Mr Shane Kennedy
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The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing on 10 – 13 October 2016.
During the course of your employment as a Paramedic with East Midlands Ambulance Service:
1. On 11/12 January 2015 in relation to Patient A:
a) You transported her in the Fast Response Vehicle (FRV) instead of the Double Crew Ambulance (DCA) despite her presentation and/or the risk of repeated seizure:
i) without any clinical justification
ii) despite a colleague and/or colleagues at the scene offering to take her in the DCA
iii) against trust policy for transporting of patients in FRVs
b) did not transport her to the hospital on blue lights despite the deterioration of her condition.
c) stopped the FRV at approximately:
i) 00:15 for approximately 4 minutes; and/or
ii) 00:21 for approximately 26 minutes; and/or
iii) 00:51 for approximately 4 minutes.
d) did not call for assistance from a DCA during the stop at Particular 1 (c)(ii)
e) did not re-check Patient A’s blood glucose levels after administration of oral carbohydrates.
2. On 31 December 2014 in relation to Patient B you:
a) did not carry out a thorough and/or complete assessment
b) as a result of your actions in 2a) you inappropriately discharged Patient B on scene
3. The matters described in paragraphs 1 and 2 constitute misconduct and/or lack of competence.
4. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
1. The Panel was provided with a signed certificate as proof that the Notice of Hearing had been sent in a letter, by first class post, on 3 September 2018 to the address shown for the Registrant on the HCPC register. The Notice of Hearing had also been sent to the Registrant by email on the same date.
2. The Panel accepted the advice of the Legal Assessor and was satisfied that Notice had been properly served in accordance with Rule 3 (proof of service) and Rule 6 (date, time and venue) of the Conduct and Competence Committee Rules 2003 (as amended).
Proceeding in absence of the Registrant
3. Mr Harrison, on behalf of the HCPC, made an application for the hearing to proceed in the Registrant’s absence, as permitted by Rule 11 of the Conduct & Competence Rules.
4. The Panel accepted the advice of the Legal Assessor and took into account the guidance as set out in the HCPC Practice Note “Proceeding in Absence”.
5. The Panel determined that it was reasonable and in the public interest to proceed with the hearing for the following reasons:
a) There has been no application to adjourn and no indication from the Registrant that he would be willing or able to attend on an alternative date and therefore re-listing the hearing would serve no useful purpose;
b) The Panel noted that the Registrant had failed to engage, in any meaningful way, throughout the proceedings. Whilst the Panel recognised that there may be some disadvantage to the Registrant in not being able to make oral submissions, the Panel noted that he had been provided with every opportunity to attend and had failed to do so. The Panel therefore formed the view that he had voluntarily absented himself from the hearing; and
c) Finally, the Panel noted its duty to act in a manner which was in the public interest and in order to achieve that aim should act in a fair, economical and expeditious manner.
6. Therefore, taking all of the aforementioned points into account and noting that the efficient disposal of cases concerning practitioners is of very real importance, the Panel determined that it should proceed in the absence of the Registrant because the public interest in proceeding with the case outweighed any detriment to the Registrant in not being present.
7. The Registrant was employed as a Paramedic by East Midlands Ambulance Service (‘EMAS’) and primarily worked as a solo responder on Fast Response Vehicles (‘FRV’). The FRV is a liveried car, as opposed to an ambulance, which would usually be crewed by two people. The individuals working on an Ambulance may both be Paramedics, or alternatively a Paramedic and a Technician or Emergency Care Assistant. Ambulance crewed in this way are referred to as double-crewed ambulances (‘DCA’s’).
8. At the Substantive Hearing, on the 10-13 October 2016, the panel considered particulars in relation to two complaints.
