Mr Keith Roper-Hitches

Preliminary Matters
Service
1. The Panel had been provided with evidence that on 1 September 2025, the Notice of Hearing Letter (NOHL) had been sent to the Registrant’s email address as registered with the HCPC. The Panel has satisfied itself that the NOHL contained the correct information relating to today’s hearing in terms of time, date and mode of hearing.
2. The Panel noted from the Legal Assessor’s advice that the Panel only required evidence that the NOHL had been sent to fulfil the terms of the rules. The Panel however, had before it a letter sent on 8 September 2025 by the Registrant in response to the NOHL and subsequent letter sent on 4 September 2025 outlining the process for the Article 30(1). It was clear from the communication from the Registrant that he was aware of today’s hearing.
3. In light of this response from Registrant the Panel concluded that there had not only been good service, but also successful receipt of that NOHL.

Hearing in private
4. The HCPC made an application for this hearing to be held in part in private. It was submitted that the matters which led to the Registrant’s referrals to the HCPC were linked to some degree with the issue of the Registrant’s health. This being the case, the Registrant should be accorded the right to a private life as enshrined in UK Human Rights legalisation.

5. The Panel sought the advice of the Legal Assessor, who reminded the Panel that there was the principle of open justice and so as a starting point all hearings should be heard in public unless there were overriding issues that accorded privacy. She took the Panel to the terms of rule 10(1)(a) of the Health and Care Professions (Conduct and Competence Committee)(Procedure) Rules 2003, as amended, which provides the Panel with a discretion to consider a matter in private for a part or the whole of the hearing.

6. The Panel noted from the HCPC bundle and the Registrant’s response to the NOHL that there were references to issues of health, historic and current. The Panel noted that the substantive hearing had been conducted wholly in private. The Panel noted however that the HCPC had stated that it did not intend to refer directly to those health issues but when making the application had appreciated that there could be reference made as part of a wider discussion.

7. The Panel considered that it was practical to hear matters relating to issues of health in discrete parts of the hearing. It also considered that as the Registrant had raised the issue of the impact of the continued HCPC process on his health in his letter of 8 September 2025 that it would be appropriate to make some reference to those issues in a private written determination.

8. The Panel therefore decided to hold parts of the hearing in private and would be producing a private version of its determination.

Proceeding in absence
9. The HCPC made an application for this matter to proceed today in the absence of the Registrant. In support the HCPC identified the following issues:
a. The Registrant has not made an application for an adjournment.
b. The Registrant did not participate in person at the Substantive Hearing.
c. The Registrant has written in the most strident terms that he wishes to have nothing further to do with the HCPC or this hearing.
d. There is nothing to indicate that the Registrant would be willing to attend a hearing at a future date if the matter were adjourned.
e. From the terms of his letter of 8 September 2025, it should be assumed that the Registrant has made an informed decision to voluntarily absent himself.
f. There is public interest is this matter proceeding today without unnecessary delay particularly as the current substantive suspension order will come to an end on 6 November and there would be little or no time to give the requisite notice of a hearing before that date should this matter be adjourned.

10. The Panel received and accepted legal advice. The Panel also took into account the terms of the HCPTS Practice Note entitled Proceeding in Absence.

11. The Panel noted the terms in which the Registrant had stated in his letter of 8 September 20205 his intention not to participate at any point in any HCPC proceedings nor would he engage with any future communications from the HCPC, an organisation he considered had let him down. The Panel noted that in response to those strident terms of disengagement the HCPC had written on 19 September 2025 identifying ways in which the Registrant could engage with his nominated paralegal and advising him that this participation at this hearing was limited to participation through a video link. There had been no response from the Registrant and the Registrant was not in attendance today.

12. From this the Panel concluded that the Registrant had no intention of attending today nor at any future date. The Panel therefore considered that nothing would be achieved by adjourning this matter and that the public interest in it going forward today outweighed any possible prejudice to the Registrant from such decision to proceed in his absence.

