During the course of your employment as a Paramedic with South East Coast Ambulance Services NHS Trust you:
1. Submitted an altered fitness to work certificate; and/or
2. Changed the date on it from 1 December 2010 to 7 December 2010;
3. Your actions at paragraph 1 and 2 were dishonest;
4. The matters set out in paragraphs 1 – 3 constitute misconduct.
5. By reason of your misconduct your fitness to practise as a paramedic is impaired.
Ms Elia made an application to amend the allegation to separate the two issues in particular 1 of submitting an altered fitness certificate and changing the date of the certificate from 1st December 2010 to 7th December 2010. The proposed amendment is set out in the HCPC case summary. Ms Elia submitted that no new matters were introduced by the proposed amendment and that Mr Taylor was not prejudiced by the amendment. Mr Connelly, on behalf of Mr Taylor, did not object to the amendment. The Panel balanced the interests of Mr Taylor and the public interest and decided to allow the amendment.
The Panel decided that parts of the case should be heard in private on the ground that it was necessary to protect the private life of Mr Taylor and other individuals. The Panel heard the following evidence in private:
• Evidence relating to Mr Taylor’s health (with the exception that evidence relating to Mr Taylor’s shoulder injury in 2010 was heard in public with Mr Taylor’s consent)
• Evidence relating to the family circumstances and health of LC
• Evidence of a matter relating to Child A’s ability and vulnerability
Mr Taylor was employed as a Band 5 paramedic by South East Coast Ambulance Service NHS Trust (the Trust). At the date of his dismissal by the Trust on 13th July 2012 Mr Taylor had been employed in the ambulance service for twenty six years.
On 15th November 2010 Mr Taylor had an accident on his push bike on his way to work and dislocated his shoulder. He provided a self certificate up to 24th November 2010. On 24th November he was issued with a one week sick certificate from his GP at Mr Taylor’s local GP surgery. On 1st December 2010 Mr Taylor was issued with a further GP certificate for one week by another GP. This certificate was provided at Mr Taylor’s request, but Mr Taylor did not see that GP. It was common practice at Mr Taylor’s GP surgery for follow on certificates to be issued on request by the patient without the GP seeing the patient. Mr Taylor did not provide any further sick certificates covering his absence to the Trust.
Mr Taylor reported to the Trust that he was fit for work on 13th December 2010. His first day back at work under his rota was 18th December 2010. No certificate had been provided to the Trust to cover Mr Taylor’s absence from 8th December 2010 to 13th December 2010. Ms AC was a Clinical and Operations Manager and she was the manager of Mr Taylor’s supervisor. She made requests for Mr Taylor to produce a sickness certificate for the period 7th to 13th December 2010. AC agrees that she made a request for an incorrect period because the request should have been to cover the period 8th to 13th December 2010. On 5th January 2011 AC made a request for Mr Taylor to have a meeting with her to discuss his sickness absence and for him to provide the missing sick certificate. The meeting did not go ahead because Mr Taylor had a rest day. A similar request was made on 18th January 2011. Again the meeting did not go ahead because Mr Taylor was working at a different location. The similar request was made on 27th January and a meeting took place on 2nd February 2011. Mr Taylor did not bring the sick certificate to the meeting and AC made a further request for the outstanding certificate in a letter dated 17th February 2011.
AC asked her station administrator to contact payroll to arrange for the appropriate reduction to be made from Mr Taylor’s pay. On 7th March 2011 a letter from HR advised Mr Taylor that seven days’ pay would be deducted. On or about 10th March 2011 Mr Taylor e-mailed a copy of a certificate and sent a copy in the post to HR. This certificate appears to be dated 7th December 2010, but in fact this certificate is an forgery. It was created by changing the two dates on the valid 1st December sick certificate from 1 to 7. Mr Taylor agrees that this certificate is a forgery and he also agrees that the forgery is obvious when the two certificates of 1st and 7th December are compared.
The forgery on the certificate was identified and Mr Taylor was invited to a meeting on 8th July 2011. At this meeting Mr Taylor was shown both certificates and he immediately agreed that there was a forgery. Mr Taylor stated that his daughter, Child A, had found the certificate and that she may have made the changes to the certificate.
