Mr Marcus J Galligan

Profession: Paramedic

Registration Number: PA11676

Hearing Type: Final Hearing

Date and Time of hearing: 09:00 30/08/2016 End: 16:00 02/09/2016

Location: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

Whilst registered as a Paramedic, on 9 March 2015, you:


1. Took an inadequate amount of equipment into the premises to treat Service User A for potential breathing difficulties in that it did not include:


a) Oxygen; and/or
b) Means to deliver oxygen; and/or
c) Relevant respiratory drugs;


2. Made an inappropriate comment to Service User A, in that you said words to the effect of "this is all bullshit";


3. Did not undertake an adequate assessment of Service User A, in that you did not carry out the following observations/assessments:


a) Primary Survey;
b) Two complete Secondary Surveys;
c) Blood Pressure;
d) 3-Lead ECG;
e) Full chest examination;


4. Recorded on a Patient Report Form that you had carried out the following observations/assessments in relation to Service User A when you had not done so:


a) Primary Survey;
b) Two complete Secondary Surveys;
c) Blood Pressure;
d) 3-Lead ECG;
e) Full chest examination;


5. Provided a false account in incident form 72053, in that you claimed that you had to leave the premises due to the threat of violence from Person B, without Service User A having signed the Patient Report Form;


6. Made an assumption that Service User A was intoxicated based on an inadequate assessment of her;


7. Made an inappropriate child welfare referral in respect of Service User A;


8. Your actions described in particulars 4, and 5 were dishonest;


9. Your actions described in particulars 2, 5 and 8 constitute misconduct;


10. Your actions described in particulars 1, 3, 4, 6 and 7 constitute misconduct and/or lack of competence;


11. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.

Finding

Background


1. The Registrant is a Paramedic and a Registered Nurse. He was employed as an Emergency Care Practitioner (ECP) at the West Midlands Ambulance Service NHS Foundation Trust (the Trust). He joined the Trust in 2002.

2. In the early hours of the morning on 9 March 2015 the Registrant was called out to a YMCA to treat Service User A, a 17 year old girl, who was presenting with breathing difficulties. The allegation relates to the Registrant’s assessment of Service User A, his use of equipment, record keeping and a comment he made.

3. Following a complaint made by Service User A’s boyfriend (Person B) an internal investigation was instigated by the Trust. The Registrant resigned from the Trust during the course of the investigation.

Preliminary matters


4. At the outset of the hearing Ms Turner made an application for the witness statement of Service User A to be admitted into evidence as hearsay as the HCPC was unable to secure her attendance. The application was opposed by Mr Toms on behalf of the Registrant.

5. Having considered and accepted the Legal Assessor’s advice the Panel determined that the hearsay evidence should be admitted for the following reasons:

• Services User A’s evidence is relevant because she was the patient concerned.

• The Panel accepted the advice of the Legal Assessor and recognised the limitations of hearsay evidence particularly the inability to test this evidence by cross examination.

• It was fair to admit Service User A’s evidence as the Panel could attach the appropriate weight, if any, to it at the end of the fact finding stage.

Assessment of Witnesses

Witness 1


6. In the Panel’s view, Witness 1 was a credible and reliable witness. He provided the Panel with a fair and measured view of his interviews with the Registrant, Service User A, Person B and the YMCA supervisor based on the preliminary investigation that he carried out. He acknowledged the limitations of his investigation, in that it was not completed due to the Registrant resigning from his post. He made concessions as appropriate when questioned by Mr Toms on behalf of the Registrant.

DT


7. DT provided character evidence on behalf of the Registrant via telephone. DT is a Registered Nurse who had worked at the Trust for several years. He spoke highly of the Registrant, whom he had known for a long time, and although he was not aware of the admissions that had been made this did not change his view of the Registrant. He stated that he would be reassured if the Registrant was ever required to treat one of his sons.

TB

8. TB provided character evidence on behalf of the Registrant via telephone. She and the Registrant had both worked regularly together as Nurse Practitioners between July-November 2015 and intermittently thereafter. TB was aware of the admissions the Registrant had made and provided a positive testimonial of the Registrant’s work with patients, particularly young patients.

MF


9. MF attended in person to provide an oral testimonial on behalf of the Registrant. MF is a retired Paramedic. He worked with the Registrant for many years, the most recent occasion being 2 years ago. He was aware of the admissions the Registrant had made and expressed surprise that the allegation had been made as this was out of character. MF provided a positive assessment of the Registrant’s clinical knowledge and his interpersonal skills.

