​​James Green​

Preliminary Matters

Service

1.    The Panel was satisfied that the Registrant had been properly serviced with notice of today’s hearing by email dated 11 November 2025. The notice advised the Registrant of the date, and time of the hearing and that it would be conducted by Microsoft Teams. A confirmation of delivery to the Registrant’s email address was received.

Proceeding in absence

2.    Mr Doyle submitted that the Panel should proceed with the hearing in the absence of the Registrant. He referred the Panel to emails from the Registrant dated 29 October 2025 and 13 January 2026 in which he confirmed that he would not be attending the hearing.

3.    The Panel accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Notes on ‘Proceeding in the Absence of the Registrant’ and ‘Interim Orders’. The Panel was satisfied that the Registrant is aware of today’s hearing and had voluntarily absented himself and waived his right to attend. The Registrant has not requested an adjournment and the Panel considered that no useful purpose would be served by an adjournment. The hearing is to consider a proposal for an agreed disposal of the Allegation and the Panel did not consider that the Registrant would be disadvantaged if the Panel were to proceed in his absence. The Panel also considered that it would be in the public interest and the Registrant’s interests for the hearing to proceed expeditiously.

4.    The Panel therefore decided that it was fair and appropriate to proceed with the hearing in the Registrant’s absence.

Background

5.    The Registrant is a registered Paramedic and was previously employed by Northwest Ambulance Service Central Manchester Sector. 

6.    On 7 June 2021, the Registrant referred himself to the HCPC due to restrictions being placed on his practice by his employer, resulting from an incident on 17 May 2021. The 
Registrant disclosed that he had administered morphine to a 17-year-old patient without checking her blood pressure. The Registrant falsely documented 110 systolic on the Patient Report Form (“PRF”)and when confronted by a colleague, he crossed out the false information before submitting the PRF.

7.    The Registrant notified his line manager and the following restrictions were placed on the Registrant’s practice on 26 May 2021:

a.    You must only work with a qualified (Band 6) paramedic or above until further notice

b.    You must not make any clinical decisions without discussing and agreeing a patient assessment and treatment plan with the qualified paramedic that you are working with.

c.    You must not undertake any clinical interventions without discussing and agreeing a patient assessment and treatment plan with the qualified paramedic.

d.    You must not administer any medicines unless under the immediate and direct supervision of the qualified paramedic that you are working with.

e.    Should you be the clinician that is completing the patient report form, you must have it reviewed and countersigned by the senior clinician, at all times.

8.    On 16 June 2021, the Trust heard a formal Stage 1 Performance Management case and issued the Registrant with a 12-month first written warning, and a further action plan was designed.

9.    On 9 August 2021, the Trust informed the HCPC that there had been a previous incident on 13 October 2020. It was alleged that the Registrant attended to Service User B, who was experiencing severe abdominal pain and conducted observations achieving a pain score of 10/10.

10.    The Registrant gave Service User B 1g of oral paracetamol and elected not to give any increased pain relief to Service User B. The allegation was upheld by the Trust, and the Registrant was asked to write a clinical reflection, and a support plan was put in place.

11.    On 14 October 2021, a Performance Stage 2 Hearing was held, and it was suggested that the Registrant reflect on his suitability as a Paramedic. On 26 October 2021, the Registrant requested to change roles to an Emergency Medical Technician 1 and to transfer to another area of the Trust.

12.    On 29 November 2021, it was confirmed that the Registrant would be offered a contract as an Emergency Medical Technician 1 and a transfer to the Liverpool area was agreed. This came into effect on 1 December 2021.

13.    On 5 February 2025, a panel of the HCPC Investigating Committee decided that there was a case to answer and referred the Allegation to the Conduct and Competence Committee.

14.    On 28 February 2025, Blake Morgan LLP, on behalf of the HCPC, raised whether the Registrant wished to pursue consensual disposal. Following the Registrant’s confirmation that he did wish to pursue this option, on 10 April 2025 Black Morgan LLP confirmed that they had received instructions from the HCPC to propose a three month Suspension Order as a consensual disposal of the matter.

