James Flood

Preliminary Matters
Service
1. The Panel was provided with a signed certificate as proof that the Notice of Hearing (‘the Notice’) had been sent, by email, to the Registrant, on 17 October 2024. The certificate confirmed that the Notice had been sent to the email address held for the Registrant on the HCPC register.

2. The Panel accepted the advice of the Legal Assessor and was satisfied that notice had been properly served in accordance with The Health Professions Order 2001 (hereafter ‘the Order’) and Rules 3 and 5 of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (hereafter ‘the Rules’).

Proceeding in absence of the Registrant
3. Ms Bernard-Stevenson, appearing on behalf of the HCPC, made an application for the hearing to proceed in the Registrant’s absence, as permitted by Rule 11 of the Rules. Ms Bernard-Stevenson submitted the following to the Panel:
i. Notice had been served in accordance with the Rules;
ii. the case is of some age, dating back to 2022;
iii. the Registrant had voluntarily absented himself;
iv. no application for an adjournment had been made by the Registrant and there was no indication before the Panel that if it adjourned the hearing that the Registrant would attend;
v. if the Panel adjourned the hearing it would be a significant and lengthy period of time before the matter could be relisted;
vi. the Registrant had provided no indication that he wished to be represented for the purposes of the hearing and it is reasonable to conclude that he has waived the right to representation;
vii. whilst there may be some disadvantage caused to the Registrant if the Panel proceeded with the hearing in the Registrant’s absence, the Registrant has had an opportunity to attend the hearing and had elected not to do so. Further, the Registrant had provided submissions to the HCPC and the Panel could have regard to those representations when considering the matters before it; and
viii. there is a general public interest in the case proceeding, having regard to the age of the matter it is in both parties’ interests that the Allegation be addressed and matters resolved today.

4. The Panel accepted the advice of the Legal Assessor and took into account the guidance as set out in the HCPTS Practice Note “Proceeding in the Absence of the Registrant”.

5. The Panel determined that it was reasonable and in the public interest to proceed with the hearing for the following reasons:
i. Notice had been properly effected;
ii. the Panel noted that the Registrant sent an email to HCPC, dated 20 November 2024, timed at 14.18pm, which stated: ‘I did receive it and there is nothing else I need to add’. At the moment I’m unable to attend as I can’t get time off work. Will that be ok or will that have a negative impact on the outcome’. The Panel was satisfied, having regard to the Registrant’s email, that it was reasonable to conclude that the Registrant was aware of today’s hearing and that his non-attendance was voluntary and therefore a deliberate waiver of his right to attend and participate in person;
iii. there had been no application to adjourn the hearing and no indication from the Registrant that he would be willing or able to attend on an alternative date if the hearing was adjourned. Therefore, re-listing the hearing would serve no useful purpose;
iv. the Panel recognised that there may be some disadvantage to the Registrant in not being able to make oral submissions to it. However, the Panel noted that the Registrant had voluntarily absented himself from the hearing and had previously provided written submissions to the HCPC, which were included within the HCPC bundle of documents, and these representations went some way to mitigate any potential disadvantage to the Registrant not being able to present his case to the Panel; and
v. there is a strong public interest in ensuring that the Allegation is considered expeditiously and similarly, it is also in the Registrant’s own interest that the Allegation is heard as soon as possible.

Privacy application
6. Ms Bernard-Stevenson, invited the Panel to conduct the parts of the hearing pertaining to the Registrant’s health and family life in private. She submitted that conducting parts of the hearing in private would protect the Registrant’s right to a private life.

7. The Panel accepted the Legal Assessor’s advice which had drawn its attention to Rule 10 of the Rules. The Panel also had regard to the HCPTS Practice Note on “Conducting Hearings in Private” and it had regard to Ms Bernard-Stevenson’s submissions. The Panel also carefully considered the public interest grounds in the case being heard in public.

8. Having considered Ms Bernard-Stevenson’s application, the Panel was satisfied that the matters pertaining to the Registrant’s health and family life should be heard in private to maintain the Registrant’s right to a private life. The Panel was satisfied, having considered the matter carefully, that the Registrant may suffer disproportionate damage if it did not hear the parts pertaining to his health in private. The Panel was also satisfied that it would be feasible, given the matters to be raised before it, to move between public and private session and therefore the hearing could be conducted in part-private.

