Ian T Neale

Preliminary Matters
Service
1. The Panel was satisfied that notice of the hearing under Rule 5(1) of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”) was sent to the Registrant by email and special delivery letter on 25 April 2025. The notice included the information required by Rule 5(1) and was sent at least 28 days before the hearing date, as required by Rule 6(2).

2. The Panel had sight of a certificate of postal service and confirmation of email delivery, both dated 25 April 2025.

3. The HCPC Certificate of Registration confirmed the Registrant’s email and postal addresses registered with the HCPC to which notice of the hearing was sent.

4. The Panel was satisfied that the Registrant had been served with notice of the hearing in compliance with the requirements of the Rules.

Application to proceed in the absence of the Registrant
5. Mr Maughan, on behalf of the HCPC, confirmed that there had been no contact from the Registrant in response to the notice of hearing. The most recent contact with the Registrant was a telephone call to him from the HCPC on 24 June 2024, in connection with another issue which did not relate to this hearing.

6. Mr Maughan submitted that it was apparent that the Registrant did not intend to be present at this hearing and had voluntarily waived his right to attend. Mr Maughan submitted that it was therefore in the public interest for the Panel to proceed and consider the case today.

7. The Panel considered the submissions on behalf of the HCPC and accepted the advice of the Legal Assessor. The Panel was reminded of its discretion to proceed in absence under Rule 11. The Panel was referred to the HCPTS Practice Note, Proceeding in Absence (June 2022), which sets out relevant guidance from the cases of R v Jones (Anthony) [2004] 1 AC 1HL and GMC v Adeogba and GMC v Visvardis [2016] EWCA Civ 162. The Panel was careful to remember that its discretion to proceed in absence is not unfettered and must be exercised with the utmost caution and with the fairness of the hearing at the forefront of its mind.

8. The Panel noted that the Registrant was given appropriate notice of today’s hearing date. He was informed of the powers available to the Panel and of his right to attend and be represented. The Registrant was offered assistance to join the virtual meeting. In the circumstances, the Panel was satisfied that all reasonable efforts had been made by the HCPC to inform the Registrant of this hearing.

9. The Panel noted that the Registrant had not contacted the HCPC in response to the notice of hearing. The Panel noted that in addition to the call on 24 June 2024, there were two communications in the hearing bundle which indicated that the Registrant is aware of these proceedings. One was an undated note referring to his personal circumstances. The other was an e-mail to Blake Morgan dated 19 October 2023 in which the Registrant stated that he had no interest in practising again and wanted his registration to be terminated. The Panel concluded that the Registrant appears to have disengaged from the HCPC proceedings.

10. The Panel was satisfied that the Registrant has voluntarily absented himself from this hearing and has waived his right to attend or be represented. He has not sought an adjournment for any reason. In the light of the only communications from the Registrant to the HCPC, the Panel concluded that there is no indication that the Registrant would attend on a future date if this matter were adjourned today.

11. The Panel was mindful of fairness to the HCPC and its witnesses. The allegation dated back to 2020 and further delay would impact on witnesses and their recollection. The Panel concluded it is also important in the public interest that this fitness to practise allegation should now be resolved expeditiously.

12. The Panel accepted that there would be a disadvantage to the Registrant if the Panel proceeded to reach a determination of the allegation in his absence. However, given the public interest in the resolution of this allegation and the fact that the Registrant appears to have disengaged from the process, the Panel concluded that it was in the public interest for this hearing to proceed today.

13. The Panel was reminded by the Legal Assessor that having decided to hear the case in the absence, it should ensure that the hearing was as fair as circumstances permit. That would include looking for points favourable to the Registrant which are reasonably available on the evidence. When considering witness evidence, the Panel ought to take reasonable steps to expose weaknesses, without extending to cross-examining witnesses.

Application to admit hearsay evidence
14. Mr Maughan sought to rely on two pieces of written evidence, both of which related to admissions made by the Registrant. These were:
• The transcript of a police interview with the Registrant on 28 October 2020
• A redacted transcript from the Registrant’s criminal trial in August 2023

15. The HCPC’s application on the basis that on 13 June 2025, a Notice to Admit Facts was served on the Registrant in accordance with the Standard Directions which apply in all HCPC cases. The Notice referred to the allegation and the two transcripts. Mr Maughan informed the Panel that the HCPC had received no objection from the Registrant within the specified time frame of 14 days, or at all.

16. The HCPC’s application also referred to Rule 10(1)(b) of the Rules. Mr Maughan referred to the provisions of the Civil Evidence Act 1995 which does not exclude the admission of hearsay evidence. He confirmed that the Registrant was put on notice of the HCPC's application to admit hearsay evidence and had not raised any objection.

17. Mr Maughan’s alternative submission was that, if the Panel was not satisfied that the evidence was admissible under Rule 10(1)(b) then, given the gravity of the matter and the high level of public interest in the case, the Panel should admit the hearsay evidence under Rule 10(1)(c), by which a panel has a discretion to receive evidence which would not be admissible in civil proceedings where it is satisfied that admission of the evidence is “necessary in order to protect members of the public”.

