HCPTS |

Profession: Paramedic

Registration Number: PA35590

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 06/05/2025 End: 17:00 13/05/2025

Location: Via virtual video conferece

Panel: Conduct and Competence Committee

Outcome: Suspended

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Allegation

As a registered Paramedic (PA35590) your fitness to practise is impaired by reason of misconduct. In that:

1. You purported to meet with, observe and/or assess Person A as part of their University Paramedic training course, on the dates listed in Schedule A, when this was not the case.

2. You signed off Person A’s practice assessment portfolio to demonstrate their competence in certain areas of practise without having adequately observed and/or assessed Person A’s practise in those areas, in that:

a. you signed off a learning contract for Person A regarding ‘cannulation’, dated 3 September 2020, stating “Student shows excellent knowledge of all areas agreed to in the Learning Contract”;

b. you signed off a learning contract for Person A regarding ‘12 Lead ECG’, dated 12 September 2020, stating ‘student has shown a substantial increase in knowledge thanks to regular exposure and frequent discussion of this subject’;

c. you signed off a learning contract for Person A regarding ‘assessment and treatment of paediatric patients’, dated 28 September 2020, stating that Person A has shown ‘significant improvement over placement’ and is ‘able to provide in-depth assessment without intervention from mentor’;

d. you signed off a learning contract for Person A regarding ‘preparation and administration of SC/ IM/ IV medication’, dated 28 September 2020, stating ‘student has shown over the placement that he is competent in all areas laid out in the learning and competencies we set out’;

e. you signed off a competency for needle cricothyroidotomy for Person A, dated 6 October 2020;

f. you signed off a competency for needle chest thoracentesis for Person A, dated 6 October 2020;

g. you signed off a competency for endo-tracheal intubation for Person A, dated 6 October 2020, and/or

h. you signed off Person A’s ‘End of Year – Named Paramedic Final Signoff Document’, dated 8 October 2020, providing an overall student performance rating of ‘Excellent’ and confirming Person A had met the HCPC standards of conduct, performance and ethics.

3. In or around August 2020, you accepted money from Person A as payment for signing off completion of their practice assessment portfolio.

4. On or around 08 April 2021, you denied the concerns raised at particulars 1 and/or 2 and/or 3 to your employer.

5. Your conduct in relation to particulars 1 and/or 2 and/or 3 and/or 4 was dishonest.

6. The matters set out in particulars 1 and/or 2 and/or 3 and/or 4 and/or 5 above constitute misconduct.

7. By reason of your misconduct your fitness to practise is impaired.

Finding

Preliminary Matters

Hearing Partly in Private

1. On behalf of the Registrant, Mr Hussain-Dupre applied for parts of the hearing to be conducted in private pursuant to rule 10(1)(a) of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 as amended (‘the Rules’). The application concerned matters of health and other aspects of the Registrant’s private and family life that were relevant to the Registrant’s case.

2. Mr Ive on behalf of the HCPC stated that the application was not opposed. The Legal Assessor advised that the application should be granted in view of the nature of the matters referred to by Mr Hussain-Dupre, rule 10(1)(a) of the Rules and Articles 6 and 8 of the European Convention on Human Rights.

3. The Panel considered that in the circumstances it was appropriate to direct that those parts of the hearing that concern the private and family life of the Registrant be conducted in private. The Panel made a direction accordingly.

Amendment

4. Mr Ive applied to amend particulars 4, 5 and 6 of the allegation in the form set out in the heading to this decision. He submitted that the amendments proposed were minor and clarificatory and would cause no prejudice to the Registrant. Mr Hussain-Dupre stated that the amendments sought were not opposed. Having received advice from the Legal Assessor, the Panel granted the application and directed that the allegation be amended in the form sought.

Background

5. The Registrant is a registered Paramedic who was employed by Central Medical Services (‘CMS’) between 2 April 2020 until 12 October 2021.

6. Between August and October 2020, the Registrant is alleged to have signed off the portfolio, placement hours log and various competencies of a Student Paramedic, Person A, in return for a financial payment. The Registrant is alleged to have done so when he had not in fact observed Person A on the dates claimed.

7. In April 2021, a work colleague, Person B raised her concerns with CMS who undertook an initial investigation in which the Registrant denied any wrongdoing. The HCPC subsequently received a fitness to practise referral from Person B in or around May 2021.

8. On 19 April 2022 a Panel of the Investigating Committee determined that the allegation in its then form was to be referred to the Conduct and Competence Committee. The allegation was first amended at a preliminary hearing on 15 December 2023.

