Brian Woolford

Preliminary Matters

Privacy

1. Mr Molloy submitted that the Panel should proceed in private where it was necessary to do so to protect the health information of the Registrant.

2. Mr Anderson agreed with Mr Molloy that any reference to the Registrant’s health information should be heard in private.

3. The Panel heard and accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Note ‘Conducting Hearings in Private’ dated February 2025.

4. The Panel accepted the submissions made by both parties. The Panel acknowledged that there is a strong public interest in ensuring that hearings are conducted in public for transparency. However, any health issues relating to the Registrant should be kept private, as he has a right to protection of his private life, so far as it relates to his health. The Panel concluded that it was feasible to conduct only part of the hearing in private as matters relating to the Registrant’s health are not intrinsically linked to the Allegation.

Background

5. The Registrant is registered with the HCPC as a Paramedic.

6. At the relevant time he had been working for both Bristol Ambulance Emergency Medical Services (“Bristol Ambulance EMS”) and the Welsh Ambulance Services NHS Trust (“WAST”).

7. On 6 April 2023, the Registrant and PP (Emergency Medical Technician at Bristol Ambulance EMS) attended at the residence of Patient A as part of a dual ambulance crew. Patient A had taken an overdose of venlafaxine, approximately four times over the toxicity levels.

8. On 8 April 2023, CB (Senior Operations Manager at Bristol Ambulance EMS) received a phone call from a duty manager within the service who informed her that there had been an incident involving the Registrant texting Patient A having attended her on 6 April 2023. CB was informed by the duty manager that the matter had also been reported to the police and that it was the officer in charge who had raised a complaint.

9. On 10 April 2023, CB was commissioned to conduct an investigation into the allegations made against the Registrant.

10. On 18 April 2023, CB was informed that the police were not going to conduct an investigation. CB therefore commenced her investigation.

11. As part of the investigation, CB obtained a copy of the messages exchanged between Patient A and the Registrant. CB obtained copies of the messages from both Patient A and the Registrant and compared them. CB noticed that there were some messages that were omitted from the thread of the exchanges provided by Patient A. However, the full exchange was provided by the Registrant. The first message was sent by the Registrant at 06:39 on 7 April 2023, further messages were exchanged by both parties on 7 April and 8 April. The last message sent was from Patient A at 13:25 on 8 April 2023.

12. As part of the investigation, CB interviewed PP. During the interview PP said that he did not have any concerns regarding the Registrant’s behaviour towards Patient A when they were attending her.

13. On 27 April 2023, a statement was obtained from the Registrant which included his account of the incident, which is exhibited by CB. In this the Registrant admitted to texting Patient A and said it was a lapse in judgment. The Registrant stated that he was checking on Patient A’s welfare as she was suffering with her mental health. The Registrant also admitted to obtaining Patient A's contact details from the ambulance record system and stated that he did so with Patient A's consent. He also stated that Patient A agreed to being contacted by him.

14. As part of the investigation, CB attempted to contact Patient A to obtain her account of the incident. On 6 June 2023, Patient A emailed CB to advise that she would respond to pre-written questions. CB sent questions on 7 June 2023.

15. On 20 June 2023, Patient A emailed CB. The email gave Patient A’s views as to why she was not willing to answer CB’s questions. Patient A had no further involvement in the investigations.

16. Following the conclusion of Bristol Ambulance EMS investigations, an investigation was also conducted by the Registrant’s other employer, WAST. That investigation was conducted by JB, National Delivery Manager for WAST. JB did not contact Patient A as he was informed about her lack of cooperation with the previous investigation.

17. As part of the WAST investigation, JB interviewed the Registrant. The Registrant made admissions, as he had done to CB. JB notes that in mitigation the Registrant stated that on attending Patient A's property on 6 April 2023, he found a suicide note and said that he was trying to be overly caring in an attempt to prevent her from taking her own life. He stated that his messages were sent from a well-being perspective rather than for his own sexual gratification. The Registrant affirmed that as soon as he identified that Patient A had misinterpreted his messages, he stopped communicating with her.

18. The HCPC conducted an investigation and on 10 January 2024, a Panel of the Investigating Committee determined that there was a case to answer.

Admissions

19. At the commencement of the hearing, and in response to the Allegation being read into the transcript, Mr Molloy stated that the Registrant admits Particulars 1a and 1b of the Allegation but denies Particular 2.

20. The Panel heard and accepted the advice of the Legal Assessor which included reference to the HCPTS Practice Note ‘Admissions’ dated October 2024.

Evidence

HCPC

21. The HCPC intended to call CB, PP, and JB to give evidence. They had all produced HCPC witness statements and exhibited various documents.

22. In light of the admissions in relation to Particular 1, the HCPC confirmed that it did not intend to call the witnesses and asked the Panel to find the facts set out in Particular 1 proved by admission.

The Registrant

23. The Registrant gave evidence on oath. He adopted the contents of his various reflective pieces as his evidence in chief and provided further details of the history of this matter in response to supplementary questions from Mr Molloy. The Registrant was cross examined by Mr Anderson and was asked questions by the Panel.