Decision on application to admit hearsay evidence
18. The Panel carefully considered the submissions of Mr Maughan and accepted the advice of the Legal Assessor. The Panel approached the applications bearing in mind the paramount importance of fairness and the interests of justice in HCPC proceedings. It bore in mind that at a final hearing, the HCPC bears the burden of proof of the factual allegations and that the civil standard of proof will apply.

19. The Panel was referred to the HCPTS Practice Note, Case Management, Directions and Preliminary Hearings (October 2024), which includes the Standard Directions. The Panel heard that the HCPC served on the Registrant a Notice to Admit Facts under the Standard Directions. The Registrant has not served any notice objecting within the time requirement of 14 days from receiving the Notice. The Panel was advised that the Standard Directions provide that in those circumstances, the Registrant is taken to admit to the specified facts or part of the case in question.

20. The Panel was advised that Rule 10 (1)(b) provides that the rules on the admissibility of evidence that apply in civil proceedings in the appropriate court in the part of the United Kingdom where the hearing takes place shall apply. In relation to the admissibility of evidence in civil proceedings, the Civil Evidence Act 1995 applies. The Act allows for hearsay evidence is admissible, subject to certain safeguards.

21. The Panel noted that the documents in question are hearsay evidence, as defined by section 1(2)(a) of the Civil Evidence Act 1995, in that they are statements made otherwise than by a person while giving oral evidence in the proceedings which is tendered as evidence of the matter stated. In this case, they are hearsay evidence of admissions by the Registrant, rather than of any other witness.

22. The Panel noted that Section 2 of the Civil Evidence Act requires that notice has to be given in relation to hearsay evidence. It had heard that the evidence in question had been served on the Registrant and that the HCPC had received no objection from him to the admission of the evidence.

23. The Panel concluded that the two documents should be admitted in evidence by virtue of the service of the notice to admit facts under the Standard Directions and in accordance with the provisions of the Civil Evidence Act 1995.

24. The Panel was also satisfied that the residual provision in Rule 10(1)(c) applied, in that if the evidence were not admissible under Rule 10(1)(b), the admission of the evidence would be “necessary in order to protect members of the public” given the serious nature of the allegation in this case.

25. Whilst the Panel was satisfied that the two documents should be admitted for the reasons stated above, given the serious nature of the allegation and to ensure requirements of fairness were met, the Panel considered the HCPC's alternative hearsay application. The Panel bore in mind the authorities on hearsay evidence. The Panel bore in mind, as emphasised in the judgment in El Karout v NMC [2019] EWHC 28 (Admin), the distinction between the issue of admissibility and the weight to be attached to the evidence if admitted.

26. The Panel was referred to the guidance in Thorneycroft v NMC, as adapted to circumstances where the evidence in question was admission by the Registrant. It noted that the admission of the statement of an absent witness should not be a routine matter. The issue of fairness should be considered before the statement was admitted. The question of the weight to be attached to the evidence was a factor to weigh in the balance but would not always answer the issue of admissibility. Although not finally determinative, the absence of a good and cogent reason for the non-attendance of the witness is an important factor. Where the evidence in question is the sole or decisive evidence, the Panel must make a careful assessment and weigh up the competing factors. The Panel should consider the issues in the case, the other evidence to be called and the potential consequences of admitting the evidence. They must be satisfied that the evidence is demonstrably reliable or that there is some means of testing its reliability.

27. The Panel considered the factors identified in Thorneycroft and concluded that there would be no unfairness in admitting the two documents. The Registrant had been given notice that the HCPC would apply to have the documents admitted as hearsay evidence at this hearing. He had been given the opportunity to submit objections to the HCPC but had not done so.

28. The hearsay evidence was the sole and decisive evidence upon which the HCPC sought to rely to prove the facts. The Panel was mindful that the charges in this case were serious and if proved, would have an adverse impact on the Registrant’s professional career. However, the Panel bore in mind that the HCPC had no power to compel the Registrant to attend this hearing to answer the allegations and he had voluntarily waived his right to do so.

29. The Panel considered that the evidence in the two transcripts bore a high degree of reliability and credibility. Both documents were officially prepared, verbatim records of the Registrant's own admissions in formal proceedings. The first was a record of a police interview, under caution, at which the Registrant was legally represented. The second was a verbatim transcript from the criminal trial setting out agreed facts given to the Court and a record of the Registrant’s own oral evidence given under oath. The Registrant had been legally represented at his trial.

30. The Panel was satisfied that it was fair and in the interests of justice that the hearsay evidence should be admitted and accepted the HCPC’s applications.

Background
31. The Registrant is a Paramedic registered with the HCPC. At the time of the allegation he was employed by Yorkshire Ambulance Services NHS Trust (“the Trust”).

