James J Hughes

Preliminary Matters:

Notice

1. At the outset of the hearing, it was brought to the Panel’s attention that the Notice of Hearing (hereafter ‘the Notice’), had been served on the Registrant on 18 September 2024. Consequently, the Registrant had only been afforded 27 days’ notice.

2. Having had the implications and consequences of 27 days’ notice explained to him by the Legal Assessor, the Registrant confirmed that he was happy to waive the 28-day notice period. The Registrant informed the Panel that he wished for the hearing to proceed so that he could address the Panel today, rather than seeking an adjournment of the matter to an alternative date so that effective notice (28 days’ notice) could be achieved.

3. The Panel accepted the Legal Assessor’s legal advice, which had drawn its attention to the Health Professions Order and the HCPC (Conduct and Competence Committee Procedure) Rules 2003 (hereafter ‘the Rules’). Having done so, and having regard to the Registrant’s submissions that i) he wanted the hearing to proceed, and ii) that he was content to waive the 28 day notice period, the Panel concluded that notwithstanding a defective notice having been served on the Registrant in that it only provided the Registrant with 27 days’ notice of the review hearing, that it was both in the public interest and the Registrant’s own interests that the matter should proceed today.

Privacy application

4. Ms Khorassani, appearing on behalf of the HCPC, made a joint application for parts of the hearing to be conducted in private. She submitted that the parts of the hearing relating to the Registrant’s health and private family life should be conducted in private, under Rule 10(1)(a) of the Rules, but that the remainder of the proceedings should be heard in public.

5. The Registrant agreed with Ms Khorassani’s application, that parts of the hearing relating to his private life and/or health, should be conducted in private.

6. The Panel accepted the Legal Assessor’s advice, which had drawn the Panel’s attention to, amongst other matters, Rule 10(1)(a) and the HCPTS Practice Note on ‘Conducting Hearings in Private’.

7. The Panel determined, given the nature of the Registrant’s submissions to previous panels and having regard to the material before it regarding the Registrant’s private life, that there was a need for requisite parts of the evidence pertaining to the Registrant’s private life and health, to be heard in private, pursuant to Rule 10(1)(a) of the Rules. The Panel considered that the Registrant would suffer disproportionate damage if it did not do so. In making its decision, the Panel also determined that it would be feasible to move between public and private session.

Background:

8. The Registrant is a registered Paramedic (PA22651) and was employed by Great Sutton Medical Centre (‘the Employer’) as a Band 7 Paramedic, from December 2019 until April 2021.

9. On 06 February 2018, the Registrant was convicted of driving a motor vehicle whilst being over the exceeded prescribed limit of alcohol at Liverpool Knowsley and St Helens Magistrates’ Court, contrary to section 5(1)(a) of the Road Traffic Act 1988 and Schedule 2 to the Road Traffic Offenders Act 1988. As a result, the following penalties against the Registrant were imposed: a) A fine of £100; b) The payment of a surcharge to fund victim services of £30; c) The payment of costs of £85 to the Crown Prosecution Service; d) A Collection Order; and e) Disqualification from holding or obtaining a driving licence for 18 months, subject to a reduction of 137 days if, by 21 January 2019, the Registrant satisfactorily completed a course approved by the Secretary of State.

10. In relation to the conviction concerns as set out above, it is also alleged that the Registrant failed to advise the HCPC of the conviction. Further, on 29 June 2020 it was alleged that, when completing an HCPC readmission form, his registration having lapsed, the Registrant did not indicate that he had received the above conviction, as he failed to tick the correct box on the form disclosing this information.

11. In July 2020, concerns were raised by the HCPC’s Registrations Department regarding the Registrant’s conduct, namely, it was alleged that the Registrant continued to work as a Paramedic whilst he was not registered with the HCPC, between 07 February 2020 and 24 July 2020.

12. As a result of the HCPC’s investigations into the above matters, the Employer raised concerns that the Registrant had failed to disclose to the Employer that he was not registered with the HCPC, between the relevant time set out above. The Employer subsequently conducted an internal investigation into these matters.

