Richard Gough

Preliminary Matters
Application for a Partly Private Hearing
1. Mr Schofield made an application for the hearing to be conducted partly in private. He submitted that the Registrant has a right to privacy and during the hearing it was likely that there would be some reference to the Registrant’s health. He submitted that the Registrant should make his submissions and any oral evidence in private so that he would not have the anxiety of trying to alternate between public and private matters. However, Mr Schofield further submitted that he would be able to make his submissions, on behalf of the HCPC, in public save for any reference to the Registrant’s health which should be heard in private. The Registrant supported the application.

2. The Panel took into account the HCPTS Practice Note – Conducting Hearings in Private and noted that Rule 10(1)(a) of The Health and Care Professions Council (Conduct and Competence) (Procedure) Rules 2003 states that:
‘…the proceedings shall be held in public unless the Committee is satisfied that, in the interests of justice or for the protection of the private life of the health professional, the complainant, any person giving evidence or of any patient or client, the public should be excluded from all or part of the hearing;…’.

3. The Panel was mindful of the ‘open justice principle’ which, in general, requires justice to be administrated in public and noted that a private hearing is the exception to the norm. The Panel also noted that the Registrant has the right to a private life. Therefore, the Panel was satisfied that any reference to the Registrant’s health should be heard in private to ensure that this aspect of the case does not form part of the public record.

4. The Panel concluded that the health matters and the non-health matters are inextricably linked from the Registrant’s perspective. The Panel accepted Mr Schofield’s submission that the Registrant was likely to find it difficult to revert between private and public sessions. The Panel took the view that this would cause significant disruption to the flow of the proceedings and may cause unfairness.

5. For these reasons, the Panel concluded that the Registrant’s submissions and any oral evidence would be heard in private. It determined that all other aspects of these proceedings would be heard in public unless they relate to the Registrant’s health.

Application to Amend
6. Mr Schofield, on behalf of the HCPC, made an application to amend the Allegation by insertion of the following words: “As a registered Paramedic (PA24127) …”. He submitted that the proposed amendment is minor in nature, provides clarity and would not cause any unfairness to the Registrant. The Registrant did not raise any objections.

7. The Panel noted that when referring the Allegation to this Committee, the Investigating Committee omitted the usual preamble. The Panel was satisfied that this preamble provides helpful clarification and does not alter the substance or meaning of the Allegation as originally drafted. In these circumstances, the Panel was satisfied that the amendment would not prejudice the Registrant. For these reasons, the application was granted.

Background
8. The Registrant is registered with the HCPC as a Paramedic. He has been a Paramedic since 2007 and was employed by the Vocare NHS 111 Service (Vocare) from 1 August 2022 as a Clinical Adviser until his resignation on 22 July 2023.

9. On 25 July 2023, the Deputy Head of Clinical Services (‘the Referrer’) of Vocare submitted a referral to the HCPC. The Referrer informed the HCPC that the Registrant’s probation period had been extended “after the usual 6 months due to issues around attendance at work.” However, on 27 June 2023, a member of staff (Person A) raised a concern. The Referrer stated that the Registrant and Person A were friends in the workplace and outside of work but there had been a disagreement. It was stated that Person A had received some inappropriate messages from the Registrant via WhatsApp and as a consequence she no longer felt comfortable in his company.

10. The Referrer informed the HCPC that an internal investigation was launched on 28 June 2023. The Referrer was the investigating officer. The Referrer stated that she had been interviewing various members of staff within the call centre as well as Person A and the Registrant. The Referrer was due to finish the report and had anticipated that the most likely outcome would be mediation and “maybe swapping shifts so they didn’t have to work together.” However, over the weekend of 21-23 July 2023, the Registrant sent Person A “a series of abusive messages, including threats that some of his friends would hurt her, she should never walk in his street, his ‘girl’ is going to give her a lesson soon, ‘I will bump into you at some point, just be ready’, ‘you will get what you deserve, you have earned it.’” The Referrer stated that text messages had also been sent to an Operational Team Manager during the same time period with threats towards Person A – “‘I’m going to have her fucked over’ ‘I hate her, ive told her Ive gone after her kids’ ‘You don’t **** on your own people , unless you want a scar’ ‘They are going to kick her head in’ ‘she wont be killed but she will be hurt (sic)’”

11. The Referrer informed the HCPC that Person A contacted the police on 23 July 2023 and reported the messages and threats.

