Eden-Rose Hargreaves
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Allegation
As a registered Paramedic (PA49146):
- On 11 August 2022 you were convicted at Crewe Magistrates' Court of driving a motor vehicle on a road after consuming so much alcohol that the proportion of it in your breath, namely 100 microgrammes of alcohol in 100 millilitres of breath, exceeded the prescribed limit, contrary to Section 5 (1) (a) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988.
- By reason of the matter set out above, your fitness to practice is impaired by reason of conviction.
Finding
Preliminary Matters
Service
1. The Panel was provided with a Service Bundle of documents. From this the Panel noted that Notice of the Hearing (“the Notice”) was served by email on the Registrant on 12 September 2024. The Notice informed the Registrant of the date, time and place of the Hearing. Mr Khan submitted that proper service of the Notice had been effected.
2. The Legal Assessor advised that Rule 6 of the Health and Care Professions Council (Conduct and Competence Committee) (Fitness to Practise) Rules 2003 (“the Rules”) required that at least 28 days’ notice of the Hearing is given to the Registrant. The requirement is to demonstrate sending of the Notice, although information demonstrating receipt could also be taken into account.
3. The Panel, having heard the HCPC’s submissions and accepted the legal advice, was satisfied that notice of the Hearing had been served on the Registrant in accordance with the Rules.
Proceeding in Absence
4. Mr Khan applied to the Panel to proceed, notwithstanding that the Registrant had failed to attend the hearing and was not represented. He submitted that the Registrant had previously indicated a wish to attend the hearing. However, more recently, the Registrant had stated an inability to attend and an acceptance of the hearing proceeding in her absence.
5. Mr Khan made reference to the factors set out in the HCPTS’ Practice Note: Proceeding in Absence identified by the courts in R v Jones [2002] UKHL 5. He also referred the Panel to the Practice Note: Adjournments and Postponements. Mr Khan submitted that, having weighed the factors, the Panel should exercise its discretion to proceed.
6. The Legal Assessor reminded the Panel of Rule 11 and the factors in R v Jones and also the case of GMC v Adeogba [2016] EWCA Civ 162. He advised the Panel that, it had to exercise its discretion with ‘utmost care and caution’. It had to decide whether all reasonable steps had been taken to draw the hearing to the Registrant’s attention, and if so, consider its discretion to proceed, balancing the interests of the Registrant as a prime consideration with the interests of the HCPC and the public.
7. The Panel considered the HCPC’s submissions and accepted the legal advice. It took into account that on 26 September 2024 the Registrant had emailed the HCPTS, to state that she was not able to get annual leave from work to attend the hearing. The Registrant had stated: “I am unable to attend the hearing which I am deeply disappointed about. However, I am accepting of the hearing going ahead in my absence. I will provide a statement to be read out on my behalf…I will also be contactable via my mobile during the hearing if there are any questions I need to answer during the hearing”.
8. The Panel accepted that the Registrant would be at some disadvantage if the hearing proceeded by not being present to take part. However, the Panel took into account that, as regards the underlying facts stage and grounds, this was a conviction case supported by court documents. There was no apparent dispute about the Registrant having been convicted. The Panel had received the Registrant’s written statement and later correspondence, which it will take into account at later stages of the hearing. The conviction was now of some age and there is a public interest in disposal of regulatory hearings. The Registrant had accepted in her email that the hearing would proceed and there had been no application for an adjournment put before the Panel.
9. Having weighed all the factors, the Panel considered that it was fair and appropriate to proceed in the Registrant’s absence.
Public/Private
10. Mr Khan asked the Panel to sit partly in private, when considering matters which concerned the Registrant’s health. He submitted that some of the information went to issues around the Registrant’s health, and parts of the hearing should therefore be conducted in private.
11. The Legal Assessor advised that hearings are conducted in public, but pursuant to Rule 10(1)(a) there may be a departure from a public hearing when the interests of justice and/or protection of the private life of the Registrant (amongst others) satisfies the Panel that it is appropriate to exclude the public.
12. The Panel accepted the legal advice. Having read the papers, the Panel was aware that there may be some references to health. Although it is in accordance with the Rules that the hearing be conducted in public, protecting the private life of the Registrant outweighed the public interest where reference was to be made to her health.
