David Ball

Preliminary Matters

Service

1. The Panel had information before it that the Notice of Hearing was sent by email, dated 13 March 2025, to the Registrant’s email address on the HCPC Register. The Panel took into account the HCPTS Practice Note entitled “Service of Documents” and accepted the advice of the Legal Assessor. 

2. The Panel was satisfied that service had been effected in accordance with Rules 3 and 6 of the Conduct and Competence (Procedure) Rules 2003 (“the Rules”). 

Proceeding in Absence

3. Mr Maughan, on behalf of the HCPC, applied for the hearing to proceed in the Registrant’s absence, and referred to an email from the Registrant to the HCPTS, dated 8 April 2025, in which he stated that he was not able to attend due to his health, but “I am clear that I want it to go ahead. I need this to end”. Mr Maughan pointed to the wider public interest in the hearing proceeding, given the potential adverse impact on the memory of the witnesses of fact, Colleagues A and B, who were attending to give evidence, if the hearing were adjourned. Further, the Panel was able to consider the Registrant’s bundle of documents which he had submitted to be considered in his absence. 

4. The Panel took into account the HCPTS Practice Note entitled “Proceeding in the Absence of the Registrant” and accepted the advice of the Legal Assessor. The Panel took into account that the Registrant had expressed that he wished the hearing to proceed in his absence. The Panel concluded that he had voluntarily waived his right to attend. He had not made an application for an adjournment and there was no suggestion that an adjournment would secure his attendance. He had submitted a bundle of documents which the Panel would consider, and this went towards addressing any potential disadvantage to the Registrant in proceeding in his absence.

5. The Panel, therefore, decided to proceed in the absence of the Registrant. 

Hearing to take place partly in private

6. Mr Maughan applied for part of the hearing to take place in private when matters of the Registrant’s health were referred to, in order to protect his private life. 

7. Mr Maughan referred to the Registrant’s email dated 8 April 2025 in which he requested that the entire hearing take place in private [redacted]. Mr Maughan submitted that there was insufficient evidence to substantiate this claim, and referred to a note [redacted] in the hearing bundle which was historic and not sufficiently detailed. In any event, Mr Maughan submitted that the exceptional circumstances required for the panel to agree to the Registrant’s request could not be demonstrated.

8. The Panel took into account the HCPTS Practice Note entitled “Conducting Hearings in Private” and accepted the advice of the Legal Assessor. The Panel decided that a fair balance in this case would be to proceed in private when the health of the Registrant was referred to, and that there were no exceptional circumstances or cogent evidence to accede to the Registrant’s request. 

Background

9. The Registrant is a Paramedic, registered with the HCPC. At the time of the alleged incidents, he was employed by North West Ambulance Service (“NWAS”), having commenced employment with NWAS in July 2002 (initially in a non-registered capacity prior to registering with the HCPC in 2005).

10. On 16 June 2023, the HCPC received a referral from NWAS about the Registrant’s alleged inappropriate behaviour and language towards two female colleagues, Colleague A and Colleague B. 

Decision on Facts

11. The Panel read the following documents:
i. HCPC’s bundle;
ii. Registrant’s bundle, including a personal statement and reflection, a response to the pre-hearing form, and submissions to the Investigating Committee;
iii. Note of fact finding interview carried out by NWAS on 23 May 2023;
iv. Case summary and submissions and addendum submissions from the HCPC.

12. The HCPC relied on the witness evidence of three witnesses:
i. Colleague A, Registered Nurse;
ii. Colleague B, Emergency Medical Technician;
iii. Witness 3, Investigating Officer for NWAS.

13. Mr Maughan made submissions on the facts, and relied on written submissions dealing with the test for the cross-admissibility of evidence, referring to the case of PSA v GMC and Garrard [2025] EWHC 318. Mr Maughan submitted that if the Panel found the conduct in respect of Colleague A proved, it could properly consider cross-admissibility of that evidence in respect of Colleague B. 

14. The Panel accepted the advice of the Legal Assessor who referred to PSA v GMC and Garrard, Haris v GMC [2021 EWCA Civ 763, Basson v GMC [2018] EWHC 505 and the HCPTS Practice Note entitled “Making Decisions on a Registrant’s state of mind”. 

15. The Panel was aware that the burden of proof is solely on the HCPC to the civil standard, namely the balance of probabilities. 

Particular 1(a)

16. The Panel took into account the oral evidence of Colleague A, as well as her witness statement which referred to the words alleged having been spoken to Colleague A. 

17. Colleague A’s evidence was that she first became aware of the Registrant on 27 April 2023 on a night shift at A&E while employed by Mersey Care NHS Foundation Trust (the Trust), never having met him before. She had recently begun as a newly qualified nurse, having been in her post for 2 months. 

18. As a result of her concerns about the Registrant’s behaviour towards her during the night shift, she raised her concerns to a colleague and then to a Band 7 Senior Emergency Manager. Colleague A’s evidence was that she felt that her concerns had not initially been taken seriously, and thereafter on her return to work on the following night shift on 28 April 2023, her concerns were escalated further until they reached the individual who was Matron and Head of A&E. Colleague A was not comfortable with her experience and did not wait to escalate it, which she did almost immediately. This gave weight to her evidence that she was upset and distressed. 