The Registrant


10. The Registrant chose to give oral evidence. Overall the Panel found the Registrant to be a credible and reliable witness. However, at times his responses to questions were guarded, lacked sufficient detail and he was unable to explain many of his actions.


Decision on Facts


The Panel’s Approach


11. 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 individual particulars of the Allegation could only be found proved if the Panel was satisfied on the balance of probabilities.

12. In reaching its decision the Panel took into account the written evidence which included the original hearing and exhibits bundle, the Registrant’s witness statement, his response to the charges, his reflective account, testimonials from his former colleagues and letters confirming three occasions when the Registrant reported being assaulted whilst on duty.

13. The Panel viewed CCTV recordings from the YMCA premises, taken on the night in question, which included a recording of the Registrant’s examination of Service User A and his interactions with Person B.

14. The Panel also took into account the submissions from both parties and accepted the advice of the Legal Assessor.

Stem of Allegation


15. As there was no dispute that the Registrant was registered as a Paramedic on 9 March 2015, the Panel went on to consider the individual particulars in turn.


Particular 1 – Found Proved (in its entirety)


‘Took an inadequate amount of equipment into the premises to treat Service User A for potential breathing difficulties in that it did not include:
a) Oxygen; and/or
b) Means to deliver oxygen; and/or
c) Relevant respiratory drugs.’

16. The Panel noted that the Registrant admitted Particular 1 in its entirety. The Panel accepted the evidence of Witness 1 that all ambulances and response cars contain a green bag. The Panel was informed that the green bag contains oxygen and the equipment needed to treat patients with breathing difficulties. The Registrant took only a defibrillator and a thermometer into the premises, but as the Registrant accepted that he was aware that Service User A was complaining of breathing difficulties, he should also have taken the entire contents of the green bag.


17. If the Registrant had taken the green bag into the premises he would have had immediate access to oxygen, the means to deliver oxygen and relevant respiratory drugs should he have required them to treat Service User A.


Particular 2 – Found Not Proved


‘Made an inappropriate comment to Service User A, in that you said words to the effect of "this is all bullshit"

18. The HCPC’s case was put on the basis that the Registrant used the phrase ‘this is all bullshit’ in a dismissive manner indicating that he was not taking Service User A’s concerns seriously. The Panel noted that the Registrant accepted that he used the word ‘bullshit’ whilst in conversation with Service User A. However, he stated that his use of the word was in the context of explaining to Service User A that that is how it would be viewed if she presented in Accident and Emergency with hyperventilation. The Panel accepted the Legal Assessor’s advice that to find this particular proved the Panel would have to accept Service User A’s account of the context, as that is the basis upon which the case had been put.

19. The Panel proceeded with caution in assessing the hearsay witness statements of Service User A and Person B because in their absence, their evidence could not be tested by cross examination.  The Panel noted that there were some discrepancies in Service User A’s statement. For example, she stated that the Registrant had not made any notes while treating her but on the CCTV recording he could clearly be seen writing for a significant period of time.  The Panel concluded that it could only give limited weight to the statement of Service User A. Therefore, although the use of the word ‘bullshit’ was inappropriate, the Panel could not be satisfied that it was used in the context as described by Service User A.


Particular 3 – Found Proved (in its entirety)


‘Did not undertake an adequate assessment of Service User A, in that you did not carry out the following observations/assessments:
a) Primary Survey;
b) Two complete Secondary Surveys;
c) Blood Pressure;
d) 3-Lead ECG;
e) Full chest examination;’


20. The Panel noted that the Registrant admitted this particular in its entirety. However, the Panel also took into account the top copy and duplicate copy of the Patient Report Form (PRF) completed by the Registrant, the CCTV evidence and the evidence of Witness 1. 


21. The Panel accepted the evidence of Witness 1 that a primary survey includes an initial assessment of the patient’s airway, breathing and circulation. The Registrant  ticked the ‘normal’ box in relation to Service User A’s breathing but also made a handwritten note that she was hyperventilating. He also ticked on the PRF that Service User A’s respiratory rate was ’10-29’, which Witness 1 stated was the normal range. However, the Registrant could not be seen looking at Service User A’s respiratory rate on the CCTV footage. The Registrant indicated on the PRF that he had taken Service User A’s radial pulse. The Panel accepted the evidence of Witness 1 that had the Registrant done so, he would have held Service User A’s wrist and monitored her pulse for a certain period of time.  The CCTV footage confirms that the Registrant did not do this.


