Deborah J Iveson

Profession: Paramedic

Registration Number: PA10136

Hearing Type: Review Hearing

Date and Time of hearing: 12:30 30/10/2015 End: 14:00 30/10/2015

Location: Health and Care Professions Council, Park House, 184 Kennington Park Road, London, SE11 4BU

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

 Allegation found proved at final hearing:

During the course of your employment as a Paramedic with North West Ambulance Service, on 20 July 2011 you attended an emergency call to a patient reported as "unconscious but breathing" (incident number 7357265) and you;

1. Demonstrated poor attitude and/or judgement at the scene of the incident, in that you:
 a). commented to others present at the scene "is [the patient] going in the back of a police van as drunk and disorderly", or words to that effect.

Finding

Preliminary Matters: 

Service

1. The Panel was aware that written notice of these proceedings was posted by first class post to the Registrant at her registered address on 29 September 2015. The Panel was shown documents which established both the fact of the service and the identity of the Registrant’s registered address. The Panel determined that service had been effected in accordance with the Rules.

Proceeding in the absence of the Registrant

2. Ms Carson on behalf of the HCPC submitted that the Panel should proceed with the hearing in the absence of the Registrant.

3. The Panel noted that no communication had been received from the Registrant since an email dated 30 October 2014.

4. The Panel heard and accepted the advice of the Legal Assessor.

5. Whilst noting that a decision to proceed in the absence of a Registrant was one to be taken with caution, the Panel concluded that in this case it was right to do so. Its reasons were as follows:

• The Registrant was not present but had been represented at the hearing on 30-31 October 2013. She was not present or represented at the hearing on 31 October 2014.

• Proper notice of this hearing had been served on the Registrant in accordance with the Rules

• It was right to treat the absence of the Registrant as being a voluntary one.

• The Registrant had not applied for an adjournment and there was no reason to suppose that if an adjournment was in fact granted the Registrant would attend a subsequent hearing.

• This was a mandatory review and there was a public interest in proceeding with it.

Background

5. Miss Iveson was employed by the North West Ambulance Service NHS Trust (the Trust) from 1997 and worked for the Transport Service until 2002 when she qualified as a paramedic after working for 2 years as an ambulance technician. 
 
6. On 20 July 2011 at 15.26 Miss Iveson responded to an emergency call in respect of an unconscious male. She was accompanied in the ambulance by an emergency medical technician. Another Paramedic was already at the scene with a police officer. 
 
7. Following a complaint an investigation was conducted in respect of the Registrant’s conduct at the scene and she was dismissed by the Trust following a disciplinary hearing.
 
8. Particular 1a was admitted by Miss Iveson. 
 
9. The Panel on 31 October 2013 found that the ground of misconduct was well-founded because there was a serious attitudinal failure which amounted to a disregard of applicable professional standards on the part of Miss Iveson, in the performance of her duties.
 
10. That Panel also found she had demonstrated insight in respect of her admission and apology in relation to particular 1a. It heard that she accepted with hindsight that her comment was not appropriate and she would not make such a comment again. Her behaviour did not delay the treatment of the service user.
 
11. The original Panel found no issues with the Registrant’s clinical practice. However, that Panel noted the nature of the behaviour displayed and the inappropriateness of the remarks made in public which were of concern to a police officer who was used to interacting with members of the emergency services. 
 
12. Miss Iveson’s dismissal from the Trust for behavioural issues occurred within months of her being given a final written warning for other similar matters. This was not a one off event and the original Panel had no confidence that it would not be repeated. 
 
13. The original Panel found that the aggravating factors included in this case include the fact that the incident took place three months into a three year caution order imposed by a Panel of the HPC in March 2011; although the
circumstances differed there were serious failings in relation to communication with a member of the public in that case also. 
 
14. The original Panel heard that Miss Iveson was not currently practising and decided that conditions of practice were not practicable or sufficient to mark the seriousness of this case. It decided that a suspension order for 12 months struck the correct balance between the public interest and the interests of Miss Iveson and would give her the opportunity to fully regain her health and reflect on the matters arising. 

