Mr Carl Hudghton

: Paramedic

: PA33749

: Final Hearing

Date and Time of hearing:10:00 20/02/2017 End: 17:00 22/02/2017

: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

: Conduct and Competence Committee
: Caution

Allegation

Allegations as amended

During the course of your employment as a Student Paramedic Practitioner with the South East Coast Ambulance Service NHS Foundation Trust, you:

1. Prevented the Mobile Data Terminal (“MDT”) from communicating your vehicle’s location (to the EOC) by continually resetting the MDT which created Automatic Vehicle Log (“AVL”) gaps on:

a. 18 April 2014;
b. 25 May 2014.

2. On 03 May 2014:

a. Prevented the MDT from communicating your vehicle’s location (to  the EOC) by continually resetting the MDT which created an AVL gap;  and /or

b. delayed the response to incident 22740574, which was a RED 2  emergency.

3. The matters described in Paragraphs 1 and 2 (a) were dishonest.

4. The matters set out in Paragraphs 1, 2, and 3 constitute misconduct.

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

Finding

Application to proceed in private

1. At the beginning of the hearing Mr Elton on behalf of the Registrant applied to have any part of the hearing which dealt with the Registrant’s health in private. Mr Foxsmith on behalf of the HCPC made no objection. The Panel allowed the application and directed that matters in the hearing dealing solely with the Registrant’s health should be heard in private.

Application to amend

2. Mr Foxsmith then applied to amend the allegation notified to the Registrant in the letter from the HCPC dated 29 April 2016 : 
1.  Created the impression that your ambulance was unavailable   to answer calls by turning off the Mobile Data Terminal which   created Automatic Vehicle Location Automated Vehicle Location    (“AVL”) gaps on:
  a.  18 April 2014;
  b.  25 May 2014.
  2.  On 03 May 2014: in relation to incident    22740574
  a.  created the impression that your ambulance was unavailable   to answer calls by turning off the Mobile Data Terminal which   created an AVL gap; and / or
  b.  delayed the response to a RED 2 emergency by 15 minutes.
  3. Did not record and/or submit a Patient Clinical Report (“PCR”)   or a Non-conveyance form in relation to:
  a. incident 22464770;
  b. incident 22660672;
  c. incident 22746709;
  d. incident 22934155.
  4. The matters described in Paragraphs 1 and 2 (a) were    dishonest.
  5. The matters set out in Paragraphs 1, 2, and 3 and 4 constitute   misconduct and / or lack of competence.
  6. By reason of your misconduct and / or lack of competence   your fitness to practise is impaired.”

3. Mr Foxsmith maintained that the application was made in order to ensure clarification in the way in which the allegation was worded.

4. He said that no injustice would be caused by amending the allegation and it would reduce the gravamen of the matters faced by the Registrant.

5. Mr Elton did not oppose this application. The Legal Assessor advised that the allegation could be amended provided that the Panel was satisfied that no injustice was thereby caused.

6. The Panel allowed the application, considering that there was no injustice.

Background

7. The Registrant was employed by South East Coast Ambulance Service (SECAmb) as a Student Paramedic Practitioner. At the time of the allegation, he was based at Guildford Ambulance Station. As a Student Paramedic Practitioner, he was a fully qualified Paramedic, but undertaking a course to become a Paramedic Practitioner, which is the same as a Paramedic, but with enhanced diagnostic skills. He completed his Practitioner training in January 2015.

8. It is alleged that the Registrant tampered with the Mobile Data Terminal (MDT) whilst attending three incidents in April and May 2014, which meant that the Automated Vehicle Log (AVL) was inaccurate. The MDT is the GPS system which tracks the vehicle’s whereabouts and job status. The information logged by the MDT is displayed in the AVL. It is alleged that the MDT was reset after the Registrant had attended an incident on three occasions. This meant that the MDT could not communicate an accurate location of the vehicle’s whereabouts.

9. When the Registrant allegedly tampered with the MDT on 3 May 2014, he was not shown as available for an emergency call out, incident 22740574, which he was within two miles of. The Service User had been triaged by the Emergency Operations Centre (EOC) as a RED 2 which is a potentially life threatening  situation, but a crew from almost ten miles away had to attend as they were shown as the closest crew available.

10.  An investigation was carried out by SECAmb. A formal Investigation Meeting was held with the Registrant on 16 February 2015. The Registrant attended this meeting and engaged with the Trust’s disciplinary process even though he had resigned from his post at SECAmb the previous month for unrelated reasons. The matter was subsequently referred to the HCPC.

Decision on facts

11. The Registrant admitted particulars 1 - 4. The Panel acknowledged that those admissions had been made and bore the admissions in mind when considering whether the particulars it was considering had been proved or not. The Panel bore in mind the burden and standard of proof and considered each particular separately.