22. The Panel accepted the evidence of Witness 1 that a secondary survey should have been completed twice whilst the Registrant was attending Service User A. The first secondary survey must be completed prior to treatment and the second secondary survey must be completed once the treatment has been carried out. The Registrant noted on the PRF that he completed both surveys within 6 minutes of each other. However, the CCTV footage confirms that the Registrant did not carry out all the elements of either the first or second survey.


23. The Registrant indicated on the PRF that he had taken Service User A’s blood pressure as part of the first and second secondary survey. Although the Registrant recorded two readings on the form, at no time on the CCTV footage can he be seen to attach a blood pressure cuff to Service User A’s arm.


24. The Panel accepted the evidence of Witness 1 that if the Registrant had competed a 3 lead ECG the CCTV footage should show him attaching four leads from the defibrillator to four points on Service User A’s body. The CCTV footage confirms that the Registrant did not do this.


25. The Registrant drew a diagram on the PRF of a triangle with an arrow through it. The Panel accepted the evidence of Witness 1 that this diagram indicates to a Paramedic or ECP that a full chest examination had been carried out and that Service User A’s chest was clear. However, the CCTV footage clearly shows that only a partial chest examination took place.


Particular 4 – Found Proved (in its entirety)


‘Recorded on a Patient Report Form that you had carried out the following observations/assessments in relation to Service User A when you had not done so:
a) Primary Survey;
b) Two complete Secondary Surveys;
c) Blood Pressure;
d) 3-Lead ECG;
e) Full chest examination’

26. The Panel noted that the Registrant admitted this particular in its entirety and took into account its findings in relation to particular 3. Having viewed the CCTV recording it was clear to the Panel that the Registrant did not complete the observations/assessments yet he recorded on the PRF that he had done so.

Particular 5 – Found Not Proved


‘Provided a false account in incident form 72053, in that you claimed that you had to leave the premises due to the threat of violence from Person B, without Service User A having signed the Patient Report Form;’

27. The Panel considered the incident report form 72053 together with the supplementary report form 72052 and the Registrant’s detailed note of the incident that took place. Although the Registrant mentions in the report that he advised Person B that ‘he is threatening physical violence to an NHS employee and that if it continued I would call the police’, there is no mention in the form that that is the reason that he left the premises without Service User A signing the PRF.

28. The Panel was constrained by the wording of the particular and concluded that there was insufficient evidence to find it proved.


Particular 6 – Found Proved

‘Made an assumption that Service User A was intoxicated based on an inadequate assessment of her;


29. The Registrant stated in his oral evidence that he made an assumption when he arrived at the YMCA that Service User A was likely to be intoxicated and have problems. He made this assumption because he had been to the YMCA on previous occasions and believed the residents were involved with drugs and alcohol. The Registrant on meeting Service User A established that she had been drinking. He stated that he could smell alcohol on her breath and that her speech was slurred. The Panel noted that in his oral evidence the Registrant confirmed that he did not ask Service User A how much alcohol she had consumed and that, in any event, his view was that patients are not always honest about how much alcohol they had consumed.
30. The Panel noted that Service User A said in her written statement that she had only consumed one drink and part of a second drink before she became unwell. She also stated that she believed her drink had been ‘spiked’.

31. The Panel accepted that it may have been reasonable for the Registrant to consider that intoxication was the reason for Service User A’s presentation, but as a healthcare professional he had a duty to consider differential diagnoses by conducting a full assessment.  A full assessment should have included taking Service User A’s blood pressure. High or low blood pressure can be indicative of medical conditions that affect speech or cognitive awareness. Testing Service User A’s blood sugar would have indicated whether Service User A was suffering from a diabetic issue and an ECG would have indicated if there were any cardiac concerns.


32. The Panel determined that the Registrant was entitled to conclude that Service User A was intoxicated only after he had conducted a full assessment. The Panel was satisfied that the Registrant did not conduct a full assessment and based his judgment on an assumption and an inadequate assessment.

Particular 7 – Found Not Proved

‘Made an inappropriate child welfare referral in respect of Service User A;’


33. The Panel accepted the evidence of Witness 1 and the Registrant that there is arguably no such thing as an inappropriate Social Services referral. The Panel noted that Service User A was 17 years old at the time and by her own admission had been drinking alcohol. The Registrant is not a child protection expert and the Panel recognised that from his perspective the threshold for referral should be low in order to ensure that those with the appropriate expertise can decide whether any intervention is required.