15. The Panel that reviewed the case on 31 October 2014 directed that the Registrant should be suspended for a further period of 12 months from the expiration of the then current order. That Panel also made the following observations;

In her email of 30 October 2014 Miss Iveson states that she has been promoted from a store assistant to a deputy manager working for a retail company. She says she has moved on with her life, learned from any mistakes and adapted to another work environment. She feels the time is now right to consider other options and wishes to move forward. She wishes to seek employment with a private ambulance company as an emergency medical technician and attend courses to refresh and update her practicing skills.  She has requested that consideration is given to conditions of practice or a continued suspension. 
The original Panel found that Miss Iveson needed to reflect upon her misconduct and suggested that she could assist the reviewing Panel by providing specific and verifiable evidence that she has recognised and addressed the serious failings in her communication with, and attitude towards the public. She has provided no specific response to this suggestion today. The original Panel also noted that Miss Iveson had some health issues and decided that a period of suspension would allow her to regain her health. She has provided no further information today in regards to her current state of health… 
The Panel today would reiterate the advice of the original Panel in respect of the further steps which may assist a future reviewing Panel. Such a Panel is also likely to be assisted by evidence of relevant courses of study undertaken, and references from Miss Iveson’s current employer commenting upon her communication with and attitude towards members of the public. It is also likely to assist if she attends in person at a future hearing. The Panel would remind Miss Iveson that she is able to request an early review of the further suspension order made today, if new information becomes available.” 

16. The Panel today has reviewed the above order.

17. The Panel considered the submissions of Ms Carson for the HCPC.  She submitted that the Registrant’s fitness to practise was still impaired and that the appropriate and proportionate order was one for this Panel to determine. She did however submit that a conditions of practice order would not be appropriate in this case and asked the Panel to consider what purpose would be served by a further suspension order.

18. The Registrant has made no representations or submissions to this Panel and none have been made on her behalf.

19. The Panel heard and accepted the advice of the Legal Assessor.

20. The Panel was aware that it had all the powers that are set out in Article 30 [1] of the Order and which are fully summarised in the letter written to the Registrant by the HCPC and dated 29 September 2015.

21. The Panel was aware that the process under Article 30 [1] of the Order was one of review and not one of appeal and that its function was to determine whether the Registrant’s fitness to practise was still impaired and if so whether the existing Suspension Order now under review remains the appropriate and proportionate means of public protection or should be varied or replaced by some other sanction or outcome.

22. This Panel concluded that the Registrant’s fitness to practise is still impaired and consequently that an order remains necessary. Its reasons are as follows;

•  This Panel had regard to the nature and the gravity of the facts found proven .The Registrant has not engaged with the HCPC and has not produced any evidence to demonstrate remediation, remorse or insight. She has not produced any of the material that was identified by the Panel on 31 October 2014 as being helpful on a further review. The Panel further concluded that there was a risk of repetition. In the absence of any evidence of remediation or insight this Panel concluded that the considerations that operated in October 2014 are still valid and as a consequence the Registrant’s fitness to practise remains impaired by reason of misconduct. Moreover the Panel considered that having regard to all the matters set out above, public confidence in the profession of Paramedic, in the HCPC, its commitment to maintaining proper standards within the profession   and in its regulatory processes would be undermined if a finding of current impairment to the Registrant’s fitness to practise was not made.

23. Having concluded that the Registrant’s fitness to practice was still impaired, the Panel proceeded to consider what order or other outcome was appropriate, proportionate and sufficient to protect the public and safeguard the public interest. This Panel took into account the principles of proportionality balancing the interests of the Registrant with the public interest.

24. The Panel had regard to the contents of the Indicative Sanctions Policy and was aware that sanctions should be considered in ascending order of severity. This Panel was aware the purpose of sanctions is not punitive but to protect members of the public and to safeguard the public interest. The latter objective includes maintaining standards within the profession, together with public confidence in the profession and in its regulatory processes.

25. The Panel has concluded that a striking off order is necessary to protect the public and is otherwise in the public interest.
The reasons for its decision are as follows;
• Given the serious nature of the misconduct that had been established at the substantive hearing together with the evident failure by the Registrant to address her failings it would be inappropriate and wholly insufficient in terms of the public interest to conclude this case by making no order or by making a caution order.
• The Panel considers that there is a real risk of repetition should the Registrant be in unrestricted practice without having remedied the failings and deficiencies that have been established.
• A  Conditions of Practice order is not appropriate as no conditions can be formulated which would address the issues identified by the original panel.
• The Registrant has not sought to engage with this review process and has not submitted any of the material suggested by the Panel that reviewed the case in October 2014 as being of assistance to this Panel.  
• In all the circumstances of this case the Panel has concluded that no purpose would be served by a further period of suspension and that the only appropriate and proportionate sanction that would adequately address the issues identified in this case is one of striking off.

Order

The Panel directed that the Registrar strike the name of Miss Deborah J Iveson from the Register.

Notes

This order will come into effect on expiry of the current order.

Hearing History

History of Hearings for Deborah J Iveson

Date Panel Hearing type Outcomes / Status
30/10/2015 Conduct and Competence Committee Review Hearing Struck off