12. The HCPC subsequently received confirmation from the police that the Registrant had been charged with harassment on 29 September 2023.

13. The police report states that Person A removed her SIM card from her mobile phone on 20 July 2023 as she had a new device and did not insert this SIM card into her new phone until 23 July 2023. When she installed the SIM card, she received a stream of messages that had been sent by the Registrant. During the Registrant’s police interview, he stated that Person A started ‘blanking’ him at work which made him uncomfortable. He found out that Person A had submitted a complaint against him related to a message he had sent to her, but she would not provide any explanation when he confronted her and continued to ignore him. The Registrant admitted that he sent a barrage of messages. When the messages were presented, the Registrant became emotional. He apologised and expressed remorse.

14. The report states that Person A felt threatened by the messages and believed that the threats were genuine. This caused her to fear for her safety and the safety of her family. The Registrant was initially offered a conditional caution, but he refused to accept this outcome. Following the decision to charge the Registrant, he changed his mind about the conditional caution. However, given his initial response, the police believed that he would fail to comply with any conditions.

Decision on Facts and Grounds
The Panel’s Approach
15. 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 particular of the Allegation could only be found proved, if the Panel was satisfied, on the balance of probabilities.

16. In reaching its decision the Panel took into account the documentary evidence including the Memorandum of Conviction. The Panel also took into account the HCPC Practice Note entitled ‘Conviction and Caution Allegations.’ The Panel was aware that in accordance with Rule 10(1)(d), it could not go behind the conviction and was required to accept a certified certificate of conviction as conclusive proof of the conviction itself and the underlying facts.

Decision
Particular 1 – Found Proved
“‘On 31 October 2023, you were convicted at Dudley Magistrates Court of “Harassment put in fear of violence” …”

17. The Panel was provided with a Memorandum of Conviction in the name of the Registrant. The Panel noted that the Memorandum of Conviction, was not certified by a court officer. However, the Panel was satisfied based on the totality of the evidence in the hearing bundle (including the police disclosure) and the Registrant’s admission that on 31 October 2023 he pleaded guilty to harassment and was therefore convicted of the offence. In reaching this conclusion, the Panel accepted the Registrant’s admission as clear and unambiguous confirmation that he entered a guilty plea to harassment at Dudley Magistrates’ Court on 31 October 2023.

18. The Panel noted that the matter was adjourned for pre-sentence reports and on 4 December 2023, the sentence imposed was as follows:

i. A 12-month Community order with:
· a Mental Health Treatment Requirement.
· a Rehabilitation activity Requirement (up to a maximum 15 days).
· an Unpaid Work Requirement (100 Hours).
ii. Restraining order.

19. The Panel was satisfied that the facts had been proved, and the statutory ground of conviction had been established.

Decision on Impairment
Submissions on behalf of the HCPC
20. Mr Schofield submitted that the Registrant’s fitness to practice is impaired based on both the personal and public component of the public interest. He referred the Panel to the emails the Registrant sent when he was subsequently employed by DHU Healthcare. He submitted that these emails indicate that the Registrant’s ability to communicate effectively with colleagues may run deeper than the one-off incident in relation to Person A.

21. Mr Schofield invited the Panel to note that the strategies the Registrant says he took included resigning from Vocare, but this did not stop him from sending the messages to Person A. He submitted that in the absence of sufficient remedial action there remains a risk of repetition. He further submitted that the “heinous and hateful nature” of the Registrant’s messages require a finding of impairment to protect the wider public interest.

The Panel’s Approach
22. In considering whether the Registrant’s fitness to practise is currently impaired, the Panel took into account the oral evidence of the Registrant and the submissions of both parties. 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.

23. 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
31. The Panel considered the Registrant’s current fitness to practise firstly from the personal perspective and then from the wider public perspective.