Particular 8 – Found Proved (in relation to particular 4); Found Not Proved (in relation to particular 5)


‘Your actions described in particulars 4, and 5 were dishonest;’


34. The Panel noted that the Registrant admitted dishonesty in relation to particular 4. The Panel was satisfied that the Registrant’s actions in recording that he had carried out observations/ assessments when he had not done so was dishonest by the standards of reasonable and honest people and that the Registrant realised at the time that his actions were dishonest.


35. As the Panel found particular 5 had not been proved, it did not go on to consider dishonesty in relation to this particular.

Decision on Grounds

The Panel’s Approach


36. Having found particulars 1, 3, 4, 6 and 8 (in relation to particular 4) proved, the Panel went on to consider whether the Registrant’s conduct amounted to misconduct and/or lack of competence. At this stage, in view of its finding that particulars 2, 5 and 7 were not proved, these did not form part of the Panel’s consideration.


37. The Panel accepted the advice of the Legal Assessor.


38. In considering the issue of misconduct, the Panel bore in mind the explanation of that term provided by the Privy Council in the case of Roylance v GMC (No.2) [2000] 1 AC 311 where it was stated that:

“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a … practitioner in the particular circumstances. The misconduct is qualified in two respects. First, it is qualified by the word ‘professional’ which links the misconduct to the profession of medicine. Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious.”


39. In considering lack of competence the Panel bore in mind that it connotes a standard of work that is unacceptably low and is usually demonstrated by a fair sample of the Registrant’s work.


Decision on Lack of Competence


40. The Panel noted that the concerns raised with regards to the Registrant’s work related to his treatment on one occasion of a single service user.  In these circumstances the Panel concluded that this did not represent a fair sample upon which the Panel could make a judgment as to the Registrant’s overall competence. The Panel concluded that the Registrant’s acts and omissions did not establish a lack of competence.


Decision on Misconduct


41. In relation to particular 4 (recording on a PRF observations/assessments which were not carried out) and particular 8 (in relation to particular 4) the Registrant accepted that his actions were dishonest and amounted to misconduct. The Panel was satisfied that inputting false observations and/or assessments on a medical record is serious as it has the potential to put patients at risk. Other health professionals rely on the integrity of the entries made by their colleagues to inform subsequent diagnoses and treatment. In this regard the Registrant’s conduct fell below the high standards expected of a registered paramedic and amounts to misconduct.


42. In relation to particulars 1, 3, 6 the Panel concluded that the Registrant’s acts and omissions individually and collectively amount to misconduct.

 

43. The Panel concluded that the Registrant’s acts and omissions were unprofessional and by failing to follow the proper procedures, based on Service User A’s presentation, he exposed her to an unwarranted risk of harm. Ensuring the availability of appropriate equipment and conducting primary and secondary surveys are fundamental to the role of a Paramedic. The Panel noted that the Registrant has additional skills as a Registered Nurse and an ECP. The Registrant’s failure to perform the basic tasks required of a Paramedic is a serious failing.

44. The Panel considered the HCPC Standards of Conduct, Performance and Ethics. The Panel took the view that the Registrant’s actions breached standards 1, 7, 10 and 13 which state:


• “You must act in the best interests of service users.” (Standard 1)


• “You must communicate properly and effectively with service users and other practitioners” (Standard 7)


• “You must keep accurate records” (Standard 10)


•  “You must behave with honesty and integrity and make sure that your behaviour does not damage the public's confidence in you or your profession” (Standard 13)


45. The Panel also considered the following HCPC Paramedic Standards of Proficiency were breached:

• “Understand the need to act in the best interests of service users at all times” (Standard 2.1)


• “Understand the need to maintain high standards of personal and professional conduct” (Standard 3.1)


• “Be able to keep accurate, comprehensive and comprehensible records in accordance with applicable legislation, protocols and guidelines” (Standard 10. 1)

Decision on Impairment

The Panel’s Approach

46. Having found misconduct in relation to Particulars 1, 3, 4, 6 and 8 (in relation to particular 4) the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired. The Panel took into account the HCPC Practice Note: ‘Finding that Fitness to Practise is Impaired’. 
47. In determining current impairment the Panel had regard to the following aspects of the public interest:


• The ‘personal’ component: the current competence, behaviour etc. 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.


48. The Panel accepted the advice of the Legal Assessor.


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


50. The Panel noted that the Registrant was made subject to a 5 year Caution Order in 2010 for failing to carry out the secondary assessment of a patient and failing to record drugs administered to a patient. The Panel was concerned by the similarities between the 2010 matters and the current matters as it suggests that the Registrant has not learnt from his previous experience.