24. As part of the Registrant’s case, he submitted documents relating to his use of emoji’s and submitted various character references and plaudits.

Legal Advice

25. The Panel heard and accepted the advice of the Legal Assessor in respect of the approach to take in determining findings of facts and the burden and standard of proof. The burden of proof rests on the HCPC and it is for the HCPC to prove the Allegation. The Legal Assessor provided advice on the issues of:

• Sexual Misconduct including reference to the HCPTS Practice Note on ‘Making decisions on a registrant’s state of mind’, dated January 2025.
• Admissions, as per the HCPTS Practice Note on Admissions.
• Testimonials.
• Good character.
• Drafting decisions, as per the HCPTS Practice Note on Drafting.

Decision on Facts

1. Between 6 April 2023 and 7 April 2023, you failed to maintain professional boundaries in relation to Service User A, in that:
a. You obtained Patient A's contact details from the patient record system whilst working for Bristol Ambulance Service for your personal use;

26. The Registrant admitted this at the outset of the hearing.

27. The Panel had regard to the HCPTS Practice Notes on Admissions. It was satisfied that the Registrant’s admission was unequivocal and was not made for reasons of expediency or on some other inappropriate basis. The Panel therefore treated the Registrant’s admission to Particular 1a as proof of that fact.

1. Between 6 April 2023 and 7 April 2023, you failed to maintain professional boundaries in relation to Service User A, in that:
b. You sent inappropriate text messages to Patient A as set out in Schedule A

28. The Registrant admitted this at the outset of the hearing.

29. The Panel had regard to the HCPTS Practice Notes on Admissions. It was satisfied that the Registrant’s admission was unequivocal and was not made for reasons of expediency or on some other inappropriate basis. The Panel therefore treated the Registrant’s admission to Particular 1b as proof of that fact.

2. Your conduct in relation to particular 1 was sexually motivated

30. The Panel considered the guidance in the Basson and Haris cases as referred to in the HCPTS Practice Note. It was aware that it must decide whether the conduct was done either in pursuit of sexual gratification or in pursuit of future sexual relationship. It noted that the HCPC plead that the conduct was in pursuit of a future sexual relationship.

31. It was mindful that it is assessing the Registrant’s state of mind, when he failed to maintain professional boundaries in relation to Patient A, by obtaining her contact details from the patient record system for personal use; and then sending inappropriate text messages to her, and that is something that the Panel may find inferentially and by deduction from his conduct and the surrounding evidence on the balance of probabilities.

32. The Panel had regard to the facts, the history, the Registrant’s explanation and any evidence as to character.

33. It is not disputed that the Registrant attended Patient A on 6 April 2023, and he did not know her prior to this attendance. The Registrant describes the attendance on Patient A as
a challenging one due to the level of disengagement from Patient A, who presented as very disconnected. In relation to the attendance on Patient A, the Panel referred to the ‘Incident ePcr’ exhibited to CB’s statement. In part this states:

‘o/e= pt has taken an overdose of venlafaxine 75mg x 28 = 2100mg. pt has explained that she has been feeling really low over the last couple of days and that tonight the patient has hit a wall and is losing her battle with her mental health. pt has stated this is the first time that she has ever taken an over dose of venlafaxine as she normally takes her zopiclone. pt has been refusing with crew throughout. crew has contacted EST (emergency service triage team) to see if there is anything else that the crew can do to help patient or to coach patient in to hospital. pt has still refused to go to hospital. while pt was talking on the phone to kelly in EST crew contacted TOXBASE and found out patient is approx over 4 times the toxicity levels. pt has been advised this and has still refused to go to hospital. Crew have explained that she could protentially die…

MH= pt has attempted suicide mulitple times and is known to the mental health team. pt has refused to cooperate with the MH teams so was taken of the MH teams client list. pt states she has a private counselling sessions but doesnt have direct number for when she is in crisis. pt has EUPD, PTSD, depression and anxiety. pt has spoken to EST who advised patient to go to hospital but pt has refused.’

34. The Panel found this contemporaneous official document of the incident shows that at the relevant time Patient A was vulnerable and the Registrant attending on her in his professional capacity was aware of this.

35. By his own admission, the Registrant states that he did obtain the contact information for Patient A from the records for his own personal use, albeit he states this was with her consent. He accepts that he has never done this before with any patient. In the past, if he has checked on patients, it has been when he has conveyed them to hospital, and if he returns to the hospital during his shift for another reason, he will check on patients as and when he can, and time allows. In his oral evidence, the Registrant stated that he had spent about 50 minutes whilst at the scene trying to build a rapport with Patient A to get her to engage with medical treatment. He said she did eventually engage, and they found they had a shared common ground in relation to family experience. The Registrant said that he was alarmed at how disconnected Patient A presented, and that he genuinely believed that she would attempt to take her own life again at all costs. The Registrant told the Panel that he wanted to do everything he could to ensure that did not happen. Hence why he obtained her number and began the message exchanges. In response to a Panel question, the Registrant acknowledged that he did not have any mental health qualifications at that time.