19. As part of the investigation, Colleague A was asked to provide a written account of the events on the night shift in question. In this document, she set out a number of comments made to her by the Registrant which she stated “offended” and “shocked” her. This is undated but it was written shortly after, as the evidence of Colleague A was that it preceded the investigating interview with her by Witness 3 which occurred on 12 May 2023. 

20. The Panel considered that Colleague A’s written account was comprehensive and detailed. One of the comments reported in this written account was that the Registrant asked her if her “curtains matched my carpet”. Colleague A was also interviewed on 12 May 2023 regarding her concerns by Witness 3. At that interview Colleague A repeated that the Registrant had made a comment “about the ‘curtains match the carpet”. The Panel, therefore, found Colleague A’s evidence consistent in this regard, being determined to raise her concerns which suggested a determined and consistent approach which added weight to her evidence. 

21. The Registrant was interviewed by Witness 3 on 13 June 2023. He was specifically asked if he asked Colleague A if the curtains match the carpet which he denied. He stated that the only comment he might have made was to call Colleague A a “ginger minger” to which she laughed and that he shouted ginger to her once or twice. 

22. The Panel concluded that Colleague oral A’s evidence was consistent with her written account and what she told Witness 3 in her interview, both accounts given not long after the incident, and was credible. 

23. The Panel, therefore, found this Particular proved. 

 

Particular 1(b)

24. Colleague A referred to these words being used by the Registrant in both her oral evidence and her witness statement. Colleague A referred to the words “fanta pubes” being said to her by the Registrant in her written account, although this was not specifically mentioned in the investigation interview with Witness 3 on 12 May 2023

25. Another colleague, AJ, who was on the same shift as Colleague A, made a statement. She was an agency nurse. AJ was not a witness in these proceedings, and therefore, the Panel approached her statement with caution. Although gave it some weight because AJ was on shift with Colleague A and her statement was signed by her on 12 May 2023 confirming that she understood that it could be presented to the placement area at which she was working. It was a detailed document, and AJ differentiated between when she was not present in the interaction between Colleague A and the Registrant, and when she was present. This was another reason why the Panel gave it some weight. 

26. In her statement, AJ recalled that the Registrant made comments of “ginger pubes” as well as “Fanta pubes” towards Colleague A and also “made an elaborate story up that he would tell people that they met on a night out and ‘slept together’”. She stated that it was evident at that point that Colleague A was “very uncomfortable”. AJ further stated that subsequently the Registrant shouted “fanta pubes” down the hall way and at that point she had to tell him it was inappropriate as there were patients and relatives in nearby rooms. AJ noted the Registrant was upset and AJ encouraged her to tell the nurse in charge. 

27. The Registrant denied calling Colleague A “fanta pubes” when interviewed by Witness 3 and also denied this in his written submissions, although he accepted he may have said “ginger minger”. In considering the Registrant’s submission that he said the words “ginger minger” was an admitted term which suggested an over-familiarity and also lack of professionalism. 

28. The Panel considered the HCPC evidence and found it consistent and clear and corroborated by documentary evidence, and was credible. 

29. In light of all the evidence, the Panel, therefore, found this Particular proved. 

 

Particular 1(c)

30. Colleague A referred to these words being used by the Registrant in both her oral evidence and her witness statement. Colleague A referred to the words “ginger pubes” being shouted to her down the corridor by the Registrant in her written account, although this was not specifically mentioned in the investigation interview with Witness 3 on 12 May 2023. 

31. AJ stated in her statement that the Registrant made comments such as “ginger pubes” as well as “Fanta pubes” and “made an elaborate story up that he would tell people that they met on a night our and ‘slept together’”. She stated that it was evident at that point that Colleague was “very uncomfortable”.

32. The Registrant denied calling Colleague A “Ginger pubes” when interviewed by Witness 3 and in his written submissions, although he accepted he may have said “ginger minger”. As set out above the Panel considered these admitted words to be over familiar and lack of professionalism, which the Panel took into account. 

33. The Panel considered the HCPC evidence and found it consistent and clear and corroborated by documentary evidence, and was credible. 

34. In light of all the evidence, the Panel, therefore, found this Particular proved. 

 

Particular 1(d)

35. Colleague A referred to these words being used by the Registrant in both her oral evidence and her witness statement. Colleague A referred to the words “ginger muff” being shouted to her down the corridor by the Registrant in her written account, although this was not specifically mentioned in the investigation interview with Witness 3 on 12 May 2023. 

36. The words used are in a similar vein to the words found to be used as set out above, in that they refer to the colour orange, and the Panel took this into account. 

37. The Registrant’s admission that he may have used the words “ginger minger” also refer to the colour “ginger” and as set out above, was unprofessional and suggested an over familiarity and lack of professionalism, which the Panel took into account. 

38. The Panel considered the HCPC evidence and found it consistent and clear and corroborated by documentary evidence, and was credible. 

39. In light of all the evidence, the Panel, therefore, found this Particular proved. 

 

Particular 1(e)

40. Colleague A referred to these words, being used by the Registrant in both her oral evidence and her witness statement, as well as in her written account written shortly after the incidence. In her investigation interview with Witness 3 on 12 May 2023 Colleague A stated that the Registrant implied that the only way he would know if the “curtains match the carpet” would be to have sexual intercourse. Colleague A went on to say that “he’s not a quitter” and “friends would want to know how he found out”. 