9. The Panel therefore ordered that the matters concerning the Registrant’s health and family life be conducted in private.

Background
10. The Registrant is a registered Paramedic with the HCPC. The Registrant was previously employed in this capacity by ID Medical Group (‘the Agency’) at the Grange University Hospital.

11. On 20 January 2022, the Registrant was arrested for driving a motor vehicle whilst under the influence of alcohol.

12. On 07 February 2022, having pleaded guilty to an offence of driving a motor vehicle having consumed excess alcohol at High Wycombe Magistrates’ Court, the Registrant was disqualified from driving for 23 months (with the option to reduce his driving disqualification to 17 months by completing the drink drive awareness course) and a fine.

13. On 10 February 2022, within three days of his conviction, the Registrant submitted a self-referral regarding his conviction to the HCPC.

14. On 27 June 2022, further to an investigation undertaken by the HCPC, an Investigating Committee (‘IC’) referred the following Allegation to a panel of the CCC:
‘As a registered Paramedic (PA051330) your fitness to practise is impaired by reason of conviction and/or health. In that:
1. On 7 February 2022 at High Wycombe Magistrates Court, you were convicted of the offence of ‘drive a motor vehicle when alcohol level above limit’ on 20 January 2022.

2. You suffer from one or more health conditions set out in Schedule 1.

3. By reason of your conviction and/or health your fitness to practise is impaired.

15. On 12 July 2024, the Health Committee (‘HC’) accepted the HCPC’s application to discontinue the health ground and transfer the misconduct ground to the CCC on the basis that there was no longer a realistic prospect of impairment on the grounds of health. The Allegation was therefore amended to the Allegation as set out above (at the start of this determination). An amended notice of Allegation was sent to the Registrant on 7 August 2024.

16. On 27 August 2024, the HCPC provided the Registrant with the following list of documents, and indicated that it considered that the Registrant’s case was one which could properly be dealt with by consensual disposal:
i. Panel decision for the discontinuance of health ground – 12 July 2024;
ii. Amended notice of Allegation;
iii. Disposal by Consent Practice Note;
iv. Consent Pro Forma for Registrant’s; and
v. Consent Order.
17. In correspondence with the HCPC, the Registrant indicated that he would be agreeable to the suggestion of the matter being disposed of by consent, and he duly completed and returned the appropriate forms on the same date (27 August 2024).

Submissions
HCPC
18. Ms Bernard-Stevenson submitted the following to the Panel:
i. a twelve-month Caution Order would be appropriate in this case;
ii. the Panel should follow the principles set out in R v Home Office Policy and Advisory Board for Forensic Pathology;
iii. the Registrant’s conduct was isolated and has not been repeated;
iv. the Registrant has reflected on his conduct and completed his sentence;
v. the Registrant has reviewed and made full admissions in respect of the Allegations put forward;
vi. the Allegation is accepted by the Registrant;
vii. the Registrant has accepted that a 12-month Caution Order would be appropriate in the circumstances of this case;
viii. the Registrant has been provided with the relevant guidance and will have had an opportunity to take advice before agreeing to consensual disposal by means of a 12-month Caution Order;
ix. the 12-month Caution Order provided sufficient public protection and anything in excess of this would be disproportionate; and
x. it would not be detrimental to the wider public interest to dispose of this matter by way of a 12-month Caution Order;
xi. the purpose of sanction is not to punish the Registrant but should protect the public and deter Registrants from acting in a similar manner, and to promote and protect public confidence in the profession and the regulatory process;
xii. the HCPTS sanction policy outlines that a Caution Order is likely to be appropriate where the issue is isolated, there is a low risk of repetition and the Registrant has shown good insight and undertaken appropriate remediation. It is evident that all of these factors are present in this case; and
xiii. the HCPC therefore submits a 12-month Caution Order would be an entirely fair and proportionate disposal of this matter.

Decision
19. The Panel carefully considered the HCPC’s application and the written and oral submissions of both parties. It accepted the legal advice of the Legal Assessor. Although the Panel delivered its decision and reasons in one determination, the Panel considered each ‘stage’ of the fitness to practise process separately. First deciding facts; then grounds and current impairment and finally the appropriate sanction.