13. In addition to the above, on 29 June 2020, it is alleged that, when completing his readmission form to the HCPC, the Registrant did not tick the box on the form to indicate that he had been disciplined by a regulatory body or his employer.

14. The matter eventually came to hearing before the Substantive Hearing Panel on 11 December 2023. The Registrant represented himself. Having heard evidence from the HCPC’s witnesses and from the Registrant, the Substantive Hearing Panel made the factual decisions outlined above. Further, it found that the Registrant was impaired in relation to the personal and public components.

15. In relation to Sanction, the Substantive Hearing Panel stated:

“170. The Panel considered all the information before it. In doing so, the Panel identified the following aggravating factors:

• That the Registrant repeated his dishonesty over a period of several months. This, the Panel concluded, was a particularly aggravating feature;

• The Registrant’s dishonesty was directed to both his employer and his regulator and had the potential to impact on his eligibility and suitability to practise as a paramedic;

• Notwithstanding that the Registrant has demonstrated some insight, the Panel has recognised that it was limited;

• The Registrant has demonstrated limited steps towards remediating his failings and keeping his knowledge and skills up to date;

• His initial lack of candour at the case review meeting in February 2021 in which he denied that his name had been removed from the register; and

• This is the third time that a disciplinary finding has been made against the Registrant. Whilst the Registrant’s two previous regulatory findings date from some years back, and were for unrelated matters, the Registrant should have had a heightened awareness of his duty to comply with his professional obligations, particularly given that the five year caution order imposed in July 2013 did not expire until mid-2018.

171. The Panel identified the following mitigating factors:

• The Registrant has engaged in the regulatory process and made early admissions to the factual particulars with the exception of the dishonesty allegations at the outset of the hearing;

• The Registrant has expressed remorse and apologised for his actions;

• The Registrant had difficult health and personal circumstances at the time [redacted];

• The risk of direct patient harm was low;

• The Registrant’s dishonesty in relation to practising as a Paramedic whilst unregistered, arose from very particular circumstances which were unlikely to be replicated, and that the Registrant believed that his registration problems, which arose following a refused direct debit payment, would be quickly resolved.

172. In the circumstances, and noting that no patient harm resulted from the Registrant’s dishonesty, the Panel concluded that the Registrant’s dishonest behaviour fell towards the lower, but not at the lowest end of the dishonesty spectrum.

173. The Panel approached the issue of sanction starting with the least restrictive first, bearing in mind the need for proportionality and to take into account the Registrant’s interests. Having done so, it concluded that taking no further action would not reflect the nature and gravity of the misconduct. The Panel concluded that taking no action would not be adequate to protect the public or the wider public interest of maintaining confidence in both the profession and the regulatory process. Such an outcome was therefore neither appropriate nor proportionate in the circumstances.

174. The Panel next considered mediation, but having had due regard to the circumstances of this case, such an outcome was inappropriate to address the issues of dishonesty. It therefore concluded that this was not an appropriate outcome.

175. The Panel then considered whether to impose a Caution Order and had regard to paragraphs 99-102 of the SP. The Panel concluded that this was also not an appropriate outcome because:

• For the reasons set out in its determination on misconduct in relation to dishonesty and impairment, the Panel did not consider the Registrant’s misconduct to be minor in nature;

• The Registrant’s insight was incomplete;

• The Panel considered that there remained an ongoing risk of repetition given the lack of effective remediation of his failings.

176. The Panel next considered whether a Conditions of Practice Order was appropriate. It had regard to paragraphs 105-109 of the SP. It has concluded that such a sanction would neither be appropriate nor proportionate to address the nature of the misconduct proved or the public interest concerns identified. The Panel concluded that workable and appropriate conditions could not be formulated that would meaningfully address the dishonesty concerns identified.

177. In the circumstances, the Panel concluded that imposing a Conditions of Practice Order was not the appropriate sanction to impose.

178. The Panel next considered the sanction of suspension. The Panel has borne in mind that this would be an appropriate sanction to impose where, even though the allegation is serious, the conduct was not fundamentally incompatible with the Registrant remaining on the register, and hence, a Striking Off Order would not be justified.