36. The Registrant said that whilst he accepted the messages were inappropriate, he had no sexual motivation. He said that his use of familiar and friendly language is just his usual style of communication, as is his overuse, and lack of understanding, of emojis. The Registrant told the Panel that he wanted Patient A to feel supported and to boost her self-esteem. He said that the purpose of the messages was related to his professional relationship as he wanted to ensure she was safe. Part of this support could be meeting her to chat if she had any further issues with her mental health. The Registrant said that it became apparent from Patient A’s text that she had misconstrued his innocent intent.

37. The Panel had regard to the statement of PP dated 15 December 2023 which exhibits the notes of the investigation meeting with CB on 17 April 2023. These notes state: ‘[PP] did mention that they were in the kitchen at the home address for about a minute. In the kitchen, there was a picture of the patience and her sister hanging on the wall and a comment was made that they were two peas in a pod and really pretty.’

38. The Panel noted that reference to Patient A’s appearance was also included in the text messages that the Registrant sent to Patient A, wherein he describes her a “good looking” mess.

39. The Panel took into account that the messages, from the start, use very informal and overfamiliar language such as “hun” and “babes” and the messages also include use of kisses (x) and on occasion, the winking kiss emoji face.

40. The Panel found that the content, tone and nature of the texts sent by the Registrant to Patient A were not overtly sexual but make clear that he is attracted to her, and that he is wanting to meet with her. The second message the Registrant sends suggests meeting up for a coffee some time. Patient A acknowledges the message but doesn’t reply specifically to meeting up. The fourth message the Registrant sends reiterates the request to contact him if she wants to chat. When Patient A does reply to say that the Registrant is “welcome here anytime”, the Registrant replies to say “OOH! That sounds like a cheeky invite?? (winking kiss face emoji x 2) What do you have in mind??xx”. The Panel took into account that this is the first and only time the Registrant uses emojis in the whole text exchange. The Panel found that the text with the emojis was in particular both inappropriate and flirtatious. The Panel found that in sending these texts the Registrant was “testing the water” as it were, to see if Patient A was attracted to him and to see whether she would reciprocate. The intent to meet up was accepted by the Registrant in his evidence, albeit he said it was not for pursuing a sexual relationship.

41. The Panel found that there was no clinical justification for the contact with Patient A, post attendance to her. The Registrant, by his own admission, has no mental health qualifications, and even if he did, it was not within his clinical remit to remain in contact with Patient A.

42. Although the Registrant states that he remained in contact with Patient A out of concern for her well-being, the Panel did not find the Registrant’s explanation as a plausible alternative explanation for his conduct, for a number of reasons.

43. If his intent was professional, albeit ill advised, and contrary to HCPC Standards, he would have used a professional tone. But from the outset he used overfamiliar language and made comments about the Patient’s appearance which were unwarranted in the circumstances. He does not set clear boundaries in the messages and he is the one pushing the issue of being available to chat and meet with the Registrant.

44. Once it is clear that Patient A is not interested in a relationship, the Registrant’s response to her changes. Despite saying he wanted to try and support her, he does not reply to her last two messages. The first of these states that: “…I’m so tired my tired is tired..i don’t know what to do I think I’ve hit my brick wall hey it cant get any worse surely x”. The last message states: “I really need help and nobody is listening.” The Panel considered the Registrant’s failure to respond to these as telling as if he was seeking to help and support her, the obvious thing to do would have been to respond when she was clearly asking for help.

45. In these circumstances, the Panel concluded that the Registrant’s conduct at Particular 1 (as admitted), was sexually motivated. Whilst the Panel found that there was no evidence that the Registrant specifically sought Patient A out because of her vulnerability and noted that she did engage in the messaging, it found that the Registrant’s conduct was done in pursuit of a future sexual relationship.

Decision to Amend Allegation

46. Having reconvened to hand down on “facts” but prior to doing so, the Panel raised with the parties an anomaly in the drafting of the Allegation. The stem of Particular 1 refers to Service User A, but the sub particulars refer to Patient A.

47. The parties agreed that this was inconsistent, and it should be Patient A throughout. Therefore, the parties agreed that the Panel should amend the Allegation accordingly. The Panel agreed to do so as the change is a minor change to provide consistency and does not impact on the nature of the Allegation. The changes are marked at the outset of this decision in Bold for the addition and strike through for the deletion.

Grounds

48. Mr Anderson submitted that the facts found proved amount to serious misconduct.

49. Mr Anderson referred to the case of Roylance v General Medical Council, Nandi v General Medical Council, and Meadow v GMC.

50. Mr Anderson submitted that the Registrant’s conduct in failing to maintain professional boundaries by obtaining a patient’s personal information to communicate in an inappropriate manner, with sexually motivated intent, is serious misconduct of the nature that would be found deplorable by fellow practitioners.

