Mr Simon Williams

: Paramedic

: PA30060

: Review Hearing

Date and Time of hearing:12:30 14/06/2017 End: 17:00 14/06/2017

: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

: Conduct and Competence Committee
: Struck off

Allegation

In or around December 2014, during the course of your employment as a Paramedic by East of England Ambulance Service, you:

 

1. Posted photographs and comments on Instagram, which breached patient confidentiality, including photographs:

 

a. of patients;

b. containing patients' medical information;

c. containing patients' personal details.

 

2. Posted inappropriate photographs and comments on Instagram, which related to your operational duties.

 

3. The matters set out in paragraph 1 - 2 constitute misconduct.

 

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

Finding

Preliminary matters:

Proof of Service

1. The Panel was informed that an original notice of hearing was sent to the Registrant’s address, as it appears on the HCPC Register, on 10 May 2017. The Panel was satisfied that good service had been effected in accordance with Rules 3 and 5 of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 (‘the Rules’) and it was satisfied that all reasonable steps had been taken by the HCPC to inform the Registrant of today’s proceedings.

Application to hear in private

2. The Panel determined that it would hear those parts of the case in which reference was made to the health and private life of the Registrant, in private, under Rule 10 (1)(a) of the Rules.  In making this decision the Panel acknowledged that there is a presumption that hearings will be held in public. The decision is to protect the private life of the Registrant which the Panel considers outweighs the public interest in this instance.

Proceeding in Absence

3. Ms Stark, on behalf of the HCPC, applied for the hearing to proceed in the absence of the Registrant pursuant to Rule 11 of the Rules.  She referred the Panel to an e-mail received from the Registrant dated 13 May 2017 in which he stated that he would not be attending the hearing due to health issues.  He gave details of his health issues and submitted that he ‘would never practice as a paramedic again’. He highlighted that he did not renew his registration last year and that he will not renew it again.

4. The Panel accepted the advice of the Legal Assessor, that the decision to proceed in the absence of the Registrant is a decision to be taken with the utmost care and caution.  The Panel had regard to the relevant Practice Note including the criteria set out in R v Jones [2002] UKHL 5 and the guidance in General Medical Council v Adeogba/ Visvardis [2016] EWCA Civ 162. In particular the Panel noted that it must consider whether to proceed by reference to all the circumstances of which it is aware, with fairness to the practitioner being of prime importance, but fairness to the regulator and the public interest also being taken into account.

5. The Panel noted that the Registrant had not sought an adjournment and that he did not wish to attend on health grounds.  Furthermore, there was a statutory requirement to review the order before 15 July 2017. It was satisfied that all reasonable efforts had been made to serve the Registrant with the notice of hearing and concluded that the Registrant had voluntarily absented himself from the proceedings. The Panel considered the Registrant’s comments in the email referred to above, and concluded that there was nothing to indicate that he was likely to attend a subsequent hearing if the matter was adjourned.

6. The wider public interest is best served by dealing expeditiously with cases where a Registrant’s fitness to practise is in issue. This is consistent with the HCPC’s role to protect the public.

7. In all of these circumstances, given the serious nature of the concerns raised and the need for timely consideration of the review before the expiry of the order, the Panel concluded that the public interest required it to consider the issues associated with this review expeditiously.  It was therefore appropriate and fair to proceed in the absence of the Registrant today. The Panel would draw no adverse inferences from his non-attendance.

Background:

8. The Registrant was employed by East of England NHS Foundation Trust (“the Trust”) from 2004. He had been an emergency medical technician initially, then became a Paramedic on 28 October 2008. By the end of 2014, when the Allegation arose, the Registrant had over 11 years’ service with the Ambulance Service and 6 years as a Paramedic.

9. The Registrant had his own company, with its own website. Its purpose was to sell jewellery online. The Allegation related to the Registrant’s inappropriate posting of photographs and comments on his Instagram account. These  had a number of “likes” on them, indicating that some members of the public had seen them and formed an opinion of them.

10. In or before December 2014, the Registrant took and then posted on Instagram 24 photos, which could be fully accessed by the public. He stated that he did so with the intention of getting more visitors to his jewellery website, which had been struggling. Some patients and patients’ medical conditions were identified from the Instagram posts and most of the Registrant’s posts related to his operational duties as a Paramedic. The employer did not know of these initially, but became aware of them on or about 11 December 2014. The Trust received a Tweet via Twitter from a member of the public, who stated that they were “not impressed” and provided a link to the Registrant’s Instagram posts.

11. The Trust decided to investigate the matter and on 12 December 2014 the Registrant was asked to engage in the investigatory process.

12. On 1 January 2015 more graphic pictures of patients being attended to were discovered by Colchester Hospital (The Hospital). It felt that the Registrant’s Instagram posts brought the Hospital into disrepute and had breached patient confidentiality.  The Hospital communicated to the Trust that the posts had shown the Hospital in a negative light and may also have damaged the reputation of the Trust.

13. The matter was heard by the Conduct and Competence Committee of the HCPC on 16 June 2016. The full particulars of the Allegation are set out in the Notice of Decision and Order. The panel considered that the facts were sufficiently serious to constitute misconduct and that the Registrant’s fitness to practice was impaired.  In particular the panel noted as follows:

‘The actions of the Registrant created enduring and repeated images of patients and events of a deeply unpleasant and offensive nature. In addition, the misguided and unintelligent comments made by him combine to create a picture of this Registrant as a highly unprofessional and naïve individual….’
‘..he had covertly taken offensive and graphic photographs of, and relating to, patients/service users and their private and confidential details and posted them on a public social media platform, often with highly inappropriate comments, also without their consent. The misfortune and ill health of the service users was there for all to see, read, and, if so inclined, to ridicule. The Panel considered this conduct to be profoundly unacceptable in any person, and especially so in a Registrant of his seniority and experience.