The Trust contacted Mr Taylor’s GP surgery with his permission to enquire about a certificate for 7th December 2010. The response was that Mr Taylor was issued with a certificate on 1st December 2010. There was no record of a certificate dated 7th December 2010, but this may be an administrative error.
On 15th August 2011 the Professional Standards department of the Trust were asked to investigate an alleged fraud. The investigation was carried out by DW who is a Professional Standards Manager.
Child A wrote two cards which were sent to managers at the Trust apologising for writing on the certificate. Mr Taylor’s position at this time is set out in his letter dated 23rd September 2011. He stated that he was now doubtful that he had requested a certificate from his GP surgery for 7th December 2011 and that it is possible that he booked fit to return to work on 8th December 2011. His position at that time was that the certificate must have been altered by Child A.
On 15th December 2011 Mr Taylor was suspended and he was dismissed by the Trust on 13th July 2012 following a disciplinary hearing. The conclusion of the Trust was that Mr Taylor had altered the certificate.
At the time of these events and for six years previously Mr Taylor lived with his partner LC. LC was also employed by the Trust as an Ambulance Technician. On 8th March 2013 LC telephoned SM, Mr Taylor’s solicitor, and asked to meet with him to discuss Mr Taylor’s employment tribunal claim. SM advised her that he could not meet with her without Mr Taylor’s permission. Mr Taylor later telephoned SM and advised him that LC had told him that she had changed the certificate. Mr Taylor was furious, angry and upset. After these events LC left the family house and the relationship ended. SM spoke to LC who confirmed that she had changed the certificate. In August 2013 SM took a statement from LC.
Decision on Facts
The Panel heard evidence on behalf of the HCPC from AC and from DW. The Panel also heard evidence by telephone from SS who is the Practice Manager of Mr Taylor’s GP surgery. The Panel read the statements of HS who is a Production Team Manager and RR, solicitor at Kingsley Napley. The Panel found that the witnesses called by the HCPC were credible. They gave their evidence fairly and clearly.
On behalf of Mr Taylor the Panel heard the evidence of LC and Mr Taylor and read the statement of SM. The Panel found that LC was a credible witness. The Panel found that Mr Taylor was generally a credible witness, except on one important point. The reasons for not accepting Mr Taylor’s evidence in its entirety are set out below.
The Panel also read testimonials, which confirm Mr Taylor’s honesty and trustworthiness in the experience of the person providing the testimonial. In relation to the character statements the Panel applied the advice of the Legal Assessor that statements as to Mr Taylor’s honesty and trustworthiness were relevant and could be taken into account when considering Mr Taylor’s credibility. Having considered the testimonials the Panel found that Mr Taylor is someone who is generally honest and trustworthy. The Panel took this into account in their assessment of the whole of the evidence.
The Panel found that Mr Taylor had submitted an altered fitness to work certificate. Mr Taylor admits that he did so, and the Panel is satisfied that the certificate was altered. The two certificates dated 1st December and 7th December are identical in every respect except for the two dates. The Panel therefore found that particular 1 is proved.
The Panel found that Mr Taylor did not alter the date on the certificate. This is because the Panel accepted on the balance of probabilities that LC changed the date. LC gave an explanation, which was credible, for why she changed the certificate and why she did not come forward at an earlier time.
LC had a reason to change the certificate. She knew that a certificate was required and that without it a deduction would be made from Mr Taylor’s pay. LC was particularly concerned about this because at the time the family could not afford any reduction in pay because of the costs of moving house.
LC did not come forward and explain that she had altered the certificate at an earlier time because she knew that she would lose her job, her home and her relationship with Mr Taylor. In full knowledge of these consequences she decided to come forward in March 2013. She had received counselling and she was prompted by Mr Taylor’s distress about the situation and the fact that Kingsley Napley were seeking to interview Child A. The Panel was surprised that LC did not come forward even when Child A was blamed for altering the certificate, but were satisfied that the explanation for her conduct is LC self interest at this time because of the very severe consequences for her which would result if she came forward.
