Mr Geoffrey Brown

Profession: Paramedic

Registration Number: PA05680

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 22/02/2019 End: 12:00 22/02/2019

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

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

The following allegation was considered and found proved by a Panel of the Conduct and Competence Committee at the substantive hearing on 22 February 2018.


While registered as a Paramedic and during the course of your employment with East Midlands Ambulance Service you:

1. On 21 December 2015 in relation to Patient A:
(a) Physically restrained Patient A for an inappropriate length of time without seeking police assistance;
(b) Did not adequately document details of the restraint on the Patient Record Form and/or Incident Report Form (IR1)
(c) Physically restrained Patient A without completing and/or recording a mental capacity assessment;
(d) Administered IV Diazemuls to the patient outside of clinical practice guidelines;
(e) Did not adequately complete and/or record patient observations in that you did not: (i) check and/or record blood glucose;
(ii) check and/or record oxygen saturation; and/or
(iii) Not proved;
(f) Did not utilise and/or document:
 (i) The use of the Paramedic Pathfinder tool; and/or
(ii) The National Early Warning Score (NEWS).
(g) Did not ensure adequate “safety netting” was completed and/or recorded.

2. On 31 March 2016, in relation to Patient B:
(a) Did not document:
(i) The use of the sepsis screening tool; and/or
(ii) Not proved
(iii) Not proved
(b) Not proved 
(c) Not proved

3. The matters set out in paragraphs 1 – 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.

Finding

Preliminary Matters

Service

1. The Panel found that there had been good service of the Notice of Hearing by a letter dated 22 January 2019 sent to the Registrant’s registered address.

Proceeding in the Absence of the Registrant

2. Ms Knight submitted that the hearing should proceed in the absence of the Registrant. She informed the Panel that there has been no contact from the Registrant since May 2017, which was prior to the Final Hearing. Ms Knight sent an e-mail to the Registrant on 21 February 2019 enquiring about his participation in today’s hearing. No reply has been received.

3. The Panel accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Note “Proceeding in the Absence of the Registrant”.

4. The Panel decided that it was appropriate to proceed in the absence of the Registrant. The Registrant has not engaged with the HCPC for nearly two years. The Panel concluded that his absence is voluntary and that there was no real prospect that he would attend a hearing at a later date. The hearing is a mandatory review of a Suspension Order which is due to expire on 22 March 2019 and there is a strong public interest in expedition of these matters.

Background

5. The Registrant is a registered Paramedic and previously employed by East Midlands Ambulance Service NHS Trust (“EMAS”) as a Band 5 Paramedic in Accident and Emergency operations. He was based in Mablethorpe Ambulance Station and was responsible for responding to patients requiring routine, urgent, or emergency ambulance care.

6. On 19-22 February 2018 a Panel of the Conduct and Competence Committee considered an Allegation which included the Registrant’s conduct in relation to an incident he attended on 21 December 2015. In respect of this incident the Registrant had responded to a call out, but failed to check Patient A’s blood glucose levels or her oxygen saturation levels. The Registrant should have made the assessment of blood glucose levels and oxygen saturation before administering IV Diazemuls because either could have been a cause of Patient A’s seizure activity. The Registrant therefore exposed Patient A to the risk of harm and his failures amounted to serious misconduct.

7. The Registrant had also failed to follow accepted guidelines for the administering of IV Diazemuls and this constituted serious misconduct.

8. In addition the Registrant had not ensured that adequate “safety netting” was completed and recorded for Patient A. The Registrant had not followed the EMAS On Scene Conveyance and Referral Procedure document and this amounted to serious misconduct.

9. The Final Hearing Panel decided that the Registrant’s actions, the overall lack of documentation of the restraint of Patient A and lack of justification for the use of IV Diazemuls meant that a future clinician dealing with Patient A would not have important information passed on to them.

10. The Final Hearing Panel also decided that the Registrant’s fitness to practise was impaired on the basis of both the personal and public interest considerations. The Registrant had failed to engage with the process since 4 May 2017 and did not attend the hearing. His written representations did not provide any evidence of insight. The Registrant indicated at that time that he had retired from the profession.

11. That Panel decided that the appropriate and proportionate order was a Suspension Order for a period of twelve months. The Panel considered a Striking Off Order, but decided that it would be disproportionate at that stage.

12. That Panel’s determination outlined to the Registrant that the Suspension Order would be reviewed and that the Registrant had the opportunity to take steps in relation to the review. In particular he might engage with the fitness to practise process and attend the review hearing, prepare a reflective piece, provide evidence of any training undertaken to maintain his professional standards and CPD, and provide up-to-date testimonials from people able to comment on any activities he has undertaken during the period of suspension, including any employment, paid or unpaid.

Decision

13. Ms Hayley submitted that the Registrant’s fitness to practise remained impaired and that the appropriate and proportionate Order was a Striking Off Order.

14. There were no submissions from the Registrant.

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

16. The Panel first considered whether the Registrant’s fitness to practise is impaired. The Panel considered that Final Hearing Panel had clearly explained to the Panel that he had the option of engaging with the HCPC and seeking to persuade this review Panel that he should be permitted to return to practice. That panel gave him guidance on the steps he could take. However, the Registrant has not chosen to engage with the HCPC and he has not provided evidence to this Panel.

17. There was therefore no information to indicate that the level of the Registrant’s insight has changed or that the Registrant has taken any action to remediate his misconduct. In these circumstances the Panel decided that there remains an ongoing risk of harm to members of the public and that the Registrant’s fitness to practise remains impaired.

18. The Panel next considered the appropriate Order. When considering sanction the Panel applied the guidance in the HCPC Indicative Sanctions Policy. It applied the principle of proportionality and started with the least restrictive option.

19. The Panel considered the options of no action or a Caution Order, but decided that neither option would provide sufficient protection against the risk of repetition of the misconduct.

20. The Panel next considered the imposition of a Conditions of Practice Order. The Panel decided that conditions of practice would not be appropriate or sufficient because the Registrant has not engaged with the HCPC and has not demonstrated to the Panel a sufficient level of insight.

21. The Panel next considered the more serious options of extending the current Suspension Order or a Striking Off Order. The Panel noted that the Registrant was given clear guidance by the Final Hearing Panel on engaging with the HCPC process. The Panel noticed the obligation on registrant’s to engage with the regulator. The Registrant has chosen not to take that option. In these circumstances, the Panel concluded that there was no realistic prospect that the Registrant will take the necessary steps to remediate his past misconduct. There was nothing to indicate that he is willing or motivated to do so or that further time would be beneficial.

22. The Panel considered the Registrant’s interests, but decided that they were outweighed by the need to protect the public and to maintain confidence in the profession and the regulatory process.

23. In these circumstances the Panel decided that the appropriate and proportionate Order was a striking Off Order.

Order

The Registrar is directed to strike the name of Mr Geoffrey Brown from the Register on the date this order comes into effect.

Notes

The order imposed today will apply from 22 March 2019.

Right of Appeal:

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

Under Articles 30(10) and 38 of the Health and Social Work Professions Order 2001, any appeal must be made to the court not more than 28 days after the date when this notice is served on you.

Hearing History

History of Hearings for Mr Geoffrey Brown

Date Panel Hearing type Outcomes / Status
22/02/2019 Conduct and Competence Committee Review Hearing Struck off
22/02/2019 Conduct and Competence Committee Review Hearing Hearing has not yet been held
19/02/2018 Conduct and Competence Committee Final Hearing Suspended