Decision on Facts

9. The amended allegation was read out by the Hearings Officer. Admissions were made by Mr Hussain-Dupre on behalf of the Registrant to the entirety of particulars 1, 2, 3, 4 and 5. Where the words ‘and/or’ appeared in the amended allegation, Mr Hussain-Dupre made clear that the admissions made were on the basis of ‘and’ not ‘and/or’.

10. The Panel refers to the admission in respect of particular 3. There was a difference in the evidence to be relied on by the parties as to the amount of money that the Registrant accepted. However, it was agreed at the outset of the hearing by both advocates on behalf of the respective parties that the sum of money was ‘significant’ and that in view of this common ground it was unnecessary for the Panel to decide what the sum had been. The Panel accepted that approach and hence it was not necessary for it to hear evidence on that point and make a decision as to the exact sum. This meant that there was no need for Person B to give evidence.

11. The Legal Assessor advised the Panel that it could properly accept the admissions. The Panel retired and on its return the Chair announced particulars 1, 2, 3, 4 and 5 of the amended allegation proven by virtue of those admissions.

12. Therefore, the Panel sets out below the facts found proved by reason of the admissions. They are as follows.

1. You purported to meet with, observe and assess Person A as part of their University Paramedic training course, on the dates listed in Schedule A, when this was not the case.

Admitted and proved.

2. You signed off Person A’s practice assessment portfolio to demonstrate their competence in certain areas of practise without having adequately observed and assessed Person A’s practise in those areas, in that:

Admitted and proved.

a. you signed off a learning contract for Person A regarding ‘cannulation’, dated 3 September 2020, stating “Student shows excellent knowledge of all areas agreed to in the Learning Contract”;

Admitted and proved.

b. you signed off a learning contract for Person A regarding ‘12 Lead ECG’, dated 12 September 2020, stating ‘student has shown a substantial increase in knowledge thanks to regular exposure and frequent

discussion of this subject’;

Admitted and proved.

c. you signed off a learning contract for Person A regarding ‘assessment and treatment of paediatric patients’, dated 28 September 2020, stating that Person A has shown ‘significant improvement over placement’ and is ‘able to provide in-depth assessment without intervention from mentor’;

Admitted and proved.

d. you signed off a learning contract for Person A regarding ‘preparation and administration of SC/ IM/ IV medication’, dated 28 September 2020, stating ‘student has shown over the placement that he is competent in all areas laid out in the learning and competencies we set out’;

Admitted and proved.

e. you signed off a competency for needle cricothyroidotomy for Person A, dated 6 October 2020;

Admitted and proved.

f. you signed off a competency for needle chest thoracentesis for Person A, dated 6 October 2020;

Admitted and proved.

g. you signed off a competency for endo-tracheal intubation for Person A, dated 6 October 2020, and

Admitted and proved.

h. you signed off Person A’s ‘End of Year – Named Paramedic Final Signoff Document’, dated 8 October 2020, providing an overall student performance rating of ‘Excellent’ and confirming Person A had met the HCPC standards of conduct, performance and ethics.

Admitted and proved.

3. In or around August 2020, you accepted money from Person A as payment for signing off completion of their practice assessment portfolio.

Admitted and proved.

4. On or around 08 April 2021, you denied the concerns raised at particulars 1 and 2 and 3 to your employer.

Admitted and proved.

5. Your conduct in relation to particulars 1 and 2 and 3 and 4 was dishonest.

Admitted and proved.

Decision on Grounds

13. Mr Ive referred to the cases of Roylance v GMC [2000] 1 AC 311 and Nandi v GMC [2004] EWHC 2317 (Admin). He submitted that the facts admitted and proved established statutory misconduct. They constituted a serious departure from professional standards then in place, namely Standards 6.1, 6.2 and 9.1 of the HCPC’s Standards of conduct, performance and ethics (January 2016). The Registrant’s conduct had, he submitted, brought the profession into disrepute.

14. On behalf of the Registrant Mr Hussain – Dupre had admitted particular 6 of the allegation at the outset of the hearing as follows: -

‘The matters set out in particulars 1 and 2 and 3 and 4 and 5 above constitute misconduct.’

Mr Hussain-Dupre also accepted on behalf of the Registrant that the facts admitted and proved constituted a falling far below the required professional standards and were serious.

15. The Panel took into account the submissions of Mr Ive and Mr Hussain-Dupre and the admissions as to particular 6. The Panel has directed itself in accordance with the advice from the Legal Assessor.