Background
13. The Registrant was first registered with the HCPC as a qualified Paramedic on 12 September 2012.

Allegation one
14. The Registrant was subsequently deregistered by the HCPC on 8 February 2017, due to non-payment of fees.

15. In May 2017, the Registrant applied to rejoin the register and at that time declared a conviction or caution. His application and declaration were reviewed by the HCPC, and the Registrant was readmitted to the Register on 9 October 2017.

16. The Registrant was employed by the South Western Ambulance Service NHS Trust, (the Trust). During the period 23 May to September 2017, however the Registrant was suspended from duty following the disclosure that his partner had made an allegation of assault against him.

17. Although on 11 August 2017 the criminal case was dismissed, the Registrant was made the subject to a Restraining Order for a period of 12 months.

18. The Trust wrote to the Registrant on 6 September 2017 confirming that he was no longer suspended and the internal investigation into his conduct had been closed.

19. The Registrant was required to meet with the County Commander at the Trust to discuss the impact of the Restraining Order would have on his work. That meeting took place on 14 September 2017. The follow up letter from that meeting sent by the Trust confirmed that the Registrant had been signed off work for a month from 11 September 2017.

20. In or around January 2019, the contents of the Registrant’s personal website and blog came to the attention of the Trust. Concerns were raised that the Registrant may have been posting inappropriate and/or offensive material which could be linked to his role as a Paramedic.

21. The Trust undertook an internal investigation and the result of that was the Registrant was suspended between 24 January 2019 and 9 May 2019.

22. News of the Registrant’s second period of suspension was subsequently disclosed to the HCPC by one of the Trust’s HR Business Partners at the Trust on 1 December 2020. By this time, the Registrant was no longer working for the Trust.

Allegation two
23. Between 25 May to 25 August 2020, the Registrant was employed by the George Eliot Hospital (the Hospital) as a Resuscitation Officer. On 18 June 2020, within a month of commencing this employment with the Hospital, the Registrant attended a Paediatric Immediate Life Support (PILS) course. This was an intermediate level course accredited by the Resuscitation Council UK.

24. Concerns were raised about the Registrant’s performance on this course which he was recorded as failing. It was a requirement of his then role to be able to undertake this function safely.

25. On 19 June 2020, the Registrant’s line manager discussed the outcome of the course with the Registrant. In view of concerns around the Registrant’s ability to carry out his role, the Registrant’s manager placed him on some short-term objectives to better understand his capabilities.

26. On 2 July 2020, the Registrant did not attend work and did not report his absence in line with the employer’s absence procedure.

27. The Registrant’s manager then expressed concern that the letter had not been provided sooner. At that point, the Manager recalled that the Registrant became angry and accused her of having a problem with him because of his disability.
28. The Registrant’s manager further reported that when the Registrant did not attend work on 2 July 2020, she searched his social media. When she went into his Twitter account there was an icon saying, “Fuck the police” and there was a picture of a Nazi uniform next to a police uniform.

Substantive hearing
29. The matters referred to above formed the basis of two referrals to the HCPC and on 9 January 2025. The Registrant had not attended the substantive hearing, nor had he been represented. The Registrant had however provided the panel with written representations. The Substantive Hearing concluded with the Panel imposing a Suspension Order for 9 months. The Substantive Hearing Panel had provided the Registrant with guidance as to the matters which he should consider providing to a reviewing panel.

Developments since the Substantive Hearing
30. On 4 September 2025, the Review Case Manager wrote to the Registrant enquiring what if any documentation and information the Registrant intended placing before this Panel.

31. On 8 September 2025, the Registrant wrote to the HCPC. The Panel had been provided with a copy of that letter and the Council’s response dated 19 September 2025. From the Registrant’s letter it was clear that he felt very aggrieved. He was disrespectful of his regulatory body and had maintained that, notwithstanding those matters relating to his former line manager at the Hospital had not been upheld, he had expressed himself as still being the victim. He particularly took exception to the fact that a member of the Trust’s HR department had breached confidentiality.