41. In her written statement dated 12 May 2023, AJ stated that the Registrant “made an elaborate story up that he would tell people that they met on a night our and ‘slept together’”, and that it was evident at that point that Colleague A was “very uncomfortable”.

42. The Registrant denied making this statement. 

43. The Panel considered the HCPC evidence and found it consistent and clear and corroborated by documentary evidence, and was credible. 

44. In light of all the evidence, the Panel, therefore, found this Particular proved. 

 

Particular 1(f)

45. Colleague A’s oral evidence was that the Registrant approached her from behind and squeezed her sides just above her hips, and that it was a firm touch. In her witness statement, she confirmed that he came up behind her and squeezed her sides. She jumped in shock and described feeling “severely uncomfortable” and had a “retching feeling”. She stated that she backed up into the wall. 

46. In her written account, Colleague A stated that the Registrant came up behind her, grabbed her around her waist and squeezed her and that it was a firm touch. She jumped and was startled, backed into the wall and had a sick feeling in her stomach. 

47. Witness 3 viewed CCTV footage which was not before the Panel. Witness 3 was inconsistent in her recollection of what she saw with regard to the touching on the CCTV and Panel did not give weight to that part of her evidence. 

48. The Registrant denied this Particular. 

49. The Panel took into account the evidence of Colleague A which was in general consistent. Her written account written near the time confirmed her oral evidence as well as the account in her witness statement, and her evidence was credible. 

50. In light of all the evidence, the Panel, therefore, found this Particular proved.

 

Particular 2

51. Colleague A in her oral evidence and also her witness statement made clear that the Registrant spoke these words. This allegation is re-iterated in Colleague A’s written account written for the investigation, and also in the investigation interview dated 12 May 2023. She was consistent in the words she said the Registrant used about the patient, and the point in time in which he made the comment about the patient. In addition, Colleague A was clear when questioned during her oral evidence that she did hear the words alleged, despite them being said not loudly so that other colleagues would not hear. 

52. The Registrant denied making this comment about the patient.

53. The Panel considered the HCPC evidence and found it consistent and clear and corroborated by documentary evidence, and it was credible. 

54. In light of all the evidence, the Panel, therefore, found this Particular proved. 

 

Particular 3 (a)

55. The Panel considered Mr Maughan’s submissions that it was open to the Panel to consider the cross-admissibility of the evidence of Colleague A evidence in respect of Colleague B. The Panel did not take this approach. Rather it considered the evidence of Colleague B in its own right in respect of each relevant charge. 

56. Colleague B’s evidence was that the first time she met the Registrant was on 6 April 2023 while attending the home of a patient and her husband. The evidence of Colleague B, both in her oral evidence and in her witness statement, was that that the sewed-on label, with the word “ambulance” which was sewn onto the on the back of her polo shirt was frayed and coming off from the polo shirt on either side. Colleague B’s evidence was that she felt the Registrant come up behind her and put his fingers into the holes on either side of the label, and made a comment about “fingers in holes”. She remembered feeling quite uncomfortable, and trying to laugh it off. She did not expect his action and was shocked and taken aback. 

57. Colleague B’s evidence was that she did not report her concerns about the Registrant, including his actions in placing his fingers in the holes in the sides of the label, until she reported it to her line manager at a progress meeting on 2 May 2023. She said that the delay resulted from needing time to reflect and she was questioning whether she should report her concerns. She subsequently raised a datix report on 3 May 2023. She attended two investigating meetings with Witness 3 on 15 May, in which she stated that the Registrant had put his fingers insider the holes in her top and he said something about fingers in holes. Her reasoning to why she delayed reporting her concerns was also explained in her investigation meeting on 29 June 2023, and therefore, this was something that she had raised before, and not simply as an explanation for the purpose of these proceedings. The Panel considered that this gave her explanation weight. 

58. In an investigation interview dated 13 June 2023 with Witness 3, the Registrant stated that he pointed out that Colleague B’s shirt was ripped at the back and grabbed it, and Colleague B made a joke saying don’t touch my flaps and they laughed. 

59. On 29 June 2023 at a second investigation meeting with Colleague B, the Registrant’s version was put to Colleague B by witness 3, namely that she had made a comment about fingers in her flaps, which she denied. 

60. The Panel took into account that Colleague B’s oral evidence and witness statement was corroborated in her investigation interviews in 2023. While there was a delay in reporting the incident, this did not detract from Colleague B’s clarity and consistency. Her memory was good about the details of the events, including the patient’s home, its layout, events that occurred, and the details of the patient’s daughter listening on the home telephone.

61. In light of all the evidence which was clear and credible, the Panel, therefore, found this Particular proved. 

 

Particular 3(b)

62. The evidence of Colleague B was that the Registrant told her that her trousers fit her really well. Colleague B told the Panel that she goes to the gym a lot and has quite muscly legs and her work trousers are quite tight including around the bottom area. 

63. In his written response to this Particular, the Registrant explained that it was Colleague B who asked about his trousers, and where he got them as hers were tight fitting, and she spoke about her weight lifting. 

