Mr Richard S North

: Paramedic

: PA09189

: Final Hearing

Date and Time of hearing:10:00 08/01/2018 End: 17:00 08/01/2018

: Park Plaza Cardiff, Greyfriars Road, Cardiff, South Glamorgan, CF10 3AL

: Conduct and Competence Committee
: Caution

Allegation

Whilst registered as a Paramedic and employed by the Welsh Ambulance Services NHS Trust;

1. On 15 November 2016, you accepted a police caution from South Wales Police Force, for Fraud by false representation, in that you dishonestly made a false representation by making travel claims for work related journeys, not made in your own vehicle, to the value of £261.69

2. By reason of your caution as set out at paragraph 1 your fitness to practice as a Paramedic is impaired.

Finding

Background

1. The Registrant is a registered Paramedic. He was employed by the Welsh Ambulance Services Trust (WAST) as a Trainee Advanced Paramedic Practitioner (TAPP). TAPPs must either hold an MSc in Advanced Clinical Practice or be working towards one. The Registrant commenced his MSc at the University of Glamorgan, Pontypridd in October 2012. The course was day release, funded by the Welsh Ambulance Service. The study leave package included course fees and travel expenses.

2. It was alleged that between October 2012 and March 2015, the Registrant was claiming for journeys made between Newtown Ambulance Station and the University of Glamorgan , despite the fact that he was actually sharing a lift with colleagues using a vehicle provided by WAST.

3. The initial concern was raised by the Registrant’s line manager, Witness SO, who had a converstion with the Registrant’s colleagues Witness MF and Witness LN following a performance meeting on 7 January 2015 at the St John Cymru office. These colleagues explained that they were travelling from North Wales to Cardiff and were meeting the Registrant to give him a lift to university. Witness SO was responsible for approving  the Registrant’s travel expenses and raised his concern with the Locality Manager. The  WAST Local Counter Fraud Specialist (LCFS) subsequently became involved and a review was undertaken of travel claims submitted by the Registrant between October 2012 and April 2015.

4. Witness MF and Witness LN provided witness statements in which they stated that the Registrant travelled with them approximately 50% of the time during year one and ‘the majority of the time’ during years two and three. The total cost of the claims paid to the Registrant over the three year period amounted to £4868.97.   Some of these claims were legitimate. 

5. In October 2015, the Registrant resigned from his post and in December 2015, he transferred £2000 to WAST as a form of repayment.

6. The Registrant was interviewed under caution at Aberyswyth Police Station on 3 September 2015. During the interview the Registrant admitted that he had travelled with colleagues on some occasions and a Police Caution was subsequently administered on 15 November 2016 at Merthyr Police Station.

7. Witnesses SO, MF and LN were not called to give evidence. The HCPC relied on their evidence as hearsay.

The Registrant’s Evidence

8. The Registrant chose to give evidence. He informed the Panel that he was first employed by WAST in 1996 in a role involving the transporting of patients which did not require ‘medical qualifications’. He stated that he qualified as a paramedic in 1999/2000 and confimed that he commenced the MSc in Advanced Clinical Practice in 2012.

9. During his oral evidence, the Registrant outlined the financial and personal difficulties he was experiencing  whilst undertaking the MSc. He stated that his financial problems resulted in him entering into a Voluntary Financial Arrangement with his creditors with the assistance of the Citizens Advice Bureau. He stated that he had accumulated debt.  The Registrant informed the Panel that the debt has been fully repaid.

10. The Registrant expressed regret and apologised for his actions. He informed the Panel that he was ‘embarrased and deeply ashamed’ by his conduct. He stated that he accepted full respsonsibilty for his behaviour, but invited the Panel to accept that due to personal and financial circumstances he was under significant strain at the time which affected his mental state. He confirmed that the stress factors are no longer present and that he promptly paid  £2,000 to WAST once they stated that that was the amount that he owed.

11. The Registrant informed the Panel that he is currently employed as Head of Urgent Care for a GP out of hours provider, for which HCPC registration is required.


Decision on Facts and Grounds

Panel’s Approach

12. The Panel accepted the advice of the Legal Assessor. The Panel noted that the Registrant admitted particular 1.  However, the Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything and the individual particulars of the Allegation could only be found proved, if the Panel was satisfied, on the balance of probabilities.

