Mr Joseph F Dutton

: Paramedic

: PA35500

: Final Hearing

Date and Time of hearing:10:00 03/03/2017 End: 17:00 03/03/2017

: London

: Conduct and Competence Committee
: Conditions of Practice


On 9 February 2015 at Liverpool and Knowsley Magistrates' Court you were convicted of:

1. Assaulting Person A by beating on 20 October 2014 Contrary to section 39 of the Criminal Justice Act 1988.

2. By reason of your conviction as described at paragraph 1 your fitness to practice as a Paramedic is impaired.



Preliminary matters:

Proceeding in private

1. The Panel heard that matters relating to the Registrant’s health were to be discussed as part of this application. Ms Wilson submitted that it was appropriate that the parts of the hearing to be held in private where reference to the Registrant’s health is made. The Panel agreed parts of the hearing should be in private where the Registrant’s health issues are discussed.


2. The Registrant is registered with the HCPC as a Paramedic. On 9 February 2015 at Liverpool and Knowsley Magistrates’ Court, the Registrant was convicted of common assault.

3. The common assault is said to have arisen out of an altercation following a road traffic incident. The altercation escalated into a fight, which was observed and broken up by an off duty Police Officer. The Registrant was subsequently arrested and charged with the offence.

Decision on facts

4. At the start of proceedings the Registrant admitted that he had been convicted of the offence in question.

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

6. The Panel has before it the document entitled ‘MEMORANDUM of an ENTRY in the REGISTER of the Liverpool and Knowsley Magistrates’ Court LJA’. It sets out clearly the conviction and the sentence imposed upon the Registrant. It is in accordance with the Registrant’s admission and therefore the Panel finds paragraph 1 of the Allegation proved by way of the Registrant’s admission

Decision on Impairment

7. The Registrant gave evidence on oath. He was subject to cross-examination and detailed questioning by the Panel.

8. The Panel also received a bundle of documents from the Registrant which included the following documents:

a) ‘Final Hearing’ bundle containing a Reflective Statement by the Registrant and statements provided by the Registrant’s barrister in the criminal matters

b) Further ‘Final Hearing’ bundle containing the Registrant’s certificates

9. The Registrant told the Panel of the circumstances of the incident leading to the conviction, his reflection, and his insight. He told the Panel he realises that by his actions he had breached a fundamental tenet of the profession in that he failed to act in a manner befitting a paramedic and has failed to obey the law.

10. The Registrant told the Panel that he regretted the entire incident and his actions that day. He told the Panel that at times he would have words with other drivers who demonstrated poor and dangerous driving and that they would normally take note of what he said as he would be in uniform. The Registrant told the Panel that on the day in question he forgot that he was not in uniform when he remonstrated with Person A about his manner of driving. He told the Panel that his actions in relation to the assault were out of character and that nothing similar had ever happened before and has not happened since. He told the Panel that he accepted that his fitness to practise was impaired on the basis that such a finding was required to maintain confidence in the profession and to declare that actions such as his were unacceptable.

11. He told the Panel of a recent incident he was approached by another driver who banged on his car window and remonstrated with him. The Registrant told the Panel that he did not react as he did with Person A.

12. The Panel then went on to consider whether the Registrant’s fitness to practise is currently impaired by reason of the conviction.

13. In reaching its decision, the Panel had regard to all the evidence before it. It took account of the submissions of Ms Young on behalf of the HCPC, and by Ms Wilson on the Registrant’s behalf.

14. Ms Young outlined the background to the case and submitted the Registrant’s fitness to practice was impaired in that this was a serious matter in that it arises out of a ‘road rage’ incident. The Registrant’s case at the criminal hearing was that he acted in self-defence. The court found that regardless of the Registrant’s case, the facts are that the Registrant had stopped his vehicle when he saw Person A’s van parked up, and walked up to Person A’s van. The Court had commented in its findings that it was “not impressed with the fact that [the Registrant] got out of his car and walked towards that van. The Court takes the view that there was no need to do that. A trained member of the Ambulance, who is trained to diffuse on this occasion was no in diffusing he was inflaming the situation [sic].”