64. The Panel carefully considered all pf the evidence. It found Colleague B to be measured, and credible. She had a detailed recollection of the incident. 

65. The Panel, therefore, found this Particular proved. 

 

Particular 3(c)

66. Colleague B’s oral evidence and witness statement was that the Registrant took hold of her arm and asked her about her tattoo, without her consent. This was reiterated in both of Colleague B’s investigation interviews on 15 May 2023 and 29 June 2023. 

67. The Registrant denied this Particular, stating that this was a made-up allegation, and that he did not know Colleague B had a tattoo until he read her statement. 

68. The Panel took into account the consistency in Colleague B’s evidence. She referred to this incident in both investigation meetings, and her evidence before the Panel was reflective of this. 

69. In light of all the evidence, the Panel, therefore, found this Particular proved. 

 

Particular 3(d)

70. Colleague B’s evidence was that the Registrant removed a hair that was lying on her breast, over the top of her uniform top. This was reiterated in Colleague B’s investigation interview on 15 May 2023.

71. The Registrant denied this Particular, stating that this was a made-up allegation

72. The Panel took into account the consistency in Colleague B’s evidence

73. In light of all the evidence, the Panel, therefore, found this Particular proved. 

 

General considerations in respect of Particular 4 in relation to Particular 1 and Particular 3

74. The Panel considered the definition of “sexual” as set out in the HCPTS Practice “Making Decisions on a Registrant’s state of Mind”, as well as the case of GMC v Haris [2020] EWHC 2518, which set out the definition taken from Section 78 of the Sexual Offences Act 2003. There are two ways to determine whether touching is sexual in that statutory provision. 

75. Firstly, under section 78(a), activity is sexual if a reasonable person would consider that whatever its circumstances or any person’s purpose in relation to it, it is because of its nature sexual.

76. Secondly, under section 78(b), activity is sexual if a reasonable person would consider that because of its nature it may be sexual and because of its circumstances or the purpose of any person in relation to it (or both) it is sexual.

 

Particular 4 in relation to Particular 1 (a)

77. The Panel considered Particular 4 in relation to Particular 1(a). This related to the Registrant’s question about whether the hair on Colleague A’s head matched the colour of her pubic hair. Such a reference to an intimate area of Colleague A’s anatomy was, in the Panel’s determination sexual because a reasonable person would consider so under section 78(b) taking into account the circumstances, which were that the Registrant made several references to Colleague A’s pubic hair and its colour. Colleague A ‘s evidence was that she felt extremely uncomfortable and that she interpreted the Registrant’s comments as sexual. The Panel considered alternative explanations for the Registrant’s comments, but could find no other reasonable explanation in a work environment and at a point in time when Colleague A and the Registrant had never met prior to the date in question. 

78. On the basis of the evidence about the circumstances the Panel decided that the Registrant’s conduct was sexual under section 78(b). 

79. The Panel, therefore, found Particular 4 in relation to Particular 1(a) proved. 

 

Particular 4 in relation to Particular 1(b) – (d)

80. The Panel considered these sub-particulars together because all statements referred to the colour of Colleague A’s pubic hair. Taking into account the comments themselves, referring to an intimate area of Colleague A’s anatomy, the Panel decided that a reasonable person would consider them sexual in and of themselves because of their nature. 

81. Therefore, the comments were sexual under section 78(a). 

82. The Panel, therefore, found Particular 4 in relation to Particular 1(b) – (d) proved.

 

Particular 4 in relation to Particular 1(e)

83. The comment in question related to the Registrant stating that people would ask him how he knew that the hair on Colleague’s head did not match her pubic hair, and the reference to not being a “quitter” suggested that he would not “quit” until he found out. The evidence of Colleague A, as well as that of AJ, was that the Registrant meant that he would find out by way of sexual intercourse. The Panel decided that was a reasonable inference in the circumstances of the comments about Colleague A’s pubic hair together with the Registrant’s comments relating to finding out that there was not a match in hair colour. 

84. In this context, the Panel decided that the statement would be considered in and of itself sexual by a reasonable person due to its nature, referring to sexual intercourse, pursuant to section 78(a). 

85. The Panel, therefore, found Particular 4 in relation to Particular 1(e)) proved.

 

Particular 4 in relation to Particular 1(f)

 

86. The Panel took into account the context relating to its findings as set above in respect of the sexual comments made by the Registrant. In this context, the Registrant approached Colleague A from behind and squeezed her sides with both hands with a firm touch. There was no clinical need, for this, nor any need to move Colleague A physically. As such, the Panel decided that the touching would be considered in and of itself sexual by a reasonable person due to its nature. It was on around the waist area, which is an intimate part of the Colleague A’s anatomy. Therefore, the Panel found that it was sexual pursuant to section 78(a).

87. The Panel, therefore, found Particular 4 in relation to Particular 1(f) proved.

Particular 4 in relation to Particular 3(a)

88. The Panel took into account that this incident in which the Registrant put his fingers in the flaps of the Registrant’s torn label on the back of her top occurred very soon after meeting her. This was not an intimate area of Colleague B’s anatomy. Further, despite Colleague B’s evidence that he said something about “fingers in holes”, the Panel did not consider that this brief comment so soon after meeting would on a reasonable person’s view be considered sexual whether either under section 78(a) or (b). 