16. The facts proved will amount to the statutory ground of misconduct if they establish professional conduct that fell short of what was proper in the circumstances and if the conduct was sufficiently serious: see Roylance v GMC [2000] 1 AC 311 and Nandi v GMC [2004] EWHC 2317 (Admin). Further guidance was given in respect of cases such as the present in Khan v GMC [2015] EWHC 301 (Admin) where Mostyn J stated at [6], -

‘The decisions from this court have demonstrated that a very strict line has been taken in relation to findings of dishonesty. This court and its predecessor, the Privy Council, has repeatedly recognised that for all professional men and women, a finding of dishonesty lies at the top end of the spectrum of gravity of misconduct …’

17. The Panel considered that the conduct found proved did not constitute a breach of Standard 6.1 as it did not amount to a failure to take (as that standard required) all reasonable steps to reduce risk of harm. However, it did amount to a breach of Standard 6.2 which states, -

‘You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user… at unacceptable risk.’

By signing off the competence of Person A in circumstances where he had neither assessed nor observed their professional competence, the Registrant created what the Panel considered to have been a huge risk of very serious harm to service users by potentially enabling Person A to work as a Paramedic when the Registrant did not know whether or not Person A was competent to do so. In the event, the intervention of Person B ensured that Person A did not achieve status as a registered Paramedic. However, the risk of harm created by the Registrant by his actions was wholly unacceptable.

18. The Registrant’s conduct also constituted a breach of Standard 9.1, which states, -

‘You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.’

In Person A’s assessment portfolio, the Registrant purported to show that he had met with Person A and assessed their professional competence. In those documents the Registrant signed off Person A’s competence both generally and in specific areas of practice. He did so in return for the payment of money. Then, some six months later, he denied that he had acted wrongfully. By engaging in that conduct, the Registrant betrayed the public’s trust and confidence in the profession.

19. The Panel considered that the Registrant’s conduct in fraudulently signing off the competence of Person A when he had not assessed or even observed their work was a serious and deplorable falling short of professional standards. That the Registrant did so in return for the payment of a significant sum of money, and then lied about the arrangement to CMS when the allegation was put to him rendered the misconduct all the more grave.

20. In those circumstances, the Panel was satisfied that each of particulars 1, 2, 3, 4 and 5 constituted misconduct. In relation to particular 2, the Panel was also satisfied that misconduct was established by reference to each of sub-particulars 2 a. – h. inclusive, such was the seriousness of every one of those acts.

Decision on Impairment

21. The Panel heard oral evidence from both parties. LF (the Registrant’s former line manager at CMS) gave evidence on behalf of the HCPC in relation to a factual dispute concerning dates. The Registrant also gave oral evidence in relation to that dispute, as well as on the issue of current impairment. Both were cross-examined.

22. The Registrant relied on extensive documentary evidence containing many pages of his reflections on his conduct and on the steps that he had taken to ensure that it was never repeated. There were also a number of testimonials from healthcare professionals and others who had worked with the Registrant over the years and who stated that they were aware of the allegations in this case.

23. Once the oral evidence had concluded, the Panel acceded to a joint application from the parties that the Panel make three findings of fact concerning the dates when (1) the Registrant informed CMS of the HCPC’s investigation that had been notified to him by the HCPC on 27 September 2021; (2) he informed CMS of the allegations that were being investigated; and (3) he admitted those allegations to CMS. Following brief submissions and advice from the Legal Assessor, the Panel announced its findings: that the dates were these. As to (1), 28 September 2021, as to (2) 28 September 2021 and as to (3), 12 October 2021.

24. The Panel’s reasons (which it now provides) for making those findings are these. The Panel accepted the evidence of the Registrant as to issues (1) and (2) and concluded that it was likely in the circumstances that he contacted CMS on 28 September 2021 to notify them of the investigation and allegations notified to him by the HCPC. However, in view of the contents of LF’s contemporaneous note of his phone call with the Registrant that took place on 12 October 2021, the Panel concluded that the Registrant made the admissions on that occasion and not in the phone call of 28 September 2021.

25. Following the announcement of the findings of fact on those issues, the advocates made their submissions on current impairment. Mr Ive submitted that the Registrant’s fitness to practise was currently impaired. He submitted that dishonesty is difficult to remediate and that it was on 12 October 2021 that the Registrant finally admitted his wrongdoing and only then because his employer put before him an analysis from attendance records showing that he had not worked with Person A on the dates contained in their portfolio.

26. Mr Ive acknowledged that the Registrant had made full admissions at the hearing but submitted that in all the circumstance a repetition of the misconduct was likely. He also submitted that the Registrant had brought the profession into disrepute, was liable to do so in the future, had breached a fundamental tenet of the profession, had acted dishonestly, and was liable to do so again in the future. Members of the public would be concerned to know that the Registrant had fraudulently signed off Person A’s practice portfolio and public confidence in the profession would be undermined if no finding of impaired fitness to practise were made.