9. The first complaint centred around the Registrant’s conduct on 11 January 2015 when the emergency services were called to the home of Patient A, a 21 year old female who had suffered a fit. The Registrant attended and made the decision to transport Patient A to hospital in the FRV, despite the DCA crew offering to transport her. This decision was contrary to EMAS policy and without clinical justification. En route to hospital the FRV was recorded as stopping on three occasions, with one stop being for 26 minutes. The panel at the Substantive Hearing in October 2016 recorded in its determination that when the Registrant was asked why he had sat for that length of time without doing anything, he could not provide any explanation. The Registrant did not call for DCA back-up or support. Upon arrival at hospital staff had concerns about the transportation of the patient and an investigation was undertaken into their concerns.
10. The second complaint concerned Patient B, a 74-year-old female who had fallen and been on the floor for a day and a half. On 31 December 2014, the Registrant assessed Patient B. However he was not thorough in that assessment because he failed to take a clinical history, examine the skin, carry out a head-to-toe examination or a physical examination based on the patient’s presentation. The Registrant assisted in moving Patient B to her bed and advised that she should see her GP in the New Year. The Registrant discharged Patient B despite her having a pressure sore which needed hospital treatment. Patient B’s family subsequently contacted the emergency services again, some hours later, whereby another solo responder attended. On the second occasion an ambulance was requested, by the solo responder, and Patient B was transported to hospital.
11. The Registrant did not attend the Substantive Hearing at which the panel found the Registrant’s conduct in particulars 1(a), 1(c)(ii), 1(d) and 2(a) and 2(b) fell well below the standards expected of a registered paramedic and were sufficiently serious to constitute misconduct.
12. The panel found that the Registrant’s actions had led to a significant risk of serious harm to patients and that the Registrant had acted with a reckless disregard for risk. Patient A had suffered a fit en route to hospital, in the FRV, and there were a number of dangerous and potentially life-threatening risks associated with this: neurological damage; airway obstruction; causing physical injury to herself and the Registrant; and distracting the Registrant thereby impairing his ability to drive safely. The Panel found that his errors were compounded by his failure to take appropriate steps to provide treatment and call for assistance when Patient A’s condition deteriorated during the car journey.
13. The panel also found, in respect of Patient B, that there was a risk of respiratory compromise and dehydration. The panel found that Patient B had suffered injury from her fall, as she had sustained a serious wound, which required urgent hospital treatment. The panel also found that all of these risks were entirely avoidable had the Registrant carried out proper assessments or examinations and followed EMAS policies.
14. In relation to particulars 1(b), 1(c)(i), 1(c)(iii) and 1(e) the Substantive Hearing Panel did not find the Registrant’s actions amounted to misconduct.
15. The panel decided that the only appropriate and proportionate sanction was a Suspension Order for 12 months with a direction that the Registrant not be able to seek an early review before the expiration of ten months. The panel felt that a reviewing panel might be assisted by the following:
I. the Registrant’s attendance at the Review Hearing;
II. evidence of the Registrant’s reflections on the findings made against him;
III. evidence of insight and remedial steps;
IV. references or testimonials in respect of paid or voluntary work;
V. evidence that the Registrant had kept his knowledge of paramedic practice up-to-date through relevant CPD; and
VI. any other evidence that the Registrant considers being relevant.
16. The Suspension Order was subsequently reviewed on the 6 October 2017. The panel at the Review Hearing found that there had been no change in the circumstances since the Substantive Hearing and that the Registrant’s fitness to practise remained impaired. There had been no engagement by the Registrant and he had failed to address the points outlined at paragraph 110 of the Substantive Hearing Panel’s determination.
17. The Review panel decided that there was no change in circumstances and that the appropriate and proportionate Order, taking into account all of the circumstances, was to extend the Suspension Order, by twelve months. This was to allow the Registrant further time to reflect and to demonstrate remediation of his misconduct. The panel also considered that a future review panel might be assisted by the provision of the information outlined at paragraph 9 above; adding to the original list, that an explanation of the Registrant’s non-engagement with the proceedings to date was also required.
18. Mr Harrison submitted, on behalf of the HCPC, that the Registrant’s fitness to practise remained impaired and that in all the circumstances nothing would be achieved by a further period of suspension and that the minimum sanction that should be imposed was a Striking Off Order.