51. Mr Anderson submitted that the HCPC Standards of Proficiency for Paramedics, have been breached as follows:

1. Be able to practise safely and effectively within their scope of practice
2. Be able to practise within the legal and ethical boundaries of their profession
2.3 understand the need to respect and uphold the rights, dignity, values, and autonomy of service users including their role in the diagnostic and therapeutic process and in maintaining health and wellbeing
2.4 recognise that relationships with service users should be based on mutual respect and trust, and be able to maintain high standards of care even in situations of personal incompatibility
4 be able to practise as an autonomous professional, exercising their own professional judgement
7.2 understand the principles of information governance and be aware of the safe and effective use of health and social care information.

52. Mr Molloy took no issue with the legal authorities and reminded the Panel that misconduct is a matter for its judgment. He reminded the Panel that not every proven fact necessarily amounts to misconduct.

53. In relation to misconduct, the Legal Assessor referred the Panel to the case of Roylance v GMC (no.2) [2000] AC 311 and to the HCPC Standards of conduct, performance, and ethics. The Legal Assessor advised that there was no settled definition of misconduct, and it was for the Panel to say in the circumstances of the case whether the behaviour, crossed the threshold properly to be categorised as misconduct. The Panel could approach the question by deciding whether an act or omission on the part of the Registrant represented a serious falling short of the standards to be expected of a HCPC registrant. However, it is important to note that not every omission or wrongdoing necessarily constitutes misconduct.

Panel Decision

54. The Panel at all times kept in mind the HCPC’s overarching objective of protecting the public which includes protecting services users, protecting public confidence in the profession and the regulatory process, and declaring and upholding proper standards of conduct and behaviour.

55. The Panel took into account the HCPC Standards of Conduct Performance and Ethics 2016 (“the Standards”). The Panel bore in mind that a departure from the Standards alone does not necessarily constitute misconduct.

56. Based on all the information before it, the Panel found the Registrant’s behaviour in relation to the facts did amount to serious professional misconduct.

57. The Panel took into account that the actions of the Registrant were not related to his Paramedic competence. His actions related to the sexually motivated failure to maintain professional boundaries with Patient A. The Panel had careful regard to the Standards and considered that the Registrant’s conduct was in breach of the following:

• 1.1 You must treat service users and carers as individuals, respecting their privacy and dignity.
• 1.7 You must keep your relationships with service users and carers professional.
• 9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

58. Patient A was a clearly vulnerable patient, who experienced mental health issues and who needed treating by the Registrant as a result of an overdose. The Registrant did not respect her privacy as he used her contact details for his own personal use. He sent Patient A text messages for which there was no clinical justification. The messages were inappropriate, informal, flirtatious, failed to set boundaries and were sent in pursuance of a sexual relationship with Patient A. In behaving in this way, the Registrant did not keep his relationship with Patient A professional.

59. The Panel considered that the actions of the Registrant were fundamentally inconsistent with what is expected of a registered Paramedic and fell far below the standards expected.

60. The Panel concluded that the conduct found proved does amount to serious professional misconduct.

Decision on Impairment

61. Mr Anderson made submissions on impairment taking the Panel through the HCPTS Practice Note titled Fitness to Practise Impairment dated February 2025.

62. In his submissions Mr Anderson acknowledged the Registrant’s previous good conduct and his lengthy career, and that this might speak to his character.

63. Mr Anderson submitted that all elements of the overarching objective are engaged.

64. Mr Anderson reminded the Panel of its findings in relation to Patient A’s vulnerability and submitted that findings of sexual motivation are more difficult to remediate.

65. Mr Anderson submitted that the Panel might consider the Registrant’s reflections show remorse, regret and provide some contextual information about the events. He submitted that the Registrant has to some degree reflected and been contrite.

66. Mr Anderson submitted that the Registrant’s actions were intentional and were towards a vulnerable service user.

67. Mr Anderson submitted that impairment should be found.

68. Mr Molloy submitted that the misconduct is remediable and referred to the Registrant’s bundle of evidence. He submitted that the reflections, training, and character references show the efforts that the Registrant has made since this incident, which was now two years ago.

69. Mr Molloy submitted that the misconduct will not be repeated, it was out of character and has not been repeated since. It occurred over a two day period and has not occurred since.

70. Mr Molloy referred to the references from Acute Medics. He submitted that these show the Registrant’s conduct since this matter to be as exemplary as it was before.

71. Mr Molloy submitted that it is clear that from the outset that the Registrant has acknowledged that his conduct fell below standards, and that he understands how and why it occurred. Whilst the Registrant can’t explain his actions on that occasion, he gives a clear understanding of the consequences on others of his actions.

72. Mr Molloy submitted that the Registrants reflections show that he understands what he has done, and that he has taken action to resolve this, to ensure that there will be no repeat.

73. Mr Molloy submitted that the Registrant admitted the primary allegation and only denied the secondary allegation, and it is wrong to equate denial with a lack of insight.

74. Mr Molloy submitted that there is no evidence of actual harm, but the Registrant himself recognised the potential for harm, which shows insight on his part.

75. Mr Molloy submitted that a fully informed member of the public would have regard to all the positive aspects, as contained in the Registrant’s bundle, and would acknowledge that whilst misconduct has been found, as of today the Registrant is not impaired.

