Mr Gary Evans

: Paramedic

: PA29945

: Review Hearing

Date and Time of hearing:10:00 07/09/2017 End: 17:00 07/09/2017

: Holiday Inn Cardiff City Centre, Castle Street, Cardiff, Cardiff, CF10 1XD, United Kingdom

: Conduct and Competence Committee
: Suspended

Allegation

During the Course of your employment as a Paramedic with the Welsh Ambulance Service On 14 October 2015 at Gwent Magistrates Court you were convicted of;

1. Inflicting Grievous Bodily Harm, contrary to Section 20 of the Offences Against the Person Act 1861.

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

Finding

Background:

1. At the relevant time, the Registrant worked for the Welsh Ambulance Service as a Paramedic. On 26 September 2015, an incident took place at the Registrant’s home address. Police were called and he was charged with the assault of Person A. On 14 October 2015, the Registrant was convicted of inflicting Grievous Bodily Harm, contrary to section 20 of the Offences against the Person Act 1861. On 9 November 2015, at Cardiff Crown Court the Registrant was sentenced to 10 months imprisonment suspended for 18 months, with a restraining order and requirements to carry out 250 hours of unpaid work, 25 sessions of rehabilitation activity and pay costs and a victim surcharge.

2. The panel at the final hearing found the facts proved. It imposed a Suspension Order for 9 months. This is the first substantive review of that order.

Impairment:

3. Ms Willmann for the HCPC detailed the background. She submitted that on all of the evidence the Registrant’s fitness to practise remained impaired. She further submitted that the present period of suspension should be extended. The Registrant gave evidence. He produced a number of testimonials. He explained that he was working for a private firm as an Ambulance Technician.

4. The Panel considered all of the material before it including the evidence given by the Registrant. The Panel considered that it was to the Registrant’s credit that he attended this hearing and the manner in which he gave his evidence. It was felt by the Panel  that he had made some efforts to keep his professional knowledge up to date but evidence of this demonstrated that steps had been taken only very recently,  indeed only a matter of days before this hearing.

5. The Panel also considered the advice given by the Legal Assessor. It first considered whether the Registrant’s fitness to practise was currently impaired. In making this decision the Panel noted the HCPTS’s Practise Note ‘Finding That Fitness to Practise is Impaired’. The Panel considered the separate elements of the ‘personal’ component: the current competence, behaviour etc. of the individual registrant and whether the conduct was remediable, whether it had been remedied and whether it was likely to be repeated.  It also considered the ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour, and maintain public confidence in the profession.

6. The Panel considered the serious nature of the conviction. It noted the words used by the previous panel:

 ‘The Panel was of the view that the nature and circumstances of the offence are very serious. It arose in circumstances when the Registrant and Person A had argued about messages on his mobile phone being accessed without his permission. During the argument the Registrant was bitten by Person A. The Crown Court Judge, in his sentencing remarks, determined that no blame attached to Person A for this. The Registrant reacted by punching Person A a number of times to the face. The level of force was described by the Crown Court Judge as “outrageous” and the Panel agreed with this. Person A sustained serious injuries by way of a fracture and has been physically and psychologically affected. The Registrant did not rely on provocation or self-defence and pleaded guilty. The Panel was bound by these underlying facts.’

7. The Panel also noted the aggravating and mitigating factors noted by the previous panel:
‘33.The Panel determined that the aggravating features include:
 
(a) The very serious assault perpetrated in a domestic setting.
 
(b)  The serious consequences for Person A, both physically and psychologically.
 
(c)   The sentence is active until May 2017 and the rehabilitation work is incomplete.
 
(d) This was a very serious criminal offence which has undermined public confidence in the Registrant.
 
(e) An absence of full insight and remediation leaving a risk of recurrence.
 
‘34.The Panel determined that the mitigating features include:
 
(a) The Registrant immediately apologised to Person A.

(b) He pleaded guilty at the first available opportunity.

(c) He has carried out the unpaid work requirement; he has discharged the financial obligations from the sentence and has nearly completed the rehabilitation requirement.

 (d) He cooperated with the subsequent Welsh Ambulance Service investigation.

 (e) He resigned on the basis that he had brought his profession and employer into disrepute.

 (f) He fully admitted matters before the Panel.

 (g) He has taken some remedial steps and has some limited insight.

(h) He has identified for himself further steps that need to be taken.

(i) He has hitherto a blemish free regulatory record.

(j) He is a competent practitioner who was on the way to becoming a Clinical Team Leader.
 
(k) The offence was out of character.

(l) He has had a long career.

(m) He undoubtedly wishes to practise in his chosen profession.

8. The Panel considers that all of these identified factors with the exceptions of 33(c) and 34(c) still apply.

9. The conviction related to a single incident whilst the Registrant was not on duty. It was however a serious assault resulting in a suspended custodial sentence. The Registrant has shown some understanding of the consequences of his behaviour and conviction. He has demonstrated an understanding of the impact of what the conviction might have upon his profession and the standards he must uphold. He has shown some insight into the effect of his behaviour on the victim. The Panel believes he has done little to try to understand the behavioural triggers on his part which led to the assault occurring. The Registrant has made some very recent efforts to obtain a place on a course of cognitive behavioural therapy. The Panel does not therefore consider that the behaviour which led to the conviction has been fully remediated and cannot be satisfied that there is no risk of repetition. The Panel therefore finds that the Registrant’s fitness to practise is impaired on the basis of the ‘personal’ component of impairment.

10. The Panel is aware that it must also look to the ‘public’ component of impairment. This is referred to in the practice note of ‘Finding that Fitness to Practise is impaired’. This states 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”.