32. The Registrant stated in the clearest of terms that he did not wish to be associated with the HCPC, and that he had no intention of returning to his profession.

HCPC submissions
33. This is the first Substantive Review Hearing of this matter. The Order is due to expire on 6 November 2025. The HCPC stated that it will be requesting the Panel to impose a Strike-Off Order for the reasons set out later in its representations.

34. The HCPC stated that the question for the Panel today is whether the Registrant’s fitness to practise remains impaired, or whether the Registrant has done enough to address the concerns identified by the Substantive Hearing panel. Further, the Panel may, when considering the Registrant’s current state of impairment, decide to renew the current Substantive Suspension Order or make an alternative order.

35. The HCPC reminded the Panel that at this review hearing there is a persuasive burden on the Registrant to demonstrate that they have fully acknowledged the deficiencies which led to the original finding of impairment, and have addressed those failings sufficiently “through insight, application, education, supervision or other achievement”.

36. The HCPC drew the Panel’s attention to the recommendation made within paragraph 144 of the Substantive Hearing decision:
“The Registrant’s engagement with the review hearing, preferably by his attendance in person, if possible;
A statement by the Registrant to demonstrate his reflections on the Panel’s decision in relation to misconduct and impairment and any steps which he has taken to ensure that such misconduct will not be repeated. This includes any steps he has made to manage his health (see paragraph 117 of this determination);
Updated medical evidence from the Registrant’s GP and any treating clinician as to his current state of mental health with particular regard to the previous diagnosis of anxiety, depression and PTSD;
Details of any employment, whether paid or unpaid, undertaken by him since November 2024 and references and testimonials from any employer;
Details of any CPD undertaken by him and any experience gained by him relevant to his practice as a Paramedic;
The Registrant’s intentions with regard to returning to work as a Paramedic.”

37. The HCPC stressed that the Registrant has not engaged with the HCPC process, and he had not heeded the guidance provided within the Substantive Hearing decision. There is no evidence that the Registrant has, since leaving practice kept his knowledge and skills up to date and undertaken any CPD. It was therefore the case that there is no evidence before this Panel to suggest that the Registrant has addressed his previous failings and that his fitness to practise is no longer impaired.

38. The HCPC referred the Panel to the letter received by the HCPC from the Registrant dated 8 September 2025, in which he states “my dead body would have to stop twitching before I ever consider working…” this it was submitted, made it abundantly clear that the Registrant has no intention of returning to his profession and it would be fruitless to impose any other Order than that of a Striking-Off Order. It was the HCPC’s view that any lesser Order than Suspension was neither proportionate, appropriate or workable, and that in light of the Registrant’s stated views a further period of suspension would serve no purpose. The HCPC therefore submitted that at the only Order that would be appropriate was that of a Striking-Off Order.

39. It was also submitted that such a Striking-Off Order was required in the wider public interest where there remain concerns about his

Decision
40. The Legal Assessor informed the Panel that Article 30(1) states that an Order must be reviewed before it expires and that at this review the reviewing Panel may:
• Extend, or further extend the period for which the Suspension Order has effect;
• Make an Order which it could have been made at the time when the Order being reviewed was imposed; or
• Replace the Suspension Order with a Conditions of Practice Order with which the Registrant must comply before he returns to practice.

41. The Legal Assessor reminded the Panel that its role today is twofold. First, to review the matter based on the evidence available and decide whether the Registrant’s fitness to practise remains impaired and if so, to secondly decide what the appropriate sanction should be. The Panel should not go behind the decision of the previous panel and this being a matter involving misconduct the Panel today had the full range of sanctions available to it.

42. The Panel took into account the HCPTS Practice Notes relating to Review of Article 30 Orders and Fitness to Practise Impairment and accepted the advice of the Legal Assessor.

43. The Panel first considered whether the Registrant’s fitness to practise remained impaired by reason of the allegation found proved at the substantive hearing.