76. The Panel heard and accepted the advice of the Legal Assessor in relation to impairment. The Legal Assessor reminded the Panel to take into account that it should have regard to both the personal and public components and keep in mind the wider public interest. The Legal Assessor referred the Panel to the HCPTS Practice Note ‘Fitness to Practise Impairment’ dated February 2025, and the Practice Note on ‘Professional Boundaries’ dated September 2024. The Panel was referred to the cases of, CHRE v (1) NMC & (2) Grant [2011] EWHC 927 (Admin), Cohen v GMC [2008] EWHC 581 [Admin], Cheatle v GMC (2009) EWHC 645 (Admin), and PSA v HCPC + Doree [2017] EWCA Civ 319.

77. The Panel considered the Registrant’s current fitness to practise firstly from the personal perspective and then from the wider public perspective. The Panel had careful regard to the HCPTS Practice Notes on impairment and professional boundaries.

78. In relation to the personal component, in accordance with the HCPTS Practice Note (Impairment), the Panel considered whether the conduct in this case is easily remediable, whether it has been remedied and whether it was highly unlikely to be repeated.

79. The Panel kept in mind that concerns that raise questions of character such as sexual motivation, may be harder to remediate. However, the Panel did think that the Registrant’s sexually motivated conduct could be remediated. Whilst the Panel recognised that a finding of sexually motivated behaviour is always considered as serious, it took into account that the misconduct in this case relates to a period of two days and is an isolated incident within a lengthy career within the ambulance service, from a Registrant of previous good character. The Panel considered that in order to remediate the Registrant would need to show fully developed insight, to include an understanding of how and why the conduct occurred. This would allow the Registrant to demonstrate what steps he would take and/or had taken to avoid a repetition of the sexually motivated misconduct recurring.

80. The Panel next had regard to whether the Registrant’s sexually motived misconduct has been remedied. The Panel took into account the documentary evidence and reflections provided by the Registrant in advance of the hearing which were supplemented by his oral evidence at ‘facts stage’.

81. The Panel kept in mind that the Registrant was of previous good character and these events have been a one-off in his career and appear out of character for him. He also admitted failing to maintain professional boundaries from the outset. However, whilst the Registrant has accepted that his behaviour fell below professional standards, the Panel was not confident that the Registrant fully understood how and why it occurred, nor had he acknowledged the sexual motivation aspect of the case. The Panel considered that the Registrant’s responses to date including his lack of acceptance of sexual motivation paint a mixed and confusing picture of his mindset. He reflects that he was trying to help Patient A but also states that he finds it “really difficult to adequately explain finitely what led [him] to believe that [he] could do more than anyone else.” He acknowledges that the messages he sent to Patient A were “over familiar misleading and inappropriate”. He states that, it was never his “intention to secure a relationship at the time or in the future” but that he can truly understand why others, including Patient A might think that.

82. Although the Registrant offers insightful reflections on the wider impact of his conduct on Patient A, and others, and offers sincere remorse, he fails to adequately grapple with the root cause of his conduct and what triggered it. He highlights his health as an issue and his commonality with Patient A, and states that he has sought help. However, the Panel noted that there was no independent evidence of this and no analysis of how this had changed his perceptions and assisted to resolve what he identifies as issues for him. The Panel found the Registrant’s insight to be developing but until such time that he is able to understand and articulate how and why the conduct occurred, and how to appropriately undertake remediation, his insight will continue to be insufficient.

83. The Panel considered whether the misconduct was likely to be repeated by the Registrant. The Panel took into account all it had read and heard about the misconduct. It kept in mind the Registrant’s partial admissions, his engagement with the HCPC process and his assertion that this behaviour would not be repeated. However, the Panel were not assured that the risk of repetition was low.

84. The Registrant still appears unable to recognise that his actions were sexually motivated. He acknowledges that they could be perceived by others in this way but does not provide reflections or detail steps that could be taken to reassure this would not be repeated. The Panel were concerned that if the Registrant is still unable to accept that what he did was sexually motivated, albeit at a time when he says that he was impacted by other issues, such as his response to suicides, then there remains a potential for the Registrant to behave in this way again. It is the failure to acknowledge this which presents a future risk of harm to patients. The action plan set out in the Registrant’s reflections, does not set out any proposed learning in relation to dealing with attempted suicides, dealing with vulnerable patients, mental health and issues of sexual motivation, all of which are features in this case.

85. The Panel took into account that in terms of clinical actions, the Registrant’s conduct in attending Patient A was good. He built up a rapport with her, sought advice about the toxicity levels, got her to speak to the mental health team and persuaded her to go to hospital. However, his misconduct thereafter in failing to maintain professional boundaries with a patient with sexually motivated intent, poses a potential risk to the public.

86. The Panel determined that the Registrant’s fitness to practise is currently personally impaired on the grounds of his misconduct.

87. The Panel next considered whether a finding of current impairment was necessary in the public interest. The Panel was mindful that the public interest encompassed not only public protection but also the declaring and upholding of proper standards of behaviour as well as the maintenance of public confidence in the profession. It took into account the guidance in the case of CHRE v NMC & Grant [2011] EWHC 927 (Admin) at paragraph 74:- ‘In determining whether a practitioner’s fitness to practise is impaired by reason of misconduct, the relevant panel should generally consider not only whether the practitioner continues to present a risk to members of the public in his or her current role, but also whether the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment were not made in the particular circumstances.’