27. Mr Hussain-Dupre referred to the oral and documentary evidence relied on by the Registrant and submitted that the misconduct related to a single incident in an otherwise unblemished career. Mr Hussain-Dupre referred to the Registrant’s medical history in particular to give context to, though not excuse, the Registrant’s dishonesty. He submitted that the Registrant had made a serious error of judgment and had then panicked when he denied the allegation when it was put to him in April 2021.

28. Mr Hussain-Dupre submitted that the Registrant had taken extensive steps to make sure that the misconduct would not be repeated. He had sought and obtained help for his medical wellbeing so that in the future he would make the right judgment calls. In his many reflections the Registrant had demonstrated great insight into the seriousness and implications of his behaviour. He was a dedicated and very capable medical practitioner who had worked in the armed forces in many challenging theatres of operations. He did engage in dialogue with CMS, having informed them of the HCPC’s allegations and by admitting them. He acknowledged that he had breached the trust placed in him as a Paramedic for financial gain and he had thought every day about the consequences of his actions, which he accepted had presented a serious risk to the public.

29. Mr Hussain-Dupre made submissions regarding the wider public interest. Ordinary members of the public would take into account all the circumstances of the case. Those included that the misconduct was out of character and that the Registrant had known when to step away from practice by removing himself from work as a Paramedic prior to the hearing of this case, having considered that it was right that he did so. Mr Hussain-Dupre submitted that dishonesty is not impossible to remediate if extensive steps are taken as had occurred in this case. The Registrant was now living in circumstances that are stable, with the necessary access to medical services and all-in-all the risk of repetition of the misconduct is very low. The Registrant’s fitness to practise, submitted Mr Hussain-Dupre, is not currently impaired.

30. The Panel received advice from the Legal Assessor, which it accepted.

31. In making its decision on the issue of current impairment, the Panel has borne in mind all the submissions made on behalf of the parties, the evidence placed before it, the facts admitted and proved and its earlier findings.

32. In directing itself on matters of legal principle, the Panel has taken into account the guidance given in the HCPTS’s Practice Note, ‘Fitness to Practise Impairment’, February 2025 (‘the Practice Note’) and case law referred to by Mr Ive and the Legal Assessor, including CHRE v NMC & Grant [2011] EWHC (Admin) 927.

33. The Panel first considered whether or not the acts which led to the misconduct are remediable. In her judgment in CHRE v Grant, Cox J. referred to passages from the judgment in R (Cohen) v GMC [2008] EWHC 581 (Admin) including the following, -

’65. … It must be highly relevant in determining if a doctor's fitness to practise is impaired that first his or her conduct which led to the charge is easily remediable, second that it has been remedied and third that it is highly unlikely to be repeated.’

In her judgment Cox J. stated at [70], -

‘An assessment of current fitness to practise will nevertheless involve consideration of past misconduct and of any steps taken consequently by the practitioner to remedy it. Silber J recognised this when referring, at paragraph 65, to the necessity to determine whether the misconduct is easily remediable, whether it has in fact been remedied and whether it is highly unlikely to be repeated.’

34. In considering whether the misconduct is remediable, the Panel has borne in mind that it is difficult, though not impossible, to remediate dishonesty.

35. Has the Registrant taken remedial action? The Registrant’s actions took place at a time when his health was very poor. In his written reflections he explained as follows: -

[Private]

36. The Registrant also explained how his financial circumstances had contributed to his dishonesty. In his written reflections on his financial status at the time, he stated that, -

[Private]

37. The Panel accepts that the Registrant’s adverse health is likely to have played a part in his decision-making. Of course, that does not excuse the Registrant’s dishonesty. It is, though, relevant to remedial action to prevent a repetition. The Registrant placed before the Panel his medical records from 2018 to give, as the Panel accepts, an accurate picture of his health.

38. [Private]

39. As a result, the Registrant’s position is that he has put in place the necessary measures to sustain his health.

40. [Private]

41. The Registrant has completed an ethics and professional standards course that addressed the importance of integrity and ethical practice in healthcare, the impact of professional misconduct on patients, colleagues and the healthcare system as a whole, and also focused on strategies for making ethical decisions under stress and avoiding future lapses in judgment.

42. As to financial matters, the Registrant stated as follows in his reflections,

[Private]

43. In the circumstances, the Panel accepts that the Registrant has taken the remedial action set out in the paragraphs above and as shown in the documents he has placed before the Panel.

