Millie M Cutbush

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Preliminary Matters

Hearing in private

1. Mr Maughan made an application for any reference to the Registrant’s private life to be heard in private. The Registrant supported that application.

2. The Panel had regard to the HCPTS Practice Note on “Conducting Hearings in Private” and accepted the advice of the Legal Assessor.

3. The Panel decided that any reference to the Registrant’s private life should be heard in private but that the hearing should otherwise be conducted in public.

Background

4. The Registrant is registered with the HCPC as a Paramedic and was employed in that capacity by South Western Ambulance Service NHS Foundation Trust (SWAST). 

5. It is alleged that, whilst on duty in December 2023, the Registrant took part in a TikTok video with a colleague (Colleague A), which contained racially insensitive language. The 49 second video contained various musical clips from predominantly Christmas songs which included offensive words and racially insensitive language. It is alleged that the Registrant can be seen reacting to each song, including with laughter. During the video the Registrant was wearing uniform and was sitting in the front seat of an ambulance. 

6. The video in question was thereafter posted online by Colleague A which led to a complaint being made to SWAST by a member of the public on or about 8 January 2024. SWAST staff identified the Registrant in the video.

7. The complaint was initially received by CR, employed by SWAST as People Partner, who reviewed the TikTok video. On the same day, he met with the Registrant and Colleague A. Colleague A was asked to remove the video, which she did. When questioned, the Registrant allegedly expressed remorse as to the content of the video and insight into the nature of the concerns raised.

8. CR appointed TB, Operations Officer at SWAST, to investigate the matter. The Registrant and Colleague A provided statements dated 9 January 2024. On 10 January 2024 TB interviewed them both. 

The evidence

9. The Panel was provided by the HCPC with:

• a bundle containing the witness statements of TB and CR

• the internal investigation statements of the Registrant and Colleague A and SWAST’s Social Media Guidance and “Our Strategy” booklet

• the video giving rise to the Allegation. 

10. The Panel was also provided with a Notice to Admit Facts completed by the Registrant dated 3 December 2025.

11. At the outset of the hearing the Registrant denied Particular 1a of the Allegation but admitted Particular 1b. 

12. The Panel announced that Particular 1b was found proved by admission.

Application to admit hearsay evidence 

13. Mr Maughan made an application for the statements of TB and CR, and accompanying exhibits, to be admitted in evidence without the need to call either witness. The Registrant did not oppose that application.

14. The Panel noted that the Registrant had made it clear in her response to the Notice to Admit Facts that she agreed the witness statements without the need for either witness to attend the hearing.

15. The Panel decided that no unfairness would be caused to the Registrant by admitting the witness statements in evidence. The Panel therefore granted the HCPC’s application.

Decision on Facts

16. The Panel took account of the submissions of Mr Maughan on behalf of the HCPC and the Registrant.

17. The Panel accepted the advice of the Legal Assessor.

18. The Panel noted that the standard of proof required is on the balance of probabilities. In other words, the Panel must be satisfied that any act alleged is more likely than not to have occurred before it can find it proved. The burden of proof is on the HCPC in respect of the factual particulars.

Particular 1a - Proved

19. The Panel found Particular 1a proved for the following reasons:

• The Registrant admitted being on duty at the relevant time with Colleague A.

• The Registrant did not dispute that she was in the video.

• Having viewed the video, the Panel was satisfied that the Registrant was a willing participant in that she was aware that she was being filmed by Colleague A, whilst reacting to the music. 

• The Registrant did not dispute that the video contained racially insensitive language.

• The Panel was satisfied that the video did in fact contain racially insensitive language.

Particular 1b    - Proved by admission

Decision on Grounds

20. The Panel went on to consider whether the facts found proved amounted to misconduct, as alleged in Particular 2 of the Allegation.

21.    The Panel was mindful that this was a matter for the Panel’s professional judgement, there being no standard or burden of proof.

22. The Panel took into account that misconduct was defined in Roylance v General Medical Council (no 2) [2001] 1 AC 311 as:

“a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a (medical) practitioner in the particular circumstances”.

In the case of Nandi v GMC [2004] EWHC 2317 (Admin), the court stated that:

“The adjective ‘serious’ must be given its proper weight, and in other contexts there has been reference to conduct which would be regarded as deplorable by fellow practitioners”.

23. The Panel found that the Registrant’s conduct in relation to Particulars 1a and 1b was in breach of the following standards of the 

HCPC Standards of conduct, performance and ethics (2016) namely: 

1.6 You must challenge colleagues if you think that they have discriminated against, or are discriminating against, service users, carers and colleagues 

2.7 You must use all forms of communication appropriately and responsibly, including social media and networking websites 

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

24. In addition, the Panel found the Registrant to have been in breach of the following standards of the HCPC Standards of proficiency for paramedics (2023), namely: 

2.1 - maintain high standards of personal and professional conduct 

2.4 understand what is required of them by the Health and Care Professions Council, including, but not limited to, the standards of conduct, performance and ethics 

2.6 recognise that relationships with service users, carers and others should be based on mutual respect and trust, maintaining high standards of care in all circumstances 

5.7 recognise that regard to equality, diversity and inclusion needs to be embedded in the application of all HCPC standards, across all areas of practice
  
25. The Panel concluded that the Registrant’s conduct fell seriously short of the standards to be expected of her in the circumstances and thereby constituted misconduct.

