Mr Jason M Garnham
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While working for The St John Ambulance & Rescue Service as a registered paramedic, on or around 9 July 2014, you:
1. Did not ensure Colleague 1 completed the following documents relevant to an aborted call from Patient A;
a) An Emergency Call Taking Form; and
b) A green Emergency Call Record
2. Did not listen to the recording of the 999 call
3. Instructed Colleague 1 to record the call from Patient A on the Control Log and take no further action
4. Did not follow up the aborted call from Patient A, in that you:
a) did not contact the Police and/or ensure that the Police were contacted; and/or
b) did not ensure that an ambulance was dispatched to Patient A's location
5. The matters set out in 1 – 4 above constitute misconduct and/or lack of competence
6. By reason of your misconduct and/or lack of competence, your fitness to practise is impaired.
1. The Registrant is a Paramedic registered with the HCPC. He had worked at the St John Ambulance and Rescue Service (the Service), the provider of ambulances in Guernsey since 1996. He had started in the Service as an Ambulance Care Assistant in 1996 and worked his way up to become a Paramedic in 2001 and Station Officer in 2012.
2. On 9 July 2014, the Registrant was on duty at the ambulance station in his role as the Duty Officer, which included responsibility for Ambulance Control Management. Manning the Control Room was Colleague 1, an Ambulance Control Assistant. At 6:13 pm, a 999 call was received and answered by Colleague 1. At the outset of the call, Colleague 1 said to the caller: “Hello caller, where do you want the ambulance to come please?” The caller responded: “I want it to come to King George V Playing Fields” (the Playing Fields). Colleague 1 then answered: “Yes, actually on the playing fields?”. After that point there was no response from the caller. Colleague 1 tried to call back twice, but was unsuccessful. The relevant forms were not completed, no ambulance was sent and no call was made to the police requesting them to attend the location.
3. The relevant forms for 999 calls comprised an Emergency Call Taking (ECT) form and an Emergency Call Record (ECR) form in either red, amber or green, depending on the type of emergency. The ECT form would be expected to be completed by the Ambulance Control Assistant (Assistant) receiving the call, and then attached to the ECT form, which was expected to be started by the Assistant taking the call and completed by the ambulance crew if they were asked to attend the incident.
4. On 10 July 2014, Patient A, a 65 year old man, was found dead at 7:40 in the Groundsman’s Hut at the Playing Fields. It was subsequently ascertained that it was Patient A who had made the 999 call at 6:13pm on 9 July 2014 which had been received by Colleague 1. The matter was reported to the police, who in turn contacted the Service on 21 July 2014.
5. On 22 July 2014, the Chief Officer of the Service authorised an investigation by the Service into the handling of the 999 call made on 9 July, and the investigation was carried out by an Acting Senior Officer. The investigation concluded that a disciplinary hearing should be convened, but the Registrant resigned from the Service on 19 January 2015, before such a hearing had taken place. On 12 February 2015, the matter was referred to the HCPC.
6. On 15 September 2015, an inquest into the death of Patient A took place. This concluded that Patient A died from natural causes. The Coroner made it clear that he did not find that “the failure in the procedures of the Ambulance and Rescue Service contributed to his death”.
7. A Substantive Hearing took place between 20 and 23 March 2017. The substantive panel found each of the factual particulars proved, and that particulars 3 and 4 were sufficiently serious so as to amount to misconduct. That Panel went on to consider whether the Registrant’s fitness to practise was impaired at that time. It had regard to the HCPTS Practice Note on Impairment and in particular the two elements of Impairment set out in the Practice Note, namely the ‘personal component’ and the ‘public’ component’. That Panel found that the Registrant’s fitness to practise was impaired on both components.
8. The substantive panel, in finding that the Registrant’s fitness to practise was impaired on the personal component said:
“The point to be made is that, notwithstanding his acknowledgement that he may have become de-skilled as a paramedic, the Registrant has otherwise displayed little or no insight into his actions in this matter. He has failed to take due responsibility and does not appear to have reflected properly about what he could have done properly nor how how his actions may have affected service users or the public’s view of his profession. Whilst it may be argued that, having undergone his experience, it is unlikely that he would act in this way again, the fact remains that, without any acknowledgement of his part in this incident, the Panel could not be satisfied on the evidence before it that he would not act in this way again. Although the Panel took the view that this case was capable of being remedied it had to conclude that there was no evidence before it that the Registrant’s failings have yet been remedied.”