44. The Panel took into account the decision of the High Court in Abrahaem v GMC [2008] EWHC 183 [Admin] where it was stated that in practical terms there is a “persuasive burden” on the Registrant to demonstrate at a review hearing that he is no longer impaired.

45. The Panel noted that at the final hearing the Registrant's position in relation to impairment was recorded within paragraphs 116 to 118 as follows:
‘116. The Panel determined that that the misconduct has not been fully remedied as the Registrant’s insight is not fully developed. He talks in some detail of the benefits to himself and others, but there was little acknowledgement of the impact of the posts on people who will have found them offensive. Nor was there evidence or real understanding of the impact on patients who may have needed help from the ambulance service due to overdose or other forms of self-harm and on the reputation of the profession. Whilst the Panel was sympathetic to the Registrant’s evidence that writing the blog was therapeutic, it had insufficient assurance that the Registrant would not either blog or post inappropriate material again in a state of deteriorating mental health.
117. It followed that the Panel found that a risk of repetition remains. It considered that if the Registrant is relatively well in terms of his mental health, then the risk of repetition is fairly low, however, should his mental health deteriorate, then there is a higher risk of repetition. As the Panel had no up-to-date information as to the Registrant’s mental health and how he is managing it, the Panel had to conclude that the risk of repetition is such that he is currently impaired on the personal component.
118. As to the public component, that Panel determined that the public interest requires a finding of current impairment given the seriously offensive nature of the posts. To find otherwise would signal that such posts are acceptable or can be overlooked, when doing so would seriously damage the reputation of the profession and the public’s trust and confidence in it.'

46. The Panel noted that at this review the focus is on a single finding by the substantive hearing panel of misconduct as identified in particular 3(a) to (c) if the allegation relating to HCPC case number FTP79042. Those findings relate to the posting of inappropriate material on the Registrant’s blog and comments posted on Twitter (as it then was known). The material in his blog had been removed by the Registrant but not the statements on Twitter, which, arguably, could not be removed voluntarily. The level of remediation to be demonstrated at this review therefore was limited to insight into why those comments should not be made by a professional within a public forum and reflection upon the ways that would have been inappropriate and damaging to him, his profession and his regulator. Such evidence would have provided this reviewing panel with the assurance that there would be no repetition in the future.

47. The Panel however had nothing before it from the Registrant that had been recommended by the substantive hearing panel as being of assistance to this reviewing Panel. The Registrant had not provided any supporting medical evidence to confirm that he is currently unable to undertake the steps required to make him fit to return to practise. Nor has the Registrant provided any evidence that he has accepted and addressed the findings made at the substantive hearing relating to insight into his former behaviour such that there would not be a repetition of the misconduct complained of. The Panel therefore concluded that the Registrant had failed to take any steps to discharge his burden to provide evidence of remediation.

48. The Registrant had however taken the opportunity to demonstrate his continued lack of insight into his former misconduct, and to express his current views of the HCPC process. In his letter of 8 September 2025, the Registrant expressed himself (amongst other things) in the following terms:
a. This letter has been nine months in the making and contains my thoughts and feelings about you as an organisation, your treatment of the individual and how you had been taken for a ride during the hearing.
b. ...your cruel, unjust and foolish decision,..
c. Following the previous hearing, it had become apparent that you had clearly not paid attention to my earlier letters and correspondence, in which I stated very clearly that I had no intention of ever practising again in any form of healthcare profession and had not renewed my HCPC membership beforehand. Therefore, I ensured that I would not and could not practice, nor intend to practice, [sic] on any member of the public.
d. Regarding the statements made by W (or whatever her name was) and her flying monkeys, you were taken in foolishly hook, line and sinker. As I had stated, in the correspondence that you appeared to have ignored, I had a good legal case to take her and the hospital to a tribunal and court. Could not one of you see that her overboard statements and comments were a ploy to defend themselves from such actions? It appears not. W stooped so low as to say I went for her. Utterly ridiculous considering it was who showed violent actions and made verbal threats to me.