44. The Panel considered the question of insight and took into account what it considered to be the Registrant’s thorough and insightful reflections on the implications of his misconduct for patient safety and public confidence in the profession. Those reflections also identified the contributing role of the Registrant’s medical condition and other personal circumstances, his understanding that honesty and integrity are of fundamental importance to professional practice, that his actions had been completely unacceptable and that he was committed to ensuring that they were never repeated having taken remedial actions and committing to continue to pursue them.

45. The Panel accepts that the Registrant made admissions to his then employer in October 2021, though the weight to be given to them is somewhat lessened by the circumstances in which the admissions were made. The Panel acknowledges that the Registrant has shown insight by making comprehensive admissions at the start of the hearing. It also considers that the Registrant showed insight by stepping away from professional practice until the conclusion of the HCPC’s case against him.

46. In assessing the risk of a future repetition, the Panel has taken into account the Registrant’s insight, all his acts of remediation and his plans for future measures to avoid a repetition. The Panel has also borne in mind what it considers to be the Registrant’s genuine commitment to avoid any future repetition of the misconduct.

47. The Panel accepts that the Registrant had a previously unblemished practice record and that his misconduct was out of character, as emphasised in the many testimonials given by referees who were aware of the Registrant’s actions that resulted in these regulatory proceedings. The Panel has also borne in mind the testimonials generally and attesting to the Registrant’s professional integrity and his commitment to the profession.

48. However, the Panel has reminded itself that dishonesty is difficult to remediate. The stability of the Registrant’s current circumstances is also relatively recent. The Panel is concerned that any material change in the stability of those circumstances, and in particular the Registrant’s health position, could give rise to impaired decision-making on his part were he to be placed in a similar situation to that which occurred in the period between August and October 2020.

49. [Private]

50. In view of the contents of the letter, the Panel considers that it has not yet been possible for the Registrant to provide a medical prognosis on his recovery.

51. The Panel also considered that the nature and gravity of the misconduct and the risk of harm it created as relevant to the risk of repetition: see paragraphs 30 and 33 of the Practice Note. The misconduct was deliberate and the Registrant was culpable for what was serious dishonesty. In choosing to act as he did, the Registrant was motivated to relieve his personal financial difficulties by taking dishonest actions that were a betrayal of public trust in the profession, exposing members of the public to a huge risk of great harm.

52. In all the circumstances and despite the many matters in favour of the Registrant, the Panel has been unable to conclude that the misconduct is highly unlikely to be repeated. The Panel has decided that there is a significant risk of repetition of the misconduct.

53. For those reasons, the Panel has concluded that the Registrant’s fitness to practise is currently impaired by reference to the personal component of impairment as set out in the Practice Note.

54. The Panel also considered the demands of the wider public interest and ‘the public component’ of fitness to practise set out in the Practice Note. The Panel has asked itself whether, given the nature of the allegation and the facts proved, public confidence in the profession and how it is regulated would be undermined if there were no finding of impairment.

55. In answering that question, it is necessary to bear in mind all the circumstances of the case with all the many positive matters in favour of the Registrant, including but not limited to his admissions and other insight he has shown, his extensive acts of remediation, that the misconduct was out of character, the Registrant’s commitment never to repeat it and that he had stepped away from practice prior to the hearing of this case.

56. However, the Registrant has brought the profession into disrepute by the nature and gravity of his misconduct.

57. The Panel has concluded that despite all the matters in his favour, members of the public would be very concerned if a registered Paramedic could betray public trust in the profession by exposing potential patients to such grave risks through acts of serious dishonesty and then go through a fitness to practise process and be found to be fit to practise.

58. Public confidence would also be undermined if the Registrant were found to be fit to practise in view of the risk of repetition on the misconduct as the Panel has found it to be.

59. The Panel has therefore concluded that, given the nature of the allegation and the facts proved, public confidence in the profession and how it is regulated would be undermined if there were no finding of impairment.

60. The Panel has also decided that in view of the nature and gravity of the misconduct, which breaches fundamental principles of the profession, it is necessary to reaffirm clear standards of professional conduct so as to maintain public confidence in the profession, with the result that the efforts made by the Registrant to address his behaviour for the future carry less weight than in some other cases : see CHRE v NMC & Grant at [73] referring to Yeong v. GMC [2009] EWHC 1923 (Admin).

61. Accordingly, the Panel has concluded that the Registrant’s fitness to practise is currently impaired by reference to the public component of impairment.

62. For all those reasons, the Panel has determined that the Registrant’s fitness to practise is currently impaired.

Decision on Sanction

63. The Panel received no further evidence at this stage of the hearing. The Panel received oral submissions from the advocates on the issue of sanction.