9. The substantive panel, in finding that the Registrant’s fitness to practise was impaired on the public component said:
“The Panel was, therefore, satisfied that public confidence in the Paramedic profession would be undermined if it did not make such a finding [of Impairment]. It was also of the view that such a finding was required in order to uphold proper standards of conduct and behaviour in the profession.”
10. In relation to sanction, the substantive panel concluded the following:
“The Panel appreciated that the Registrant may, for whatever reason, have found it difficult to accept responsibility for his actions in this matter and noted that he has indicated that he wishes to remain a registered Paramedic and to utilise his skills in that regard. Consequently, the Panel has decided to give him an opportunity to show that he is willing to remedy his failings by imposing a Suspension Order for a period of 12 months to enable him to demonstrate that he has gained insight into his failings and wishes to remedy them”
11. The substantive Panel set out a number of suggestions that may assist a future reviewing Panel, namely:
• Evidence of reflection about this matter together with evidence of insight and remorse;
• Evidence that the Registrant has kept his skills and knowledge up to date, together with evidence of CPD;
• Evidence of the Registrant’s future intentions about practising as a Paramedic and details of his plans, if any, for such a return;
• Up to date and relevant testimonials;
• The Registrant’s continued engagement with the HCPC.
12. Ms Bass accepted that the Registrant had engaged with the HCPC and had sent in documents, providing evidence in the areas suggested by the substantive panel. She accepted that he was articulate and passionate about his profession. However, she submitted that the Registrant’s fitness to practise remained impaired, and that whilst he showed remorse, he did not show sufficient insight to a level where there was no longer a risk of repetition. She invited the Panel to extend the Suspension Order.
13. The Registrant participated in the hearing by telephone. He submitted written documentation for the Panel’s consideration, which included a written reflective piece, highly positive references from fellow professionals who had worked with the Registrant in his role as a Paramedic, CPD certificates, and a letter from the Royal Yachting Association, confirming the Registrant’s role as an RYA First Aid Instructor. He also gave evidence on affirmation.
14. The Panel heard and accepted the advice of the Legal Assessor. The Panel exercised its independent judgement in determining whether the Registrant’s fitness to practise remains impaired. It kept in mind the need to protect the public, to maintain public confidence in the profession, and to uphold proper standards of conduct and behaviour.
15. The Panel found the Registrant’s evidence to be open, honest and consistent. He gave full and detailed answers to the questions put to him and accepted responsibility for his actions. He acknowledged that he had been defensive in the past, but fully accepted that no one else was to blame for his actions. He also understood that following the incident, public perception of the Service would be not be seen ‘in a good light’.
16. The Panel was of the view that the Registrant, through his written submissions and his oral evidence, now shows fully developed insight into his past misconduct and the Panel considers that he has provided evidence in all the areas suggested by the previous panel concerning what might assist this Panel. The Panel has found this evidence of great assistance, and in particular, given the strong insight, the Panel is satisfied that there is no significant risk of repetition.
17. In the past, the Registrant’s actions have placed the public at risk of harm, breached the fundamental tenets of the profession and brought the profession into disrepute. However, in light of all the material provided to it and the Registrant’s oral evidence, the Panel finds that there is no significant risk that he will do so again in the future.
18. The Panel is conscious of the need to declare and uphold proper standard of conduct and behaviour and finds that, in the circumstances of this case, this will have been achieved by the time of the expiry of the existing 12 month Suspension Order.
19. The Panel finds that the Registrant’s current fitness to practise is no longer impaired and directs that the existing Order should lapse on its expiry.
ORDER: The Registrar is directed to allow the Suspension Order of Mr Jason M Garnham to lapse on expiry.
History of Hearings for Mr Jason M Garnham
|Date||Panel||Hearing type||Outcomes / Status|
|09/03/2018||Conduct and Competence Committee||Review Hearing||No further action|