32. On 20 November 2020 the HCPC received information regarding a concern relating to the Registrant from the Associate Director of Paramedic Practice at the Trust. The referral concerned an allegation that on 24 October 2020, the Registrant had sexual intercourse with a vulnerable Service User, A, when attending at their home address.

33. The Registrant was the subject of a police investigation in respect of the allegation. He was arrested and interviewed by the police on 28 October 2020, when he accepted that he had had sexual intercourse with Service User A. The Registrant was charged with a criminal sexual offence and his case proceeded to a trial in August 2023. At the trial, in formal agreed facts and in his evidence, the Registrant admitted that he had attended Service User A in his capacity as a Paramedic and that he had had sexual intercourse with her. The Registrant denied this conduct amounted to the criminal offence alleged. His defence was consent. The Registrant was acquitted of the offence at trial.

34. At this hearing, the HCPC called three witnesses from the Trust. The HCPC did not call any evidence from Service User A who had declined to be involved in the HCPC proceedings. The HCPC's case relied, in addition to the three Trust witnesses, on admissions made by the Registrant made in a police interview and during his criminal trial in August 2023.

35. The Registrant was not in attendance at this hearing and had provided no submissions. He had not indicated any admissions to the HCPC allegation.

The HCPC’s evidence
36. The HCPC relied on the evidence of admissions recorded made by the Registrant in the police interview on 28 October 2020 and as recorded in the transcript of the criminal proceedings, both of which appeared in the hearing bundle.

37. The police interview was included in the hearing bundle. The interview was conducted under PACE and the Registrant was advised by a solicitor.

38. During the interview the Registrant admitted having sexual intercourse with Service User A.

39. The trial transcript was included in the hearing bundle. This recorded a statement to the Court setting out a number of formally agreed facts. The admitted facts referred to Trust records confirming that the Registrant had attended Service User A on his own on two occasions, the first being 18 September 2020.

40. On 24 October 2020, the date of the incident, the log recorded that Service User A rang for an ambulance at 8pm.

41. In further agreed facts it was recorded that the Registrant admitted that he had contravened the Yorkshire Ambulance Service code of conduct, in that on the 24 October 2020 whilst on duty attending a 999 call he had sex with a female patient at their home address. It was also recorded that during the disciplinary proceedings the Registrant admitted having consensual sexual intercourse with Service User A.

42. In his evidence-in-chief and in cross-examination at the trial, the Registrant provided further detail describing the sexual intercourse with Service User A.

43. On the question of whether the Registrant was aware that Service User A was vulnerable, in his evidence at trial, the Registrant accepted that she was.

The HCPC’s Witness - SB
44. SB adopted his witness statement signed on 28 January 2025.

45. SB, a Paramedic employed by the Trust, attended at the home address of Service User A on 25 October 2020, accompanied by his colleague VD.

46. During the visit, as a result of information disclosed by Service User A relating to a visit from the Registrant on the previous day, SB contacted PH, his Clinical Supervisor, by telephone seeking advice. Following that conversation, advice was given to Service User A to report her concerns to the police.

47. SB subsequently provided statements to the Trust and for the police Investigation. He produced both statements in his evidence.

The HCPC’s Witness - VD
48. VD adopted her witness statement signed on 31 January 2025. VD is an Emergency Care Assistant employed by the Trust. She was present with SB during the visit to Service User A's address on 25th October 2020. VD subsequently provided statements to the Trust and for the police Investigation. She produced both statements in her evidence.

49. VD stated that she and SB attended on Service User A at her home following a 111 call.

50. Service User A disclosed information to VD and SB regarding Mr Neale’s attendance on the previous day as a result of which SB contacted PH for advice.

The HCPC’s Witness - FFCP
51. FFCP adopted her witness statement signed on 11 March 2025.

52. FFCP is a Paramedic and is currently employed by the Trust as a Vaccination and Relationship Manager. At the relevant time, she was a Tactical Commander with responsibility for the locality management of four ambulance stations.

53. FFCP produced her police witness statement dated 4th December 2020 and the manuscript notes she took at her meeting with the Registrant on 25th October 2020 after the concern had been reported by the crew who attended on Service User A on that day.

54. FFCP confirmed that during the meeting she asked the Registrant about his attendance at Service User A’s home address on the previous day, but there was not any discussion of any allegation that the Registrant had sexual relations with Service User A. The Registrant did not refer to any sexual contact with Service User A. FFCP said that at that time it was not clear whether there was an allegation or to whom it related.
55. FFCP said that following her meeting with the Registrant on 25th October 2020 she did not have any further involvement in the Trust’s investigation relating to the Registrant.

Submissions on facts
56. Mr Maughan submitted that the Panel should be satisfied that the facts were proved based on the evidence presented by the HCPC. He reminded the Panel of the admission by the Registrant that he had had sexual intercourse with Service User A at her home on 24 October 2020, as evidenced in the transcript of the criminal trial proceedings and in the record of the police interview.