12. The Panel first considered the witnesses who had given evidence. The HCPC called two witnesses, Witness 1 and Witness 2. The Panel found them both to be credible and fair minded. They gave balanced and honest evidence. They were prepared to talk about the culture existing at Guildford Ambulance Station at the time of the allegations concerning the Registrant. The witnesses gave evidence that they were involved in the investigation which spanned the whole of SECAmb. The alleged MDT tampering however, was found to have been limited to around 10 of approximately 40 members of staff at Guildford Ambulance Station. One of the 10 included an Acting Clinical Team Leader. 

13. The Registrant also gave evidence. The Panel found him to be open and honest. He gave evidence about the culture which existed at Guildford at the time he was employed there. He explained how he had been shown by others to prevent the MDT from showing the location of his ambulance by continually resetting it. He accepted that he had carried out these actions three times. On each occasion he had carried out the action for purely personal reasons. He accepted that it was wrong and dishonest to do this. He has also accepted the risk, or potential risk, that his behaviour could have occasioned to service users who may have needed an emergency vehicle.

14. The Panel then considered the individual particulars.     

Particular 1 (a) and (b)

15. The Panel found this proved. In making this decision it relied upon the evidence given, in particular the evidence of the witnesses of the HCPC, the Registrant and his admissions.

Particular 2 (a) and (b)

16. The Panel found this proved. In making this decision it relied upon the evidence given, in particular the evidence of the witnesses of the HCPC, the Registrant and his admissions.

Particular 3

17. The Panel found this proved. It took account of the Registrant’s evidence that on three occasions his behaviour was admitted to be dishonest.

Decision on grounds

18. Having found all of the facts proved, the Panel went on to consider whether they amounted to misconduct. The Panel bore in mind that that misconduct needs to be serious and is behaviour that is falling short of the standards expected of a registered paramedic.

19. The Panel determined that the Registrant was in breach of the following paragraphs of the Standards of conduct, performance and ethics (1 August 2012):

• 1 You must act in the best interests of service users. 
• 13 You must behave with honesty and integrity and make sure that your behaviour does not damage the public’s confidence in you or your profession.

20.   The Panel considered that all of the matters found proved were serious. The Registrant’s conduct resulted in a delayed response to a RED 2 emergency on one occasion. On the other two occasions the Registrant admitted his intention was to make himself unavailable towards the end of his shift.  The behaviour exhibited by the Registrant fell well below the standard to be expected of him. Further it was dishonest.

21. For all of the factors identified the Panel considers that the matters found proved were so serious as to have amounted to misconduct.

Decision on impairment 

22. Having found that the matters found proved amounted to misconduct. The Panel went on to consider whether the Registrant’s fitness to practise is currently impaired. It first considered the personal component. It considered whether the conduct was remediable, whether it had been remedied and whether it was likely to be repeated. The Panel took account of the evidence given by the Registrant, his witness statement, his reflections and his essay on dishonesty. He gave the Panel a number of examples of the way his conduct could have impacted on service users, his colleagues and the profession and the way he has put his learning into practice. This was corroborated by the testimonials provided. He explained about the culture at Guildford and his personal circumstances at the time. He did not seek to put these forward as excuses for his behaviour, which he said was inexcusable, but as background.

23. The Panel has been presented with a number of current testimonials and references made by work colleagues, who are aware of the allegations. His manager, GE, at UK Specialist Ambulance Services (UKSAS) where the Registrant has been working as a paramedic since April 2015, said the Registrant was “a mentor /leader type figure…” and “professional and trustworthy” and “he is a highly valued and respected member of staff whom I have no issue in trusting completely”. His former superior officer in the 3rd Battalion the Princess of Wales’s Royal Regiment, MS, where the Registrant had served since September 2014 as a Combat Medical Technician, states that the Registrant displays “the British Army’s Six Core Values at all times… Selfless commitment, Respect for others, Loyalty, Integrity, Discipline and Courage, both moral and physical”.     

24. The Panel considered that the Registrant has shown a great deal of remorse and insight into his behaviour. It was clear that he understood and was shamed by the actions that have brought him before this hearing. He had a previously unblemished career and his acts of dishonesty were “out of character”, again corroborated by the testimonials provided.

25. For all of the reasons related above the Panel is satisfied that the concerns identified in the findings of fact are capable of being remedied and have been remedied. The Panel considers that there is little risk of repetition and, in so far as the personal component of impairment is concerned, the Registrant is not currently impaired.

26. However the Panel is aware that it must also look to the public component of impairment. It notes the passage in the Practice Note of ‘Finding that Fitness to Practise is impaired’ which states that it is important for Panels to recognise that the need to address the “critically important public policy issues” identified in Cohen - to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession - means that they cannot adopt a simplistic view and conclude that fitness to practise is not impaired simply on the basis that, since the allegation arose, the Registrant has corrected matters or “learned his or her lesson”.

27. Due to the serious nature of the misconduct found, the Panel concludes that the public component applies in this case. The matters found proved involved the taking out of service, for short periods of time, an Emergency Response Vehicle. This had the potential to put service users at risk as the vehicle would not be in a position to respond to an emergency in a timely manner. The Panel considers that any member of the public, discovering that a delay in deploying an emergency vehicle was caused by the dishonest actions of a paramedic, would be properly concerned. Their confidence in the profession would be undermined if a finding of impairment was not made.