179. The Panel considered that a Suspension Order was the appropriate sanction to impose because:

• The matters found proved, as set out in the Panel’s determination on misconduct, represented serious breaches of the Standards of Conduct Performance and Ethics;

• The Registrant has demonstrated some insight into his failings particularly in relation to Particular 1;

• The Panel was mindful that a striking off order was appropriate for the most serious cases of dishonesty. It considered that the Registrant's failings were not so serious that they were fundamentally incompatible with remaining on the register. In reaching that conclusion, it had regard to paragraph 121 of the SP which states that a Suspension Order may be appropriate where “there is evidence to suggest that the Registrant is likely to be able to resolve or remedy their failings”. The Panel noted, as set out in the Panel’s determination on impairment, that the Registrant has developed some insight into his dishonest behaviour even though that process was not as yet complete.

180. To satisfy itself that a Suspension Order was the appropriate and proportionate sanction to impose, the Panel considered whether a Striking-off Order was justified. It had regard to paragraph 130 of the SP which states that: “A striking off order is a sanction of last resort for serious, persistent, deliberate or reckless acts” whilst setting out a non-exhaustive list of applicable circumstances. The Panel was satisfied, given the identified mitigating factors, that the facts of this case were not of such gravity so as to merit such a restrictive sanction. It concluded that the public protection, and the public interest concerns could be adequately met by the imposition of a Suspension Order which would restrict the Registrant’s ability to practise as a Paramedic until such time as a reviewing panel determined that he was fit to do so.

181. The Panel therefore imposes a Suspension Order for a period of 6 months. The Panel concluded that that was an appropriate and proportionate period of time to enable the Registrant to reflect on the nature and gravity of the misconduct found proved and to allow him an adequate period of time to address and remediate his failings.

182. So far as any future review is concerned, the Panel considered a future reviewing panel would be assisted by:

• His attendance at any review hearing;

• Further evidence of remediation in relation to addressing his dishonest behaviour;

• [redacted];

• Evidence of reflection on his conduct demonstrating meaningful insight into the impact of his dishonest behaviour on the wider profession and the public;

• Up to date references / testimonials in relation to any work undertaken by the Registrant, whether paid or unpaid;

• Evidence that the Registrant had kept his skills and knowledge up to date;

• Any other evidence the Registrant considers would assist him to demonstrate that he is suitable to return to unrestricted practice.”

16. The Suspension Order was subsequently reviewed on 14 June 2024, where it was extended for a further four months. At that review, the previous review panel (in its public decision) stated the following:

‘27. The Panel noted that, whilst the Registrant had submitted a reflective piece, he had not supplied the Panel with all of the suggested evidence or material, for instance, any “Up to date references / testimonials in relation to any work undertaken by the Registrant, whether paid or unpaid” or “Evidence that the Registrant had kept his skills and knowledge up to date”.

28. The Panel was disappointed by this since it considered that the direction from the last panel had been particularly clear about what proof regarding his progress needed to be supplied. Although the Registrant had given evidence about what he had done in the last six months and before, which had not been challenged by Ms Khorassani in cross examination, he had failed to provide the corroborative evidence that had been requested.

29. The Panel appreciated the difficulties the Registrant had experienced over the previous few months and sympathised with him, but considered that he could have made better efforts to comply with the previous panel’s directions, not least, for example, by asking those who gave him voluntary work to supply written testimonials. The lack of such corroborative evidence therefore made it difficult for the Panel to conclude that the Registrant had fully remediated his Misconduct.

30. The Panel was appreciative of the Registrant’s oral evidence and considered that he gave good answers regarding, for instance, the effect of his dishonesty upon members of the public. To that extent, the Panel was satisfied that the Registrant has made progress regarding his insight, which it considers has improved since the last hearing. However, the Panel considered that he had not attained full insight.