57. Mr Maughan submitted that the Registrant had also admitted in the criminal proceedings that he did not maintain professional boundaries with Service User A. He reminded the Panel of the evidence of admissions from the Registrant. He had also attended the Service User on a previous occasion. Mr Maughan referred to the evidence of the Paramedic and Emergency Care Assistant, SB and VD. He submitted that the Panel could be satisfied in the light of the evidence that the Registrant knew, or ought to have known, that Service User A was vulnerable.

58. In respect of Particular 2, Mr Maughan referred to the HCPTS Practice Note, Making Decisions on a Registrant’s State of Mind, which provided guidance on the meaning of sexual motivation provided in the regulatory cases of Basson v GMC and Haris v GMC. He submitted that the Panel should find the Registrant’s conduct was for the purpose of sexual gratification.

Decision on Facts
59. The Panel accepted the advice of the Legal Assessor. The Panel was advised that the standard of proof in HCPTS proceedings is the civil standard, the balance of probabilities. The burden of proof in respect of factual matters was upon the HCPC and it was not for the Registrant to prove his innocence.

60. The Panel was reminded that Particular 2 alleged that the conduct alleged in Particular 1 was sexually motivated. The Panel was advised that if it found the facts in Particular 1 proved, it should then go on to consider whether it was satisfied on the balance of probabilities that that proven conduct was sexually motivated.

61. The Panel was referred to the HCPTS Practice Note, Making Decisions on a Registrant’s State of Mind. The Practice Note referred to the guidance in the cases of Basson v GMC [2018] EWHC 505 (Admin) and Haris v GMC [2021] EWCA 763. In Basson, it was said that a sexual motive means that the conduct was done either in pursuit of sexual gratification or in pursuit of a future sexual relationship.

62. It was also stated in the case of Basson that the state of a person’s mind is not a matter that can be proved by direct observation, but only by inference or deduction from the surrounding evidence. This was a balancing exercise in which the Panel should consider all the evidence and the circumstances, including the facts, the history, any alternative explanation offered by the Registrant and any evidence as to the Registrant’s character. The Panel must then, on the balance of probabilities, consider whether the sexual motive can reasonably be inferred from all the evidence.

63. In considering the facts alleged, the Panel bore in mind that the Registrant had not made any formal admissions to the allegation brought by the HCPC and had not provided any submissions.

64. The Panel bore in mind that whilst it had considered information from the Registrant’s criminal trial, the Registrant was acquitted of the criminal charge, his defence being “consent”. The Panel was mindful that in the HCPC proceedings, the Registrant faces a different charge which is not criminal in nature. The HCPC made no allegation relating to consent.

65. The Panel considered the factual particulars against the above background:

Particular 1(a) – Found Proved
On or around 24 October 2020
a. You did not maintain professional boundaries with Service User A in that you had sexual intercourse with them whilst in attendance at their address in your capacity as a paramedic.

66. The Panel had accepted the HCPC's application to admit the record of the police interview with the Registrant on 28 October 2020 and the extract from the transcript from the Registrant’s Crown Court trial in August 2023. The Panel was satisfied that it could properly rely on the admissions made by the Registrant in both documents.

67. The Panel had concluded that both documents were official records which were credible and reliable. The police interview record was a PACE compliant police interview, conducted under caution. The Registrant was legally represented at the interview. The record of the interview was a formal, verbatim transcript. In the case of the transcript from the criminal trial, this was a formal record of the criminal proceedings. It was a verbatim transcript prepared by a transcription service, Opus 2 International Limited, and certified by that company as an accurate and complete record of the proceedings. The Registrant was also legally represented at the trial.

68. In these documents, the Registrant admitted attending on Service User A at their home address on 24 October 2020. He attended, whilst on duty and in uniform, in response to the Service User A’s emergency 999 call to the Trust’s ambulance service. The Registrant attended Service User A’s home address in a rapid response vehicle. He admitted having sexual intercourse with Service User A on that visit on the 24 October 2020.

69. In the trial transcript, the Registrant admitted that he had contravened the Trust’s code of conduct.

70. On the basis of the Registrant’s admissions, the Panel was satisfied on the balance of probabilities that the Registrant had sexual intercourse with Service User A as alleged.

71. Service User A was a patient who had sought emergency medical assistance from the Trust’s ambulance service. The Registrant attended her at her home address in the course of his professional duties as a Paramedic and healthcare professional. The Panel was satisfied that having sexual intercourse with a service user whilst attending in the course of professional duties clearly amounted to failing to maintain the appropriate professional boundaries between a Paramedic and a patient.

Particular 1(b) – Found Proved
b. You knew or ought to have known that Service User A was vulnerable

72. The Panel noted that it is recorded in the criminal trial transcript that the Registrant during his evidence agreed that Service User A was vulnerable.

73. The Panel noted from the trial transcript that the Registrant had previously attended a call out to Service User A himself on one previous occasion.

74. The Panel also heard evidence from Paramedic SB and Emergency Care Assistant VD about Service User A’s condition when they attended her on 25 October 2020, the day after the Registrant’s visit.