Amendment of the Allegation
13. Mr Khan applied to the Panel to amend particular 1 which made reference to “the Road Traffic Ad 1988”. to read “Road Traffic Act 1988”. He submitted that the information provided by the Registrant was clear that the Registrant’s conviction was contrary to Road Traffic Act 1988 and it was clear that the Allegation notified contained a typographical error.
14. The Panel was satisfied that there had clearly been a typing error and no injustice was caused by the amendment. The Panel amended the Allegation.
15. The Panel was provided with a Hearing bundle and additional correspondence from the Registrant together with her associated documents.
Background
16. The Registrant is a Paramedic registered with the HCPC. On 01 August 2022, the Registrant made a self-referral to the HCPC. In the referral, the Registrant stated that she had been charged with driving under the influence of alcohol on 25 July 2022.
17. On 19 December 2023, a Panel of the HCPC’s Investigating Committee referred a case to the Conduct and Competence Committee.
18. In the Hearing Bundle the Panel was provided with a number of documents, including:
i. The Registrant’s self-referral form dated 01 August 2022
ii. The Police Charge sheet, undated
iii. Community Order dated 11 August 2022 and other court documents
iv. Certified Court Extract, certified on 05 March 2024
v. Registrant’s written statement dated 31 October 2022
vi. Registrant’s ‘Statement in relation to allegation’ dated 27 February 2023
vii. Certificate of Completion, TTC course provider, dated 19 December 2023
viii. DBS certificate for Registrant, dated 23 September 2024
ix. Registrant’s statement to the Panel
19. The Panel did not hear from any witnesses and no formal witness statements for the Hearing were provided. Mr Khan took the Panel through the Hearing bundle. He submitted that, pursuant to Rule 10(1)(d) a certified copy of the certificate of conviction is admissible as proof of the conviction and the underlying facts. Mr Khan submitted that the facts of the conviction were proved by both the court documents provided and the Registrants own admission in her written ‘Statement in relation to allegation’ provided to the Investigating Committee.
20. The Legal Assessor advised the Panel that the burden of proving the facts in an Allegation lay on the HCPC. Rule 10(1)(d) states that a certified copy of a certificate of conviction is admissible as proof of the conviction and underlying facts. In this case, however the documents included a certified extract of the court record, which was not a certificate of conviction.
21. The Legal Assessor advised that the Panel had a broad power to admit documents, pursuant to Rule 10(1)(b) and 10(1)(c), which included documents which would be admitted by a court in civil proceedings in the relevant area and also other documents not so admissible, if satisfied that admission of the evidence is necessary in order to protect the public.
Decision on Facts
1. On 11 August 2022 you were convicted at Crewe Magistrates’ Court of driving a motor vehicle on a road after consuming so much alcohol that the proportion of it in your breath, namely 100 microgrammes of alcohol in 100 millilitres of breath, exceeded the prescribed limit, contrary to Section 5 (1) (a) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988.
22. The Panel took into account that, in her self-referral the Registrant had informed the HCPC that she had been charged with a drink-drive offence. This raised an issue concerning public protection, in the Panel’s view.
23. Although the Registrant had not attended the hearing and no production statement had been provided by the HCPC, regarding any documents, the Panel noted that a Hearing bundle had been provided in advance to the Registrant. In the correspondence the Registrant had agreed to the Hearing bundle and asked for her further statement and documents to be included, which had occurred.
24. The Panel considered that it was necessary in the interests of justice in order to protect members of the public for it to admit the documents provided in the Hearing bundle. In her statement referred to by Mr Khan, the Registrant had stated that she did not dispute allegation 1 of the Allegation.
25. Taking into account the combination of the certified court extract from Crewe Magistrates’ court which set out the particulars of the charge and the conviction, certified on 05 March 2024, the Registrant’s admission, and the undated Police Charge sheet, the Panel concluded that it was satisfied of the facts in particular 1 of the Allegation.
Decision on Grounds
26. Having found the facts of the Allegation proved, the Panel next considered whether its findings satisfied a statutory ground of impairment.