13. In reaching its decision the Panel took into account the documentary evidence including the witness statements of SO, LN, MF and the Registrant, the travel claim forms, the signed Police Caution, confirmation of the debt arrangement and the Registrant’s references. The Panel also took into account the HCPTS Practice Note entitled ‘Conviction and Caution Allegations’. The Panel was aware that it could not go behind the Caution and was required to accept the certification from South Wales Police as conclusive proof of the Caution itself and the underlying facts.

Particulars 1 – Found Proved

14. The Panel was provided with a copy of a Police Caution in the name of the Registrant, which was signed by a police sergeant. The Panel accepted the documentation as conclusive evidence that the Registrant received a Police Caution for fraud by false representation  on 15 November 2016. The Panel noted that a Police Caution cannot be administered unless:
• the evidence is sufficient to provide a realistic prospect of conviction;
• the offender unequivocally admits having committed the offence; and
• the offender agrees to accept the Caution and understands the significance of doing so.

15. Therefore, the Panel was satisfied that the facts and grounds had been proved.

Decision on Impairment

Panels Approach

16. The Panel went on to consider whether the Registrant’s fitness to practise is currently impaired. The Panel took into account the submissions made by both parties on. The Panel also took into account the HCPTS Practice Note: ‘Finding that Fitness to Practise is Impaired’ and the HCPTS Practice Note: ‘Conviction and Caution Allegations’. The Panel accepted the advice of the Legal Assessor.

17. In determining current impairment the Panel had regard to the following aspects of the public interest:
• The ‘personal’ component: the current behaviour of the individual registrant; and
• The ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.


Decision

18. The Panel considered the Registrant’s current fitness to practise firstly from the personal perspective and then from the wider public perspective.

19. The Panel considered the HCPC Standards of Conduct and Ethics and was satisfied that the Registrant’s conduct and behaviour represented a significant departure from the following standard:
• 9.1 - ‘You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

20. The Panel recognised that demonstrating remediation following a Police Caution for a dishonesty offence can be difficult, as the basis for this type of misconduct is an attitudinal failing. However, the Panel was encouraged by the Registrant’s attendance. The Panel recognised that it is difficult to publicly acknowledge committing an act of dishonesty and accept that the primary motivation was financial gain. The Panel took the view that the Registrant should be given full credit for acknowledging his shortcomings. The Panel accepted that the Registrant was facing difficult personal and financial circumstances at the time, although as the Registrant acknowledged, these circumstances cannot excuse his behaviour. The Panel took the view that the Registrant demonstrated significant insight with regards to the underlying factors which led him to disregard the high standards of conduct, honesty and integrity expected of all registered practitioners.   The Registrant demonstrated that he was fully aware of the damage he had caused to his personal reputation.  The Panel concluded that the Registrant’s embarrassment and shame were sufficiently profound that the risk of repetition was low. In reaching this conclusion the Panel also took into account the fact that the Registrant had a previous unblemished professional record for approximately 16 years.

21. Although the Registrant had reflected on the impact of his behaviour on himself as a professional, he did not appear to have considered the impact on his profession and the wider public, beyond the colleagues that have known him for a long time. However, the Panel was satisfied that the Registrant had demonstrated sufficient insight and, having concluded that the risk of repetition was low, the Panel did not find the Registrant’s fitness to practise impaired on the basis of the personal component.

22. In considering the public component,  the Panel had regard to the important public policy issues which include the need to protect the public, maintain confidence in the profession and declare and uphold proper standards of conduct and behaviour.

23. Members of the public would be extremely concerned to learn that a registered paramedic had committed a criminal offence of dishonesty resulting in a Police Caution. The Panel took the view that such conduct and behaviour would be wholly unacceptable in any circumstances, but was aggravated by the fact that it was repeated on numerous occasions and persisted for a significant period of time. The Panel noted that the Registrant’s actions could not be described as a one-off error of judgement and his fraudulent activities only stopped when he was caught. The Panel concluded that the Registrant’s repeated dishonest conduct demonstrated a lack of integrity which brought the profession into disrepute and undermined a fundamental tenet of the profession. In these circumstances,  the Panel concluded that public confidence would be significantly undermined if a finding of impaired fitness to practise was not made, given the nature and seriousness of the Registrant’s conduct and behaviour. Furthermore, a finding
of impairment is required to deter other registrants and to declare and uphold the high standards expected of all registered practitioners.

24. The Panel concluded that the Registrant’s current fitness to practise is impaired on the basis of the wider public interest and therefore the HCPC’s case is well-founded.