64. Mr Ive referred to the HCPC’s Sanctions Policy, March 2019 (‘the Sanctions Policy’) and his submissions included the following. He made clear that the HCPC maintained a neutral stance on the issue of sanction. Mr Ive referred to the purposes of sanctions and the relevance of proportionality in the Panel’s decision-making. Mr Ive identified aspects of the case that, he submitted, aggravated and mitigated the misconduct, drawing attention to pertinent aspects of the Sanctions Policy.

65. Mr Ive referred to those paragraphs of the Sanctions Policy that address ‘serious cases’, including dishonesty. He referred to paragraphs 56 and 57 in particular, which pointed to the requirements of honesty and trustworthiness in Standard 9 and that dishonesty undermines public confidence in the profession and can impact on the public’s safety. A panel that has found a registrant’s fitness to practise to be impaired because of dishonesty is likely to impose a more serious sanction due to the adverse effect of such conduct on public confidence and the potential dangers to public safety.

66. Mr Ive also referred to the importance of a sanction having the necessary deterrent effect and drew the Panel’s attention to paragraph 131 of the Sanctions Policy, which identifies circumstances in which a striking off order is necessary.

67. In his submissions, Mr Hussain-Dupre referred to the extensive remediation undertaken by the Registrant and reminded the Panel that it is possible to remediate dishonesty. He invited the Panel to give the Registrant the opportunity to complete his remediation. Mr Hussain-Dupre drew attention to the contextual importance of the Registrant’s medical history and how the stability of his current circumstances would enable him to access the medical support that would be necessary to enable him to return to work as a Paramedic.

68. Mr Hussain-Dupre referred to aggravating and mitigating factors of the case. He acknowledged the seriousness of the misconduct and submitted that a period of suspension for 12 months marks the gravity of the misconduct and would have the necessary deterrent effect. A striking off order would be disproportionate, he submitted.

69. The Panel has taken into account its findings in the case to this stage, all the evidence so far as relevant to the issue of sanction and the submissions for the parties. It has directed itself in accordance with the advice of the Legal Assessor that it was given on the issue of sanction.

70. The Sanctions Policy identifies the purposes of sanctions as follows: -

‘10. The primary function of any sanction is to protect the public. The considerations in this regard include:

• any risks the registrant might pose to those who use or need their services;
• the deterrent effect on other registrants;
• public confidence in the profession concerned; and
• public confidence in the regulatory process.

11. Sanctions are not intended to punish registrants, but instead ensure the public is protected. Inevitably, a sanction may be punitive in effect, but should not be imposed simply for that purpose.’

71. The requirements of proportionality must be met by a panel in its decision-making.

72. In assessing the seriousness of the misconduct for the purposes of the issue of sanction, the Panel is called on to take into account and appropriately weigh the mitigating and aggravating features of the misconduct: paragraphs 25-28, 43 and 44 of the Sanctions Policy.

73. The Sanctions Policy makes clear that matters of mitigation are likely to be of considerably less significance in regulatory proceedings, where the overarching concern is the protection of the public, than to a court imposing retributive justice: paragraph 25. The Legal Assessor also advised the Panel to similar effect, referring to the judgment of Sir Thomas Bingham MR in Bolton v Law Society [1994] 1 WLR 512 at 518 and 519.

74. The Panel considered the following to be mitigating factors in the case. The insight shown by the Registrant (see paragraphs 44 and 45 of this decision) constitutes a genuine recognition of the concerns raised and an understanding of the potential impact of his actions. The Registrant has also shown genuine remorse for his misconduct, stating in his reflections of October 2022 that, ‘[e]ver since the incident I have felt shame and disgust at myself on a daily basis’ and explaining that he knew what he had done was wrong. In his reflections prepared for this hearing, the Registrant stated, -

‘I fully acknowledge and admit to my involvement in the incident in which I signed off a colleague’s clinical competencies in exchange for financial compensation. I deeply regret my actions...’

75. The Registrant has undertaken appropriate and extensive remediation (see paragraphs 38 – 43 of this decision). The Panel considers that as a result of the Registrant’s insight and remediation, the risk of a repetition, though significant, is much less than it was in late 2020 and much of 2021, even though dishonesty is difficult to remediate.

76. [Private]

77. [Private]

78. The Panel proposes to say more about those matters in the later stages of this decision and bears in mind that the present case raises concerns that are so serious that the Panel is likely to impose a serious sanction (paragraph 40 of the Sanctions Policy).

79. The Panel considered the following matters aggravated the Registrant’s misconduct. In acting dishonestly by falsely certifying the competence of a student practitioner for financial gain, the Registrant abused the trust placed in him by the public as a member of the profession, which has to be seen as completely trustworthy in order to operate effectively.