27. The Panel took into account that, pursuant to Article 22 of the Health Professions Order 2001 (as amended) a conviction is a statutory ground of impairment. Article 22, so far as relevant, states:
22 Allegations
(1) This article applies where any allegation is made against a registrant to the effect that--
(a) his fitness to practise is impaired by reason of--
(i) …
(ii) …
(iii) a conviction or caution in the United Kingdom for a criminal offence, or a conviction elsewhere for an offence which, if committed in England and Wales, would constitute a criminal offence,
(iv) …
28. The Panel was therefore satisfied that, having found the fact of the conviction proved, it was also satisfied that there was a statutory ground for a finding of impairment.
Decision on Impairment
29. The Panel next considered whether, on the evidence before it and its findings, the Registrant’s fitness to practise is impaired.
30. Mr Khan submitted that, in her responses to the Allegation, the Registrant denied that her fitness to practise is impaired.
31. [redacted]
32. Mr Khan submitted that the Panel should determine whether it regarded the Registrant’s fitness to practise is currently impaired. He submitted that the Panel should find the Registrant’s fitness to practise is impaired.
33. In the written case summary, the HCPC had submitted that the standards that the Registrant was operating fell so far below those expected that professional standards and public confidence in the profession required a finding of impairment. It was submitted that in the course of her duties the Registrant is required to operate a vehicle and that the fact that the Registrant had been convicted of a driving offence gave rise to concerns as to how it might affect her in a work context as a registered Paramedic.
34. Mr Khan submitted that, as a Paramedic, the Registrant is likely to be required to operate a vehicle. He submitted that the public perception of the Registrant was relevant in the context of her being a Paramedic. Mr Khan submitted that the Registrant had been working in the role of personal independence payment (PIP) assessor until recently. The Registrant had expressed being keen to remain in the profession, but her skills as a Paramedic were yet to be tested.
35. Mr Khan submitted that the Registrant’s reflections on the incident omitted to provide any reflection on the impact on the wider profession. The Registrant had not demonstrated any insight in this regard. He accepted that the Registrant had provided details of CPD courses undertaken, however, he submitted, the information did not give details of the length of any of the courses, or to what they related. Although the Registrant had stated that in recent times she had worked as a Paramedic for an events company, she had not given details about the extent of this work or for how long it had been undertaken.
36. The Registrant had provided her written statements concerning impairment.
“In relation to allegation 2., I do not believe my fitness to practice is impaired presently. However, I do agree, that the grounds of allegation and my conviction constitutes as gross misconduct. I am fully aware that my conviction affects the publics confidence in my practice and my behaviour at the time of the incident occurring, does not meet the standard of a registered professional clinician; and for that, I am deeply remorseful in my actions and behaviour. I apologise wholeheartedly for my actions and behaviour on 24/07/2022 and I am extremely regretful of the incident. I am fully aware of the severity of what my actions could have caused that night and it completely goes against myself and what I represent as a registered professional. Words can’t express my guilt or emotions for my actions or how out of character they are for myself.
37. The Registrant stated that she understood why her fitness to practise was being questioned. [redacted] The Registrant stated that she was not justifying her actions, but they were the reason behind her poor decision-making.
38. The Registrant stated the importance to her of her role as a Paramedic, and that she had kept her skills and CPD up to date. The Registrant stated that she had found work as a PIP assessor and her health was improving. Since September 2024, the Registrant stated, she had changed role to a care co-ordinator and was not using her Paramedic skills.
39. The Registrant had provided information from an Occupational Health doctor which referred to blood and urine testing undertaken on 26 July 2022 having not detected evidence of alcohol excess in the weeks previous to the offence, or any pattern of heavy regular alcohol excess. The Registrant also produced a letter from the DVLA dated 31 July 2024, which stated that she satisfied the medical standards for safe driving. The letter stated that her driving licence would be returned. The DVLA had asked the Registrant to attend a blood test, which had given a result which was consistent, though did not prove, abstinence from alcohol.
40. The Registrant also produced a certificate of completion from a Drink Driving Course which the Registrant had undertaken and reduced her driving ban in length. A copy of the Registrant’s DBS check demonstrated that the unpaid work requirement was changed by the court to a fine of £846. The Registrant stated that this was due to the unavailability of unpaid work programs. There were no other adverse entries. The Registrant maintained that she had discharged the fine imposed by the court.