15.    On 13 May 2025, the Registrant returned a signed consensual disposal pro forma dated 11 May 2025. He confirmed that he had read the relevant Practice Note, that he admitted the substance of the allegation, that his fitness to practise is currently impaired and that he accepts a three month Suspension Order as a way of disposing of the matter. 

16.    Due to an error within the pro-forma signed by the Registrant on 11 May 2025, a further copy of that document was sent to the Registrant who returned a signed copy on 23 February 2026.

HCPC submissions

17.    Mr Doyle submitted that consensual disposal was appropriate in this case. He referred to the Registrant’s admission of the substance of the Allegation, that it amounts to misconduct and that his fitness to practise is impaired.

18.    Mr Doyle submitted that consensual disposal would secure the appropriate degree of public protection. He submitted that there has been a passage of time of over four years since the allegations occurred, during which time the Registrant has been working as an Emergency Medical Technician. Mr Doyle referred to the absence of any incidents and the insight demonstrated by the Registrant. He submitted that the Registrant has reflected on the specific factors that contributed to the incidents occurring and has taken steps to avoid them being repeated. Mr Doyle submitted that there is a low risk of repetition.

19.    Mr Doyle submitted that positive testimonials have been provided by the Registrant’s current employer which states the following:

“[the Registrant] maintains an up to date CPD and acts within the trust policies and procedures. ..I have witnessed firsthand [the Registrant’s] ability to provide excellent patient care and have confidence in his decision making abilities at a paramedic level. I have notice significant personal growth over the past few years and [the Registrant] seeks support if he requires it to become a more competent and proficient clinician. [The Registrant] has made amends from past experiences and has made a positive commitment to becoming a better clinician”.

20.    Mr Doyle submitted that consensual disposal is not detrimental to the public interest. He submitted that there is no wider public interest in the Allegation being considered at a final hearing and it is in the public interest to avoid any further expense, given that the Registrant has made full admissions. The HCPC submitted that the public interest requires the imposition of a short suspension order, to reflect the serious nature of dishonesty and in order to uphold proper standards of conduct and to maintain public confidence in the profession and the HCPC as its regulator.

Decision

21.    The Panel accepted the advice of the Legal Adviser. She reminded the Panel of its important role, independently from the HCPC, in assessing whether the proposal for disposal by consent is in accordance with the HCPC’s overarching objective.

22.    The Panel should consider whether the proposal for consensual disposal satisfies the requirements set out within the HCPTS Practice Note ‘Disposal of Cases by Consent’ in that:

•    The appropriate level of public protection is being secured

•    Doing so would not be detrimental to the wider public interest

•    The Registrant understands what they are consenting to and the effect of the Consent Order

23.    The Legal Assessor advised that the principles and approach set out within the HCPC Sanctions Policy are a helpful guide to relevant factors which may inform a decision on whether the proposed sanction within the Consent Order secures sufficient public protection and whether it would be detrimental the wider public interest. 

24.    The Legal Adviser also advised the Panel on case law relating to dishonesty as summarised in the HCPC Sanctions Policy.

25.    The Panel was satisfied that the Registrant understands the effect of the proposed Consent Order. It noted the content of the correspondence between the HCPC and the Registrant. The Registrant asked questions relating to the impact of the Suspension Order on his current role as an EMT and that he clearly agreed to the proposal for a three month Suspension Order. The Panel was satisfied that the Registrant understood the effect of the Consent Order.

26.    The Panel next considered whether the proposed Order secured an appropriate degree of public protection. The Panel carefully considered the level of insight demonstrated by the Registrant and was satisfied that it was sufficient for the following reasons. The Registrant referred himself to the HCPC. He has throughout demonstrated his understanding of the role of the regulator and his professional responsibilities regarding his registration.