32. The Panel considered the HCPC Standards of Conduct and Ethics [2016 Edition] and was satisfied that the Registrant’s conduct and behaviour represented a significant departure from standard 9.1 which states:

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

33. The Panel was mindful that the Registrant’s messages to Person A were threatening in nature, insulting and persistent (albeit during a period of less than 24 hours). The Registrant’s behaviour which led to his harassment conviction demonstrated a course of conduct which represented a significant breach of the high standards of personal conduct and behaviour expected of a registered practitioner. The Panel took the view that such conduct was inherently serious. However, the Panel concluded that the Registrant’s underlying behaviour was capable of being remediated provided that he was able to demonstrate sufficient insight to demonstrate his conduct was firmly in the past and was highly unlikely to be repeated.

34. The Panel noted that the Registrant pleaded guilty at an early stage of the criminal proceedings. Although this may have been (at least in part) due to the strength of the evidence, the Panel also noted that the Registrant apologised during his police interview and expressed remorse. He also accepted during his oral evidence that his behaviour towards Person A was “abhorrent.”

35. The Panel noted that the Registrant had written a letter of apology to Person A in which he stated (amongst other things):

“As I have said in my statement to the police, I cannot apologise enough to explain how much regret I have for that. I didn’t even remember most of it and I broke down in tears when the police officer told me what I had written, the number of texts and length of texts that I sent. It was horrid, personal and intimidating. Worst of all, not a bit of it was even true.

I can only imagine the hurt, upset, and distress this must have caused you is not something I can recall, and for this I cannot apologise enough to you and those close you who must have been supporting you.

Whatever the close friendship I perceived, it cannot excuse the barrage of abuse that I sent you via text you that night. These actions were inexcusable, and I only hope you now can see and perceive that these actions say more about me, than they do about you.”

The Panel concluded that the Registrant’s letter to Person A demonstrated empathy, remorse (which the Panel accepted as genuine) and a degree of insight into the impact of his behaviour and the consequences of his actions.

36. The Panel did not consider the Registrant’s email correspondence whilst employed by DHU Healthcare to add anything of substance to its assessment of impairment. The Panel accepted the Registrant’s submission that this email communication was of a different nature and character to the behaviour underlying his conviction. Furthermore, it did not provide a sufficient basis upon which the Panel could conclude that the Registrant has an attitudinal deficiency.

37. However, the Panel was not satisfied that the level and scope of the Registrant’s insight is fully developed. During his oral evidence, the Registrant primarily focused on himself. The Panel was particularly concerned that, at times, the Registrant appeared to minimise the seriousness of his behaviour. He repeatedly emphasised that he and Person A were personal friends and that he had been “betrayed” and “bullied” by her. In terms of the steps the Registrant has taken to avoid re-occurrence these were limited in nature and the Panel had little confidence he would have control of his emotions if a similar situation were to arise.

38. The Panel took the view that, in the absence of any meaningful reflection on the impact of his criminal conduct on Person A and her family, and evidence to the contrary, there is an on-going risk that the Registrant’s behaviour would be repeated. The Panel took into account the character references that the Registrant provided. These were from a clinical support lead and a clinical adviser. However, the Panel was only able to afford these references limited weight as their names were redacted and they did not appear to have been provided for the purposes of these proceedings.

39. The Panel concluded that, for the reasons stated above, the Registrant’s fitness to practise is currently impaired based on the personal component. 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.

40. The Panel noted that paramedics occupy a position of trust, and the role necessarily involves demonstrating high standards of personal conduct at all times. The Registrant’s conduct fell far below the standard expected of a registered practitioner. The Panel concluded that it is unacceptable for a paramedic to make repeated threats towards a colleague, including where that colleague has also been a friend. The Panel concluded that the Registrant’s conduct and behaviour risked causing harm to Person A and his criminal conviction breached a fundamental tenet of the profession and brought the profession into disrepute. The Panel concluded that a reasonable and well-informed member of the public would be extremely concerned by the Registrant’s criminal conviction. The public have a legitimate expectation that all HCPC registered professionals will abide by the law and avoid exposing others to the risk of harm. As a consequence, the Panel was satisfied that public confidence in the profession and in the HCPC as a regulator would be undermined if a finding of impairment was not made, given the seriousness of the Registrant’s conviction.

