February 2024, (after he had been sent the notice of hearing and been sent the hearing bundle) the Registrant wrote, “I still will not be attending the hearing as I have previously stated.”

⦁ There has been no suggestion by the Registrant that he might attend a hearing on another occasion, and there has been no request for an adjournment.

⦁ In his various emails, the Registrant has advanced a case which the Panel would be able to consider.

⦁ In these circumstances, the Panel was satisfied that the clear public interest in the allegation being resolved outweighed the absence of the Registrant, and that fact necessitated a direction that the case should proceed in his absence.

Background

4. The Registrant is a Paramedic, and, at the time of the incident underpinning the HCPC’s allegation against him, he was employed in that capacity by the West Midland Ambulance Service (“WMAS”).

5. On 29 June 2022, WMAS received a 999 call made with respect to a 94 year-old lady who was found collapsed in her garden. Two separate ambulance crews were dispatched. One of the crews comprised the Registrant and a student Paramedic, and they arrived at the scene before the other crew of two qualified Paramedics.

6. The Registrant and his colleague commenced CPR on the lady, and, when the other crew arrived, the advanced life support protocol was put in place. While this was being undertaken, the lady’s daughter-in-law arrived at the scene and she was asked whether a “do not resuscitate” (“DNR”) direction had been signed by the lady. Her daughter-in-law did not know, and so telephoned the lady’s son. The son also did not know, and so at that stage the Registrant entered the lady’s home to see if he could discover a DNR form.

7. The Registrant was in the house for a short time, and when he emerged it appeared to some people that his demeanour had changed. Unknown to the Registrant initially there were cameras installed in the house and garden, and, while in ignorance of them, he had found a pot with bank notes in it. He counted out some notes and put them into his pocket. Very shortly thereafter he became aware of that there were cameras and very soon after pocketing the bank notes, he replaced them in the pot. He asked if the cameras were live, and later suggested that it would be upsetting for the family to view the captured images as it might have disclosed the fall or resuscitation of the elderly lady, who died during these events.

8. When the lady’s son saw the images of the Registrant putting bank notes in his pocket the matter was referred to both WMAS and the Police.

9. The Registrant was charged with the offence of theft in a dwelling. He appeared at the Shrewsbury Crown Court on 4 April 2023 and pleaded guilty to the charge. The sentence imposed on him was a sentence of 18 weeks imprisonment suspended for 12 months, a requirement that he should undertake 120 hours of unpaid work within 12 months and orders for the payments of costs and a victim surcharge.

10. The criminal charge did not specify the sum of money that the Registrant put in his pocket. However, in the Crown Court, prosecuting counsel submitted that it was “perhaps £60 at most”, but when defending counsel submitted to the Judge, on the basis of the colour of the bank notes seen in the captured images, said that, “…. we are talking (sic) a sum that doesn’t exceed £20 ….”, the transcript records prosecuting counsel replying, “Yes”.

Decision on Facts and Grounds

11. As the allegation is a “conviction allegation” which contends that the Registrant’s fitness to practise is impaired by reason of the conviction, the fact advanced in particular 1 is also the ground.

12. The Panel accepted the advice given by the Legal Assessor that the fact of the conviction is a matter that is to be proved by the HCPC on the balance of probabilities.

13. Having carefully considered the matter, the Panel found particular 1, and therefore the statutory ground, proven for the following reasons:

⦁ It accepted the Certificate of Conviction dated 11 May 2023, as a true and accurate record of the matters stated in it.

⦁ It accepted that the transcript of the proceedings in the Shrewsbury Crown Court as accurate was a hearsay document, but it accepted it because it accorded with the terms of the Certificate of Conviction and it also accorded with statements made by the Registrant himself.

⦁ The statements made by the Registrant which corroborated both the Certificate of Conviction and the transcript were the passages in his email dated 24 January 2024 in which he stated that he had been, “…. convicted of a crime …”, refers to CCTV as being an element of the circumtances of the crime, and the references to the sentence imposed.

Decision on Impairment

14. In addressing the issue of current impairment of fitness to practise, the Panel accepted the advice it received from the Legal Assessor and applied the guidance contained in the HCPTS Practice Note entitled, “Fitness to Practise Impairment”. Accordingly, it considered both the personal and public components.

15. With regard to the personal component, the Panel acknowledges that an act of dishonesty (as the theft of which the Registrant was convicted is an example) is not easily remediable. The Panel acknowledges that the Registrant had an unblemished character before the theft, that he pleaded guilty when he appeared in the Crown Court, and has expressed the shame he feels as a result of the conviction. However, there are elements of what he has stated about the incident that has led the Panel to conclude that his acceptance of his actions, and thus his insight, is not fully developed. In particular:

⦁ In an email he sent on 24 January, he wrote this: “The information sent to me stated that the only reason the money was returned was the camera had caught my actions this was not the case but once again the perception of this footage was such I could not defend my actions as it does not show what I was thinking at the time ….”. The Panel was unable to square this statement with his plea of guilty.