19. Save for a short email, dated 26 February 2018, there were no written submissions or documents provided by the Registrant.
20. The Panel accepted the advice of the Legal Assessor.
21. The Panel found there to be no change in the circumstances since the Substantive Hearing or Review Hearing and for that reason found that the Registrant’s fitness to practise remains impaired.
22. In making its decision, the Panel had regard to both the personal and public elements of impairment.
23. The Panel noted that the Substantive Hearing panel, in its determination, had found the Registrant to be “dismissive of the suggestion that his treatment of the patients had been inappropriate” and that “he demonstrated no remorse or recognition of the risks to which he had exposed the patients”. The Registrant has failed to engage with the regulatory process and notwithstanding an email sent by the Registrant, dated 26 February 2018, indicating that he might ‘consider revisiting the profession’, the Registrant has not provided the Panel with any written submissions, nor has he provided any evidence of remediation or remorse.
24. Moreover, the Panel considered the Registrant’s email demonstrated a continued lack of insight when he stated ‘I am currently not practising as a Paramedic as you took away that privilege. Nor am I doing any voluntary work for the same reason’.
25. The Panel considered that the Registrant’s continued lack of insight and remorse meant that there was a significant risk of repetition of his behaviour and there was, therefore, a real risk to the public should he be permitted to continue practising unrestricted. In these circumstances, the Panel was satisfied that public confidence in the profession and the regulatory process, has well as professional standards, would be undermined were the Panel not to find impairment.
26. For the reasons set out above, the Panel decided that the Registrant’s fitness to practise is currently impaired on both the personal and public components.
27. The Panel has borne in mind that sanction is a matter for its own independent judgment and that the purpose of a sanction is not to punish the Registrant but to protect the public. Further, that any sanction must be proportionate, so that any order must be the least restrictive order that would protect the public interest, including public protection.
28. The Panel considered the option of a Caution Order however, it decided that it would not provide adequate protection for the public and would not address the on-going risk to the public identified by the Substantive Hearing panel.
29. The Panel next considered the option of replacing the existing Suspension Order with a Conditions of Practice Order. However, the Panel decided that conditions would not be appropriate or sufficient because of the Registrant’s failure to properly engage with the HCPC or provide any evidence of remorse, remediation or insight. Further, the Panel had no confidence that the Registrant would be willing or able to comply with any conditions imposed.
30. The Panel next considered extending the current Suspension Order versus imposing a Striking-off Order. The Panel noted the Registrant’s mitigating factors, as identified by the Substantive Hearing panel and also noted the admissions made by the Registrant during the EMAS investigation process. The Panel took the Registrant’s email, to the HCPC, indicating that he may like to return to practise at some point, into account.
31. The Panel considered that a further extension of the Suspension Order would not be appropriate because the Registrant has been provided with two opportunities over a two year period since the Substantive Hearing in October 2016 to remedy his failings and had failed to provide any evidence of him engaging with these opportunities. The Panel has no evidence of any insight, remorse, or completed CPD. The Panel were not confident that the Registrant was willing, or capable, of remedying his failings given that he had failed to provide evidence of any meaningful steps taken in this regard. The Panel considered that the Registrant has a continuing lack of insight and little to no prospect of remediating his failings and for these reasons a Suspension Order was not appropriate.
32. The Panel consider that in all the circumstances a Striking Off Order is the only appropriate and proportionate sanction which both protects the public and satisfies the wider public interest in upholding proper standards and maintaining public confidence in the profession.
33. In coming to its decision, the Panel took into account the principle of proportionality, and the impact that such a sanction will have on the Registrant’s right to practise his profession, as well as the likely reputational and financial impact. However, the Panel decided that the need to protect the public and uphold the public interest outweighed the Registrant’s interests in this regard.
ORDER: That the Registrar is directed to strike the name of Shane Kennedy from the Register on the date this order comes into effect.
No notes available