75. The Panel was of the view where a person urgently calls an ambulance service seeking medical attention, there is an imbalance of power in the relationship between the health professional, in this case the Paramedic, and the service user. The service user is therefore vulnerable in that sense.

76. The Panel was satisfied on the balance of probabilities that Service User A’s vulnerability would have been evident to the Registrant on his visit on 24 October 2020 and that he was aware that she was vulnerable.

77. The Panel found Particulars 1(a) and 1(b) proved.

Particular 2 – Found Proved
Your conduct in relation to Particular 1 was sexually motivated.

78. The Panel referred to the guidance on allegations of sexually motivated conduct in the HCPTS Practice Note, Making Decisions on a Registrant’s State of Mind (January 2025).

79. The Panel noted paragraph 10 which states:
“The best evidence of a registrant's motivation is their behaviour. If the conduct is overtly sexual in nature, the absence of a plausible, innocent explanation for the conduct will invariably result in a finding of sexual motivation.”

80. The Panel considered the factors listed at paragraph 9 of the Practice Note. The act of sexual intercourse, as admitted by the Registrant, is clearly overtly sexual. There could be no suggestion that such conduct was clinically appropriate or clinically justified. No alternative explanation for the conduct had been provided by the Registrant.

81. The Panel considered the guidance on the meaning of sexual motivation given in the case of Basson in the light of the circumstances of this case. The Panel concluded on the balance of probabilities that the Registrant had sexual intercourse with Service User A in pursuit of immediate sexual gratification and found that on this basis, his conduct was sexually motivated.

82. The Panel found Particular 2 proved.

Submissions on misconduct and impairment of fitness to practise
83. Mr Maughan’s submission was that the Panel should find the ground of misconduct established and should find the Registrant’s fitness to practise to be currently impaired.

84. Mr Maughan referred to the HCPTS Practice Note, Fitness to Practise Impairment. Mr Maughan reminded the Panel of relevant considerations and case law in relation to the ground of misconduct and impairment of fitness to practise.

85. In relation to misconduct, Mr Maughan submitted that the Panel had found that the Registrant had sexual intercourse with a vulnerable service user in the course of duty. This constituted nothing other than a gross breach of the HCPC’s standards which were in place to protect patients and the wider public who are cared for by Paramedics in the safety of their own homes.

86. Mr Maughan submitted that the Registrant had given in to sexual desire to take advantage of a service user in whose home he was present to provide care. This was an abuse of his position of trust as a Paramedic. His actions put the service user at risk of harm. His conduct was wholly incompatible with the standards required of a Paramedic.

87. Mr Maughan noted that the trial transcript recorded that the Registrant in his evidence acknowledged that his actions constituted a gross breach of trust. He submitted that the Panel may consider the seriousness of the misconduct to be aggravated by the Registrant’s failure to disclose what had happened at his meeting with FFCP on the day following the incident.

88. Mr Maughan submitted that the following paragraphs of the HCPC’s Standards of Conduct, Performance and Ethics (January 2016) were relevant: Standards, 1.7, 6.1, 6.2, 7.1, 7.4, 8.1, and 9.1. From the Standard of Proficiency for Paramedics, Mr Maughan submitted that Standards 2, 2.2, 2.8, 3.1 and 4.1 were applicable.

89. In relation to the personal element of current impairment, Mr Maughan invited the Panel to conclude that the Registrant's conduct is not remediable given its exceptionally serious nature. He submitted there was a concerning lack of insight especially in relation to the impact of his actions in relation to Service User A. The HCPC believed there was a real risk of repetition and a high risk of harm to similarly vulnerable patients in the future.

90. In relation to the public component of impairment, Mr Maughan submitted that the Registrant’s misconduct concerned a gross breach of the trust bestowed on Paramedics. Service User A had called for help and invited the Registrant into her home. He had exploited her vulnerability to serve his own sexual desire. Mr Maughan submitted that fellow Paramedics, patients and the wider public may feel unable to place their trust in Paramedics and in the regulatory process. He submitted that confidence in a profession which relies on patients being able to put their trust in Paramedics when they enter their homes at times of real vulnerability would be significantly undermined were a finding of current impairment not made in this case.

91. Mr Maughan said that the HCPC’s submission was that the Registrant’s fitness to practise is currently impaired in respect of the personal and public components of current impairment.

Decision on Grounds
92. The Panel considered all the evidence and submissions on behalf of the HCPC. It accepted the advice of the Legal Assessor. The Panel was referred to the relevant legal authorities relating to the ground of misconduct and current impairment of fitness to practise. The Panel was advised to refer to the HCPTS Practice Notes, Fitness to Practise Impairment (February 2025) and Professional Boundaries (September 2024).

93. The Panel was reminded that findings of misconduct and current impairment do not necessarily follow because findings of fact have been made and that these are matters for its own judgment, rather than application of the legal standard of proof.