51. In assessing the scope and level of the Registrant’s insight, the Panel noted that his reflective account is not fully developed. Furthermore, in his oral evidence the Registrant was unable to explain adequately for example, why he recorded assessments on the PRF which he had not done. The Panel concluded that the Registrant had not remedied his misconduct because he has not demonstrated an ability to recognise and understand why it took place.  In these circumstances the Panel concluded that there is an ongoing risk of harm to service users and an ongoing risk of repetition. The Panel concluded that for these reasons the Registrant’s fitness to practise is currently impaired based on the personal component.


52. In considering the public component the Panel had regard to the critically important public policy issues which include the need to maintain confidence in the profession and declare and uphold proper standards of conduct and behaviour.


53. The public would expect a regulatory body to address professional conduct, such as this, which falls far below the standards expected of a registered practitioner and for this to be reflected in a finding of impairment. The Panel takes the view that the Registrant poses a risk to service users, has brought the profession into disrepute and has breached fundamental tenets of the profession by acting dishonestly and failing to act in the best interest of Service User A. There is a risk that all of these features are likely to be repeated in the future. In all the circumstances, the Panel determined that on the basis of the ‘public component’ a finding of current impairment was necessary to protect public confidence in the profession and declare and uphold proper standards of conduct and behaviour. 


54. In conclusion, the Panel found that the Registrant’s fitness to practise is currently impaired and therefore the HCPC’s case is well-founded.

Decision on Sanction


Panel’s Approach


55. The Panel accepted the advice of the Legal Assessor. The Panel was mindful that the purpose of any sanction is not to punish the Registrant, but to protect the public and the wider public interest. The public interest includes maintaining public confidence in the profession and the HCPC as its regulator and upholding proper standards of conduct and behaviour. The Panel applied the principle of proportionality by weighing the Registrant’s interests with the public interest and by considering each available sanction in ascending order of severity.


56. The Panel had regard to its findings in relation to misconduct and impaired fitness to practise. The Panel also took into account the HCPC’s ‘Indicative Sanctions Policy’ (ISP) and the submissions made by Ms Turner, on behalf of the HCPC and those made by Mr Toms on behalf of the Registrant.


57. In determining the appropriate sanction, if any, the Panel considered and balanced the mitigating and aggravating factors.


58. The Panel identified the following mitigating factors:


• The Registrant expressed remorse during the preliminary internal Trust investigation conducted by Witness 1 and resigned during the process, which the Panel accepted as his recognition that his actions had undermined the confidence his employer had placed in him;


• The Registrant made a significant number of admissions at the outset of the hearing, through his legal representative, which demonstrated a willingness to accept responsibility for his own actions;


• The Registrant provided 5 positive testimonials from former colleagues who were able to attest to his competence as a practitioner, his clinical knowledge and his care of patients;


• No actual harm was caused to Service User A.

59. The Panel took into account the following aggravating factors:


• The Registrant’s dishonest actions represented a significant and serious breach of the trust that his employers and the public place in Paramedics;


• The Registrant’s shortcomings were basic and fundamental to the role of a Paramedic;


• At the time of the incident on 9 March 2015 the Registrant was subject to a 5 year Caution Order, which had been imposed on 21 June 2010 in relation to an incident that occurred on 9 December 2008;


• Despite receiving a Caution Order in 2010 for misconduct relating to inadequate secondary assessments and record keeping, the Registrant went on to repeat very similar misconduct in respect of Service User A;


• It was evident from Witness 1, the Registrant’s character witnesses and from the evidence of the Registrant himself, that he knows what is expected of him in his role as a Paramedic but chose not to discharge his duties appropriately;


• The Registrant is a highly trained professional with qualifications as an ECP which are above the standards required to perform the role of a Paramedic safely and effectively. He is also a Registered Nurse.

Panel’s Decision

60. The Panel first considered taking no action. The Panel concluded that, in view of the nature and seriousness of the Registrant’s misconduct and in the absence of exceptional circumstances, to take no action on his registration would be wholly inappropriate. Furthermore it would be insufficient to protect the public, maintain public confidence and uphold the reputation of the profession.

