Jasmine Fletcher
Profession: Paramedic
Registration Number: PA40016
Hearing Type: Voluntary Removal Agreement
Date and Time of hearing: 10:00 20/02/2024
End:
17:00 20/02/2024
Location:
Virtually via video conference
Panel: Conduct and Competence Committee
Outcome: Voluntary Removal agreed
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Allegation
Whilst registered as a paramedic and employed by South Western Ambulance Service NHS Foundation Trust;
1) On or around 2 November 2016, while attending Service User 6, you:
a) Did not carry out a drugs check (“Med check”) before administering drugs to Service User 6.
b) Incorrectly administered Benzylpenicillin to Service User 6 instead of hydrocortisone.
2) On or around 27 November 2016, while attending Service User 5, you did not recognise that Service User 5 was experiencing partial seizure activity.
3) On or around 9 January 2017, while attending Service User 1, you:
a) Did not recognise that Service User 1 was possibly septic.
b) Did not recognise that Service User 1 had an elevated National Early Warning Score (NEWS).
c) Did not provide a pre-alert to the hospital.
4) On or around 10 January 2017, while attending Service User 2, you:
a) Did not assess Service User 2 for:
i) Photophobia
ii) Rashes
iii) General Behaviour
iv) Dehydration
b) Did not display knowledge of:
i) The importance of red flags in Paediatric fever and/or illnesses.
ii) Kernigs and/or Brudzinski signs.
5) On or around 25 January 2017, while attending Service User 3, you:
a) Did not administer Entonox to Service User 3 until you were advised by a colleague to do so and/or did not recognise that Entonox could be administered prior to taking a set of observations.
b) Did not consult the Joint Royal Colleges Ambulance Liaison Committee Guidelines until prompted to do so by a colleague before administering:
i) Ondansetron
ii) Morphine
6) On or around 26 January 2017, while attending Service User 4, who was in severe respiratory distress, you:
a) Used an inappropriate method to gain information in that you attempted to have a conversation with Service User 4.
b) Requested an inadequate level of back up.
7) Not Proved
8) The matters set out in paragraphs 1 - 7 constitute lack of competence.
9) By reason of your lack of competence your fitness to practise is impaired.
Finding
Preliminary Matters
1. The Panel has been asked to give effect to a Voluntary Removal Agreement (“VRA”) entered into by both the Registrant and the HCPC. The hearing was originally scheduled as a review of a substantive Conditions of Practice Order, but at the request of the Registrant the application was changed to that being considered.
Service of the notice of hearing.
2. The Panel was satisfied that the email dated 22 January 2024 informing the Registrant that the present hearing would take place constituted a valid notice of hearing. That email gave notice that the Conditions of Practice Order would be reviewed, but nothing turns on the fact that the hearing is concerned with the VRA as the change has taken place as a result of a request by the Registrant.
Proceeding in the absence of the Registrant.
3. After the Panel stated that it was satisfied that there had been good service of the notice of hearing, the Presenting Officer applied for a direction that the hearing should proceed in the absence of the Registrant. She drew the attention of the Panel to an email written by the Registrant’s Solicitor on 13 February 2024 in which it was stated, “I confirm that [the Registrant] will not attend or be represented at her Voluntary Withdrawal hearing and consents to the hearing proceeding in her absence.”
4. In deciding whether to accede to the application, the Panel followed the guidance contained in the HCPTS Practice Note entitled, “Proceeding in the Absence of the Registrant”. The Panel concluded that in view of the clear statement in the email sent by the Registrant’s Solicitor dated 13 February 2024, the fact that the Registrant had signed the VRA and did not suggest that she would be minded to participate in a hearing on another occasion, it was appropriate to proceed with the hearing in the absence of the Registrant.
Background
5. The Registrant is a Paramedic registered with the HCPC. On 30 May 2016 the Registrant joined the South Western Ambulance Service NHS Foundation Trust (“the Trust”) as a graduate Paramedic, having completed a Paramedic degree at the University of Worcester. She was assigned a mentor/preceptor with whom she was to undertake two weeks of shifts. She completed a local induction, a manual handling assessment and an emergency driving course.
6. However, the Registrant did not in fact receive the full supported practice she was entitled to as a preceptee, having only worked a few shifts with her preceptor before the preceptor went off sick. A preceptorship period of six months is something that all staff, including newly qualified paramedics undergo at the Trust. It allows them to work under the supervision of a more experienced paramedic for an initial set of eight shifts and then once a month for the rest of the six month period. Newly qualified paramedics can be given any assistance and support they might need during this initial period and then hopefully signed off as able to practice independently after this period.
7. Between 23 January 2024, and 30 January 2024, a panel of the Conduct and Competence Committee considered the allegations set out at the head of this document. They found all of the factual elements of the allegation (save for particular 7) to be proven, and that those facts amounted to a lack of competence. When it addressed the issue of current impairment of fitness to practise, the final hearing panel recorded the fact that the Registrant had not worked as a Paramedic for many years and had undertaken no Continuing Professional Development since 2019. It concluded that it could not be satisfied that the Registrant could provide safe and effective practice and there accordingly remained a risk of future harm to patients. That panel therefore made a finding of current impairment of fitness to practise on both the personal and public components of that concept.