20. The Panel is aware that it may accept the disposal consented to, or alternatively, in accordance with the HCPTS’ Practice Note “Disposals of Cases by Consent” the Panel may set the case down for a Substantive Hearing.

21. The Panel took into account that the parties are in agreement as to the appropriate disposal of the case. However, it has made its own decision on each stage of the fitness to practise proceedings and whether it agrees that the consent to a sanction is proportionate and meets the needs of public protection.

22. The Panel first considered whether the facts of the Allegation, that the Registrant, on 07 February 2022 at High Wycombe Magistrates Court, was convicted of the offence of driving a motor vehicle when his alcohol level was above the legal limit was made out. The Panel noted that this offence occurred while the Registrant was not working in his capacity as a paramedic. The Panel had the Registrant’s admission as to the facts, contained in his signed pro-forma application for disposal by consent. In accordance with the HCPC’s processes, the Panel accepted the Registrant’s admission as proof of the facts. Notwithstanding the Registrant’s admission, the Panel also noted that it had before it the Certificate of Conviction which outlined that the Registrant had been convicted of the aforementioned offence. The Panel therefore found the facts, set out in particular 1 of the Allegation, proved.

23. The Panel next considered whether the facts found proved amounted to a statutory ground. The Panel noted that ‘conviction’ was a statutory ground under Article 22(1)(a) of the Health Professions Order 2003. Consequently, having regard to the certification of conviction presented to it, the Panel found that the statutory ground of ‘conviction’ was also made out.

24. The Panel next considered whether the Registrant’s fitness to practise is currently impaired. It took into account that the Registrant had admitted the same in his application for disposal by consent. The Panel was mindful that the matter of impairment of fitness to practise is for its own judgement.

25. The Panel took into account that the question is as to any current fitness to practise impairment. The Panel also considered the HCPTS’ Practice Note ‘Fitness to Practise Impairment’.

26. The Panel first considered whether the Registrant was currently impaired on the ‘personal’ component (the current behaviour of the Registrant) and then considered whether he was impaired on the ‘public’ component (the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession).

27. In addressing the personal component of impairment, the Panel asked itself whether the Registrant is liable now or in the future to repeat the conduct of the kind that led to his conviction. In reaching its decision the Panel had particular regard to the issues of insight, remorse and remediation.

28. The Panel noted that the Registrant had accepted, in the signed pro-forma application for disposal by consent, that he was currently impaired. Whilst the Panel noted that the Registrant had not attended today’s proceedings, it also determined that the Registrant could be considered to have engaged extensively, and in a meaningful way, throughout the regulatory process. In forming this view, the Panel noted that the Registrant had: made a self-referral to the HCPC, in a timely manner; provided submissions to the HCPC in respect of his conviction; and had made admissions to the Allegation before it. The Panel also noted that the Registrant had, in his submissions to the HCPC, expressed remorse for his actions and had also demonstrated some developing insight into the factors which led to his conviction. Additionally, the Panel also noted that the Registrant claimed to have ceased consuming alcohol, and it also noted that it had evidence before it that he had successfully completed his ‘drink drive’ rehabilitation course. In this regard, the Panel considered that the Registrant had also undertaken some remediation.

29. However, whilst the Panel considered that the Registrant had taken some positive steps, the Panel was not satisfied that the Registrant had demonstrated full insight into his actions or had remediated matters fully. The Panel noted, for example, that the Registrant had not provided any medical evidence to support his contention that he had ceased consuming alcohol, or that he had engaged with GP services. Further, he had also not provided any evidence to suggest that he had undertaken any continuing professional development, nor had he provided detailed reflections on the potential impact of his actions on public safety and/or the wider public confidence in the Paramedic profession. In view of this, the Panel concluded that the Registrant still posed an ongoing, albeit low, risk to the public.

30. The Panel also concluded that the Registrant’s actions in consuming alcohol and driving his motor vehicle when he was above the legal limit to drive, brought the profession into disrepute, breached fundamental tenets of the profession. In view of the fact that the Panel had determined that the Registrant had demonstrated some, but not full, insight into the ramifications of his actions, the Panel was left concluding that the Registrant is currently impaired on the personal component.

