Mrs Edna Pool

Profession: Paramedic

Registration Number: PA15731

Hearing Type: Review Hearing

Date and Time of hearing: 09:00 22/06/2018 End: 11:30 22/06/2018

Location: Novotel Glasgow Centre, 181 Pitt Street, Glasgow, G2 4DT, United Kingdom

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

The following allegation was considered by a Panel of the Conduct and Competence Panel at a Substantive Hearing on 7 June 2016.


On 23 June 2015 at Dumfries Sheriff Court, you:

1. Were convicted of an offence of failure to provide a specimen of breath for analysis upon request, contrary to Section 7(6) of the Road Traffic Act 1988.

2. By reason of your conviction as set out at paragraph 1 your fitness to practise as a Paramedic is impaired.


The Panel at the substantive hearing found the following:


Facts proved:  1

Facts not proved: None

Grounds: Conviction


The panel found the Registrant’s fitness to practise to be impaired and a Suspension Order for a period of 12 months was imposed as a sanction. This decision was reviewed on 6 June 2017, 24 November 2017, and 3 March 2018 and those panels imposed further Suspension orders for periods of 6, 3, and 3, months respectively.

Finding

Preliminary Matters

1. The Panel were satisfied that the Registrant was notified of the date and time of this hearing via a letter dated 6 June 2018 by both email and post. The email address used had been successfully used to correspond with the Registrant previously.

2. The Registrant acknowledged receipt of the Notice of Hearing, which was given on 8 June 2018 and not 6 June 2018 as stated in the bundle, and good service had clearly therefore been effected.

3. The Registrant acknowledged that she had been informed of the hearing. The Panel noted that the Registrant had been advised that the hearing may proceed in her absence and that the Panel could consider striking her from the Register. 

4. The Presenting Officer submitted that it was in the public interest for the hearing to proceed in the absence of the Registrant given the serious nature of the impairment. The Registrant advised that she would not be attending the hearing. She has not indicated through correspondence with HCPTS that she wished to be represented at the hearing.

5. The Panel noted the provisions of the HCPTS Practice Note in respect of proceeding in absence and received advice from the Legal Assessor. They were satisfied that it was appropriate for them to exercise their discretion to hear the matter in the absence of the Registrant. Although proceeding in absence may disadvantage the Registrant, given the serious nature of the matters to be determined, and the Registrant’s acceptance of the finding of impairment on 7 June 2016 and admission that she had not maintained her skills or attended any courses, the public interest was best served by proceeding with the hearing.


Background

6.   The Panel noted the background information set out in detail by the final hearing panel that determined that she was impaired on 7 June 2016. In summary, the Registrant was a paramedic employed by the Scottish Ambulance Service until her dismissal on the grounds of gross misconduct on 15 January 2015. On 23 June 2015 the Registrant was convicted of failing to provide a specimen of breath contrary to Section 7(6) of the Road Traffic Act 1988. She pleaded guilty to this offence. A HCPC Suspension Order for a period of 12 months was imposed on her.  This decision was reviewed on 6 June 2017, 24 November 2017, and 3 March 2018 with a Suspension Order being imposed by each Panel hearing this matter.

Decision

7.    The Panel has listened carefully to the submissions made by the Presenting Officer and taken account of all of the information provided to it, as well as accepting and applying the advice received from the Legal Assessor in relation to the proper approach to determining this matter. They have also had regard to the policies adopted by the HCPC in relation to the approach to take to Fitness to Practice proceedings and Indicative Sanctions. They also considered the guidance document issued by HCPC in relation to Returning to Practice, as well as the following HCPTS Practice Notes:

a. Postponements and Adjournments;

b. Proceeding in the Absence of the Registrant;

c. Review of Article 30 Sanction Orders;

d. Unrepresented Registrants;

e. Finding that Fitness to Practice is Impaired;

 And the following HCPC standards documents:

a. Standards of Proficiency for Paramedics;

b. Conduct, Performance and Ethics.

8.   The Panel reminded itself that Suspension Orders are imposed only when there is either a serious on-going risk to service users or the public from the Registrant’s lack of professional knowledge or skills, conduct or unmanaged health problems, or when the allegation is so serious that public confidence in the profession or the regulatory process would be seriously harmed if the Registrant was allowed to remain in practice on an unrestricted basis. The review process is to consider whether the Registrant’s fitness to practise remains impaired and if so, whether the existing order or another order needs to be in place to protect the public. The key issue which needs to be addressed is what, if anything, has changed since the current order was imposed.  The factors to be taken into account include:

a. the steps which the Registrant has taken to address any specific failings or other issues identified in the previous decision;

b. the degree of insight shown and whether this has changed;

c. the steps which the Registrant has taken to maintain or improve her professional knowledge and skills;

d. whether any other fitness to practise issue has arisen;

e. whether the Registrant has complied with the existing order.

9.   The Panel must consider whether the concerns which led to a finding of impairment at a hearing on 7 June 2016 remain. As the decision in Abrahaem v GMC [2008] EWHC 183 (Admin) indicates, in practical terms this places a “persuasive burden” on the Registrant to demonstrate at a review hearing that she has fully acknowledged the issues which led to the original finding and has addressed them sufficiently “through insight, application, education, supervision or other achievement...”.

10.  The Panel reminded itself that when reviewing sanctions under Article 30 of the Health and Social Work Professions Order 2001 (the Order), the Reviewing Panel may:

a. confirm the order;

b. extend, or further extend, the duration of the order; 

c. reduce the duration of the order (but a caution order cannot be reduced to less than one year);

d. replace the order with any other order which the Panel could have made (to run for the remaining term of the original order); or

e. revoke the order or revoke or vary any condition imposed by it; or

f. Replace the order with a striking-off order.