11. The Panel considered the HCPC’s Standards of conduct, performance and ethics and in particular:

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

12. The Registrant failed to comply with this standard. Although this was a one-off incident, the Registrant by his actions and subsequent conviction has caused harm to the public confidence in the profession. The Registrant has made very late efforts to keep up his knowledge and CPD. He has not obtained any certified CPD and he only joined the College of Paramedics 6 days prior to this hearing. The public, knowing the facts and findings in this case would be caused great concern and their confidence in the profession would be undermined if a finding that the Registrant’s fitness to practise was impaired was not made. The Panel therefore finds that the Registrant’s fitness to practise is impaired on the basis of the ‘public’ component.
 
Sanction:
 
13. Having found that the Registrant’s fitness to practise continues to be impaired, the Panel went on to consider the question of sanction. It heard submissions from Ms Wilmann and the Registrant. Before reaching its decision, the Panel considered the HCPC Indicative Sanctions Policy and accepted the advice of the Legal Assessor.

14. The Panel considered the gravity of the matter found proved and identified the aggravating and mitigating factors above.

15. In deciding what sanction, if any, to impose, the Panel has reminded itself that the purpose of sanctions is not to be punitive but to protect service users and the public interest, although a sanction may have a punitive effect. The Panel has taken into account the principle of proportionality, balancing the interests of the public with those of the Registrant.

16. The Panel is aware of the risk of recurrence from which the public need to be protected.

17.  There is a need to demonstrate to the public and to practitioners the importance of adhering to the fundamental requirement of keeping high standards of personal conduct by declaring and upholding proper standards of professional behaviour.

18. There is also a need to maintain public confidence in the profession and the regulatory process.

19. The lapse was isolated but very serious. There is evidence of limited insight, there is no independent evidence of remedial action and there is a risk of recurrence.

20.   Accordingly, the seriousness of this case meant that taking no action was not an option and a Caution Order, even for the maximum duration, was inadequate as such an Order is suitable for cases that can be regarded as being slightly more serious than those for which no action or mediation is appropriate. Such an outcome would not protect members of the public or provide the required level of public reassurance.

21. The Panel then considered and excluded the imposition of a Conditions of Practice Order on the grounds that such an outcome was insufficient based on the seriousness of this case. The risk of recurrence makes this Order unsuitable. The issue in this case is largely attitudinal making it difficult to formulate appropriate conditions. Such an Order would not adequately address the public reassurance requirements or act as a sufficient deterrent for others.

22. The Panel then went on to consider the imposition of a Suspension Order and concluded that such an order for 6 months was sufficient.

23. In terms of the length of the Order, the Panel was satisfied  that 6 months sufficiently marked the seriousness of the case, gave the Registrant long enough to remedy matters by producing certified material and demonstrating detailed insight into these matters that would assist a future reviewing panel.

24. The Panel is reassured in its decision by the fact that the public will be protected by the Suspension Order which will prevent the Registrant from practising until he is able to demonstrate to a reviewing Panel that his fitness to practise is no longer impaired. This outcome will maintain confidence in the regulatory process as members of the public will be reassured by the fact that cases such as this are taken seriously and departures from fundamental and core duties are not tolerated.

25.  In addition, there was merit in imposing an Order that was capable of being reviewed as it is possible that the Registrant will reflect on the findings against him and develop a willingness to bring about changes to his approach. He can use the time away from practice to take steps to reflect, develop insight and remediate the situation. A review will give him an opportunity to engage with this process and demonstrate that his fitness to practise is no longer impaired.

26. The Panel took account of the fact that the Order is restrictive in nature and that it will prevent the Registrant from practising in his chosen profession for the time being. However, this consideration was balanced against the need for public protection and reassurance. The Panel concluded that the public’s rights were dominant.

27.  In such circumstances the Panel had an alternative to invoking the sanction of last resort and it was thus not necessary to impose a Striking Off Order. Such an Order would have been disproportionate when a lesser Order satisfied the need for public protection and reassurance. In these circumstances, it would be inappropriate to impose an Order that has no review mechanism. It would have been contrary to the public interest to impose a Striking Off Order at this time as it might have resulted in the removal of a competent practitioner from the register that is capable of providing a safe and effective service to members of the public in the future.

28.  In all the circumstances the Panel believes a 6 month Suspension Order, to be a necessary and proportionate sanction.

29.   A reviewing panel may be assisted by the following:

 (a) The Registrant’s personal attendance at the Review Hearing.

(b) A reflective account, prepared by the Registrant, which demonstrates his understanding of the impact of his behaviour on others, his personal responsibility for that behaviour, the triggers for that behaviour, and how the Registrant will prevent any recurrence of the behaviour in the future.

 (c) Evidence of insight and remedial steps.

 (d) Up to date references or testimonials in respect of paid or voluntary work.

(e) Comprehensive evidence that the Registrant has kept his knowledge of Paramedic practice up to date through relevant certified CPD, together with a detailed plan to demonstrate how he proposes to return to his professional practice in a safe and competent manner.

 (f) Any other evidence the Registrant considers being relevant

Order

ORDER: The Registrar is directed to suspend the registration of Gary Evans   for a further period of 6 months on the expiry of the existing order. The order imposed to today will apply from 10 October 2017

Notes

This Order will be reviewed again before its expiry on 10 April 2018 or earlier if new evidence which is relevant to the Order becomes available after it was made.

Hearing history

History of Hearings for Mr Gary Evans

Date Panel Hearing type Outcomes / Status
07/09/2017 Conduct and Competence Committee Review Hearing Suspended
12/12/2016 Conduct and Competence Committee Final Hearing Hearing has not yet been held