31. Furthermore, the Panel considered that the Registrant had not given sufficient thought to how he would facilitate any return to practice, given that he had not worked as a paramedic for some three years and was currently not registered with the HCPC. In particular, the Panel considered that the Registrant had not demonstrated that he had sufficiently kept his skills as a paramedic up to date. The Panel noted his evidence that he had had a long career as a paramedic and had had no complaints about his clinical skills, but his training to date did not encompass specific paramedic learning, which was concerning to the Panel given his absence from the profession for so long. Moreover, the Registrant, although he had confirmed taking the mandatory courses specified and completed online reading and research, had not given any evidence about what he had learned from these.

32. Accordingly, the Panel concluded that, although the Registrant has made good progress towards remediating his failings, further work and evidence was needed.

33. The Panel first considered that the Registrant remained impaired with regard to the personal component. It was of the view that the conduct was remediable, but as it had not yet been fully remedied (for the reasons outlined above) it was likely to be repeated. The Panel therefore found that the Registrant’s fitness to practise remained impaired on personal grounds.

34. Further, the Panel determined that a finding of impairment was also necessary in order to maintain public confidence in the profession and uphold standards. A reasonable and informed member of the public would expect such a finding on the basis that the Registrant remained impaired on public grounds.

Decision on Sanction

35. The Panel considered the Sanctions Policy of the HCPTS and accepted the advice of the Legal Assessor that a sanction should be the least that is necessary to ensure public protection. The Panel reminded itself that the purpose of a sanction is not to punish the Registrant and that a sanction must be reasonable and proportionate.

36. The Panel determined that the nature of the concerns in this case were too serious to make no Order.

37. The Panel considered whether to impose a Caution Order but decided that it was inappropriate because a Caution Order would not provide sufficient public protection.

38. The Panel determined that a Conditions of Practice Order was not appropriate because the Registrant had not shown sufficient insight and such an order was not appropriate to address the current outstanding issues.

39. The Panel then considered an extension of the current Suspension Order. It considered that the Registrant, having made some progress with his remediation, required only a relatively short period of further suspension to provide the next reviewing panel with the evidence requested and the further reflections needed. The Panel therefore concluded that an extension of the current suspension order would be appropriate and proportionate.

40. The Panel considered that a further extension to the current order of four months would be sufficient to enable the Registrant to reflect further and assemble the documentary evidence required to demonstrate that he had fully remediated his failings and would not repeat them.

41. On that basis, the Panel concluded that, given that the Registrant had made progress since the last hearing and had the capacity to respond positively to a further suspension in order to allow him to fully remediate his practice, an Order Striking Off the Registrant would be entirely disproportionate.

42. The Panel determined that the current Suspension Order be extended by a period of four months so as to expire on 12 November 2024.

43. Towards the end of that period there will be a further review hearing. The Panel considered a future reviewing panel would be assisted by:

• The Registrant’s attendance at any review hearing;

• Further evidence of remediation in relation to addressing (i) how he would ensure that he would prevent any repetition of his failings in the future by utilising support; and (ii) how he would manage a return to practice, given that his absence from working as a paramedic for three years had diminished his skills as such;

• Up to date references / testimonials in relation to any work undertaken by the Registrant, whether paid or unpaid;

• Evidence that the Registrant had kept his skills and knowledge up to date, together with an analysis of what he has learned from all CPD activities;

• Any other evidence the Registrant considers would assist him to demonstrate that he is suitable to return to unrestricted practice.’

Submissions and oral evidence:

The submissions and oral evidence outlined below are a summary of the parties’ submissions and oral evidence to the Panel and are not a verbatim account.

HCPC:

17. Ms Khorassani briefly outlined the background of the case to the Panel as the Panel had indicated that they had read and carefully considered the 62 page HCPC bundle before it.

18. Ms Khorassani also submitted that the Registrant’s fitness to practise remains impaired on both the personal and public components and that the HCPC was inviting the Panel to extend the Suspension Order for a further period of time, for a term at the Panel’s discretion, as the Registrant had not provided any evidence, since the previous review, that he had complied with the previous panel’s recommendations.