89. The Panel, therefore, did not find Particular 4 in relation to Particular 3(a) proved. 

 

Particular 4 in relation to Particular 3(b)

90. The Registrant’s comment about Colleague B’s trousers fitting her “really well” was a comment about how they fitted on her body. Colleague B’s evidence, which the Panel accepted as consistent and credible, was that they were tight fitting and that she had muscles due to going to the gym. This led the panel to find that the Registrant was commenting on how they displayed the form of her body, and that this was what he was referring to. As such, he was noticing the shape her body under her trousers. 

91. The Panel also took into account, by way of context, Colleague B’s evidence that the Registrant had come to sit very close to her on the sofa, his shoulder was touching hers, and he was persistently trying to engage her in conversation, to the extent that she eventually was very annoyed as she felt she was hampered in caring for the patient. This evidence had been given in the investigation meeting on 15 May 2023 and 29 June 2023, and was credible in that there was a consistency in the account. 

92. The Panel carefully considered this, and found that a reasonable person would consider that this was sexual in the context of the circumstances including the Registrant’s purpose in making the comment about the trousers, pursuant to section 78(b). 

93. The Panel, therefore, found Particular 4 in relation to Particular 3(b) proved.

 

Particular 4 in relation to Particular 3(c)

94. The Panel took into account the evidence before it that the Registrant is heavily tattooed. This was stated by Colleague B herself. In addition, the Panel took into account the record of investigation interview with JM, a NQP Paramedic who attended the incident with the Registrant , and who attended an investigation meeting with Witness 3 on 9 June 22023. He also confirmed that the Registrant was heavily tattooed and that the Registrant spoke about tattoos to everyone as they were a particular interest of his. 

95. The evidence was that the Registrant’s particular interest in tattoos was a background to the Registrant’s conduct, and explained his interest. In light of this context, and the Registrant ‘s interest, the Panel was unable to find that a reasonable person would consider his behaviour sexual pursuant to either section 78(a) or 78(b).

96. The Panel, therefore, found Particular 4 in relation to Particular 3(b) not proved.

 

Particular 4 in relation to Particular 3(d)

97. The Registrant’s conduct in removing a hair which was lying against Colleague B’s breast area was an act which led him to touch an intimate area of her body. There was no clinical need to do this, or indeed any reasonable explanation other then he wished to touch this area of her body. The Panel also took into account Colleague B’s evidence that the Registrant, had, prior to removing the hair, come to the sofa where she was sitting and had sat very close to her so that he was touching her. 

98. His act of touching her breast area to remove a hair was an act which the Panel found a reasonable person would consider sexual by its very nature, pursuant to section 78(a). 

99. The Panel, therefore, found Particular 4 in relation to Particular 3(d) proved. 

 

Particular 5 in relation to Particular 1(a) –(f)

100. The Panel considered all of the findings in relation these sub-particulars together, because it took the view that they were part of a course of conduct over the night shift which should be considered together as setting the context. As such, the Panel took the view that to decide on motivation, it was necessary not to consider aspects of the behaviour in isolation. The Panel has already found that they all constitute behaviour which was sexual in nature. 

101. The Registrant engaged in a course of conduct over the course of several hours on a night shift in which he referred to and asked about the colour of Colleague A’s public hair, made a statement from which it can be reasonably inferred that he would find out by sexual intercourse, and he touched her in a sexual manner. The character of the conduct being sexual, was without any plausible alternative explanation for the conduct other than being in pursuit of sexual gratification and also in pursuit of a future sexual relationship 

102. In coming to this conclusion, the Panel took into account Colleague A’s evidence that the Registrant sent a friend request on Facebook, and Colleague A exhibited a screenshot from her mobile phone to demonstrate this. The Panel inferred from this a desire to engage further with Colleague A and from this it could also be inferred that the Registrant, taking in to account the context, was seeking a sexual relationship. 

103. The Panel, therefore, found Particular 5 in relation to Particular 1(a) – (f) proved.

 

Particular 5 in relation to Particular 3(a)

104. The Panel has already found that Registrant’s behaviour in Particular 3(a) was not sexual. For the same reasons as set out in its reasoning for that conclusion, the Panel was unable to find any evidence that the Registrant behaved in that way due to a sexual motivation, whether for sexual gratification or in pursuit of a future sexual relationship.

105. The Panel, therefore, found Particular 5 in relation to Particular 3(a) not proved
 

Particular 5 in relation to Particular 3(b)

106. The Panel has already found that the Registrants behaviour in Particular 3(b) was sexual. There was no clinical or professional justification for such a comment or interest in Colleague B, and in the absence of any alternative plausible explanation for the conduct, the Panel found that there was a sexual motivation, namely for a sexual gratification and the pursuit of a sexual relationship. In this regard, the Panel also took into account that the Registrant sent a friend request on Facebook to Colleague B as well as a request to follow her on Instagram, and from this can be inferred a desire to engage further with Colleague B. As such, the Panel found that, taking in to account the context, the Registrant was seeking sexual gratification and the pursuit of a sexual relationship. 