80. The Registrant also failed to admit to the misconduct for a period of 14 months from August 2020, having denied it in April 2021.

81. Further, by acting as he did the Registrant placed members of the public at huge risk of harm. As the Registrant acknowledged in his written reflections, the carrying out of the medical procedures he certified ‘without the proper qualifications and training can be severe and life-threatening.’

82. The Panel proceeded to consider the potential sanctions in ascending order of seriousness.

83. The misconduct was far too serious to justify ‘no action’ on the Registrant’s registration. Some action was also required to address the risk of a repetition of the misconduct.

84. Mediation would not address the grounds of the impairment.

85. A caution would neither reflect the seriousness of the misconduct, nor the risk of its repetition. The misconduct is not ‘isolated, limited or relatively minor in nature’, nor is there a low risk of repetition: see paragraph 102 of the Sanctions Policy.

86. Conditions of Practice are less likely to be appropriate in more serious cases, such as dishonesty and abuse of professional position: paragraphs 108 and 109 of the Sanctions Policy.

87. Moreover, any conditions would have to be workable and in view of the nature of the misconduct, conditions would be unworkable. The Panel refers to its findings on misconduct, current impairment and as to the seriousness of the misconduct set out below. In the circumstances, conditions of practice would not sufficiently address the seriousness of the misconduct and conditions of practice would not be workable and therefore would not address the risk of repetition of the misconduct. Therefore, conditions of practice are not appropriate in this case.

88. The Panel next considered a period of suspension. The Sanctions Policy states the following with respect to suspension: -

‘121. A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register. These types of cases will typically exhibit the following factors:

• the concerns represent a serious breach of the Standards of conduct, performance and ethics;
• the registrant has insight;
• the issues are unlikely to be repeated; and
• there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings.’

89. In deciding whether or not a sanction of suspension (up to the maximum period of 12 months) would be a sufficient and proportionate response to the impairment, the Panel also considered whether the circumstances required a striking off order, or whether such an order would be disproportionate.

90. The Panel considered those parts of the Sanctions Policy concerned with striking off orders. It noted that such an order would be a long-term sanction. Article 33(2) of the Health Professions Order 2001 (as amended) provides that, unless new evidence comes to light, a person may not apply for restoration to the Register within five years of the date of a striking off order being made, and panels do not have the power to vary that restriction: paragraph 128.

91. The Sanctions Policy states that: -

‘130. A striking off order is a sanction of last resort for serious, persistent, deliberate or reckless acts involving (this list is not exhaustive) –

• dishonesty (see paragraphs 56 – 58);
• …
• …
• …
• abuse of professional position … (see paragraphs 67–75);
• ..
• …
• …

131. A striking off order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process. In particular where the registrant:

• lacks insight;
• continues to repeat the misconduct or, where a registrant has been suspended for two years continuously, fails to address a lack of competence; or
• is unwilling to resolve matters.’

92. In determining whether or not a suspension order would be a sufficient sanction, the Panel has given particular consideration to where the misconduct lies on the scale of seriousness.

93. In doing so, the Panel has borne in mind paragraphs 56 – 58 of the Sanctions Policy, which explain why dishonesty is so serious in the present regulatory context. Dishonesty undermines public confidence in the profession and can, in some cases does impact the public’s safety. In this case, the Registrant’s misconduct did potentially impact the public’s safety most seriously until Person A’s own wrongdoing was exposed by the intervention of Person B. Dishonesty such as fraud can have a significant impact on the trust placed in a practitioner, in this case the Registrant, who has been dishonest and compromised public safety.

94. It is also necessary to make an assessment of the seriousness and degree of the dishonesty, taking into account the factors set out in paragraph 58 of the Sanctions Policy. The Panel’s assessment is that the circumstances in which the Registrant signed off the professional competence of the student trainee for financial reward and exposed the public to great risk of harm and then lied about it and failed to admit to it until October 2021, placed his misconduct at the top end of the spectrum of dishonesty, though the context of the misconduct as set out in paragraph 77 of this decision does mitigate the dishonesty.

95. The Sanctions Policy also treats ‘abuse of professional position’ as a serious case. Paragraph 68 states, -

‘Our Standards of conduct, performance and ethics require registrants to ensure that their conduct justifies the public’s trust in them and their profession. This means being honest and trustworthy and acting in the best interests of service users, as well as ensuring that their relationships with service users and carers remain professional. Where a registrant is found to have abused their professional status, this is highly likely to reduce the public’s trust in them and their profession. The greater the alleged abuse of trust, the more serious the panel should consider the concerns.’

96. Paragraph 69 explains that a registrant may abuse their professional position in a number of ways, such as an abuse of position for financial gain.