61. The Panel went on to consider a Caution Order. The Panel noted paragraph 22 of the ISP which states:

“A caution order is an appropriate sanction for cases, where the lapse is isolated, limited or relatively minor in nature, there is a low risk of recurrence, the registrant has shown insight and taken appropriate action.  A caution order should also be considered in cases where the nature of the allegation means that meaningful practice restrictions cannot be imposed but where the registrant has shown insight, the conduct concerned is out of character, the risk of repetition is low and thus suspension from practice would be disproportionate.  A caution order is unlikely to be appropriate in cases where the registrant lacks insight.”


62. Although the Registrant’s inadequate care and assessment of Service User A could be viewed as an isolated incident, within the context of his career as a whole, the Panel noted that the Caution Order imposed in 2010 was for very similar failings. On both occasions these failings involved fundamental omissions which had the potential to present an unwarranted risk of harm to patients. The current matter cannot be described as minor and is aggravated by the previous misconduct. Given that the Registrant’s actions were repeated within 7 years the Panel was unable to conclude that the risk of recurrence was low and was unable to conclude that a further Caution Order would have any permanent effect on the Registrant’s future behaviour.


63. Furthermore, in view of the Panel’s finding of dishonesty, the Registrant’s limited  insight into his misconduct and whilst the risk of repetition remains, the Panel concluded that a Caution Order would be inappropriate and insufficient to meet the public interest.


64. The Panel went on to consider a Conditions of Practice Order. The Panel bore in mind that any conditions imposed would need to be appropriate, proportionate, workable and measurable. The Panel noted that the ISP states “conditions of practice are unlikely to be suitable in situations where problems cannot be overcome, such as serious overall failings, lack of insight, denial or matters involving dishonesty or the abuse of service users”.

65. The Panel concluded that a Conditions of Practice Order was not workable for three main reasons. First, the Registrant’s shortcomings would require close supervision which would rule out working as a sole responder. Furthermore, the Panel took the view that it would be inappropriate and would represent an unfair burden to expect either a senior practitioner or a junior practitioner to supervise the Registrant.  Secondly, even if conditions could be formulated, in view of the Panel’s patient safety concerns, they would have to involve close supervision and be so restrictive that in effect it would amount to suspension. Thirdly, there are no conditions that could be formulated to address the Registrant’s dishonest behaviour as it is an attitudinal failing. As a consequence a Conditions of Practice Order would not uphold public confidence in the profession and standards of conduct and behaviour.

66. Therefore, the Panel concluded that it would not be possible to formulate appropriate conditions.

67. The Panel next considered a Suspension Order. The Panel noted that a Suspension Order would prevent the Registrant from practising during the suspension period, and therefore to that extent would protect the public. However, there has been no demonstration of sufficiently developed insight and no meaningful reflection by the Registrant. As a consequence the Registrant continues to pose a risk to patients.

68. In the Panel’s view the nature and seriousness of the Registrant’s dishonesty and repeated failings in the fundamental care of a patient seriously undermines public confidence.  There is no evidence that the Registrant has the willingness or ability to perform the role that he has been trained to do without ignoring practice guidelines and protocols. The Panel reached this conclusion having carefully considered the additional training that the Registrant has received as a Registered Nurse and as an ECP, none of which has prevented him from making fundamental omissions in patient care. Furthermore, the 2010 Caution Order should have alerted the Registrant to the consequences of making assumptions and looking for shortcuts. The Panel noted that the 2010 Panel made it clear how seriously it viewed the Registrant’s misconduct.

69. The public have a right to expect that when they dial 999 in an emergency they will receive an adequate assessment and that information about this assessment will be accurately and honestly recorded.

70. In these circumstances a Suspension Order would not be sufficient to maintain public confidence in the profession and the regulatory process and would not have a deterrent effect on other registrants.


71. Having determined that a Suspension Order does not meet the public interest the Panel determined that the Registrant’s name should be removed from the Register. A Striking Off Order is a sanction of last resort and should be reserved for those category of cases where there is no other means of protecting the public or the wider public interest. The Panel decided that the Registrant’s case falls into this category because of the nature and gravity of his misconduct, his lack of insight, the high risk of repetition and his dishonesty.

Order

Order: That the Registrar is directed to strike the name of Mr Marcus J Galligan from the Register on the date this order comes into effect.


The order imposed today will apply from the expiry of the appeal period (the operative date) on 30 September 2016.

Notes

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


Under Article 29(10) of the Health and Social Work 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.

Interim Order:
The Panel makes an Interim Suspension Order under Article 31(2) of the Health and Social Work Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest.  This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

Hearing History

History of Hearings for Mr Marcus J Galligan

Date Panel Hearing type Outcomes / Status
30/08/2016 Conduct and Competence Committee Final Hearing Struck off