27.    The Registrant made early admissions to his dishonesty when he was challenged by his crew mate. He has maintained this position and he has also acknowledged that his behaviour was wrong by his admission of misconduct. His admissions have been unequivocal and he has not sought to blame others. The Registrant has also demonstrated his understanding of the seriousness of dishonesty in his acknowledgement of misconduct, that his fitness to practise is currently impaired, and his agreement to the proposed sanction.

28.    The Panel also considered that the Registrant demonstrated insight by his decision to stand down from the role of newly qualified Paramedic to that of a technician (EMT), a role that does not require registration. While this decision was also connected with the ongoing performance management process, the Panel was of the view that the Registrant’s overall recognition that he was not, at that time, fit to practice as a Paramedic, demonstrated personal reflection and insight into his own capability, level of confidence, and ability to meet the HCPC standards.

29.    The Panel considered that the testimonials provided by the Registrant provided evidence of his insight. The testimonial from the Registrant’s line manage referred to the Registrant’s personal growth and to his commitment to being a better clinician. The Panel gave weight to the testimonials as objective evidence in support of the Registrant’s insight and his positive attitude in making amends for his past behaviour.

30.    While there was little evidence that the Registrant has reflected on the impact of his dishonest behaviour on the reputation of the profession. The Panel was of the view that his level of insight was sufficient.

31.    The Panel was not of the view that the dishonesty in this case indicated a deep-seated attitudinal issue. The dishonesty was a single incident, and was otherwise out of character for the Registrant. It was an attempt to cover up a clinical failure, but it did not involve pre-planning.

32.    The Panel also had regard to the evidence of the Registrant’s unblemished practice in the role of EMT over four years since the events. There is no evidence of repetition of dishonesty, and there is evidence of safe and effective practice in the role of EMT.

33.    Although dishonesty is difficult to remediate, the Panel noted that a significant period of time has elapsed since the events in the Allegation. This period of safe and effective practice, without repetition, reassured the Panel that the risk of repetition is low.

34.    Having reviewed the evidence, the Panel was satisfied that the proposed Suspension Order for three months provides a sufficient level of public protection.

35.    The Panel next considered the wider public interest. The Panel considered that the most serious aspect of the Allegation was the dishonest conduct. The Panel also took into account paragraph 1 of the Allegation, which involved, over a relatively short period of time, patient harm due to the insufficient pain relief administered by the Registrant.   The Panel considered carefully whether the proposed sanction was sufficiently serious to mark the seriousness of the Registrant’s conduct.

36.    The Panel had regard to the guidance in the HCPC Sanctions Policy, including paragraphs 56 - 58 which address dishonesty. Dishonesty is always serious as it undermines public confidence in the profession. The dishonesty in this case involved some aggravating and some mitigating features. It related to professional practice and involved a cover up of a clinical failure. It included the Registrant lying to a colleague. It was a single isolated incident, there is no evidence of an underlying attitudinal issue, and the Registrant has demonstrated insight and effective practice in an unregulated role. The Registrant’s line manager has provided a positive testimonial. 

37.    The HCPC Sanctions Policy indicates that for dishonesty a more serious sanction is appropriate and that Panels should take into account the form and degree of dishonesty. In this case the Panel was of the view that the dishonesty was not at the high end of the spectrum of seriousness. 

38.    The Panel considered that a Suspension Order is a serious sanction. It sends a clear message to the Registrant, to members of the profession and to the public that dishonesty and a failure to administer adequate pain relief to a patient is not acceptable within the Paramedic profession. 

39.    Panel bore in mind the purpose of a sanction, which is not to punish a Registrant, and the requirement of proportionality, as explained within the HCPC Sanctions Policy. Having considered all the circumstances, the Panel was of the view that the proposed Consent Order would not be detrimental to the wider public interest. It would mark the seriousness of the Registrant’s misconduct and would be compatible with the principles set out within the HCPC Sanctions Policy.

40.    The Panel therefore agreed to the proposed Consent Order.

ORDER: The Registrar is directed to suspend the registration of Mr James Green for a period of 3 months from the date this Order comes into effect.

This Order will be reviewed before it's expiry

History of Hearings for ​​James Green​