15. Ms Young submitted that the Registrant’s fitness to practise is impaired in that he has breached a fundamental tenet of the profession. She further submitted that his oral testimony revealed a lack of insight on the part of the Registrant.

16. Ms Wilson, on behalf of the Registrant, reminded the Panel that the Registrant accepted that his fitness to practise is impaired in that the public would expect a finding of impairment in order to maintain public confidence in the profession and to maintain proper standards of performance and behaviour.  She submitted that he has demonstrated insight and the Panel can be assured that he would not put himself in a similar position again.

17. The Panel accepted the advice of the Legal Assessor. He reminded the Panel that when considering impairment, the Panel should consider the nature and gravity of the offence for which the Registrant has been convicted and that it was entitled to and should take into account the underlining facts of the conviction.

18. The Panel then went on to consider whether by reason of his conviction, his fitness to practise is currently impaired. For this purpose, the Panel took into account the approach formulated by Dame Janet Smith in her 5th report of the Shipman inquiry, and which was cited with approval in the case of CHRE v NMC & Grant, as follows, by asking itself the following questions:
“Do our findings of fact in respect of the Registrant’s conviction show that his fitness to practise is impaired in the sense that he:

a) has in the past acted and/or is liable in the future to act so as to put patient or patients at unwarranted risk of harm; and/or

b) has in the past brought and/or is liable in the future to bring the paramedic profession into disrepute; and/or

c) has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the paramedic profession?

19. The Panel also considered whether the conviction is such that the need to uphold professional standards and public confidence in the professions would be undermined if a finding of impairment were not made.

20. The Panel considered the oral evidence of the Registrant. It found his evidence to be less than credible in certain respects, and his answers were evasive at times.

21. In coming to its decision on impairment, the Panel took into consideration the following in favour of the Registrant:

a) The Registrant has fully engaged with the HCPC process.

b) The Registrant accepted his fitness to practice was impaired by reason of the conviction because he has brought the profession into disrepute and that he has breached a fundamental tenet of the profession.

c) The conviction did not relate to the competence of the Registrant as a paramedic.

d) The Probation Officer who assessed Mr Dutton observed that he had “learned a salutary lesson from his first involvement in the punitive aspects of the Criminal Justice System” and concluded he was a “Low” risk of re-offending. This is the lowest risk assessment the Probation Service can make;

e) The Registrant has successfully completed his sentence, and is no longer subject to the Supervision Order;

f) The Registrant submitted a document entitled ‘Reflective Statement of  the Registrant’ to the Panel;

g) The references provided on behalf of the Registrant;

22. However, the Panel is concerned that the Registrant sees fit to challenge drivers who demonstrate poor or dangerous standards of driving. Whilst the Registrant recognises that he placed himself in the situation, he commented that ‘grown men do not like being told that they are driving badly’.

23.  The Panel determined that the Registrant has not demonstrated that he will not continue his practice of challenging with other drivers and does not appear to recognise that this practice is what led to the incident in the first place. This practise is not part of the role of a paramedic and the Panel was concerned that the Registrant appeared to feel that being in uniform empowered him to engage with other drivers in this way. Therefore the Panel is not satisfied that he is not liable to put himself in a similar situation that lead to the conviction in the first place.

24. The Panel was concerned that the Registrant appeared to take no account in his reflective statement or his verbal evidence today of the impact of his assault on Person A or the public who witnessed the assault. Although he expressed regret about the overall event, he did not express contrition about the effect on Person A or the general public.

25. The Panel has heard no evidence as to any remedial action focused on the elements of his misconduct.

26. The Registrant’s responses to questions about the risk of repetition satisfied the Panel in respect of patients but did not satisfy the Panel in relation to similar circumstances with members of the public.

27. The Panel also determined that with this conviction, the Registrant has breached a fundamental tenet of the profession, namely that it is incumbent on members of the profession not to behave in this manner and not to transgress the laws of the land.

28. Therefore, Panel determined that the Registrant’s fitness to practise is currently impaired by reason of his conviction both on the personal and public component of impairment.