Decision on impairment

26. The Registrant denied that her fitness to practise is currently impaired by reason of her misconduct, as alleged in Particular 3 of the Allegation.

27. The Registrant stated that, immediately after the incident came to light, she underwent training in equality and diversity and the appropriate use of social media. She had written a reflective statement with regard to the incident. She had also taken the decision to withdraw from social media. She acknowledged that her involvement in the incident had been thoughtless and stupid and assured the Panel that it would never be repeated.

28. When asked by the Panel how the public would regard the video, and her association with it, she stated that the reputation of the profession would be damaged and that patients and service users, particularly those of a minority ethnic background, might be deterred from using the ambulance service.

29. By way of explanation of her misconduct, the Registrant told the Panel that at the time of the incident she was preoccupied and distracted [redacted].

30. The Panel took account of the submissions of Mr Maughan and the Registrant respectively. 

31.The Panel also had regard to the HCPTS Practice Note on “Finding that Fitness to Practise is Impaired” and accepted the advice of the Legal Assessor.

32. In determining whether the Registrant’s fitness to practise is impaired, the Panel took into account both the personal and public components of impairment. The personal component relates to the Registrant’s own practice as a Paramedic, including any evidence of insight and remorse and efforts towards remediation. The public component includes the need to protect service users, declare and uphold proper standards of behaviour on the part of registrants and maintain public confidence in the profession and the Regulator.

33. With regard to the personal component, the Panel accepted the Registrant’s expressions of remorse as genuine. She acknowledged that her conduct could have damaged the reputation of the profession and the Trust who employed her. The Panel was satisfied that the Registrant has good insight into the consequences of her misconduct and had taken appropriate remedial steps.

34. The Panel accepted that this was an isolated incident. Having regard to the Registrant’s remorse and insight, the Panel considered that it was very unlikely that she would repeat such misconduct in the future.

35. Accordingly, the Panel found that the Registrant’s fitness to practise is not currently impaired having regard to the personal component.
36. With regard to the public component, the Panel was satisfied that the Registrant does not pose a risk to the public. However, the Panel considered that the Registrant’s misconduct was a serious departure from professional standards which required a finding of current impairment as a deterrent to others, to uphold proper professional standards and to maintain public confidence in the profession and the HCPC as its Regulator. In the Panel’s judgement, public confidence in the profession and the regulatory process would be undermined if there were no finding of current impairment. 

37. Accordingly, the Panel found that the Registrant’s fitness to practise is impaired on public interest grounds alone. 

Decision on Sanction

38. The Panel had regard to the HCPC’s Sanctions Guidance and accepted the advice of the Legal Assessor. 

39. Having decided that the Registrant is not impaired in respect of the personal component, the Panel considered how best to address the wider public interest in upholding proper standards of conduct and maintaining public confidence in the profession and the regulatory process. The Panel also applied the principle of proportionality, balancing the interests of the Registrant with those of the public, and considered the available sanctions in ascending order of seriousness.

40. The aggravating factors in this case are that the video containing racially insensitive material was uploaded and at least one member of the public saw it and was offended by it. The profession thereby potentially suffered reputational damage.

41. The mitigating factors are the following:

• the Registrant had some difficult personal circumstances at the time which may have distracted her from appreciating the inappropriate nature of her association with the video

• her misconduct was of a passive nature; it was her colleague who produced the video and posted it on social media

• the Registrant has shown consistent and unqualified remorse

• she has shown insight into the consequences of her misconduct

• she has taken undertaken appropriate remediation

• the Panel has determined that there is no likelihood of her misconduct being repeated

• her fitness to practise is not impaired in respect of the personal component.

42. The Panel noted that, following the incident, the Registrant received a final written warning from her employer, but was not dismissed and was deemed fit to practise as a Paramedic without restriction.

43. The Registrant’s misconduct was too serious for the Panel to take no further action. The Panel considered that some mark should be placed on her registration to send a message to the public and the profession that her conduct in participating in the offending video whilst on duty was inexcusable and unacceptable.

44. The Panel carefully considered the indicative features for imposing a Caution Order and decided that they apply to a large extent in this case. In particular:

• this was an isolated incident of misconduct which is very unlikely to be repeated

• she has expressed remorse and has a clear understanding as to why the video was inappropriate and should never have been published

• it did not involve the Registrant’s clinical practice and it is in the public interest that a clinically competent Paramedic should be able to practise.

45. In deciding the length of a Caution Order, the Panel sought to balance the need to send a sufficiently robust message by way of a deterrent against such misconduct to the profession with fairness to the Registrant. 

46. In all the circumstances, and given that the Registrant has been subject to these proceedings for some two years, the Panel considered that the appropriate and proportionate sanction is a Caution Order for a period of 12 months.

47. For the sake of completeness, the Panel did not consider that a Conditions of Practice Order would be relevant or appropriate as there were no concerns about the Registrant’s clinical competence. The Panel considered that a Suspension Order would be disproportionate.

ORDER: The Registrar is directed to annotate the Register in respect of Miss Millie M Cutbush with a Caution Order for a period of 12 months.

History of Hearings for Millie M Cutbush