⦁ Again, in an email sent on 7 February 2024, he wrote: “I sincerely regret my actions on that day and very sorry for any upset to the family caused my intentions were good but my actions looked bad but it was to late to rectify my actions …”. Again, the Panel is unable to reconcile this remark with a plea of guilty to an offence of theft.

16. The absence of full acceptance of the true circumstances of the incident, and a lack of complete insight into it and the consequences of it, have the consequence that the Panel is driven to conclude that there is a risk of repetition. For that reason the Panel has concluded that the Registrant’s fitness to practise is impaired upon the personal component.

17. So far as the public component of impairment of fitness to pracitise is concerned, the conclusion of the Panel on the personal component, with the attendant risk of repetition, means that a finding of impairment is inevitable. However, even if the Panel’s view of the risk of repetition had been other than it is, and had been that there was no risk of repetition, the Panel would nevertheless have concluded that a finding of public component impairment of fitness to practise would be necessary. Paramedics necessarily have contact with members of the public when they are acutely vulnerable for a variety of reasons, and it is in the nature of a Paramedic’s practice that they will be required to enter the homes of those who are vulnerable. Fair-minded members of the public would not be prepared to tolerate being attended (or their loved ones being attended) by a Paramedic who had acted as the Registrant did.

18. Having concluded that the Registrant’s fitness to practise is impaired on both the personal and public components, the allegation is well founded. It follows that the Panel must go on to consider the issue of sanction.

Decision on Sanction

19. The Panel accepted the advice of the Legal Assessor in relation to Sanction and it also paid close attention to the HCPC’s Sanctions Policy.

20. The Panel acknowledged that it is customary to begin a decision on sanction by identifying aggravating and mitigating factors. The Panel has already referred to the fact that before the theft on 29 June 2022, the Registrant was a man of unblemished character. But, so serious is the conviction, the Panel is of the view that nothing would be gained by a lengthy examination of aggravating and mitigating factors.

21. The present case is properly to be considered a serious one for a number of reasons. In the categories identified in the Sanctions Policy, it involves not only dishonesty but also, because the Registrant was able to enter the lady’s home because she was in a state of extreme vulnerability and he was present as a Paramedic, an abuse of professional position and a breach of trust.

22. Consistent with the advice it received, the Panel accepted that a sanction should not be imposed to punish a registrant. The factors that can justify the imposition of a sanction are the need to protect the public and the need to ensure that the public will be able to maintain a proper degree of confidence in the Paramedic profession and the regulation of it. The Panel must first decide whether any sanction is required at all. If a sanction is required, then the available sanctions must be considered in an ascending order of seriousness until one that meets the circumtances of the case is reached.

23. In the view of the Panel this is a case in which sanction is required. It is also a case that is far too serious to result in the imposition of a caution order.

24. A conditions of practice order would be inappropriate for a number of reasons. The requirement to act honestly is one that is fundamental to professional registration, and not one to be imposed by a bespoke condition of practice. Furthermore, such an order would necessarily involve the Registrant practising as a Paramedic, albeit subject to the conditions imposed, and that would not allay the real concerns of members of the public about being attended by him. Finally, and quite apart from the foregoing, the communications received from the Registrant indicate that he would not wish to even attempt to return to practise as a Paramedic.

25. Having rejected the imposition of conditions of practice, the Panel next considered whether a suspension order might be appropriate. In that context it had regard to paragraph 121 of the the Sanctions Policy. In the judgement of the Panel, the factors suggested as being typically exhibited in cases resulting in a suspension order are not present in this case; the Registrant’s insight is incomplete, because of that it is not possible for the Panel to say that it is unlikely that issues will not be repeated, and there is no evidence to suggest that the Registrant will be likely to be willing or able to resolve or remedy his failings. Furthermore, the Panel took the view that a suspension order could be appropriate were there to be some appreciable change in the factors requiring it to be made by the end of the period of suspension. The Panel is satisfied that members of the public would still be as unwilling to be attended by the Registrant in a year from now as they would be at the present time. Accordingly, the Panel rejected the making of a suspension order as an appropriate disposal.

26. The Panel therefore considered a striking off order. The Panel noted that this case meets three of the non-exhaustive list of serious cases identified in paragraph 130 of the Sanctions Policy as being the type of case that might result in striking off; it involves dishonesty and abuse of professional position, and it is a criminal conviction for a serious offence. Furthermore, this is a case in which the Panel is satisfied that no lesser sanction would ensure that the public would be satisfied that someone who wishes to practise as a Paramedic simply cannot behave as the Registrant had done; were the Panel to decide otherwise, public confidence in the Paramedic profession and the regulation of it would be seriously diminished. Furthermore, were the Panel to decide on any sanction other than striking off they would be failing to declare and uphold proper professional standards, and there would be an insufficient message communicated to other registrants who might feel tempted to behave as the Registrant did.

27. For all these reasons the Panel has determined that the sanction to be applied must be a striking off order. The Panel acknowledges that this is the sanction of last resort, but it is satisfied that it is a proportionate response given the seriousness of the allegation and the fact that no lesser sanction would serve to maintain a proper degree of public confidence.

ORDER: The Registrar is directed to strike the name of Mark Titley from the Register on the date this Order comes into effect.

No notes available

History of Hearings for Mark Titley