19. Ms Khorassani also drew the Panel’s attention to Abrahaem v GMC [2008] EWHC 183.

20. Ms Khorassani further submitted:

(i) there is not yet sufficient evidence to demonstrate a sustained and maintained change, or that the original findings have been addressed by the Registrant;

(ii) the Registrant has not provided sufficient evidence of remediation;

(iii) the Registrant has not discharged the persuasive burden;

(iv) the Registrant has had limited engagement with the HCPC since the last review hearing;

(v) the Registrant has not provided the required information sought by the previous reviewing panel; and

(vi) the HCPC invite the Panel to extend the current Suspension Order to enable the Registrant with a final opportunity to engage with the HCPC and provide the required evidence to demonstrate that his fitness to practise is no longer impaired.

Registrant:

21. The Registrant elected to give oral evidence to the Panel. In doing so, he stated the following:

(i) he has found the regulatory process very difficult;

22. In response to questions from Ms Khorassani, the Registrant also stated the following:

(i) he “did not know” whether his fitness to practise remained impaired because he was an experienced Paramedic and no question had been raised over his clinical practice;

23. In response to questions from the Panel, the Registrant stated the following:

(i) he would love to go back to the Paramedic profession, and he did his best for as many people as he could and his clinical judgement has never come into question;

(ii) he is vastly experienced and highly trained and “not once has his clinical competence come into play”; and

(iii) his knowledge and experience “never leave him”.

Decision:

24. The Panel took into account the documents furnished to it by the HCPC (62-page bundle). It also had regard to the oral evidence before it from the Registrant and it also had regard to the HCPC submissions.

25. The Panel considered the relevant Practice Notes issued by the HCPTS, ‘Fitness to Practise Impairment’ and ‘Review of Article 30 Sanction Orders’, together with the HCPC’s Standards of Conduct, Performance and Ethics.

26. The Panel accepted the advice of the Legal Assessor who had reminded it that the purpose of the review is to consider the issue of current impairment of the Registrant. The Legal Assessor also reminded the Panel of the following:

i. the Panel could have regard to a number of factors when reviewing the Order. Namely, the previous panel’s findings, the extent to which the Registrant has engaged with the regulatory process, the scope and level of insight and the risk of repetition;

ii. the Panel could take account of a range of issues, when considering current impairment, which in essence comprises the two components:

a) the ‘personal’ component: the current competence and behaviour of the Registrant; and

b) the ‘public’ component: the need the protect the public, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

iii. it is only if the Panel determines that the Registrant’s fitness to practise remains impaired, that the Panel should go on to consider sanction by applying the guidance as set out in the HCPC ‘Sanctions Policy’;

iv. the Registrant bears the “persuasive burden” of demonstrating that he has fully acknowledged the deficiencies which led to the original findings and has addressed his impairment sufficiently through ‘insight, application, education, supervision or other achievement’ Abrahaem v GMC [2008] EWHC 183; and

v. the principle of proportionality required the Panel to consider the Registrant’s interests to be balanced against the interests of the public.

27. In making its decision, the Panel had regard to both the personal and public elements of impairment.

28. The Panel noted that the Registrant’s misconduct in this case related to a finding that he had been convicted of driving with excess alcohol and a failure to honestly and appropriately disclose this information to the HCPC on more than one occasion.

29. The Panel noted the previous reviewing panel’s public decision (June 2024), which it was not bound by, and as set out above.

28. The Panel was disappointed by this since it considered that the direction from the last panel had been particularly clear about what proof regarding his progress needed to be supplied. Although the Registrant had given evidence about what he had done in the last six months and before, which had not been challenged by Ms Khorassani in cross examination, he had failed to provide the corroborative evidence that had been requested.

29. The Panel appreciated the difficulties the Registrant had experienced over the previous few months and sympathised with him, but considered that he could have made better efforts to comply with the previous panel’s directions, not least, for example, by asking those who gave him voluntary work to supply written testimonials. The lack of such corroborative evidence therefore made it difficult for the Panel to conclude that the Registrant had fully remediated his Misconduct.

30. The Panel was appreciative of the Registrant’s oral evidence and considered that he gave good answers regarding, for instance, the effect of his dishonesty upon members of the public. To that extent, the Panel was satisfied that the Registrant has made progress regarding his insight, which it considers has improved since the last hearing. However, the Panel considered that he had not attained full insight.