49. The Panel noted that the evidence of W relating to aggressive behaviour had not been found proven by the substantive hearing panel, however the Registrant has not appreciated this, or has chosen to still focus on the historic harms that he considers he has been the victim of. There is further text in his letter which supports the view that he has failed to undertake any reflection on past events.

50. The Panel also noted that the Registrant considered that the HCPC and this Panel had no locus as he had failed to renew his registration. The position was that once there had been a referral to the HCPC, the Registrant’s registration continued until there was a final resolution of the issues that were the subject of that referral.

51. Taking all this into consideration the Panel has concluded that on the personal component the Registrant is not currently fit to practise.

52. In relation to the public component, the Panel considered that the public would be concerned by the comments made by the Registrant about his profession and his regulatory body. The opportunity that the Registrant had to demonstrated remorse, regret and insight had been ignored and there had been no appreciation that there had in fact been that opportunity to regain his professional standing and return to his chosen profession.

53. Accordingly, the Panel found that his fitness to practise remains impaired on both the personal and the public components.

54. With regard to sanction, the Panel took into account the HCPC’s Sanctions Policy. In assessing this issue of sanction, the Panel considered the need to protect the public and gave appropriate weight to the wider public interest, which includes the reputation of the profession and public confidence in the regulatory process. The Panel applied the principle of proportionality and considered the available sanctions in ascending order of seriousness.

55. The Panel considered that the concerns about the Registrant’s fitness to practise as demonstrated by his current attitude to regulatory process remained too serious to take no further action or for the imposition of a Caution Order.

56. The Panel considered whether to impose a Conditions of Practice Order but decided that conditions of practice would not be appropriate in the absence of any evidence that the Registrant’s attitude to past events had been remediated. In the Panel’s view those attitudinal matters would make it impossible for the Registrant to be able to fully comply with any conditions which the Panel imposed.

57. The Panel also considered that conditions of practice would not be appropriate because the Registrant had shown no willingness to engage with the HCPC and had made it clear to the HCPC that he had no intention of returning to practice as a Paramedic.

58. In relation to suspension the Panel took into account the guidance within section 121 of the HCPTS Sanctions policy which states that such an order would be appropriate in the following situations:
• 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.

59. The Panel considered that the Registrant had shown no insight and there was nothing to support findings that the risk of repetition had been addressed. Further, there was nothing to demonstrate that the Registrant would resolve those failings, given the Registrant’s expressed intention not to return to practise as a Paramedic. His statement that he considered himself to be no longer registered did not support the possibility of imposing a further period of suspension.

60. Further, his expressed contempt for his regulatory body, the impact all of these proceedings have had on him, and his stated wish not to be further contacted, arguably supported the view that to impose a Suspension Order for a further period of time would not be in the Registrant’s own interests either. Additionally, to continue with this Article 30 review process would incur more expense to the public purse and it was therefore not in the public's interest to do so.

61. In relation to the imposition of a Striking-Off Order the Panel took into account the terms of paragraph 131 of that guidance which states that it is appropriate in situations where the registrant lacks insight and there is no willingness to resolve the issues. In the Panel’s view this is the position in this case.

62. The Panel therefore concurred with the HCPC’s position that the appropriate and proportionate sanction in this instance was the imposition of a striking-off Order. Such an Order will permanently remove the Registrant’s name from the HCPC Register with effect from 6 November 2025.

63. Finally, the Panel wished to record that whilst its decision today reflects the Registrant’s current views of his past conduct and the HCPC proceedings there may come a day when those views change. The Registrant should therefore be aware that if in five years’ time if he is able to provide the HCPC with evidence that he has renewed enthusiasm for his profession and realised that his previous decisions to place posts on social media were examples of poor judgment, then he may wish to produce evidence that he is, subject to further training, fit to return to his chosen profession.

The Registrar is directed to strike the name of Keith Roper-Hitches from the Register of Paramedics.

The Order imposed today will apply from 6 November 2025.

History of Hearings for Mr Keith Roper-Hitches