11.    The decision reached by the Panel must be proportionate, striking a fair balance between interfering with the Registrant’s ability to practise and the overarching objective of public protection.

12.   The Registrant has confirmed that she does not intend to practise while she is caring for her husband, but once this level of care is no longer required, she intends to complete any courses necessary and undertake voluntary work with a view to returning to practice. She expressed some remorse for the night in question and the subsequent events. She highlighted that, at the time of the offence, she was suffering from an undiagnosed health condition.  She acknowledges in her email of 20 June 2018 that she has not taken any steps to keep her knowledge and skills up to date in the three years since the conviction. She states that she is unable to provide any up to date medical information in respect of her health, stating this is due to financial constraints as she is not working. She asks that the HCPC seek this information on her behalf. She asserts that she is more aware of the symptoms of stress and would seek medical advice. By way of reflection, she states that she had been suffering from an undiagnosed health condition and that her behaviour was out of character and she believed influenced by this condition.

13.  The position of the HCPC is that the Registrant’s fitness to practise remains impaired. The Registrant has had four opportunities, spanning over approximately two years, to provide the information requested by previous panels and, in the HCPC’s submission, the information provided by the Registrant falls well short of what has been requested.

14.    The HCPC is under an obligation to prove the allegation against the Registrant, once this has been proved at final hearing the HCPC no longer possesses the same investigatory powers, including to obtain medical records. It is the Registrant’s responsibility to provide the evidence requested and she did accept this was the case in her telephone call with the HCPC Case Manager.

15.   The Registrant does make some reflective comments in her email but, in the HCPC’s submission, these are extremely limited and the HCPC is concerned that the Registrant still has not provided a proper reflective piece, despite having had two years to do so. The comments she has made tend to focus on the impact these events had on herself, rather than the risk her actions may have posed to the safety of the public and the impact her actions had on the reputation of her profession. Furthermore, she has also expressed that she felt her dismissal from her employment was unfair. Her comments suggest she still has not demonstrated meaningful insight and does not fully appreciate the seriousness of her behaviour. The previous review panel also suggested that it would be helpful for the Registrant to provide references or testimonials, but the Registrant has not done so. In the HCPC’s view, the Registrant has not demonstrated meaningful engagement. In light of these matters, the HCPC submits that there remains a lack of evidence of insight and remediation.

16.   The HCPC submitted that there remains a risk of repetition and that the Registrant’s fitness to practise remains impaired on the basis of the personal component. They also submit that the Registrant’s fitness to practise remains impaired on the basis of the public component as, due to the seriousness of the initial conduct and the lack of evidence of insight and remediation, confidence in the regulatory process and the profession would be undermined if a further finding of impairment were not made.

17.  The HCPC also made submissions in respect of the appropriate sanction, stating that given the seriousness of the concerns and the limited evidence of remediation, it would not be appropriate to allow the order to lapse or to impose a caution order. They maintain their position that it would be hard to formulate relevant conditions which target the concerns raised in this case as the offence took place outside of a professional setting. The HCPC invited the Panel to consider strike-off given the overriding duty to protect members of the public and maintain public confidence in the regulatory process and integrity of the profession.

18.    The Panel were satisfied that the Registrant’s fitness to practise remained impaired. This was the fourth review undertaken, yet very little new information had been provided by the Registrant. The Panel were not persuaded by the limited information that had been provided by the Registrant that her fitness to practise was no longer impaired.   Her remorse appears to centre around the night of the incident and the impact on her, and there is no evidence of acceptance of the potential risk posed to the children in her vehicle at the time, or her failure to comply with the request by the Police to provide a specimen of breath.   Her reflection was similarly limited and did not take account of the effect on her profession or the safety of the public.  She still does not appear to appreciate the seriousness of the situation almost three years after her conviction.  It is also worthy of note that she has objected to her dismissal by her employer, yet she pleaded guilty to the charge at court.  Previous review panels had all set out clearly what the Registrant could do to address the fact of her impairment yet the Registrant had only engaged immediately before the review hearing. 

19.   It is acknowledged by the Panel that the Registrant’s personal circumstances are currently challenging, however the Panel has a duty to consider the safety of the public when determining whether the Registrant is fit to practise. In the Panel’s opinion, for the reasons stated above, she remains impaired in respect of both the personal and public aspect.

20.   Turning to sanction, the Panel reflected the number of opportunities the Registrant had had to engage with the proceedings. Given the limited progress she had made, it was unlikely that a further extension of the Suspension Order would result in the impairment concerns being substantially addressed by the Registrant. Given the lack of testimonials, limited documentation and lack of meaningful insight into her behaviour and the consequences of it, the Panel believed that there was no benefit to the Registrant in continuing the Suspension Order as they had no confidence that she would be in a position to address her impairment in the foreseeable future. The Panel were mindful of the public resources that had been dedicated to the Registrant’s case. Accordingly, they considered that the appropriate sanction to impose was to order that the Registrant be stuck off the Register. 

Order

The Registrar is directed to strike the name of Mrs Edna Pool from the Register on the date this Order comes into effect.

Notes

 The Order imposed today will apply from 5 July 2018.

Hearing History

History of Hearings for Mrs Edna Pool

Date Panel Hearing type Outcomes / Status
22/06/2018 Conduct and Competence Committee Review Hearing Struck off