14. The panel found that that the Registrant had breached a number of fundamental tenets of the profession and imposed a Suspension Order for a period of 12 months on 16 June 2016.

Decision

15. This is the first review of the Suspension Order, imposed on 16 June 2016 for 12 months.  It came into effect, following the appeal period, on 15 July 2016.  It will therefore expire on 15 July 2017.

16. The Panel heard representations from Ms Stark on behalf of the HCPC and received and accepted the advice of the Legal Assessor. 

17. The panel noted the findings of the previous Panel, namely that the Registrant’s fitness to practise was impaired by reason of his misconduct.

18. In undertaking its task today, the Panel is not undertaking a rehearing of the matters which were brought against the Registrant, nor going behind previous findings. The Panel reminded itself that the decision as to what is the appropriate and proportionate disposal at this review hearing is a matter for its judgment alone.

Impairment

19. The Panel accepted the advice of the Legal Assessor, had regard to the HCPC Practice Note “Finding that Fitness to Practise is Impaired”, dated July 2013 and noted the guidance in the case of Meadows v GMC [2007]1 All ER 1, and Council for Healthcare Regulatory Excellence (CHRE) v NMC and Grant [2011] EWHC 927.

20. With the exception of the e-mail dated 13 May 2017, the Panel noted that there had been no communication from the Registrant since the imposition of the order by way of an update to his circumstances. Indeed, there had been a complete and continuing lack of engagement with the fitness to practise process. There was no information from the Registrant in relation to any steps he had taken, since the imposition of the Suspension Order, to address his fitness to practise. Indeed the only information available, namely the e-mail dated 13 May 2017, suggested that he was not practising and had no intention of practising in the future.

21. The Panel noted the comments of the previous panel in which they considered that the case was ‘extremely serious’ and that the misconduct was ‘profoundly unacceptable’. The Suspension Order was imposed in order to allow the Registrant to demonstrate evidence of: insight; reflection on his management of information governance and its applicability to his practice; remediation; effective practice.

22. In the absence of any evidence of remediation, insight, reflection or improvement in his practice, the Panel determined that the Registrant remains at risk of causing harm to service users and of bringing his profession into disrepute.  Accordingly, the Panel found that the Registrant’s fitness to practise remains impaired by reason of his misconduct.

Sanction

23. The Panel is aware that the purpose of any sanction is not to be punitive, though it may have a punitive effect. The Panel has borne in mind that its primary function at this stage is to protect the public, while reaching a proportionate sanction, taking into account the wider public interest and those of the Registrant. In so doing, the Panel has taken account of the Indicative Sanctions Guidance, applying it to the Registrant’s case on its own facts and circumstances.

24. In determining the appropriate and proportionate sanction, the Panel had regard to the seriousness of the Registrant’s misconduct and also bore in mind that he has not provided evidence of any steps taken by him to remedy the issues identified.

25. The Panel first considered taking no action, however it concluded that this would be inappropriate and would not be sufficient to protect patients, the public or the reputation of the profession.  The Panel considered that this was not an appropriate case for mediation and that a Caution Order would be insufficient.

26. The Panel was unable to formulate any workable or practicable conditions of practice, given the Registrant’s lack of engagement and the lack of any information as to his current situation and whether he has maintained his clinical knowledge and skills.

27. The Panel carefully considered whether to confirm or extend the current Suspension Order and was mindful that the purpose of such an order includes a Registrant being able to demonstrate that his fitness to practise is no longer impaired at the time the order is reviewed. The Panel noted that the Registrant has been given the opportunity over the last year to demonstrate that he has addressed the issues identified at the final hearing on 16th June 2016.  Due to the fact that the Registrant has apparently disengaged from the regulatory proceedings and has clearly stated that he no longer wishes to practice as a Paramedic, the Panel determined that there is no useful purpose served by the imposition of a further term of suspension. The Panel can identify no realistic prospect of remediation in this case.

28. Accordingly, the Panel considered that a striking off order is now appropriate.  There has been an ongoing failure to address the issues which gave rise to the Suspension Order. There is a complete lack of evidence of any type of remediation, reflection and insight on the part of the Registrant.  In all of these circumstances, the Registrant presents a continuing risk to the public if he is allowed to practise in the future. The Registrant has demonstrated an inability or unwillingness to resolve matters which suggests that any other sanction is now inappropriate. There is no information available that the Panel may look to, which may make it possible to construct a route back into practice for the Registrant. In these circumstances this order is now an appropriate and proportionate sanction which protects the public from the risks identified and also maintains public confidence in the profession and the regulatory process.

Order

ORDER: That the Registrar is directed to strike the name of Simon Williams from the Register upon expiry of the existing Order.

Notes

This Order will come into effect on 15 July 2017.

Hearing history

History of Hearings for Mr Simon Williams

Date Panel Hearing type Outcomes / Status
14/06/2017 Conduct and Competence Committee Review Hearing Struck off
16/06/2016 Conduct and Competence Committee Final Hearing Suspended