88. The Panel had regard to the factors identified by Dame Janet Smith in her 5th Shipman Report and cited in CHRE v (1) NMC and (2) Grant. The Panel considered whether:

• a- The Registrant has in the past and/or is liable in the future to place service users at unwarranted risk of harm.
• b- The Registrant has in the past brought and/or is liable in the future to bring the profession into disrepute.
• c- The Registrant has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the profession.

89. In relation to a), the Panel determined that the Registrant had placed Patient A at unwarranted risk of harm, by breaching professional boundaries in the way that he did. Whilst there is no evidence of actual harm, his misconduct could have caused harm, and in an email to CB, Patient A describes the ambulance service as “a service we are supposed trust.” [sic]. The Registrant himself acknowledges that in behaving as he did, which he says was to prevent the patient from further harming herself, “he created a situation where the greatest harm was [him].”

90. The Registrant entered into an inappropriate personal relationship with Patient A, who he knew to be a vulnerable patient, over social media, with sexually motivated intent, which included an intent to meet up with her. He used her contact information that was available to him as a result of his clinical attendance on her, to make personal contact with her other than for the purpose of providing clinical care to her. Whilst this was an isolated incident and did not involve overtly sexual messages, it involved clinically unjustified contact. There is a potential risk that when boundaries are breached in this way, it impacts on the trust and confidence in healthcare professionals which may make it less likely that members of the public will seek treatment in future or increase the risk that they will be suspicious of advice and treatment offered and less likely to engage with it effectively. This creates unwarranted risk of harm.

91. In relation to b), that is the question of whether the Registrant has in the past brought the profession into disrepute, the Panel determined he had. A significant aspect of public interest is upholding proper standards of conduct and behaviour so as not to bring the profession into disrepute. The role of the HCPC Standards is to set out in general terms how Registrants are expected to behave and outline what the public should expect from their health and care professional. In breaching three of the HCPC Standards of conduct, performance and ethics, as already set out within this decision, the Registrant has brought the profession into disrepute.

92. The Panel then considered c), being whether the Registrant had breached fundamental tenets of the profession. The Panel took into account that it is essential to the effective delivery of the ambulance service that the public can trust Paramedics to act within professional boundaries and comply with the Standards which are fundamentally in place to ensure patient safety. In acting as he did, towards a vulnerable patient, the Registrant abused his professional position, failed to have regard to the power and trust placed in him as a registered Paramedic, and failed to set clear boundaries. The Panel considered that the conduct, as described, demonstrated a breach of the fundamental tenets of the profession.

93. The Panel asked itself, given the nature of the Allegation and the facts found proved, would public confidence in the profession and how it is regulated be undermined if there were to be no finding of impairment?

94. Based on its findings in relation to the unwarranted risk of harm, the bringing the profession into disrepute and the breaching of the fundamental tenets of the profession, the Panel concluded that it would be undermined if there were to be no finding of impairment. The Panel considered that not to make a finding of current impairment of fitness to practise in relation to the misconduct would seriously undermine public trust and confidence in the profession and would fail to uphold and declare proper standards.

95. The Panel therefore decided on the public interest element of impairment that the Registrant’s fitness to practise is currently impaired.

Decision on Sanction

96. Mr Anderson submitted that the HCPC remain neutral on sanction. Mr Anderson reminded the Panel to have close regard to the HCPC Sanctions Policy Last updated March 2019.

97. Mr Anderson submitted that there are no other findings against this Registrant. He was of good character. His conduct was clinically good. He showed remorse and offered an apology and is developing insight.

98. Mr Anderson submitted that there was a potential for harm to Patient A who was a vulnerable patient with mental health issues, and the Registrant abused his position of trust by pursing an inappropriate relationship with her, which was sexually motivated.

99. Mr Anderson reminded the Panel to exercise fairness and of the concept of rejected defence as referred to in the HCPTS Practice Note on Impairment.

100. Mr Molloy submitted that the decision of the Panel should take into account the relevant parts of the Sanctions Policy and be consistent with the Panel’s findings to date.

101. Mr Molloy acknowledged that sexual motivation is serious but submitted that this case is at the lowest end of spectrum. It took place over two days, involved limited text messages exchanged, and there was some engagement by Patient A.

102. Mr Molloy reminded the Panel of its decision that the Registrant’s insight is developing and that the conduct can be remediated.

103. Mr Molloy submitted that the Panel has evidence the Registrant has complied with an Interim Conditions of Practice Order.

104. Mr Molloy acknowledged that the misconduct was a serious breach of standards, but that the Registrant has developing insight, and the conduct is unlikely to be repeated. No concerns have been raised since and the conduct was short lived, a one-off and is out of character for the Registrant.

105. Mr Molloy submitted that there is no evidence to suggest a complete lack of insight or repeated misconduct or that the Registrant is unwilling to resolve matters.

