Miss Lesley A Millen

Profession: Paramedic

Registration Number: 19083

Hearing Type: Voluntary Removal Agreement

Date and Time of hearing: 10:00 23/10/2020 End: 17:00 23/10/2020

Location: Hearing taking place virtually

Panel: Conduct and Competence Committee
Outcome: Restored

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Allegation

Your fitness to practice as a registered health professional is impaired by reason of your misconduct and/or lack of competence in that:


At all material times you were employed as a Paramedic by Mersey Regional Ambulance Service NHS Trust.


1. On Saturday, 11th December 2004 you threw a hot drink into the face of a patient whilst outside Royal Liverpool University Hospital.


2. On Monday 29th of August 2005 you were called to a KS who had been sick and lost consciousness after her drink had been spiked.


Whilst at the family home of KS you:


a) Used excessive force when checking on Miss G who had suffered a fit, which resulted in the patient having bruises on her chest;


b) Made inappropriate comments to and about members of the family and the local area.


3. Following your attendance on 15th of January 2006, when you were called to attend to a Road Traffic Accident on Woolton Road, Liverpool you failed to complete a Clinical Incident Report in relation to a patient who was incorrectly intubated.

Finding

Background
1. The Applicant was qualified so as to enable her to register as a Paramedic in late 2004, and was employed in that capacity by the Mersey Regional Ambulance Service NHS Trust. On 13 February 2006, the Applicant registered as a Paramedic with the Regulator, at that time called the HPC (now HCPC). A final hearing was held on 25 – 29 February and 31 March 2008, in respect of allegations arising during the course of her employment.

2. During the late evening of Saturday, 11 December 2004, an ambulance with which the Applicant was not involved arrived at the Royal Liverpool Hospital. The ambulance conveyed a large male patient who had been fully conscious when the journey started. On arrival at the hospital the patient was unresponsive and, after examining him, the ambulance crew considered that he was feigning lack of consciousness. The crew, assisted by other ambulance personnel, struggled to remove the patient from the ambulance say that he could be handed over to the hospital staff. The Allegation found proved by the final hearing panel, was that the Applicant, who was also in the area, deliberately poured a small quantity of liquid from a cup of tea or coffee from which she had been drinking, over the face of the still unresponsive patient in an apparent attempt to rouse him.

3. During the late evening of 29 August 2005, the Applicant was working as a solo responder in a rapid response vehicle. In that role she responded to an emergency call and visited the home of KS, a middle-aged female patient. KS had been to a bar with work colleagues and suspected that her glass of wine had been “spiked”. KS felt unwell at the bar and was still sufficiently unwell when she reached her home that an ambulance was called for her. The final hearing panel found proved that on arrival at the home of KS, the Applicant inappropriately jumped to the conclusion that KS was drunk (when she was not) and that assumption coloured the manner in which the Applicant behaved. The final hearing panel also found proved that while the Applicant was attending to KS, Miss G, the daughter of KS, suffered an epileptic seizure which was construed by the Applicant as attention seeking rather than a genuine loss of consciousness. As a result of this assumption, the final hearing panel found proved that that the Applicant administered a sternum rub to Miss G, a procedure which was both inappropriate and undertaken with excessive force. The final hearing panel also found proved that the Applicant was personally abusive and threatening, shouting words of personal abuse towards the household generally.

4. Very late at night on 15 January 2006, the Applicant was working as a solo responder in a rapid response vehicle when she attended the scene of a very serious road traffic accident. The patient involved in the collision was a very large man who had suffered serious injuries. By the time the Applicant arrived, other emergency services and two ambulance technicians were on the scene. The Applicant intubated the patient. The final hearing panel found proved that the intubation tube was incorrectly positioned in the oesophagus, rather than the trachea from the outset; the medical practitioner at the Accident and Emergency Department who treated the patient, told the Applicant at the time that the tube was incorrectly positioned and she accepted what he said; and the Applicant did not complete the Clinical Incident Report form as was required for a patient who had been incorrectly intubated.

5. A final hearing was held on 25 – 29 February and 31 March 2008. Having made its findings of fact, the final hearing panel found that those facts amounted to misconduct. About misconduct the final hearing panel said:
‘Each of the particulars found to be proved involves deliberate and inappropriate behaviour. The circumstances of Particulars 1 and 2 demonstrate a wholly unacceptable attitude on the part of [the Applicant] towards patients and other members of the public she encountered in the course of her work. Particular 3 was the deliberate ignoring of an important requirement designed to improve technique and thereby the safety of the public. Each element of the facts found is misconduct of the most serious type.’