41. The Legal Assessor advised the Panel that the decision as to impairment is for the Panel’s judgement, based on the findings of fact and the statutory ground. He referred the Panel to the HCPTS’ Practice Note: ‘Fitness to Practise Impairment’. He advised that the Practice Note gives two bases for impairment: the ‘personal’ and ‘public’ components of impairment and he reminded the Panel of the test for impairment set out in CHRE v NMC & Grant [2011] EWHC 927 (Admin).
42. The Panel noted the facts behind the original conviction, which were available to a limited degree from the official documents. The Registrant had been found to have driven a Ford Fiesta on a road, having consumed alcohol so that 100 microgrammes had been detected in 100 millilitres of breath. The Registrant had been disqualified from driving for 25 months, required to do 60 hours unpaid work, which had been altered to a fine, not due to the Registrant’s fault. The Registrant had pleaded guilty to the offence.
43. The Panel considered that the level of the court’s sentence had indicated that this was a serious offence. The Panel had limited information about the surrounding events, but the driving ban had been imposed for a significant period.
44. Having said that, the Panel also took into account that the Registrant had undertaken an appropriate drink-drive reduction course and her ban had been reduced as a result. Taking into account the Registrant’s assertion that there had been attendant personal stressors and the evidence that the drinking had not been part of a pattern at the time, the Panel was prepared to accept that this had been a ‘one-off’ event.
45. The Panel noted that it had no information before it which suggested any connection between the incident and the Registrant’s professional duties.
46. The Registrant had offered her apologies for her actions. She had offered some reflections concerning the effects of her actions. She had also stated that she recognised the seriousness of her actions, the potential further impact and how the Registrant’s actions damaged public confidence in her. Although there was not a further discussion on wider public confidence, the Panel did find that there was a significant degree of insight displayed in the Registrant’s statements provided.
47. The Panel took into account the evidence of the facts behind the conviction, the registrant’s apology, her reflections and taking responsibility for the incident. [redacted] The Panel considered that the Registrant had done everything which could reasonably be expected of her to remediate the offence. It concluded that there was a very low risk of repetition and it was highly unlikely that there would be a repetition.
48. The Panel also considered, however, that a conviction of this nature was a serious matter for a registered Paramedic, also bearing in mind the particular response of the court. The Panel bore in mind the Standards of Conduct Performance and Ethics (“SoC”) and Standards of Proficiency for Paramedics (“SoP”) which had applied at the time, namely:
(SoC)
9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
(SoP)
3.1 understand the need to maintain high standards of personal and professional conduct.
49. Though the Panel considered that there was some limitation to the information about the Registrant’s CPD, it had concluded there was a low risk of repetition in any event. The Panel’s concerns in relation to impairment centred around the wider public interest and the maintenance of public confidence in the profession.
50. The Panel considered that in being convicted of this offence, the Registrant fell far below the expected standards. The Panel also concluded that, due to the seriousness of the matter, which was reflected in the level of the court sentence, members of the public would be shocked and concerned at a registered Paramedic receiving such a conviction. Further, there was a need to send a message as to the standards expected of the profession. For these reasons, the Panel considered that a finding of impairment was necessary in order to maintain public confidence in the profession and to declare and uphold proper standards.
51. The Panel concluded that the Registrant’s fitness to practise is impaired.
Decision on Sanction
52. The Panel next considered what, if any sanction it was necessary to impose on the Registrant’s registration in response to its having found impairment of fitness to practise as a Paramedic.
53. Mr Khan made no positive submission as to the appropriate sanction the Panel should impose. However, he made some general observations about the case and the HCPC’s Sanctions Policy. Mr Khan informed the Panel that it could be taken that the Registrant has no previous adverse fitness to practise findings recorded against her.
54. Mr Khan reminded the Panel of its finding of impairment based around the need to maintain public confidence in the profession and to declare professional standards. He reminded the Panel that the purpose of sanctions is not punishment, but that a proportionate sanction may have a punitive effect. The important aim of sanctions is to ensure that the public is protected.