Decision on Sanction

29. The Panel accepted the advice of the Legal Assessor and had close regard to the HCPC’s Indicative Sanctions Policy document in reaching its decision on sanction. The Panel was aware that the purpose of a sanction is not to punish. Rather, a sanction should only be imposed to the extent that it is required to protect the public, to maintain a proper degree of confidence in the profession and the regulatory process, and to declare and maintain proper standards among fellow professionals. To ensure this approach the Panel reminded itself to first consider whether its findings require the imposition of any sanction all. If they do, then the available sanctions must be considered in ascending order of seriousness until one that satisfies the factors already identified is reached. The Panel confirms that it has followed this approach in the present case.

30. The Panel has had regard to the oral evidence of the witnesses, all the documentary evidence presented, and to the submissions of both parties. It also took into account the aggravating and mitigating factors as outlined above in its determination on misconduct and impairment.

31. In considering the matter of sanction, the Panel started with the least restrictive moving upwards.

32. The Panel first considered taking no action but concluded that, given the nature of the conviction, this was an insufficient sanction which would not provide an adequate level of protection for the public or meet the wider public interest.

33. The Panel then considered whether to make a caution order. The Panel determined that circumstances of the criminal offence are such that a caution order is not appropriate for the same reason as set out above.

34. The Panel next considered the imposition of a Conditions of Practice Order. It considered that, whilst it was unusual to impose a Conditions of Practice Order for matters involving a criminal conviction, the particular features of this case makes the imposition of a Conditions of Practice Order a possibility. The circumstances leading to the Registrant’s conviction relate to a core competency required of a Paramedic, namely his driving skills; that includes the manner in which he should interact with other road users, his responsibilities as a road user, and how to manage situations when he is driving, as well as his ability to manage conflict situations within and outside his work situation.

35. The Panel therefore considered whether it was possible to draft conditions of practice that were workable and measurable, and which would meet the need to protect the public, to maintain a proper degree of confidence in the profession and the regulatory process, and to declare and maintain proper standards among fellow professionals. After careful consideration, the Panel determined that it was possible to draft such conditions and therefore, the Panel is satisfied that the appropriate and proportionate response in these circumstances is to impose conditions upon the Registrant’s practice and registration.

36. The Panel determined that the Conditions of Practice Order would be for 12 months. The conditions to be imposed upon the Registrant’s practice are as set out below.


The Registrar is directed to annotate the Register to show that, for a period of 12 months from the date that this Order comes into effect (“the Operative Date”), you, Mr Joseph F Dutton, must comply with the following conditions of practice:

1. You must promptly inform the HCPC if you take up new employment as a Paramedic.

2.  You must promptly inform the HCPC of any disciplinary proceedings taken against you in your role as a Paramedic by your employer.

3. You must undertake an advance driving programme(s) or course(s) within six months from the date of this Order coming into force. Such course should cover the following areas:

(a) interaction with other motorists;

(b) managing road users;

(c) how not to intimidate other road users

(d) your responsibilities as a driver

4. Attendance at a course on conflict management and/or resolution.

5. You must forward the details of such completed programmes or courses at least two weeks before the review of this Order.

6. You must write a reflective piece that takes into account the effect of your actions on the general public. It must encompass your current thinking on the impact of the event on the victim, and how the general public and your paramedic peers would view your conviction for road rage assault.

7. You must inform the following parties that your registration is subject to these conditions:

a) any organisation or person employing or contracting with you to undertake work as a Paramedic;

b) any agency you are registered with or apply to be registered with as a Paramedic (at the time of application);

c) any prospective employer seeking to employ you as a Paramedic (at the time of application).

8. You will be responsible for meeting any and all costs associated with complying with these conditions.


The Order imposed today will apply from the expiry of the 28 day appeal period (the operative date) on 31 March 2017.

This Order will be reviewed again before its expiry on 31 March 2018.

Hearing history

History of Hearings for Mr Joseph F Dutton

Date Panel Hearing type Outcomes / Status
22/02/2018 Conduct and Competence Committee Review Hearing Conditions of Practice
03/03/2017 Conduct and Competence Committee Final Hearing Conditions of Practice
08/11/2016 Conduct and Competence Committee Final Hearing Adjourned part heard