6. In relation to impairment, the final hearing panel said:
‘Behaviour of the sort found proved by the Panel clearly impairs the fitness to practice of healthcare professional at the time when the behaviour occurs. The Panel has not overlooked the fact that it is required to decide whether the fitness of [the Applicant] to practise is currently impaired, that her comprehensive denial of fault has the consequence that the Panel cannot conclude that her behaviour now would be any different to that found proved by the Panel between December 2004 and January 2006.’

7. In relation to sanction, the final hearing panel said that as a consequence of the findings made, the only two options for sanction were between suspension and striking-off. It said:
‘The view of the panel is that there would only be a purpose in making a suspension order if there was a realistic prospect that repetition would not occur in the future, and in the case of [the Applicant] this would involve an acceptance on her part that she had behaved inappropriately. There has been no such acceptance… the panel therefore rejects suspension as being an appropriate disposal. The consequence of this rejection is that a striking-off order is arrived at… it is also the sanction the Panel considers to be required to address the very serious nature of the allegations it has found to be proved.’

8. On 23 October 2019, the Applicant applied for readmission to the Register. In that application she disclosed the fitness to practise proceedings and that they had resulted in the strike-off. In support of her application, she has provided information about her current employment as a Health Care Assistant at a GP surgery, a reflective statement dated 27 February 2020, and references from professional colleagues working at the surgery.

Decision
9. The Panel was provided by the HCPC with a bundle of documents which included the original determination from the final hearing; the Applicant’s application for readmission; and some supporting documentation. The Applicant provided the panel with a bundle of documents, including a reflective statement by her, dated 27 February 2020, and character references from a number of professionals with whom she was now working. The Applicant also provided the Panel with a number of certificates of training including a Diploma in Health and Social Care obtained in 2017.

10. The Panel has carefully considered the submissions of Ms Fielding on behalf of the Applicant, and Ms Knight on behalf of the HCPC. The Panel has taken account of the Practice Note entitled ‘Restoration to the Register’ published by the HCPTS. The Panel has heard and accepted the advice of the Legal Assessor.

11. The Applicant gave oral evidence to the Panel, and responded to questions from Ms Knight and from the Panel. In summary, her evidence included the following:
• She completely accepted the findings of the final hearing panel and recognised that her actions amounted to deliberate and serious misconduct which could properly be described as of the ‘utmost gravity’;
• She accepted that the final hearing panel had no choice but to strike her off the Register because at that stage she was still denying her behaviour;
• She could not explain her behaviour, but was totally ashamed of it. She had been going through a hard time at work with some colleagues, which had been acknowledged by the final hearing panel, but she was clear that this was no excuse for her actions.
• She recognised that her colleagues would have been ashamed of her. She had let them down as well as patients, her employer, and her family. She wanted to apologise and move forward to do her job and show that she could treat patients with respect and dignity.
• Having reflected she acknowledged that her behaviour would have had a great effect on public confidence in the profession, recognising that when someone telephones for an ambulance, they expect professionals to come and help them in their time of need. She agreed that her behaviour may make the public think twice about calling Paramedics.
• She explained that she would like to think a member of the public would think she had moved on, learnt her lesson and changed, and for the previous five years had been doing a good and capable job.
• She explained that she had been working as a Health Care Assistant at the Maassarani Group for the last five years and treated her patients with dignity and respect, some of whom were particularly vulnerable.

12. The Panel also heard evidence from Dr Maassarani who had met the Applicant five years before at a charity event and in conversation she had told him that she had been struck off. He had subsequently approached her and offered her employment on the proviso that she provided good references, which she had done. He made it clear that she was a valued member of staff who behaved in a very professional manner. He confirmed that he wished to employ the Applicant as a Paramedic within the Group and to support her with training and funding in order to facilitate that process.

13. The Panel also heard evidence from EH, the Compliance and Governance Director at the Maassarani Group. She confirmed that the Group would be happy to support the Applicant with any conditions of practice imposed. In relation to the Applicant’s character, she explained that she had never seen the Applicant treat patients differently if they were in a different socio-economic group. She said that the Applicant worked with patients in vulnerable groups. EH had only ever seen the Applicant treat them with the utmost respect and the feedback she received confirmed that.

14. The Panel considered that there was no dispute that the matters found proved and which amounted to misconduct were very serious, particularly in light of the Applicant’s continued denials at that time.