Having found that particular 1 is proved the Panel considered whether Mr Taylor’s actions were dishonest. The Panel found that Mr Taylor knew that the certificate could not have been genuine. Mr Taylor denies that he knew this and on this point the Panel did not accept his evidence.
The Panel found that Mr Taylor returned to work on 18th December 2010. Mr Taylor does not dispute this and it is confirmed by the self certification form signed by Mr Taylor dated 21st December 2010, the return to work interview form also signed by Mr Taylor on 22nd December 2010 and the GRS record which shows that Mr Taylor reported fit for work on 13th December 2010.
The Panel found on the balance of probabilities there was no certificate for 7th or 8th December 2010. The evidence from the GP practice, confirmed by SS, is that it is possible that there was an administrative mistake at the GP surgery and that a certificate was issued. However, there is a record of the two previous certificates issued to Mr Taylor on 24th November 2010 and 1st December 2010. The Panel’s view on the balance of probabilities is that it is more likely that Mr Taylor overlooked the need to renew his certificate.
The Panel found that at the time Mr Taylor was first asked to provide a certificate on 5th January 2010 the events would have been fresh in his mind and Mr Taylor would not have been confused about when he had returned to work. He did not challenge the suggestion that he needed a certificate for 7th December 2010. Mr Taylor, was an experienced member of staff and had been absent from work due to sickness on a number of occasions. He knew that there was a requirement for a sick certificate. Mr Taylor did not respond to any of the requests to provide a certificate. On the balance of probabilities the Panel found that Mr Taylor’s failure to respond to the correspondence by providing a certificate or stating that a certificate was not required was because he knew that he did not have a certificate. Mr Taylor’s explanation is that he did not focus on the letters because he had more important things to attend to at the time. The Panel did not accept that this is a sufficient explanation. Mr Taylor was aware that pay might be deducted because he was warned about this in the letter dated 17th February 2011. The possibility of pay being deducted was a very serious issue for the family at this time.
The Panel’s view that Mr Taylor did not believe at this time that a certificate existed is reinforced by DWs’ investigation log. This records that Mr Taylor claimed in a telephone call on 8th March 2011 that he had worked on 7th December 2010, 11th and 12th December 2010. Mr Taylor was unable to recollect this. If Mr Taylor genuinely believed that there was a certificate and that it was lost he would not have claimed that he had returned to work. Only two days later Mr Taylor sent an altered sick certificate to the Trust.
The Panel’s view that Mr Taylor knew that he did not have a certificate is also reinforced by the fact that he did not go to his GP surgery himself to ask them to check their records. The GP surgery is close to Mr Taylor’s home and is a friendly practice.
Mr Taylor had a motive for submitting a certificate that he knew was not correct. His family could not afford to lose the money that was liable to be deducted from his salary. He was under pressure from LC on this point. Mr Taylor knew that he did not have a valid certificate for 7th December 2010. When the certificate was provided to him by Child A he would have been surprised. He would have looked at it carefully. The Panel agrees with Mr Connelly’s submission that the forgery is clumsy and foolish. On the balance of probabilities the Panel concluded that Mr Taylor knew that the certificate could not have been genuine. He very quickly admitted the forgery when he was shown both certificates at the interview on 8th July 2011.
Mr Taylor knew that the certificate was not genuine. Although he was not personally responsible for making the alteration he submitted the document. His action was dishonest because he knew he was submitting a certificate which was not genuine and by the standards of reasonable and honest people this is dishonest.
The Panel therefore concluded that Mr Taylor’s action in submitting an altered fitness to work certificate was dishonest.
Decision on Grounds
The Panel applied its professional judgment in considering whether the dishonest action of Mr Taylor in submitting an altered fitness to work certificate constituted misconduct. This is a breach of the trust and confidence which is essential in the employment relationship. It is also a breach of the HCPC Standards of Conduct, Performance and Ethics paragraph 3 which requires that you must maintain high standards of personal conduct, paragraph 14 which requires that you must behave with integrity and honesty and paragraph 16 that you must make sure that your behaviour does not damage your profession’s reputation. Mr Taylor’s conduct fell below the standards of honest and reasonable people and well below the standards that are expected of a paramedic.