107. The Panel, therefore, found Particular 5 in relation to Particular 3 (b) proved. 

 

Particular 5 in relation to Particular 3(c)

108. The Panel has already found that Registrant’s behaviour in Particular 3(a) was not sexual. For the same reasons as set out in its reasoning for that conclusion, the Panel was unable to find any evidence that the Registrant behaved in that way due to a sexual motivation, whether for sexual gratification or in pursuit of a future sexual relationship.

109. The Panel, therefore, found Particular 5 in relation to Particular 3 (c) not proved.

 

Particular 5 in relation to Particular 3(d)

110. The Panel has already found that the Registrants behaviour was sexual. The act removing a hair laying across Colleague B’s breast was in relation to an intimate part of her body. There was no clinical or professional justification for removing a hair so that he was likely to touch her breast. In the absence of any alternative plausible explanation for the conduct, the Panel found that there was a sexual motivation, namely for a sexual gratification and the pursuit of a sexual relationship. In this regard, the Panel also took into account that the Registrant sent a friend request on Facebook to Colleague B as well as a request to follow her on Instagram, and from this can be inferred a desire to engage further with Colleague B. As such, the Panel found that, taking in to account the context, the Registrant was seeking sexual gratification and the pursuit of a sexual relationship. 

111. The Panel, therefore, found Particular 5 in relation to Particular 3 (d) proved.

 

Decision on Grounds

112. The Panel next considered whether the facts found proved in constituted misconduct. 

113. Mr Maughan relied on his written skeleton argument and submitted that the facts found proved amounted to misconduct. He submitted that the Registrant acted inappropriately by subjecting two junior female colleagues to repeated comments of a derogatory, harassing and sexual nature as well as sexualised physical conduct. In addition, the Registrant failed to treat a service user with the respect and dignity by failing to communicate in a profession and polite manner regarding their treatment.

114. Mr Maughan submitted that the Registrant had breached various Standards set out within the HCPC Standards of conduct, performance and ethics, as well as the Standards of Proficiency for Paramedics. Mr Maughan submitted that the facts found proved were serious. 

115. The Panel took into account the advice of the Legal Assessor who referred to the case of Roylance v GMC [2000] 1AC 311 and Nandi v GMC EWHC 2317. The Panel bore in mind that the issue of misconduct is a matter for its judgment, that there was no burden of proof at this stage, and that the conduct in question must be serious enough to constitute misconduct. A breach of the relevant standards was not necessarily in itself determinative of whether there was misconduct. The Panel also took into account the HCPTS Practice Note entitled “Professional Boundaries”.

116. The Panel decided that the Registrant had breached the following standards:

‘HCPC Standards of conduct, performance and ethics (2016)

1.Treat service users and carers with respect

1.1 - You must treat service users and carers as individuals, respecting their privacy and dignity.

2.Communicate with service users and carers

2.1- You must be polite and considerate
Work with colleagues

2.5 You must work in partnership with colleagues, sharing your skills, knowledge and experience where appropriate, for the benefit of service users and carers

Identify and minimise risk

6.1- You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible.

9. Personal and Professional Behaviour

9.1 - You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.
 
HCPC Standards of Proficiency Paramedics (2014)

2.1- understand the need to act in the best interests of service users at all times

2.2- understand what is required by them by the HCPC

2.3- understand the need to respect and uphold the rights, dignity, values, and autonomy
of service users…

3.1- understand the need to maintain high standards of personal and professional conduct

9 be able to work appropriately with others

9.1 be able to work, where appropriate, in partnership with service users, other professionals, support staff and others

9.2 understand the need to build and sustain professional relationships as both an independent practitioner and collaboratively as a member of a team

9.3 understand the range, scope and limitations of operational relationships between paramedics and other health and care professionals.’

117. The Panel considered that the sexual and sexually motivated behaviour towards both Colleague A and Colleague B, including touching of intimate areas of the body was behaviour which fell far below what was expected of the Registrant in the circumstances. Colleague A and B were both junior professional female colleagues. Colleague A was a newly qualified nurse who had been in her role for some two months, and Colleague B was a junior member of the profession, namely an EMT. As a more senior healthcare professional, it was even more important that the Registrant did not exploit his senior position. Instead, he appeared to target both female colleagues with both sexual and sexually motivated language and physical touching. 

118. The Registrant breached professional boundaries, leading to distress and upset to both Colleague A and B. Both Colleague A and B’s evidence was that they were hampered and distracted from performing their professional roles whilst they were being subjected to the Registrant’s behaviour, and this created a significant risk to the patients in their care, because they may not have been able to carry out their roles to the best of their ability. In addition, both Colleague A and B’s evidence described an insistent and harassing aspect to the Registrant’s behaviour towards them which created the risk that the Registrant himself would be distracted from his own professional obligations towards the patients in his care at the time. 

119. The sexual and sexually motivated behaviour was not an isolated or a one -off incident, rather there were more than one instances in respect of both Colleague A during the night shift, and towards Colleague B during a call-out to a patient’s home. 

120. As such, the Panel decided that the following matters of fact which have been found proved fell so far below the standards required of the Registrant as to constitute misconduct:
1 (a) - (f), 3 (b) and (d);
Particular 4 in relation to Particular 1(a) – (f);
Particular 4 in relation to Particular 3(b) and (d)
Particular 5 in relation to Particular 1(a) – (f);
Particular 5 in relation to Particular 3(b) and (d).