Decision on Sanction

Panel’s Approach

26. The Panel accepted the advice of the Legal Assessor. The Panel was mindful that the purpose of any sanction is not to punish the Registrant twice for the same offence, but to protect the wider public interest. The public interest includes maintaining public confidence in the profession and the HCPC as its regulator, upholding proper standards of conduct and behaviour and deterring other registrants from similar behaviour. The Panel applied the principle of proportionality by weighing the Registrant’s interests with the public interest and by considering each available sanction in ascending order of severity.

27. The Panel took into account the submissions made by both parties and its findings on impairment of the Registrant’s fitness to practise. The also Panel had regard to the Indicative Sanctions Policy (ISP).

Decision

28. In determining the appropriate sanction, if any, to impose the Panel first identified what it considered to be the mitigating and aggravating features of the case. The Panel identified the following mitigating factors:
• The Registrant’s early admissions to his former employer and the police and taking full responsibility for his actions;
• The conduct occurred during a period of very challenging personal circumstances which had interrelated financial issues at a time when finances were already under considerable pressure;
• The conduct was an isolated lapse in an otherwise unblemished 16-year paramedic career;
• The Registrant repaid the amount requested without challenge;
• The positive character references submitted on the Registrant’s behalf which attested to his usual honesty and integrity;

The Panel identified the following aggravating factors:

• The fraudulent travel claims were repeatedly submitted, and the dishonest conduct persisted for a significant period of time;
• The Registrant breached the trust his employers and the public are entitled to expect from all registered practitioners. 

29. The Panel first considered taking no action. The Panel concluded that, in view of the nature and seriousness of the Registrant’s conduct to take no action on his registration would be inappropriate. Furthermore, in the absence of exceptional circumstances the Panel concluded that taking no action would be insufficient to maintain public confidence and uphold the reputation of the profession.

30. The Panel then considered a Caution Order.  The Panel noted paragraph 28 of the ISP which states:

“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.”

31. The Panel took the view that the Registrant’s Police Caution and his underlying dishonest behaviour could not be properly described as minor in nature. However, the Panel was satisfied that his conduct was isolated, within the context of his professional career as a whole, and was very unlikely to be repeated given the insight that the Registrant has demonstrated.  Having had the opportunity to assess the Registrant’s demeanour when he gave evidence, the Panel concluded that the attitudinal deficit which resulted in the fraud was no longer an issue.  The Panel accepted the Registrant’s evidence that his referees were made aware of his Police Caution and these proceedings, even though these factors were not mentioned in their references. The Panel noted that, despite this knowledge, more than one referee described the Registrant as ‘honest and trustworthy’ which the Panel took into account in concluding that the Registrant’s conduct was out of character. The Panel was satisfied that the Registrant fully appreciated that his behaviour was unacceptable and that he had promptly taken appropriate steps to remediate his conduct and behaviour, once the fraud had been discovered, by admitting his wrongdoing and repaying the amount requested. Furthermore, the Panel was satisfied that, during his evidence, the Registrant demonstrated genuine remorse and substantial personal mitigation.

32. In these circumstances, the Panel concluded that a Caution Order would adequately mark the seriousness of the Registrant’s dishonest behaviour and therefore meet the wider public interest in terms of declaring and upholding proper standards of conduct expected of registered practitioners and maintaining public confidence in the profession.

33. Prior to confirming its decision to impose a Caution Order the Panel went on to consider a Conditions of Practice Order. The Panel concluded that the Registrant’s Police Caution for fraud by false representation and the underlying facts upon which it is based, was not amenable to conditions. As a consequence, the Panel took the view that it was not possible to formulate workable conditions. The Panel next considered a Suspension Order. The Panel concluded that in the circumstances of this case, a Suspension Order would be punitive and disproportionate.

34. Having determined that a Caution Order was the appropriate and proportionate sanction the Panel went on to consider the duration. The Panel concluded that although the Registrant’s conduct was towards the lower end of the spectrum with regard to offences of dishonesty it was towards the higher end of the scale with regard to culpability, in that the dishonesty was repeated and continued for a prolonged period of time. In these circumstances the Panel concluded that the Caution Order should be imposed for the maximum period of 5 years to send a clear message to the public, the Registrant and other registrants re-affirming the high standards of behaviour expected of all registered practitioners.

 

Order

Order: That the Registrar is directed to annotate the register entry of Richard Shane North with a caution which is to remain on the register for a period of 5 years from the date this order comes into effect.

Notes

No notes available

Hearing history

History of Hearings for Mr Richard S North

Date Panel Hearing type Outcomes / Status
08/01/2018 Conduct and Competence Committee Final Hearing Caution