31. The Panel next considered whether the Registrant’s fitness to practise is impaired on public interest grounds. In considering the public component the Panel had regard to the public interest, which included the need to maintain confidence in the profession and declare and uphold proper standards of conduct and behaviour.

32. The Panel was of the view that the reasonably informed member of the public would consider the Registrant’s conviction to be serious. He had been convicted of driving a motor vehicle, having consumed so much alcohol that he was over the legal driving limit. In view of the nature of Paramedic practice, the Panel considered that the Registrant should have been very alive to the potential ramifications of his actions both on himself, as the driver of his own motor vehicle, but also of the potential lethal impact on other road users or members of the public.

33. The Panel was of the view that the public have to be able to trust healthcare professionals to act with integrity both at home and/or at work. Having been convicted of an offence the Panel was satisfied that the public’s trust and confidence in the Registrant would have been undermined. Further, the Panel also considered that public trust and confidence in the wider Paramedic profession, alongside the need to maintain confidence in the wider profession and to declare and uphold proper standards, would be undermined if a finding of impairment were not made in the circumstances of this case.

34. The Panel therefore concluded that the Registrant’s fitness to practise is currently impaired on the wider public interest component also.
35. Having determined that the Registrant’s fitness to practise is currently impaired, the Panel went on to consider the matter of sanction.

36. The Panel accepted the legal advice that it had to be guided by the HCPC’s Sanctions Policy (May 2019). The Panel therefore considered the sanctions from the least serious restriction, in order to be proportionate.

37. Having found that there is a risk, albeit low, to the public from which it requires protection, the Panel considered that either referring the matter to mediation or taking no action did not meet the need for public protection.

38. The Panel next considered a Caution Order and paid particular regard to Paragraph 101 of the Sanctions Policy which states:
‘…
• 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.’

39. In determining that a Caution Order was the appropriate order to impose, the Panel had regard to the following:
i. the Registrant’s actions could be considered to be isolated. He had not repeated them, nor had there been any other complaints made against him since the offence date (2022) and over two years prior to today;
ii. the Panel had identified that there was a low risk of repetition of the Registrant’s actions;
iii. whilst the Panel considered that the Registrant had shown developing insight, the Panel considered that he had demonstrated insight into the causes of his actions at the time; and
iv. the Panel also noted the Registrant had undertaken some remediation (the ‘drink-drive’ rehabilitation course).

40. Therefore, having regard to the aforementioned, the Panel concluded that the minimum sanction which is sufficient to protect the public is to impose a Caution Order for a period of twelve months. The Panel considered that twelve months was appropriate so as to allow the Registrant a further opportunity to reflect on his actions and to ensure that they would not be repeated by him moving forward. The Panel also considered that the public will be protected by a Caution Order because the Registrant will understand, should his actions be repeated during this time, they would likely be raised as part of any further fitness to practise matters considered by a future panel. In this regard therefore, the Panel considered that the public could have some assurance as to the Registrant’s future conduct.

41. Having regard to the Sanctions Policy, and the next sanction available to it, the Panel considered that a conditions of practice order would not be workable or appropriate in this case given the Registrant’s conviction derived from his conduct in his private life and not whilst undertaking his role as a Paramedic. Therefore, the Panel considered that there were no conditions of practice which could be formulated to mitigate this.

42. Furthermore, the Panel also considered a suspension order to be disproportionate at the current time. In forming this view, the Panel noted that this was an isolated incident, the Registrant had demonstrated insight, there was a low risk of his actions being repeated and, as previously outlined, the Registrant’s conduct had not arisen whilst working as a Paramedic. The Panel considered that there was also a public interest in ensuring a competent Paramedic practitioner remains in service.

43. For all of these reasons, the Panel agreed to the imposition of a 12-month Caution Order, by consent.

44. The draft Consent Order provided to the Panel will be signed on behalf of the Panel by the Panel Chair. The Panel approves the Disposal by Consent as requested by the parties.

The Registrar is directed to annotate the Register entry of Mr James Flood with a caution which is to remain on the HCPC Register for a period of 12 months 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 James Flood