28. The Panel therefore finds that the Registrant’s fitness to practise is impaired on the basis of the public component.

Decision on sanction 

29. Having found that the Registrant’s fitness to practise is impaired by reason of his misconduct, the Panel went on to consider the question of sanction. In making this decision, the Panel is fully aware that the primary purpose of sanction is not to be punitive but to determine the degree of public protection which may be required as a result of the Registrant’s impairment of fitness to practise. The Panel considered all of the matters that had been put before it including the testimonials and the evidence given by the Registrant.

30. The Panel first determined the aggravating factors:

• This was a case of dishonesty.
• He was dishonest on three occasions over a period of six weeks.
• His actions had the potential of causing harm to service users.
• The Registrant put his interests above those of service users.

31. The Panel has identified the following mitigating factors:

• The actions of the Registrant were at the lower end of the spectrum of dishonesty and were limited in nature and time.

• The Registrant was not an initial instigator of these actions. There was already in existence at Guildford Ambulance Station a culture within which these actions were carried out by others, including an Acting Clinical Team Leader.

• The Registrant had no intention of causing any harm and no actual harm was caused to service users.

• He had a previous unblemished record.

• He made full admissions at this hearing, including dishonesty and misconduct.

• His personal circumstances at the time.

• The Registrant has demonstrated remorse and full insight.

• There has been no repetition of similar behaviour.

• He has produced positive references from his employers and other testimonials.

32. As the Panel’s finding of impairment was made on public interest grounds alone it has to consider the issue of sanction on this basis: there are no issues of service user safety to address. Public interest includes ensuring that the public’s confidence in the profession and the regulatory process is not undermined.

33. The Panel considered the sanctions in ascending order in order to apply the proper principles of proportionality.

34. The Panel determined that to conclude the case without taking any action would not sufficiently address the public interest. Similarly mediation would not be relevant or appropriate.

35. The Panel then considered a caution order. The Indicative Sanctions Policy states at paragraph 20:

36. A caution order is an appropriate sanction for cases, where the lapse is isolated, limited or relatively minor in nature, there is a low risk of recurrence, the Registrant has shown insight and taken appropriate remedial action. A caution order should also be considered in cases where the nature of the allegation means that meaningful practice restrictions cannot be imposed but where the registrant has shown insight, the conduct concerned is out of character, the risk of repetition is low and thus suspension from practice would be disproportionate. A caution order is unlikely to be appropriate in cases where the registrant lacks insight.

37. The Panel has noted above in the list of mitigating factors that the lapses by the Registrant are limited in nature, have been remediated the Registrant has full insight and there is now little risk of recurrence.

38. The Panel has concluded that taking into account the public interest and the serious nature of the misconduct, a caution order is the appropriate sanction. It is clear that such misconduct has to be marked. A caution order is sufficient to act as a deterrent to other paramedics and to maintain public confidence in profession.

39. Applying the proper principles of proportionality the Panel notes that the starting point for a caution is one year and a Panel should only impose a caution for a longer period if the facts of the case make it appropriate to do so. The Panel has identified the relevant facts in this determination particularly the aggravating and mitigating factors. The Panel has not identified any facts which would make it appropriate to impose a caution order for longer than the starting point. The Panel therefore has determined in this case to impose a sanction of a caution order of one year.

40. The Panel went on to consider the next sanction. As the Panel is considering sanction on the basis of public interest there are no conditions of practice that can be formulated that address the public interest.

41. The Panel then considered suspension. The Indicative Sanctions Policy states at paragraph 32:

42. Suspension should be considered where the Panel considers that a caution or conditions of practice would provide insufficient public protection or where the allegation is of a serious nature but unlikely to be repeated and, thus, striking off is not merited.

43. The Policy goes on to state at paragraph 35:

44. Panels need to be aware that suspension for short periods of time (i.e. less than a year) may have long term consequences for the registrant, including being dismissed from his or her current employment.

45. There is no doubt that the Registrant’s behaviour was totally unacceptable. However, a Suspension Order would remove a highly valued paramedic from practice and the Panel has concluded that this would be disproportionate. In reaching this decision the Panel takes  into account that although the dishonesty occurred three times this has to be seen in the context of an otherwise unblemished career and the culture at Guildford station at the time.

46. Having considered the guidance set out above the Panel considered that in all the circumstances of this case a suspension order would be wholly disproportionate, unnecessarily punitive, and serve no useful purpose in this case.

47. In all the circumstances the Panel determined that a Caution Order for one year is the appropriate and proportionate sanction

Order

That the Registrar is directed to annotate the register entry of Carl Hudghton with a caution which is to remain on the register for a period of 1 year from the date this order comes into effect. 

Notes

No notes available

Hearing history

History of Hearings for Mr Carl Hudghton

Date Panel Hearing type Outcomes / Status
20/02/2017 Conduct and Competence Committee Final Hearing Caution