Misconduct
94. The Panel first considered whether the Registrant’s actions amounted to misconduct. The Panel was mindful that before making a finding of misconduct it must be satisfied that there has been a serious falling short of the HCPC’s Standards of Conduct, Performance and Ethics.

95. The Panel had found proved an allegation of a very serious sexual nature. The Registrant had attended, in the course of his professional duties, the home of a service user who had called for urgent assistance from the ambulance service. The Panel considered that the Registrant’s actions in having sexual intercourse with the service user during this attendance constituted an extremely serious abuse of his professional position as a Paramedic.

96. The Panel had found the Registrant’s conduct to be sexually motivated in that it was undertaken with a view to obtaining personal sexual gratification.

97. The Panel bore in mind the imbalance of power between the service user and the Registrant in his position as a healthcare professional. The Registrant took advantage of his professional position and disregarded appropriate professional boundaries. The Panel concluded that these actions were very serious and fell far short of the standards expected of an HCPC registered Paramedic. They amounted to a gross breach of the trust placed in the profession by patients and the public.

98. The Panel considered that the following paragraphs of the HCPC Standards of Conduct Performance and Ethics (January 2016) had been breached:
Standard 1.7 You must keep your relationships with service users and carers professional.
Standard 6.1 You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible.
Standard 6.2 You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk
Standard 7.1 You must report any concerns about the safety or well-being of service users promptly and appropriately
Standard 7.4 You must make sure that the safety and well-being of service users always comes before any professional or other loyalties
Standard 8.1 You must be open and honest when something has gone wrong with the care, treatment or other services that you provide
Standard 9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

99. The Panel considered that the following Standards of Proficiency for Paramedics (2014) had been breached in this case:
Standard 2 be able to practise within the legal and ethical boundaries of their profession
Standard 2.2 understand what is required of them by the Health and Care Professions Council
Standard 2.8 be able to exercise a professional duty of care
Standard 3.1 understand the need to maintain high standards of personal and professional conduct
Standard 4.1 be able to assess a professional situation, determine the nature and severity of the problem and call upon the required knowledge and experience to deal with the problem

Decision on Impairment
100. Having found misconduct proved, the Panel next considered whether the Registrant’s fitness to practise is currently impaired by reason of his misconduct.

101. The Panel kept at the forefront of its mind the HCPC’s overarching objective and the critically important public policy issues, to protect the public by protecting, promoting and maintaining the health safety and well-being of the public; by promoting and maintaining public confidence in the professions it regulates; and by promoting and maintaining proper professional standards and conduct for members of the professions.

102. The Panel bore in mind that the question of impairment is a matter for its own judgement and that the purpose of fitness to practise proceedings is not to punish a registrant for past acts or omissions, but to protect the public from those who are not fit to practise.

103. The Panel had regard to the conduct of the Registrant, the nature, circumstances and gravity of the findings and in particular the need to protect the public, to declare and uphold proper standards of behaviour and to maintain public confidence in the profession.

104. The Panel had not received any submissions or evidence of remediation from the Registrant as he appeared to have disengaged from the HCPC proceedings. The Panel had heard that in one of his last communications with the HCPC’s solicitors he had stated that he no longer wished to practise as a Paramedic.

105. The Panel considered the personal component of current impairment, that is the current competence and behaviour of the Registrant. The Panel was of the view that it would be very difficult for the Registrant, even had he engaged with this process, to remedy such a serious breach of professional boundaries and misuse of his professional position. Such conduct was likely to be attitudinal in nature and therefore difficult to remedy.

106. There was no evidence or information before the Panel to indicate the Registrant’s current attitude to his past actions. There was no evidence that he has demonstrated any insight or has made efforts to remediate his actions. There was no evidence of remorse or apology before this Panel.

107. There was no indication that the Registrant has undertaken any meaningful reflection on the impact of his actions upon Service User A or on the Paramedic profession, or on public confidence in the profession.

108. In short, the type of misconduct found proved is difficult to remedy and the Registrant has not provided any evidence that he has made any attempt to do so. In these circumstances, the Panel concluded there was a real risk of the repetition of the sexual misconduct in question in the future. If there was a repetition, the physical and mental health and safety of service users, many of whom were likely to have vulnerabilities, would be put at risk of harm.

109. The Panel concluded that the Registrant’s fitness to practise is impaired in relation to the personal element of current impairment.

110. In relation to the public component of current impairment, the Panel considered that the public would expect Paramedics to meet the basic and fundamental standard of protecting patients and not to abuse their position of trust. The findings of sexual misconduct towards a vulnerable service user would seriously undermine the confidence and trust of the public in the Paramedic profession and could affect their willingness to seek treatment from health professionals. The Panel was also in no doubt that other members of the Paramedic profession would find the Registrant’s conduct deplorable.

111. The Panel considered that all four factors identified in the report of the Fifth Shipman Inquiry as indicating current impairment are engaged in this case. The Panel was of the view that he Registrant has in the past, and is liable in the future, to represent a risk to service users, has brought the profession into disrepute, has breached a fundamental tenet of the profession and has acted in such a way that his integrity can no longer be relied upon. The Panel concluded that public confidence in the profession would be undermined if a finding of current impairment were not made in this case.