97. The Panel’s assessment is that the abuse of trust in this case was again at the top end of the spectrum of seriousness.

98. It is true that if the Registrant were suspended, for the maximum period of 12 months, the risk of repetition would be contained and that period of suspension would allow him to embed and further his remedial action, giving him an opportunity to take further steps to remediate his misconduct.

99. However, the Panel has borne firmly in mind that personal mitigation is of less relevance than in criminal cases because of difference between the two jurisdictions. It has also reminded itself that in serious cases where there has to be an intense focus on the need to maintain public confidence and uphold professional standards, personal matters affecting a registrant should not be given undue weight.

100. The insight, remediation and remorse shown by the Registrant are clearly substantial matters in his favour, as are his otherwise unblemished professional record and the abilities he clearly possesses as a practitioner. A striking off order would also be severe in its likely effect, excluding the Registrant from the profession for a period of at least five years. There is also, in the right circumstances, a public interest in facilitating the return to work of an otherwise competent practitioner.

101. Those factors on their own would not render a suspension order, even of the maximum period, sufficient to reflect the gravity of the misconduct and would not create the necessary deterrent effect. The Registrant’s grave misconduct constituted most serious violations of fundamental principles of registered practice. His betrayal of public trust in the profession by accepting money for signing off the competence of a student trainee when he had no idea whether they were competent or not exposed members of the public to horrific risk. His conduct was appalling and the Registrant made matters even worse by then lying about it and not admitting it until October 2021.

102. [Private]

103. The Panel has weighed all the demands of the public interest in this case and the statutory overarching objective in its consideration of the appropriate sanction to reflect the gravity of the misconduct, including both its aggravating and mitigating aspects.

104. Taking all those matters into account, a suspension order of 12 months is sufficient in what the Panel considers to be the wholly exceptional circumstances of this case. The Panel has concluded that a suspension for a period of one year protects members of the public and provides the necessary deterrent effect, maintains public confidence in the profession and in the regulatory process. It does so by declaring that this sort of conduct is completely unacceptable and did not result in a striking off order only because of the wholly exceptional circumstances in which it occurred. The Panel considered that a striking off order, in the circumstances of this case, would be unnecessary and disproportionate.

105. The suspension order will be reviewed before it expires. The Panel was informed by Mr Hussain - Dupre that the Registrant proposes to find work as a Healthcare Assistant following this hearing. A panel at a review hearing is likely to be assisted by the following –

• An up-to-date medical report (or reports) on the Registrant’s health;
• References addressing the Registrant’s honesty and integrity in his work as a healthcare assistant or in any other role.

Order

Order: That the Registrar is directed to suspend the registration of Shane Williams for a period of 12 months from the date this Order comes into effect.

Notes

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.

Interim Order

Application

1. Mr Ive applied on behalf of the HCPC for an interim suspension order of 18 months under Article 31(1), (2) of the Health Professions Order 2001 as amended. Mr Hussain-Dupre did not oppose the imposition of such an order. The Panel received advice from the Legal Assessor, which it has accepted.

2. The Panel refers to its finding that there is a significant risk of a recurrence of the misconduct. In view of that finding and the nature and seriousness of the misconduct, the Panel was satisfied that there is a real risk of harm to the health and safety of service users if no interim order were imposed.

3. Members of the public would be most concerned if no interim order were considered necessary during the 28-day period before the Suspension Order took effect, and if the Registrant did appeal, in the period before disposal of the appeal. There would be serious damage to public confidence in the profession and its regulation if, having reached the conclusions that it did in the earlier parts of this decision and the grounds on which it did so, the Panel considered that no interim restriction were necessary. Therefore, an interim order is also in the wider public interest.

4. There must be good and sufficient reason to impose an interim order. The Panel has conducted a balancing exercise, balancing the need to protect the public and the wider public interest against the consequences that an interim order could have on the Registrant. The Panel concluded that an interim order is required in order to contain the risks in this case both to members of the public and the wider public interest. The Panel asked itself whether or not an interim conditions of practice order would suffice. However, interim conditions of practice would not be workable in view of the nature of the misconduct and would not adequately address either the risk of harm to members of the public or the risk of damage to public confidence in the profession.

5. The Panel has concluded that an interim suspension order is necessary in the circumstances of this case to protect members of the public and is otherwise in the public interest.

6. In view of the likely time for the disposal of any appeal, should the Registrant decide to do so, the Panel decided to impose an interim suspension order for a period of 18 months.

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.

Hearing History

History of Hearings for Shane Williams

Date	Panel	Hearing type	Outcomes / Status
06/05/2025	Conduct and Competence Committee	Final Hearing	Suspended