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

42. It was not possible to conclude the case at the first listing and accordingly the hearing was adjourned for sanction to be dealt with on another date.

Decision on Sanction
43. The case resumed on Friday 31 January 2025. The same persons were present, save for the changes as reflected on the first page of this determination.

44. In reaching its decision on sanction, the Panel took into account the submissions made by Ms Mosely and those made by the Registrant, together with all the relevant evidence and all matters of personal mitigation. The Panel also referred to the guidance issued by the Council in its Sanctions Policy. The Panel had in mind that the purpose of sanctions was not to punish the Registrant, but to protect the public, maintain public confidence in the profession and maintain proper standards of conduct and performance. The Panel was also cognisant of the need to ensure that any sanction is proportionate. The Panel accepted the advice of the Legal Assessor.

45. Acknowledging that the offence itself was serious, the Panel did not consider there to be any aggravating factors in this case.

46. The Panel considered there to be the following mitigating factors:

• admissions to the police and a guilty plea at court;
• no previous adverse findings before the HCPC;
• an isolated, out of character incident in an otherwise unblemished 23 year career as a Paramedic;
• no repetition of the behaviour in the 18 months since the offence;
• an unsolicited, sincere letter of apology to the victim at a very early stage;
• genuine remorse;
• appropriate remedial steps taken by attending courses on professional boundaries;
• much improved and genuine insight demonstrating the Registrant had read the Panel’s decision on current impairment very carefully and reflected further on his behaviour and its impact upon the victim;
• a low risk of repetition - as reflected in the Probation Service Pre-Sentence Report (provided for the sanction hearing, but not seen at the time of considering current impairment - see more below);
• the provision of an additional testimonial from a Consultant Paramedic, who was aware of this hearing and the allegation faced by the Registrant (see more below).

47. The Consultant Paramedic said that it came as a shock to him to hear of the allegation of harassment by the Registrant and of making threats to a female colleague, describing it as out of character. It was not the type of behaviour or a trait of the Registrant’s that he had ever been aware of, having known the Registrant for many years. He said that the Registrant was valued by colleagues and well-liked amongst his peers. He said the Registrant is and always was "a safe clinician and never placed patients in harms way.”.

48. The Pre-Sentence Report provided the Panel with some helpful additional information, not previously seen. The Probation Officer described how the Registrant displayed “genuine remorse” during their interview, with the Registrant saying he was “embarrassed looking at the things he has said and tells me that he has never done anything violent to anyone before so he doesn’t know why he was saying the things he was.”. The Probation Officer assessed the Registrant as posing a low risk of re-offending.

49. The Registrant addressed the Panel at length. He said his letter of apology was heart-felt and expressed the remorse he felt at the time and still feels about the way he behaved. He said he wrote it of his own volition and invited the Panel to consider it to be both highly reflective of his behaviour and insightful. He added that, after writing the letter, he had an overwhelming sense of guilt. With regards to the way the Panel had said he came across when addressing them at the impairment stage, the Registrant acknowledged that his responses had concentrated on himself and he apologised for that. He said he was attempting to explain the situation he found himself in. He said in his 23 year career he had never transgressed before or after and that he has, since this episode, established more robust professional boundaries. He assured the Panel that this was an isolated incident and that “It will not happen again.”

50. The Registrant noted philosophical changes in his approach to life and the Continuing Professional Development he has completed during his Interim Conditions of Practice Order. He assured the Panel that he took these proceedings very seriously and said he had “strived to make amends” and take stock of his life and career. He has been able to identify his strengths and how best to contribute to the Paramedic profession. He said he was not currently working and financially had used all his savings. He was worried that, as the only income earner, he may lose his house if unable to gain employment soon. He told the Panel about two potential roles in education and training that he had applied for, having recognised that this was where his skills now lay. He did not want to return to frontline Paramedic roles, such as in an ambulance or working for the 111 service.