The Panel therefore concluded that his action constituted misconduct.
Decision on Impairment:
The Panel considered the submissions of Ms Elia and Mr Connelly and had regard to the guidance in the HCPC practice notice “Finding that Fitness to Practise is Impaired”. The Panel considered whether Mr Taylor’s fitness to practise is impaired at today’s date.
The Panel first considered the personal component. The Panel took into account Mr Taylor’s good character and is satisfied that the dishonest conduct it has found is an isolated incident and will not be repeated. The Panel is also satisfied that Mr Taylor is a competent practitioner.
The Panel next considered the public component. The public component includes the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession. Mr Taylor accepts that the conduct the Panel has found is wrong, but he denies his conduct. He has therefore not demonstrated full insight. In the Panel’s view this is not a case where the conduct can be remedied. There is no risk to service users in this case, but it is important that the Panel’s decision upholds proper standards of behaviour and maintains public confidence in the profession. Mr Taylor has breached a fundamental tenet of the profession and it is important that the seriousness of his misconduct is marked by the Panel. In the Panel’s judgment it was necessary for the Panel to conclude that Mr Taylor’s fitness to practise is currently impaired to declare and uphold proper standards of behaviour and to maintain public confidence in the profession. This is necessary because a paramedic reading this decision might take the view that a similar serious act of misconduct might be treated in the same way.
The Panel therefore concluded that Mr Taylor’s fitness to practise is currently impaired.
Decision on Sanction:
The Panel considered the submissions of Ms Elia and Mr Connelly and applied the guidance in the HCPC Indicative Sanctions Policy. The Panel identified the following aggravating circumstances.
• Mr Taylor does not have full insight
• Breach of trust in the employment relationship
• Mr Taylor’s actions caused his young daughter to become involved
The Panel identified the following mitigating circumstances.
• Mr Taylor was caught up in a silly mistake which escalated
• The stressful circumstances at the time impaired Mr Taylor’s judgment
• Mr Taylor suffered a genuine injury and it is likely that he would have been able to obtain a sick certificate
• This is an isolated incident
• At the time Mr Taylor made an offer to repay the money
• Many testimonials from fellow paramedics
• Mr Taylor’s previous unblemished record of twenty six years service
In considering sanction the Panel had regard to the nature of the dishonest conduct. In the Panel’s judgment this was an isolated and silly error by Mr Taylor that escalated out of his control. The Panel considered the sanctions in ascending order of severity. The Panel decided that it would be not be appropriate to take no further action because this would not be sufficient to mark the seriousness of the dishonest conduct. Mediation is not appropriate in this case. The Panel considered carefully the guidance in the Indicative Santions Policy on a Caution Order. The guidance suggests that a Caution Order is a possibility in a case involving dishonesty. The Panel considered the guidance in full and took the view that a Caution Order is the appropriate and proportionate sanction in this case. The benchmark for a Caution Order is three years and Panels should start with a one year caution and only impose a caution for a longer period if the facts of the case make it appropriate to do so. The Panel’s view was that the facts of this case did make it appropriate to impose a caution order for more than a year, and for more than the benchmark of three years. This is because of the wider public interest considerations which are the deterrent effect to other registrants, the reputation of the profession and public confidence in the regulatory process. This case involves dishonesty and the wider public interest considerations are particularly important for the reasons stated above in the Panel’s decision on fitness to practise. The Panel decided that the appropriate and proportionate sanction is a caution order for five years.
The Panel considered the more severe sanctions of a conditions of practice order, a suspension order or a striking off order. A conditions of practice order is not appropriate because it cannot address the issue of dishonesty. The Panel decided that a suspension order or a striking off order were not appropriate or proportionate having regard to the nature of the dishonesty in this case and the mitigating factors.
The Registrar is directed to annotate the register entry of Michael Taylor with a caution which is to remain on the register for a period of five years from the date this order comes into effect.
The Registrant has a right of appeal to the High Court of England and Wales.