106. Mr Molloy submitted that a strike off would be disproportionate.

107. The Panel heard and accepted the advice of the Legal Assessor, who referred it to the HCPC Sanctions Policy, which states that any sanction must be proportionate, is not intended to be punitive and should be no more than is necessary to meet the legitimate purposes of providing adequate protection to the public, to protect the reputation of the profession, maintain confidence in the regulatory system, and declare and uphold proper professional standards.

108. The Legal Assessor also referred to the following HCPTS Practice Notes:

• Impairment (dated February 2025) paragraph 12 – 14.
• Conditions Bank (dated November 2023)
• Making decision on a registrant’s state of mind (dated January 2025) paragraph 20 – 23.
• Professional Boundaries (dated September 2024)
• Drafting fitness to practise decisions (dated November 2023) paragraph f.

109. The Panel applied the principle of proportionality by weighing the Registrant’s interests with the public interest and by considering each available sanction in ascending order of severity. The Panel considered the mitigating and aggravating factors in determining what sanction, if any, to impose.

110. The Panel identified the following aggravating factors:

• The imbalance of power between the Registrant and Patient A.
• The potential for harm to Patient A as a result of the boundary breaches.
• The vulnerability of Patient A, who experienced mental health issues, and who needed treatment from the Registrant as a result of an overdose.

111. The Panel identified the following mitigating factors:

• The Registrant is of previous good character.
• The Registrant has practised as a Paramedic since the events to which the Allegation relates. There have been no concerns raised, and he has evidenced positive feedback from his employer who is fully aware of the HCPC case against him.
• The Registrant has produced some reflective pieces using a reflective model.
• The Registrant fully engaged with both his employers investigations and with the HCPC investigation, and he made admissions at the outset in relation to the primary facts.
• The Registrant has shown a commitment to Paramedic practice, having entered the profession as a mature student.

112. The Panel had careful regard to the seriousness of the case, taking into account the guidance in Sanctions Policy under the heading “serious cases”.

113. The Panel considered its findings to date and noted that it had found the Registrant to have abused his professional position. He inappropriately accessed Patient A’s medical notes to obtain her contact details for his own personal use to make contact with her. He then undermined professional boundaries by seeking to pursue an inappropriate relationship with Patient A. His conduct included sending flirtatious messages to Patient A, who was a vulnerable service user due to her mental health issues at that time.

114. The Panel took into account the following paragraphs of the Sanctions Policy:

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

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

115. In considering it findings to date, the Panel found that the Registrant’s actions do fit into the definition of Predatory Behaviour and combined with Patient A’s vulnerability this does elevate the seriousness of the case.

116. The Panel took into account its findings that the Registrant’s conduct had been sexually motivated, so it had careful regard to the paragraphs within the Sanctions Policy relating to sexual misconduct. The Panel reminded itself that whilst the conduct was sexually motivated, it did not involve overtly sexual messages, it was isolated/time limited, there was no evidence that the Registrant specifically sought out Patient A because of her vulnerability, and she did engage in the messaging. The Panel therefore concluded that the sexual misconduct is at the lower end of seriousness.

117. The Panel started by considering the least restrictive sanction first, working upwards only where necessary. It took into account that the final sanction should be a proportionate approach and will therefore be the minimum action required to protect the public.

118. The Panel firstly considered referring the case to mediation. The Policy states that mediation is likely to only be appropriate in cases where the Registrant’s impairment is minor, is isolated in nature and unlikely to recur, and where the registrant has displayed sound insight and has undertaken significant remediation. The Panel had regard to its findings to date. It noted that it had found that Patient A was a clearly vulnerable patient, who experienced mental health issues and who needed treating by the Registrant as a result of an overdose. The Registrant did not respect her privacy as he used her contact details for his own personal use. He sent Patient A text messages for which there was no clinical justification. The messages were inappropriate, informal, flirtatious, failed to set boundaries and were sent in pursuance of a sexual relationship with Patient A. The Panel did not consider this to be minor impairment and in any event in the circumstances of this case, facilitating a meeting with Patient A is not appropriate.

119. The Panel next considered taking no action. Given the Panel’s findings, as summarised in the paragraph above, the Panel found that taking no further action would not be appropriate or proportionate and would not meet the overarching objective.

120. The Panel next considered whether a Caution Order would be appropriate. In light of the Panel’s findings relating to the seriousness of certain aspects of the case, as already set out above, the Panel did not consider this misconduct to be minor in nature. Therefore, it concluded that a Caution Order is not appropriate or proportionate.

121. The Panel next considered whether to impose a Conditions of Practice Order. The Panel took into account the Sanctions Policy which notes that:

“Conditions are also less likely to be appropriate in more serious cases, for example those involving:
…
• abuse of a professional position, including vulnerability.
• sexual misconduct (see paragraphs 76–77).”

122. The Panel considered that this case involves both abuse of a professional position and sexual misconduct (albeit at the lower end of the spectrum), and that such conduct cannot be described as minor. Further, there are no concerns about the Registrant’s clinical practice and as the messaging to Patient A occurred outside of the Registrant’s role, the Panel could not formulate any workable conditions which could realistically be monitored. For these reasons the Panel concluded that Conditions of Practice would not be suitable.