31. Furthermore, the Panel considered that the Registrant had not given sufficient thought to how he would facilitate any return to practice, given that he had not worked as a paramedic for some three years and was currently not registered with the HCPC. In particular, the Panel considered that the Registrant had not demonstrated that he had sufficiently kept his skills as a paramedic up to date. The Panel noted his evidence that he had had a long career as a paramedic and had had no complaints about his clinical skills, but his training to date did not encompass specific paramedic learning, which was concerning to the Panel given his absence from the profession for so long. Moreover, the Registrant, although he had confirmed taking the mandatory courses specified and completed online reading and research, had not given any evidence about what he had learned from these.

32. Accordingly, the Panel concluded that, although the Registrant has made good progress towards remediating his failings, further work and evidence was needed.

33. The Panel first considered that the Registrant remained impaired with regard to the personal component. It was of the view that the conduct was remediable, but as it had not yet been fully remedied (for the reasons outlined above) it was likely to be repeated. The Panel therefore found that the Registrant’s fitness to practise remained impaired on personal grounds.

34. Further, the Panel determined that a finding of impairment was also necessary in order to maintain public confidence in the profession and uphold standards. A reasonable and informed member of the public would expect such a finding on the basis that the Registrant remained impaired on public grounds.’

30. In particular the Panel noted that the Registrant had not provided the previous reviewing panel with any evidence of testimonials or work undertaken. Nor had he provided evidence that he had kept his skills and knowledge up to date.

31. The Panel also noted that the previous reviewing panel’s public determination (at paragraph 43) was very clear regarding what might assist the Panel when reviewing the Order today (as set out above). The Panel noted that the Registrant had again not provided any evidence to it for the purposes of today’s review hearing.

32. The Panel noted and commended the Registrant for his attendance and engagement at today’s review hearing. However, the Panel was also disappointed the Registrant had, notwithstanding clear guidance from the earlier reviewing panel, not furnished any documentation to it for the purposes of today’s review hearing.

33. Having had regard to the Registrant’s oral evidence to it, the Panel was troubled by the Registrant’s lack of insight in respect of the impact on his actions and how they have affected the Paramedic profession and the wider public. Noting that the Registrant chose to focus primarily upon how the finding and regulatory proceedings had impacted him. The Panel did recognise that the Registrant had taken some steps towards demonstrating some insight, but the Panel considered this to be limited at the current time.

34. The Panel also noted that whilst the Registrant had stated in his oral evidence that he had undertaken some independent reading and research, the Panel noted that, again, the Registrant had not provided any documentary evidence to confirm the same. Whilst the Panel acknowledged the Registrant’s private and personal circumstances, the Panel noted that the Registrant had also not produced a written list of the reading that he had undertaken to place before the Panel as evidence of the same.

35. In the Panel’s view, the Registrant’s oral evidence did not address to the Panel’s satisfaction, the Registrant’s understanding of the impact of his actions and dishonesty on the public or the profession. Further, the Panel also considered that the Registrant’s oral evidence did not outline how he would prevent such conduct from being repeated in the future.

36. The Panel next had regard to the lack of testimonials provided by the Registrant. The Panel noted that the previous reviewing panel had requested testimonials be provided to account for and attest to the Registrant’s voluntary work. Again, whilst the Panel had sympathy for the Registrant’s personal circumstances, the Panel considered that the Registrant’s response that he “didn’t like asking people for things” lacked insight.

37. In the Panel’s view, as an individual wishing to return to Paramedic practice and considering that he bears the persuasive burden, the Registrant had not taken any positive steps to provide the required evidence that his fitness to practise was no longer impaired and that he was safe to return to Paramedic practice. Further, the Panel also considered that the Registrant demonstrated an attitude whereby he was of the view that oral evidence and/or submissions to a panel, without the requested documentary evidence to attest to his fitness to return to practise being provided, was sufficient, despite very clear indications from two previous panels to the contrary.

38. Given the aforementioned, the Panel considered that it could not yet be confident that the Registrant had demonstrated the required insight or that he has taken steps to remediate his failings and therefore it could also not be confident that his behaviour would not be repeated.