55. It was submitted by Mr Khan that the Panel had made reference to some potential mitigating factors. These included that the matters behind the conviction had been accepted as a ‘one-off’ by the Panel. He submitted that the Registrant had entered a guilty plea at court, which had been a demonstration of insight.
56. On the other hand, Mr Khan said, there had been inherent danger involved in the fact of having driven a vehicle whilst under the influence of alcohol. He submitted that as a registered Paramedic there was a potential for service user harm, if the Registrant had been required to drive as part of her duties. Mr Khan accepted that the Registrant had not been charged with any offence involving dangerous driving.
57. The Registrant had provided her written statements, as referred to above and the Panel took these into account. It noted that the Registrant is now in a role as a care co-ordinator. She is working in her spare time as a Paramedic in sports events. The Registrant stated that she has continued to complete a BSc Paramedic practice top-up degree. The Registrant has received the return of her driving licence, following her successful completion of a drink drive awareness course, resulting in a reduced driving ban, and her completion of a medical for the DVLA. The Registrant stated that she would like to resume employment in primary care and she has continued to keep up with her CPD.
58. The Legal Assessor advised the Panel that it had to consider what, if any sanction to impose. The Panel should be guided by the Sanctions Policy (March 2019) (“SP”) and should approach the sanctions starting with the least serious, moving up to impose the sanction which was the least severe which met with the level of impairment. He advised the Panel that it must balance the public interest with the Registrant’s interests.
59. The Legal Assessor referred the Panel to the cases of CHRE v GDC & Fleischmann [2005] EWHC 87 (Admin) and PSA v GDC & Patel [2024] EWHC 243 (Admin). In the former, the court had said that, as a general rule, a practitioner should not be allowed to return to practice until having successfully completed a criminal sentence and the latter had qualified this to the extent that this was not a hard and fast ‘rule’ but adapted to the circumstances of the case.
60. The Panel first considered any particular aggravating and mitigating factors. It did not identify any particularly aggravating factors, beyond the facts of the case and the finding of impairment.
61. The Panel did consider that there was mitigation in certain matters. The Panel had accepted that the incident had been a ‘one-off’ event. It had been demonstrated from the blood test information that the Registrant did not have long-term issues with alcohol. The Panel had found a low risk of repetition. The Panel accepted that there had been an early guilty plea to the driving offence and an early referral to obtain help. The Registrant had demonstrated insight and had offered her fulsome apologies.
62. The Panel noted that the Registrant had provided some information about her suffering from a health condition. She had referred to personal issues and stressors at the time having affected her decision-making. However, the Panel considered that it had limited information about the detail of this and its effects. Moreover, the Registrant had stated that she did not seek to excuse herself from her behaviour by these matters. As a result, the Panel could not give them very much weight.
63. The Registrant has no previous regulatory history, so far as the Panel has been informed.
64. The Panel has already noted above that the court considered the drink driving offence to have been serious, by its imposition of an initially 25-month driving ban and a community order. The Panel considered that the Registrant had completed her sentence, according to the information before it. She had taken on board the issues that were engaged by her conviction and demonstrated the development of insight.
65. The Panel considered that the conviction in this case was too serious for the Panel to end the case with a referral for mediation, or to take no action. It considered that to take either course did not sufficiently serve to protect the public.
66. The Panel considered that imposing a caution, which could be imposed for between 1 and 5 years, could in certain cases serve to mark a panel’s concern over poor conduct. It noted that some of the features referred to in paragraph 101 of the SP were met. The Registrant had shown insight and undertaken some remediation. The Panel accepted the incident as a ‘one-off’ event which was highly unlikely to be repeated.
67. However, a caution order left the public unprotected in that it did, in the view of the Panel fail to meet the level of seriousness of the conviction and therefore did not meet the need for public protection.
68. The Panel was mindful of paragraph 83 of the SP, which states:
“… if a registrant has a conviction or caution for a less serious offence which nevertheless had an impact on fitness to practise, typically panels should not permit the registrant to resume unrestricted practice.”
The Panel had concluded that the conviction had impacted the Registrant’s fitness to practise, in terms of giving rise to the need to maintain public confidence and declare proper professional standards.