51. The Panel found the Registrant to be much more reflective and insightful in addressing the Panel at the sanction stage. It was clear, and encouraging, that he had given careful thought to the Panel’s decision on current impairment. He had, thereby, demonstrated a much more satisfactory level of insight and persuaded the Panel that the risk of his repeating such behaviour was low. The Registrant had clearly given careful thought to the areas of work that he should now pursue, thereby avoiding the more stressful front-line work.

52. Notwithstanding the extensive mitigation in this case, the Panel did not consider this was an appropriate case to take no further action or consider mediation. Neither disposal would reflect the seriousness of the conviction and the need to maintain public confidence in the profession.

53. The Panel next considered whether a Caution Order would adequately reflect the seriousness of the conviction. The Panel’s role, as indicated by the Sanctions Policy, was not to punish the Registrant twice for the same offence, but to protect the public, maintain high standards amongst registrants and maintain public confidence in the profession.

54. The Policy suggests a Caution Order might be appropriate in cases in which:

• the issue is isolated, limited, or relatively minor in nature;
• there is a low risk of repetition;
• the registrant has shown good insight; and
• the registrant has undertaken appropriate remediation.

55. The Panel is satisfied that the offending behaviour in this case was isolated, essentially a one-off and very much out of character. It could not, however, be characterised as relatively minor in nature. The contents of the messages sent to Person A were, as the Registrant acknowledged, abhorrent. They were threatening in nature and frightening for Person A to receive. That said, the Panel is now satisfied, following the information received at the sanction stage, that there is a low risk of repetition, the Registrant has shown good insight and has undertaken appropriate remediation.

56. However, in light of the seriousness of the behaviour, the Panel went on to consider more onerous sanctions before coming to a decided position.

57. The Panel therefore considered whether a Conditions of Practice Order would be appropriate. The Panel noted that the Registrant had been subject to an Interim Conditions of Practice Order for some time and had complied with it. The conditions included completing CPD relevant to the issues identified in this case and the Registrant had done that. There were, therefore, no other matters that needed to be addressed by way of conditions. There has never been any question about his skills as a clinician and thus no areas of his practice outstanding where conditions might have a role to play.

58. The Panel therefore looked at the guidance in the Sanctions Policy about when a Suspension Order might be the appropriate sanction. This is a case where, in the Panel’s view, a Suspension Order could be justified. However, in light of the extensive mitigation, the Panel formed the view that such a sanction would only serve to punish the Registrant for a second time.

59. In all the circumstances, the Panel concluded that a Suspension Order would be disproportionate in this case. The Panel thus returned to the Sanctions Policy and noted the following guidance:

“A caution order should be considered in cases where the nature of the allegations mean that meaningful practice restrictions cannot be imposed, but a suspension of practice order would be disproportionate. In these cases, panels should provide a clear explanation of why it has chosen a non-restrictive sanction, even though the panel may have found there to be a risk of repetition (albeit low).”

60. The Panel considered this case fell within that guidance and that accordingly a Caution Order would be appropriate. It was out of character and occurred once in an otherwise blemish-free career as a Paramedic. There are no concerns about the Registrant’s clinical skills and a professional colleague has spoken of him as a well-valued and liked Paramedic who is a safe clinician. Importantly, he has now shown much better insight into his behaviour and the risk of repetition has thereby been further diminished.

61. Accordingly, notwithstanding its earlier observations in paragraphs 37 and 38 above, the Panel is now much more reassured about the level of reflection and insight shown by the Registrant and considers there is not a need to restrict his practice.

62. The Panel therefore makes a Caution Order. The Order is for two years to reflect the seriousness of the conviction. The Registrant should be in no doubt that any finding of current impairment by his regulatory body is a serious matter and he should not take this Caution lightly.

The Registrar is directed to annotate the Register entry of Mr Richard Gough with a Caution which is to remain on the Register for a period of two years from the date this Order comes into effect.

Right of Appeal
You may appeal to the High Court in England and Wales against the Panel’s decision and the Order it has made against you.

Under Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you. The Panel’s Order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

History of Hearings for Richard Gough