121. The Panel considered its factual finding in relation to Particular 2 and concluded that the Registrant’s statement showed a disregard for the dignity of, and disrespect towards, the patient whom he had brought in to A&E, which breached a fundamental requirement for the treatment of patients with respect. As such, by referring to him in a derogatory manner, the Registrant fell far below the standards expected of him. Therefore, this factual finding also constituted misconduct. 

Decision on Impairment

122. Mr Maughan referred to his written skeleton argument and submitted that the Registrant’s fitness to practise was impaired on the basis of both the personal and public components. He referred to the HCPTS Practice Note entitled “Fitness to Practise Impairment”. 

123. The Panel accepted the advice of the Legal Assessor who referred to CHRE v (1) NMC (2) Grant [2011] EWHC 927. The Panel took into account the HCPTS Practice Notes entitled “Fitness to Practise Impairment” and “Professional Boundaries”. The Panel was aware that current impairment is a matter for its own independent judgment and that public protection and the wider public interest should be considered. 
 
124. The Panel took into account the questions formulated by Dame Janet Smith in the Fifth Shipman report, as set out in the case of CHRE v (1) NMC and (2) Grant [2011] EWHC 927, which are presented in Grant as a test of impairment and ask whether a practitioner:

“a. has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or
b. has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or
c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession;…”

125. The Panel decided that the Registrant had acted in all the ways as set out in these questions by his past actions, taking into account its finding on Misconduct. He had also put colleagues at an unwarranted risk of harm. 

126. The Panel carefully considered the Registrant’s written submissions included in his bundle. The Registrant referred to matters of his own health [redacted]. The Panel also took into account that the report in the bundle, dated 2023 was brief and did not [redacted] give any real explanation of the effects it could have on his ability to practice. [redacted]

127. While the Registrant expressed an apology, and remorse, the Panel considered that he showed limited insight into the misconduct. He focused to a large extent on his own difficulties and health. There was no demonstration of an understanding of his behaviour was not merely “banter”, to use his word, but damaging and upsetting for Colleague A and B. Nor was there a demonstration of an understanding that it created a challenging work environment for them and had a negative impact upon them personally as well as their ability to focus on their work. 

128. The Registrant showed no real understanding of the impact of his behaviour on the confidence of colleagues, or the public confidence in him or the profession as a whole, nor of the impact upon patients if they were to witness such behaviour. The Panel considered it significant that all the of Registrant’s misconduct took place in the vicinity of patients.
129. There was no evidence of any meaningful reflection or any steps taken to address the misconduct or the attitude which led to the misconduct, such as by training or education, or steps taken to address the attitude which led to the misconduct. There was no reflection or training to address or demonstrate an understanding of the professional boundaries which he should have adhered to, why they are important, and how to avoid crossing it in the future. The Panel could not identify any meaningful acceptance of the need to change his thinking and behaviours. 

130. As such, the Panel decided that there was limited insight and no remediation demonstrated by the Registrant. Consequently, the Panel decided that there was a real risk that the Registrant could repeat his actions and thus behave in the ways set out in Grant in the future in the same or similar circumstances. 

131. The Panel was, therefore, of the view that the Registrant’s fitness to practise is currently impaired on the basis of the personal component. 

132. The Panel next considered the wider public interest. 

133. With regard to the misconduct, the Panel was of the view that it was serious. The registrant was a senior member of staff and had a duty to adhere to professional boundaries and set an example to more junior colleagues. He should not have breached professional boundaries by engaging in sexual and sexually motivated behaviour towards those more junior colleagues, causing them distress and upset while they were engaged in their clinical work. In these circumstances, the Panel decided that the need to uphold proper standards of conduct and performance, and the need to maintain confidence in the profession would be undermined if no finding of impairment were made. 

134. The Panel, therefore, found the Registrant to be impaired on the basis of both the personal component and the public components. 

Decision on Sanction

135. Mr Maughan reminded the Panel of the general principles governing the imposition of a sanction, and referred the Panel to the HCPC Sanctions Policy (SP). Mr Maughan submitted that the misconduct was serious and that sexual misconduct was a serious matter, as set out in the SP. 

136. The Panel took into account the SP, the HCPTS Practice note entitled “Professional Boundaries” and accepted the advice of the Legal Assessor. The Panel bore in mind that sanction is a matter for its own independent judgment, and that the purpose of a sanction is not to punish the Registrant but to protect the public and uphold the wider public interest. Further, any sanction must be proportionate, so that any order that the Panel makes is the least restrictive order that would protect the public and the public interest.

137. The Panel was of the view the following were aggravating factors: 

i. the misconduct was repeated in relation two different colleagues over a short space of time;
ii. exploitation of a position of seniority;
iii. limited insight and lack of remediation;
iv. distress caused to colleagues and potential harm to patients.

138. The Panel was of the view the following were mitigating factors: 

i. Apology and some remorse expressed;
ii. [redacted];
iii. [redacted];
iv. long history of public service as a Paramedic. 

