Mr Alan G Fisher
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Allegation
While registered as a Paramedic with the Health and Care Professions Council and working in the capacity of an Emergency/ Urgent Care Practitioner, you:
1. On 25 August 2016, in relation to Patient B (a child) you:
a) Worked outside of your scope of practice in that you removed a foreign body from Patient B’s wrist.
b) Did not document that you had obtained consent to perform the procedure.
c) Did not document the size, depth and location of the foreign body.
d) Did not document Patient B’s drug history, allergy status and past medical history.
e) Did not document the drug name, or the amount administered.
f) Did not request a further x-ray following the procedure and discharged Patient B.
2. On 18 September 2017, in relation to Patient A you:
a) Incorrectly diagnosed dislocation of shoulder on x-ray.
b) Performed a manual manipulation twice for a suspected dislocated shoulder but did not identify a fracture after 2 x-rays.
c) Recorded Patient A’s past medical history as nil, however on the Emergency Doctor’s documentation, past medical history details previous right shoulder dislocation and myocarditis.
3. In relation to Patient 1, you performed a manual manipulation of a shoulder prior to x-ray.
4. In relation to Patients 2 and 3, you worked outside of your scope of practise in that you removed a foreign body.
5. In relation to Patient 4, you did not identify a fracture on examination.
6. You did not pass 6 out of 9 of your Objective Structured Clinical Examination (OSCE) assessments on essential examination skills
7. In a number of cases, including those listed at Schedule A, you completed assessments which included inadequate detail in that you:
a) Included limited history;
b) There was a lack of past medical history, allergies or medication;
c) Did not include specific detail on the examinations carried out.
8. The matters set out in paragraphs 1 – 7 constitute lack of competence and/or misconduct.
9. By reason of your lack of competence and/or misconduct your fitness to practise is impaired.
Schedule A attached below;
Schedule A
A1. Patient 6
A2. Patient 7
A3. Patient 8
A4. Patient 9
A5. Patient 10
A6. Patient 11
A7. Patient 12
A8. Patient 13
A9. Patient 14
A10. Patient 15
A11. Patient 16
A12. Patient 17
A13. Patient 18
A14. Patient 19
Finding
Preliminary Matters
Service
1. The Notice of Hearing was sent by email to the Registrant’s registered email address on 18 August 2020. Receipt of this was confirmed by the Registrant on 19 August 2020. Good service was found by the Panel.
Proceeding in absence
2. The Panel, in this context, took particular note of the email to the HCPC from the Registrant, dated 18 September 2020, within which he indicated that he would not be attending today’s hearing. There has been no application to adjourn these proceedings and the Panel took the view that it would be to the Registrant’s advantage for this case to proceed today. Such a course would also be in the public interest. In these circumstances and given the decision that good service has been effected, the Panel granted Ms Lykourgou’s application that it would be appropriate for this hearing to proceed in the absence of the Registrant, in accordance with the provisions of rule 11 Procedure Rules.
Background
3. At the material time (August 2016 – September 2017), the Registrant was employed as an Urgent Care Practitioner in the Minor Injuries Unit with the Harrogate and District Foundation Trust (The Trust). He was a paramedic of some 23 years’ experience.
4. On 3 November 2017 the HCPC received a referral from the Trust setting out details of a number of incidents in which the Registrant had allegedly worked outside the scope of his practice. He had failed to restrict himself to the treatment of minor injuries. There were also failures noted in his documentation.
5. On 19 June 2018 the HCPC was informed by the Trust that the Registrant had not been able to demonstrate adequate levels of improvement in his practice despite the fact that he had been placed on a Capability Action Plan which had been extended beyond its normal period by a further six weeks.
6. The consequence of this was that the Registrant was re-deployed by the Trust into a clerical role.
7. On 20 December 2018 the Registrant informed the HCPC that he had now “no intentions of returning to a clinical role in the future”.
8. On 17 July 2019 a panel of the Investigating Committee of the HCPC determined that the Registrant had a case to answer in response to an allegation that his fitness to practise was impaired by reason of his lack of competence and/or misconduct.
9. On 1 May 2020 the Registrant emailed the HCPC to the following effect “… I will NOT dispute any of the points listed, or challenge this investigation in any way. These patients were my responsibility and I failed them.”
10. On 10 May 2020 the Registrant emailed the HCPC to state that he would no longer be looking to maintain his registration as a Paramedic.
11. In an email of 29 June 2020, the HCPC explored the possibility with the Registrant of disposing of the case by way of voluntary removal of his name from the Register.
12. In his reply of 30 June 2020, the Registrant agreed to this course of action and repeated that he fully accepted responsibility for his failings. He added “I felt I let my patients down and failed to give them the care they expected and deserved.”
13. On 18 September 2020 the Registrant duly signed the Voluntary Removal Agreement.
Decision
14. In considering the submission of Ms Lykourgou, the Panel took into account the contents of the bundle, the HCPTS Practice Note of March 2018 entitled Disposal of Cases by Consent and the advice it received from the Legal Assessor which it accepted.
15. Throughout its deliberations, the Panel was mindful that the Registrant made full admissions to his failings from the outset and has accepted that, by reason of these, his fitness to practise is impaired.
16. It is plain to the Panel that the Registrant has engaged fully with this process. He has demonstrated throughout his communications with the HCPC that he has been very thoughtful and has demonstrated remorse and shame. This attitude was encapsulated in his comment in an email of 30 June 2020 that he felt he had let his patients down and failed to give them the care they expected and deserved. The Panel was impressed by this and similar comments from the Registrant and notes that the Trust has sufficient faith in him that it has provided him with a non-clinical role, which does not place any anxiety burden on him.
17. The Panel’s duty includes consideration of public protection. Would this be secured if its decision is to approve this unopposed application? In answering this question in the affirmative, the Panel took the view that the removal of the Registrant's name from the Register would protect the public in that he would no longer be able to practise as a paramedic.
18. In relation to the public interest, the view of the Panel is that a well-informed member of the public would not be affronted if the desire of the Registrant to remove his name from the Register is granted. This is a man who, until August 2016, had had an unblemished career. He has engaged with the procedure to the full and seems to be flourishing in his current employment. If his mind changes, he can, after the expiry of five years, apply for reinstatement to the Register.
19. For the above reasons, the Panel determines that the name of Mr Alan G Fisher be removed from the Register.
Order
ORDER: The Registrar is directed to remove Mr Alan G Fisher from the Register.
Notes
No notes available
Hearing History
History of Hearings for Mr Alan G Fisher
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 01/12/2020 | Conduct and Competence Committee | Voluntary Removal Agreement | Voluntary Removal agreed |