112. The Panel found that the Registrant’s fitness to practise is currently impaired in respect of both the personal and public components of current impairment.
The HCPC’s submissions on Sanction
113. Mr Maughan reminded the Panel of the purpose of sanctions in regulatory proceedings and of the appropriate approach when considering the issue of sanction. He referred to the HCPC Sanctions Policy.

114. Mr Maughan highlighted the Panel’s findings in relation to facts, misconduct and impairment and submitted that, having regard to those findings, the Panel should conclude that this was a serious case according to the factors in the Sanctions Policy, given the nature of the sexual misconduct and the abuse of professional position. Mr Maughan drew the attention of the Panel to the sections in the Policy relating to Sexual Misconduct cases, Predatory Behaviour, Vulnerability and Abuse of Professional position.

115. Mr Maughan reminded the Panel that it should consider any mitigating factors in this case. Mr Maughan identified the aggravating factors present, with reference to the Panel’s findings, as breach of trust; risk of harm if there was repetition; lack of insight, remorse and apology and an overall absence of remediation. Mr Maughan submitted that harm had been caused to Service User A.

116. Mr Maughan submitted that as the findings involved abuse of the Registrant’s professional position, including predatory behaviour, the matter should be taken particularly seriously.

117. Mr Maughan submitted that the appropriate sanction was a matter for the Panel. However, he addressed the factors identified in the Sanctions Policy relevant to each of the available sanctions.

118. Mr Maughan’s submissions suggested that any sanction less than suspension would not be indicated according to the sanctions guidance. He noted that factors which might indicate that suspension would be appropriate are not present, for example: insight and that the issues are unlikely to be repeated, and that there is evidence to suggest that the registrant is likely to be able to remedy their failings. Mr Maughan suggested that the Panel may therefore conclude that a striking off order is required.

119. Mr Maughan submitted that given the issues in the case of abuse of professional position, the vulnerability of Service User A and the Registrant’s failure to raise concerns, any lesser sanction than striking off was not likely to be appropriate.

Decision on Sanction
120. The Panel took account of the submissions on behalf of the HCPC and those of the Registrant. The Panel accepted the advice of the Legal Assessor and referred to the HCPC Sanctions Policy.

121. In considering sanction, the Panel was mindful that a sanction is not intended to be punitive. However, a sanction may be necessary in the public interest and may have a punitive effect. The Panel bore in mind throughout that any sanction it may decide to impose must be proportionate, that is, it must only restrict the Registrant’s right to practise to the extent necessary to protect the public and the public interest.

122. The Panel was mindful throughout that the HCPC’s overriding objective is to protect the public. A panel must consider the risk the Registrant may pose in the future and determine what degree of public protection is required. The Panel must also give appropriate weight to the wider public interest, which includes the deterrent effect on other registrants, the reputation of the profession and public confidence in the regulatory process.

123. The Panel had found that the Registrant’s conduct was an abuse of his professional position as a Paramedic and that he took advantage of a vulnerable service user who was seeking care. The Panel had found that the conduct was sexually motivated, for the purpose of the Registrant obtaining sexual gratification. The Panel was in no doubt that the Registrant’s misconduct was of a very serious nature.

124. The Panel referred to the guidance in the HCPC Sanctions Policy concerning serious cases. The types of case referred to included cases involving sexual misconduct, predatory behaviour, vulnerability and abuse of professional position. The Panel concluded that all of these issues were engaged in relation to its findings in this case. The Panel’s conclusion, applying the Sanctions Policy, was that the Registrant’s case clearly fell into the category of serious cases.

125. The Panel considered that the following aggravating factors were present:
a. The allegation involved a breach of trust which was a fundamental aspect of the relationship between the Registrant and Service User A. There was abuse of his privileged professional position as a registered healthcare professional.
b. The Registrant’s behaviour was predatory, in that the Panel had found that it was sexually motivated for the purpose of sexual gratification.
c. The Registrant had not engaged with the HCPC proceedings and had provided no evidence of insight, remorse or apology. In his evidence in the criminal proceedings there was some indication that the Registrant recognised he had committed a gross breach of trust and he appeared to accept that Service User A was vulnerable. However, there was no indication that he demonstrated any awareness of the impact of his conduct upon Service User A. Further, there was no information relating to insight, remorse or apology before the Panel in these, HCPTS, proceedings, nor was there evidence of any attempt to remedy his misconduct.

126. The only mitigating factors which the Panel identified were that the Registrant had no fitness to practise history and the brief information he provided to the HCPC concerning his health in an undated communication some time ago.

127. The Panel took these factors into account when considering sanction. The Panel concluded it could give limited weight to the few mitigating factors and was mindful that mitigation is of considerably less significance in regulatory proceedings where protection of the public is the overarching consideration. The Panel concluded that the gravity of the aggravating factors in this case far outweighed the mitigating factors.