8. The sanction imposed by the final hearing panel was a Conditions of Practice Order for a period of 12 months. The conditions of the Order imposed were as follows:
1. When updating your knowledge and skills as part of the HCPC’s return to practice requirements you must complete at least 30 days of supervised practice. The remaining days can be made up of any combination of formal study, private study and/or supervision.
2. Your supervised practice must be with a Practice Placement Educator registered with the HCPC.
3. Your Practice Placement Educator must be provided with a copy of this determination so that they are aware of the issues that have previously arisen with your practice and which need particular attention.
4. You must provide the HCPC with a report from your Practice Placement Educator when you have successfully completed all aspects of the return to practice requirements, in accordance with these conditions, confirming this to be the case.
5. You must promptly inform the HCPC if you take up any employment as a Paramedic.
6. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer, when employed as a Paramedic.
7. You must inform the following parties that your registration is subject to these conditions:
A. any organisation or person employing or contracting with you to undertake professional work;
B. any agency you are registered with or apply to be registered with (at the time of application); and
C. any prospective employer (at the time of your application).
9. The 12 months Conditions of Practice Order was due to expire on 27 February 2024, and as has already been stated, was scheduled to be reviewed today. On 2 February 2024, the Registrant’ Solicitor wrote an email in the following terms:
“I met with [the Registrant] today and she advised:
• She has not worked as a paramedic since 2017 and did not manage to secure work as a paramedic after her HCPC conditions were imposed last year;
• She has now secured a new job working on maintenance of overhead lines for National Grid. She absolutely loves this work and it is the first time since 2017 that she has felt herself to be “on her way back up out of the spiral”;
• She believes the only potential outcome at her forthcoming review hearing would be for the Panel to extend the conditions on her registration, to afford Jasmine a further opportunity to secure employment [as a paramedic] notwithstanding her conditions;
• She doesn’t think there is a realistic possibility of her being able to resurrect her career as a paramedic at this stage;
• She also doesn’t feel mentally robust enough to go through another public HCPC hearing;
However, she does not wish to be ‘struck off’ the HCPC register.”
10. On 19 February 2024, the Registrant’s Solicitors sent an email to the HCPC’s Solicitors in which the following was stated:
“I confirm that I did discuss this [i.e. the signing of the VRA] with [the Registrant]……. . However, I had a Teams with her to go through the document and she went next door with her laptop in order for her neighbour to act as the witness to her (electronic) signature.”
11. The Panel was provided with a full skeleton argument dated 16 February 2024, prepared by the Presenting Officer. The Panel was satisfied that this document provided a clear, appropriately detailed and objectively justified explanation of the HCPC’s agreement to the VRA.
Decision on Application
12. The Panel accepted the advice it received from the Legal Assessor and followed the guidance contained in the HCPTS Practice Note entitled, “Disposal of Cases by Consent”. Accordingly, it addressed four issues, namely:
• Whether the Registrant was truly seeking removal from the HCPC Register, and fully understood the terms of the VRA.
• Whether the VRA had been properly and fully executed, and, in particular, whether it contained an acceptance of the decision made by the final hearing panel so that finding could be applied in the event of a future application for re-admission to the Register.
• Whether agreeing to the VRA taking effect would afford a proper degree of public protection.
• Whether there were any other public interest considerations that would make voluntary removal from the Register inappropriate.
13. When the Panel addressed these four considerations, it decided:
• The emails from the Registrant’s Solicitor on 2 February 2024 and 19 February 2024 referred to above make it clear that the Registrant does indeed wish to be removed from the HCPC Register and fully understands the effect of the VRA.
• The VRA is in proper form, has been executed by the Registrant (and the HCPC) and contains an acceptance by the Registrant of the findings made by the final hearing panel.
• Giving effect to the VRA would provide a proper degree of public protection. To do so would provide the same consequence (albeit without any associated stigma) of a striking off order, yet as the finding against the Registrant was one of lack of competence, such an outcome would not have been available had the hearing proceeded as originally intended as a review of the Conditions of Practice Order.
• There are no other public interest considerations that would suggest that voluntary removal would not be appropriate. The allegation against the Registrant was one of lack of competence. Although serious, they did not involve behaviour of the most egregious nature. More importantly, this is a post-final hearing application for voluntary removal, and, accordingly, the allegations made against the Registrant have not been removed from public scrutiny.
14. It followed from these findings that the Panel agreed to the VRA having effect. Accordingly, the Panel will direct the Registrar to remove the name of the Registrant from the HCPC Register with immediate effect.
Order
ORDER: The Registrar is directed to remove the name of Jasmine Fletcher from the Register with immediate effect.
Notes
No notes available
Hearing History
History of Hearings for Jasmine Fletcher
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 20/02/2024 | Conduct and Competence Committee | Voluntary Removal Agreement | Voluntary Removal agreed |
| 23/01/2023 | Conduct and Competence Committee | Final Hearing | Conditions of Practice |