39. Consequently, the Panel was not satisfied that in all the circumstances the Registrant does not still pose a real and on-going risk to the public and that public confidence in the profession would not be undermined should the Registrant be permitted to return to unrestricted practice.

40. Accordingly, the Panel concluded that the Registrant’s fitness to practise remains impaired on both the personal and public components. The Panel considered whether an order was necessary in the Registrant’s own interests, in view of his oral evidence to it however, the Panel concluded that there was insufficient evidence before it, at the current time, to conclude that it was.

41. The Panel bore in mind that sanction is a matter for its own independent judgment and that the purpose of a sanction is not to punish the Registrant but to protect the public. Further, that any sanction must be proportionate, so that any order must be the least restrictive order that would protect the public interest, including public protection.

42. The Panel considered the option of a Caution Order however, it decided that it would not provide adequate protection for the public in view of its findings.

43. The Panel next considered the option of a Conditions of Practice Order. However, the Panel decided that conditions would not be workable, or appropriate, at the current time. In forming this view, the Panel noted that the Registrant had not indicated to it that he would be willing to comply with a Conditions of Practice Order, he had failed to demonstrate sufficient insight into his failings and it also had regard to the fact that he is not currently working. Additionally, the Panel also noted that in respect of a finding of dishonesty, that it was difficult to craft Conditions of Practice Order for something which the Panel considered could be attitudinal in nature. For all of these reasons, the Panel determined that a conditions of practice order was not appropriate or workable.

44. The Panel next carefully considered extending the current Suspension Order versus imposing a Striking-off Order. The Panel noted the Registrant’s engagement and the difficulties that he had continued to endure, since the last review hearing. The Panel also noted that the Registrant had taken some steps to reflect on his behaviour and whilst it considered his insight, remorse and remediation to be limited, the Panel noted that the Registrant’s insight did appear to be developing.

45. The Panel also considered that a Striking-off Order would be disproportionate at the current time. In forming this view, the Panel took account of the Registrant’s oral evidence to it, that he wished to return to Paramedic practice, and it also had regard to the fact that the Registrant could go on to make a valuable contribution to the Paramedic profession. Having done so, the Panel determined that, in the current circumstances, notwithstanding the serious findings made against the Registrant, the Registrant should be afforded with a further opportunity to satisfy a future panel that his fitness to practise is no longer impaired. However, the Panel was also of the view that should the Registrant attend a future review hearing without any documentary evidence to support his oral evidence and/ or submissions, then a future reviewing panel may well consider that a Striking-off Order is the only remaining appropriate option available to it. In forming this view, the Panel noted the repeated requests made to the Registrant, by both the Substantive Hearing panel and the previous reviewing panels, to provide documentary evidence and noted his repeated failure to do so.

46. However, notwithstanding the aforementioned, the Panel determined that the appropriate and proportionate Order, at the current time, is to extend the current Suspension Order. The Panel determined that this should be for a period of six months to allow the Registrant time to reflect further, to demonstrate insight into his misconduct and to take steps to demonstrate and evidence that his fitness to practice is no longer impaired.

47. The Panel considered that a review panel may be assisted by the following:

a) The Registrant’s attendance at a future review hearing;

b) evidence of remediation in relation to addressing:

(i) how he would ensure that he would prevent any repetition of his failings in the future by utilising support; and

(ii) how he would manage a return to practice, given that his absence from working as a paramedic for three years had diminished his skills as such;

c) [redacted];

d) Up to date references / testimonials in relation to any work undertaken by the Registrant, whether paid or unpaid;

e) Evidence that the Registrant had kept his skills and knowledge up to date, together with an analysis of what he has learned from all CPD activities;

f) Any other evidence the Registrant considers would assist him to demonstrate that he is suitable to return to unrestricted practice.

The Registrar is directed to suspend the Registration of Mr James Hughes for a further 6 months from the date of the expiry of the current Order.

The Order imposed will apply from 12 November 2024.

The Order will be reviewed again before its expiry on 12 May 2025.

History of Hearings for James J Hughes