128. The Panel considered whether it was necessary to impose a sanction. The Panel had in mind that the allegations proved were serious and that its decision must uphold public trust and confidence in the profession. It considered the sanctions in ascending level of severity in order to ensure its approach was proportionate.

Mediation or No Action
129. The Panel concluded that in this case, neither mediation nor taking no action would be appropriate. The Panel determined that due to the gravity of its findings in this case a sanction was necessary in the public interest.

Caution Order
130. The Panel considered the factors in the Sanctions Policy in relation to a Caution Order. It concluded that the issues in this case were not minor in nature. Whilst this was a single incident, it concerned very serious sexual misconduct towards a vulnerable service user. There was very limited insight and none had been demonstrated in the HCPTS proceedings. The Panel had concluded that there remained a risk of repetition and that the Registrant continues to pose a risk of harm to service users and the public.

131. The Panel concluded that a Caution Order was not sufficient or appropriate in the circumstances.

Conditions of Practice
132. The Panel next considered a Conditions of Practice Order. Given that the Registrant had not engaged with this process and had indicated that he did not intend to practise in the future, the Panel could not have the required confidence in his willingness to comply with conditions of practice. The Panel concluded that it would be difficult to formulate conditions which could address the concerns arising from the Registrant’s sexual misconduct in his role as a Paramedic.

133. Most significantly, the Panel’s view was that conditions of practice would not reflect the gravity of the sexual misconduct findings in this case, nor would such an order address the concerns regarding the wider public interest.

134. Referring to paragraph 109 of the Sanctions Policy, the Panel was not satisfied that the Registrant’s conduct was minor, out of character, capable of remediation or that it was unlikely to be repeated. These factors indicated that a conditions of practice order was not appropriate in this case.

Suspension
135. The Panel carefully considered whether an order of suspension would be sufficient to address the public protection and public interest concerns in this case.

136. The Panel referred to paragraph 121 of the Sanctions Policy. The concerns represent serious breaches of the HCPC’s standards. The Registrant has shown no insight in these proceedings as he has not attended. The Panel did not consider the concerns were unlikely to be repeated. There had not been satisfactory evidence to suggest that the Registrant was likely to be willing or able to resolve or remedy the failings.

137. The Panel concluded that a Suspension Order would not provide adequate protection to the public or the public interest nor would it maintain public confidence in the Paramedic profession.

Striking Off Order
138. The Panel concluded that the only appropriate and proportionate sanction in this case was a Striking Off Order. The allegations concerning Service User A were very serious. Considering paragraph 131 of the Sanctions Policy, the Registrant had not demonstrated any real intent or efforts to remedy the misconduct. The Registrant remained a continuing risk to service users and the public.

139. The Panel considered that the sexual misconduct found proved at this hearing was fundamentally incompatible with registration as a health professional on the HCPC Register.

140. The Panel considered the proportionality of its decision. It took into account the impact that a Striking Off Order may have on the Registrant’s interests. However, the Panel concluded that any lesser sanction would not address the issues of wider public interest and public confidence in the Paramedic profession and in the regulatory process. The Panel therefore concluded that these issues outweighed Registrant’s interests in this case.

141. The Panel concluded that the necessary and appropriate order was a Striking Off Order.

The Registrar is directed to strike the name of Ian T Neale from the Register on the date this order comes into effect.

Right of Appeal
You may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made against you.

Under Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you. The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

Application for an Interim Order
1. Mr Maughan made an application under Article 31 of the Health Professions Order 2001 for an Interim Suspension Order to cover the appeal period. The application was on the ground that such an order was necessary for the protection of the public and was otherwise in the public interest.

2. The Panel accepted the advice of the Legal Assessor. It bore in mind that an interim order in these circumstances is discretionary. The Panel must consider whether an interim order is required, applying the test set out in Article 31(2) of the Health Professions Order 2001, and if it so decides, must act proportionately. This means balancing the public interest with the interests of the Registrant and imposing the lowest order which will adequately protect the public.

3. The Panel considered the issue of proportionality and balanced the interests of the Registrant with the public interest. The Panel had determined to impose a substantive Striking Off Order in respect of the Registrant. Given the gravity of the issues and the sanction imposed, the Panel considered it would be inconsistent not to impose an immediate interim order of suspension to address the residual risk and public interest issues during the appeal period and to cover the period of any appeal proceedings, should an appeal be lodged.

4. The Panel considered whether interim conditions of practice would be appropriate but concluded that conditions which would address the Panel’s concerns could not be formulated, for the same reasons as given in its substantive decision.

5. Accordingly, the Panel determined that an interim order of suspension was necessary in order to protect the public and in the wider public interest.

6. The Panel concluded that the appropriate and proportionate duration of the interim suspension order was 18 months, as the interim order would continue to be required pending the resolution of an appeal in the event of the Registrant giving notice of an appeal with the 28-day period.

Interim Order
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. 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 Ian T Neale