69. The Panel next considered a Conditions of Practice order. However, it did not find that there were identifiable areas of practice which required remediation. The SP stated, in paragraph 108, that: “conditions are also less likely to be appropriate in more serious cases, for example those involving: …. criminal convictions for more serious offences”.
70. The Panel concluded that, given the seriousness of the drink driving offence, a Conditions of Practice Order was not sufficient.
71. The Panel therefore considered imposing a Suspension Order. It noted paragraph 121 of the SP, as follows:
“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:
• the concerns represent a serious breach of the Standards of conduct, performance and ethics;
• the registrant has insight;
• the issues are unlikely to be repeated; and
• there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings.”
72. The Panel has already referred above to the breaches of standards which were engaged in the case. It did consider that these had been serious breaches. However, the Panel had also found mitigation in the Registrant’s early acceptance of responsibility and her expression of apology and development of insight. The conviction had been a ‘one-off’ event.
73. The Panel also considered that imposing a Suspension Order has the effect of sending out a message of the expected standards of behaviour for the profession. Therefore, it serves to both maintain public confidence in the profession and to declare proper professional standards. Thus, it is a measure which protects the public in an appropriate case.
74. The Panel was aware that it could go further and consider a Striking-Off order. However, due to the matters of mitigation referred to above, the Panel concluded that it is sufficient to impose suspension. In that case, it was disproportionate to go further than suspension.
75. In terms of the period of suspension, the Panel bore in mind paragraph 122 of the SP which states that “panels must ensure that their primary consideration is what is necessary and proportionate in order to ensure that the public is protected”.
76. The Panel was aware that it may suspend registration for up to 1 year. However, in this case, the Panel took into account that it had identified earlier that there were no further steps it would require for the Registrant to develop her insight or remediation. The Panel was satisfied already, having carefully read and considered all that the Registrant has written, that it is highly unlikely the Registrant will repeat the matters which led to her conviction.
77. In the light of these matters, the Panel’s conclusion is that a short period of suspension will sufficiently mark the level of the Registrant’s impairment of fitness to practise. Balancing the need for that marking with the Registrant’s interests, the Panel concluded that a period of 3 months’ suspension is proportionate.
78. The Panel took into account, before making the decision, that imposing a 3 months’ suspension is likely to have an impact on the Registrant in both professional and financial terms. However, taking into account the need to protect the public, the Panel was satisfied that the public interest outweighed the Registrant’s interests, and that it was proportionate and appropriate to impose this suspension.
79. Towards the end of the period of suspension, the provisions of the Health Professions Order 2001 (as amended) set out that another panel ‘shall’ review the order. This Panel cannot bind that future panel. However, it may assist the next panel for the Registrant to attend the review and provide to that panel the following:
a. Any further written reflections on the conviction and the impact on the wider profession of the Registrant’s conviction;
b. Details of any CPD undertaken and how the Registrant has maintained her Paramedic knowledge and skills;
c. Personal testimonials and references;
d. Any other information the Registrant believes may assist that panel in making decisions about the Registrant’s fitness to practise.
80. The Panel directs that the Registrant’s registration is suspended for 3 months.
Order
ORDER: The Registrar is directed to suspend the registration of Ms Eden-Rose Hargreaves for three months.
This Order will start on 26 November 2024 and expire on 26 February 2025, if no appeal is made.
Notes
Interim Order
Application
1. Mr Khan applied for the Panel to make an Interim Suspension Order to cover the appeal period. He submitted that it was appropriate for the interim order to be imposed in order to cover the same public interest as in the Panel’s determination.
Decision
2. The Panel took into account that it, in its determination on impairment, it had found that there was a low risk of repetition. Its finding of impairment had been based on the wider public interest alone. The Panel was mindful that there is a ‘high bar’ for imposing an interim order purely in the wider public interest. On consideration of its findings, the Panel was not satisfied that an interim order is necessary to protect the public, was otherwise in the public interest, or in the interests of the Registrant.
3. The Panel decided not to make an interim order under Article 31(2) of the Health Professions Order 2001.
Hearing History
History of Hearings for Eden-Rose Hargreaves
Date | Panel | Hearing type | Outcomes / Status |
---|---|---|---|
28/10/2024 | Conduct and Competence Committee | Final Hearing | Suspended |