123. The Panel next considered a Suspension Order. The HCPC Sanctions Policy states: ‘A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register.’

124. The Panel was mindful that it had found that the Registrant’s sexually motivated conduct could be remediated, if the Registrant could show fully developed insight, to include an understanding of how and why the conduct occurred. The Panel noted that the Registrant has provided insightful reflections on the wider impact of his conduct towards Patient A, and others, and offered sincere remorse, but that his insight is still developing as to his understanding and articulation of how and why the conduct occurred. Hence there remains a potential for the Registrant to behave in this way again.

125. The Panel took into account that the concerns found proved do represent a serious breach of the Standards of conduct, performance and ethics, as previously identified. However, the Registrant’s insight is developing, and he has acknowledged that his actions could be perceived as sexually motivated, albeit he has yet to provide the reassurance that this would not be repeated. Whilst there remains a potential risk for repetition, the Panel balanced this against the Registrant having remained in practice as a Paramedic with no further concerns occurring. On the totality of the evidence before it, the Panel was satisfied that there is evidence to suggest that the Registrant is likely to be able to resolve and remedy his failings.

126. The Panel found that the misconduct in this case was such that the requirements of public protection and the wider public interest would be adequately served by imposing a Suspension Order.

127. The Panel did consider whether a Strike Off Order would be appropriate. Whilst the Panel recognised the seriousness of the Registrant’s actions, it did not find these to be persistent or calculated, and it was out of character for the Registrant. The misconduct has not been repeated, and the Registrant has developing insight and has shown through his engagement and attendance with the HCPC process that he is willing to resolve matters. The Panel therefore considered that a striking off order would be disproportionate and draconian.

128. The Panel, having decided that a Suspension Order would adequately protect the public and meet the wider public interest, next considered the length. It decided that the proportionate length was nine months because this reflects the seriousness of the misconduct whilst recognising that the Registrant is already on his journey to developing insight into his actions.

129. Throughout its decision making, the Panel had regard to proportionality and balanced the public interest against the Registrant’s interests. The Panel noted that the Registrant is currently employed outside of Paramedic practice but may seek to return. The Panel took into account the consequential personal, financial and professional impact a Suspension Order may have upon the Registrant but concluded that these considerations are significantly outweighed by the Panel’s duty to give priority to public protection and the wider public interest.

130. The Panel concluded that the appropriate and proportionate order is a Suspension Order for 9 months.

131. The Panel acknowledged that this final Suspension Order will be reviewed by a panel before it expires. Whilst it is not for this Panel in any way to seek to bind the discretion of any reviewing panel, it considered that such a panel might find it helpful for the Registrant to produce, at least 14 days before the next hearing, evidence of the following:

• Demonstration of the Registrant’s insight through an updated reflective statement.
• How he has maintained his continuing professional development.
• Up to date character references, which may include his current employer(s)
• Any independent evidence relating to his health
• Details of appropriate remediation regarding the issue of sexual motivation

132. The reviewing panel is also likely to be assisted by the Registrant’s continued engagement and attendance at the review hearing.

Order: The Registrar is directed to suspend the registration of Mr Brian Woolford for a period of 9 months from the date this Order comes into effect

Interim Order

Application

133. Mr Anderson submitted that an Interim Suspension Order is necessary in line with the findings of the Panel in relation to the Allegation. Mr Anderson submitted that an Interim Order would safeguard the public and the wider public interest.

134. Mr Anderson submitted that having made substantive findings, the Panel has a basis for an Interim Order. He submitted that an Interim Order is necessary for public protection and
that it is otherwise in the public interest.

135. Mr Anderson submitted that the Interim Suspension Order should be made for eighteen months to cover the appeal period.

136. Mr Molloy submitted that it was a matter for the Panel whether an Interim Order should be made, but he reminded them of the need for necessity.

Decision

137. The Panel heard and accepted the advice of the Legal Assessor to consider whether an Interim Order is necessary under Article 31, to protect the public or in the public interest or the Registrant’s own interest, because of the nature of the findings made in this case. The Legal Assessor drew the Panel’s attention to the HCPC Sanctions Policy which states: ‘An interim order is likely to be required in cases where: … the allegation is so serious that public confidence in the profession would be seriously harmed if the registrant was allowed to remain in unrestricted practice.’ The Legal Assessor also advised the Panel to take into account the HCPTS guidance note entitled ‘Interim orders’ dated September 2024.

138. The Panel was satisfied that it is appropriate to direct that the Registrant’s registration should be subject to suspension on an interim basis, in the same terms as the substantive order set out above. This order is required for the protection of the public and is in the public interest to protect against the risks that the Panel has identified within its substantive decision. Taking into account its findings, including sexual motivation, the Panel considered that an Interim Conditions of Practice Order would not be sufficient to protect the public. The Panel concluded that the appropriate length of the Interim Suspension Order is 18 months, as an Interim Order would continue to be required pending the resolution of an appeal, in the event of the Registrant giving notice of an appeal within 28 days.

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

140. This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Brian Woolford