139. The Panel took the view that the sexual misconduct in this case was serious. It was repeated. It related to two junior female colleagues on separate days and there are similarities between the incidents in that there were sexualised words used as well as physical touching. There was an abuse of a position of seniority and a breach of professional boundaries. The impact on both colleagues was explained by them in their evidence, causing them distress, upset, and hampered their ability to perform their duties towards their patients. The Registrant has not been able to show that he understands such impact, or the wider impact on patients, the profession and public confidence in the profession as a whole. Moreover, the Panel has already decided that there is a real risk of repetition resulting from the absence of sufficient insight and any remedial steps to address the misconduct.

140. The Panel first considered taking no action. The Panel concluded that, in view of the nature and seriousness of the Registrant’s misconduct and the ongoing risk to public protection, it would be inappropriate to take no action. It would be insufficient to protect the public, maintain public confidence and uphold the reputation of the profession.

141. The Panel then considered a Caution Order. The Registrant’s misconduct was not minor in nature, it was not an isolated event, and there is a real risk of repetition. Furthermore, the Registrant has not demonstrated that he has taken any of the steps required to address that misconduct. Therefore, the Panel concluded that a Caution Order would be inappropriate and insufficient to protect the public and meet the public interest.

142. The Panel next considered a Conditions of Practice Order. The Panel took into account that the Registrant has not attended these proceedings and in his email dated 8 April 2025 he stated that he wishes to be removed from the HCPC Register as he ‘never” wants to return to practice due to his poor health. As such, there is no suggestion that the Registrant would wish to comply with any conditions. In addition, the Panel took into account that the sexual misconduct was a matter of attitude on the part of the Registrant, and it would be impossible to formulate conditions to deal with attitudinal issues. The Panel therefore decided that conditions would be unworkable and neither sufficient to protect the public, nor in the public interest. 

143. The Panel next considered a Suspension Order. The Panel was of the view that, in light of the Registrant’s absence from the regulatory proceedings, and his limited insight and lack of remediation, as well as his expression that he no longer wishes to practice and wishes to be removed from the Register, he is either unable or unwilling to resolve his failings. These incidents of sexual misconduct occurred in 2023 in a clinical environment towards two different junior female colleagues in two separate incidents over a short space of time. There has been no evidence of remedial steps taken, presented to the Panel. The underlying issues of limited insight, absence of steps taken to address the misconduct, and the ongoing real risk of repetition, led the Panel to conclude that Suspension would not be appropriate or sufficient to protect the public or uphold the wider public interest. 

144. All of these factors led the Panel to decide that, in light of the nature and gravity of the concerns, coupled with the real risk of repetition, Striking Off is the only way in which the public can be protected, and which the wider public interest could be upheld in terms of maintaining proper standards of professional conduct and behaviour, and upholding confidence in the profession. The Panel was also of the view that any lesser sanction would lack a deterrent effect. 

145. In coming to its decision, the Panel took into account the principle of proportionality, and the impact that such a sanction will have on the Registrant’s right to practise his profession, as well as potential reputational and financial impact. However, the Panel decided that the need to protect the public and uphold the public interest outweighed the Registrant’s interests in this regard. 

146. The Panel, therefore, decided to impose a Striking Off Order.

 

ORDER: That the Registrar is directed to strike the name of David Ball from the Register on the date this order comes into effect.

This Order comes into effect on 27 June 2025.

Interim Order

Application for an interim order to cover the appeal period

112.   The Panel heard an application from Mr Maughan for an 18-month Interim Suspension Order to cover the appeal period. He submitted that such an order is necessary for the protection of the public and is in the public interest. 

113.   The Panel considered the HCPTS Practice Note entitled “Interim Orders” as well as Paragraphs 133-5 of the SP. The Panel accepted the advice of the Legal Assessor.

114.   The Panel decided whether or not to hear the application for an interim order in the absence of the Registrant. In deciding this issue, the Panel took into account that the Registrant had been informed, in the Notice of hearing dated13 March 2025, that this Panel may impose an interim order at any stage of the hearing. In addition, the Panel took into account the reasons set out in its earlier decisions to commence the hearing in the absence of the Registrant. In the circumstances, and for the same reasons, the Panel determined that it would also be fair, proportionate and in the interests of justice to proceed.

115.   The Panel took into account its previous findings in respect of impairment and sanction, and the need to protect the public and uphold the public interest. The Panel came to the conclusion that an interim order is necessary to protect the public and that an interim order is also in the wider public interest in order to maintain public confidence in the profession and to uphold proper standards. Public confidence in the profession and the regulatory process would be seriously harmed if the Registrant were not made subject to an interim order during the appeal period.

116.   The Panel was mindful of its decision at the sanction stage that Conditions were not appropriate. The Panel considered that not to impose an Interim Suspension Order would be inconsistent with its finding that a Striking Off Order is required, and that an Interim Suspension Order was necessary.

117.   The Panel recognised that the Panel must take into consideration the impact of such an interim order on the Registrant as part of the principle of proportionality, and must balance the impact on the Registrant with the need to protect the public and uphold the public interest. The Panel was satisfied that the need to protect the public and the public interest outweighed the Registrant’s interests in this regard.

118.   The Panel decided to impose an Interim Suspension Order for a period of 18 months, in duration which is necessary and proportionate to allow any appeal which the Registrant may bring, to be concluded.

Decision

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 David Ball

Date	Panel	Hearing type	Outcomes / Status
07/05/2025	Conduct and Competence Committee	Final Hearing	Struck off