15. The Panel was satisfied that the Applicant now fully accepted her misconduct, and did not seek to minimise or excuse her previous attitude and behaviour. Although she could not explain why she had behaved in that way, the Panel did not accept the HCPC position that this meant she did not have insight into her misconduct, given that the incidents happened around 15 years ago and she had demonstrated to the Panel today that she was now a very different person to back then.

16. The Panel considered that the Applicant had real insight into her past behaviour and its impact on the profession and the public. She had recognised that people would be ‘appalled’ at her behaviour, especially as she understood that the public should be able to hold Paramedics in high regard. In light of this, the Panel did not consider that there was a risk of repetition that she would behave that way again.

17. The Panel gave great weight to the evidence it heard from Dr Maassarani and EH, and the written references which had been provided from other professionals at the Maassarani Group. It was clear to the Panel that the Applicant was a well-regarded and valued member of the Practice, and has been for the previous five years.

18. The Panel considered from all the evidence it had heard and had read, that the Applicant would be capable of safe and effective practice, albeit recognising that she had not practised as a Paramedic for 12 years and so would need to take steps to bring her Paramedic skills and knowledge up to date. The certificates provided by the Applicant satisfied the Panel that they represented sufficient knowledge to support the Formal Study and Private Study aspect of returning to practice as set out in the HCPC ‘Return to Practice’ booklet.

19. The Panel was further satisfied from all of the evidence that the Applicant had demonstrated that she was a fit and proper person to return to the Paramedic part of the Register. It did not think that public confidence would be undermined on discovering that a Paramedic had been restored to the Register, in circumstances where the misconduct had occurred nearly 15 years earlier, and the Applicant had learnt from and remedied that misconduct.

20. The Panel concluded that the Applicant should be restored to the Register. It also concluded that in order to ensure the safety of the Applicant’s practice, the maintenance of public confidence in the profession, and the maintenance of proper professional standards, the Applicants restoration should be subject to a Conditions of Practice Order as set out below. The Conditions of Practice Order will be for a period of 12 months from the date on which the restoration takes effect. The Panel considered that this period was sufficient to facilitate the Applicant’s return to unrestricted practice as a Paramedic.

Order

The Registrar is directed to restore the name of Lesley Anne Millen (the Applicant) to the Paramedic Part of the Register, but restoration is only to take effect once the Applicant has:
a) provided the Registrar with any information and declarations required for admission to the Register;
b) paid the prescribed restoration fee; and
c) satisfied the Registrar that, in relation to the Applicant, there is or will be in force appropriate cover under an indemnity arrangement.
The Registrar is further directed to annotate the Register to show that, for a period of 12 months from the date that this Order takes effect (the Operative Date), the Applicant must comply with the following conditions of practice:
1. You must confine your professional practice to your current employer, the Maassarani Group.

2. Before undertaking unsupervised work as a Paramedic, you must:
A. satisfactorily complete a period of not less than 20 days of supervised practice with a registered Paramedic, in accordance with the HCPC Return to Practice Booklet; and
B. forward a report from that registered Paramedic, confirming the successful completion of the supervised practice to the HCPC.

3. You must place yourself and remain under the supervision of a workplace supervisor/mentor registered with the HCPC or other appropriate statutory regulator and supply details of your supervisor to the HCPC within two weeks of the Operative Date. You must attend upon that supervisor as required and follow their advice and recommendations.

4. You must work with your workplace supervisor to undertake a Skills Gap Analysis, identifying the education and training required to bring your skills and knowledge for the role of Paramedic up to date.

5. Having completed a Skills Gap Analysis, you must work with your workplace supervisor/mentor to formulate a Personal Development Plan designed to facilitate your return to unrestricted practice as a Paramedic.

6. Within three months of the Operative Date you must forward a copy of your Personal Development Plan to the HCPC.

7. You must meet with your workplace supervisor/mentor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan.

8. You must allow your workplace supervisor/mentor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan. You must provide a report from your workplace supervisor/mentor to the HCPC before any review of this order.

9. You must promptly inform the HCPC if you cease to be employed by your current employer.

10. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.

11. You must inform your employer that your registration is subject to these conditions.

12. Any condition requiring you to provide any information to the HCPC is to be met by you sending the information to the offices of the HCPC, marked for the attention of the relevant Case Manager.

Notes

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

Under Articles 33(12), (13) and 38 of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this decision is served on you.

Hearing History

History of Hearings for Miss Lesley A Millen

Date Panel Hearing type Outcomes / Status
23/10/2020 Conduct and Competence Committee Voluntary Removal Agreement Restored