Miss Lesley A Millen

Profession: Paramedic

Registration Number: 19083

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 30/03/2021 End: 17:00 30/03/2021

Location: Hearing taking place virtually

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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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

Preliminary matters

1. This hearing was conducted virtually in accordance with the current protocol adopted by the HCPTS in response to the COVID-19 pandemic.

2. It was confirmed at the beginning of the hearing that the Registrant’s correct first name is Lesleyanne, one word, and not Lesley Anne, as shown on the Register.

Background

3. The Registrant has requested by way of email dated 17 February 2021, an early review of the terms of the Conditions of Practice Order that was imposed on her future practice at a Restoration Hearing held on 23 October 2020. At that Restoration Hearing fresh evidence of the Registrant’s insight into her former behaviour and details of current level of competence were placed before that hearing panel and approval sought for her name to be restored to the Register.

4. The original decision to remove the Registrant’s name from the Register related to the following Allegation which was considered at a Final Hearing held on the 25-29 February and 31 March 2008:

Your fitness to practise 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, 11 December 2004 you threw a hot drink into the face of a patient whilst outside Royal Liverpool University Hospital.

2. On Monday 29 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 15 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.

5. The Restoration Hearing imposed the following 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 practise:

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.

6. On 26 November 2020 Ms Fielding wrote to the HCPC informing it that the Registrant’s Workplace Supervisor/Mentor would be Dr Rami Messing.

7. On 24 January 2021 Ms Fielding sent to the HCPC a copy of the Registrant’s Personal Development Plan (the Plan), which stated that Dr Aman Amir, of the Maassarani Group, had, in the role of Workplace Supervisor/Mentor, undertaken the preparation of the Plan. The Plan set out what was intended in terms of compliance with the Conditions and identified those who would be undertaking and overseeing elements of the Plan. The Plan was accompanied by a Skills Gap Analysis.

8. On 2 February 2021 the HCPC received details of:

a.  GP Practice Paramedic Competencies and Training Requirements.
b. Nurse Competencies and Training Requirements.
c. GP Practice Paramedic – Primary Care Workforce Competencies.

9. On 17 February 2021 Ms Fielding emailed the HCPC stating that:
As intimated previously it has proved impossible for Ms Millen to comply with the requirements of the above Order to work under the supervision of a paramedic for 20 days.
Paramedics are generally employed by the Ambulance Services and due to Covid[sic] restrictions no additional persons are allowed. As the Panel was aware the Maassarani Practice does not employ any paramedics, in fact the Panel was advised that they hoped to commence this with Lesley. At the moment they are not in a position to employ a paramedic but are keen for Lesley to get through the first year and comply with the Order.
So it appears that a formal Application must be made to the Panel asking them to review and revise their Order and substitute some other training in lieu of supervision by a paramedic.

Evidence and Submissions

10. The Panel had before it a bundle prepared by the HCPC of 46 pages. This included the decision of the Restoration Hearing and subsequent correspondence between Ms Feilding and the HCPC. The Panel subsequently received a further document from the HCPC, the substantive hearing in 2008 when the Striking Off Order has been imposed.

11. The Panel received at the hearing the detailed written presentation of Ms Fielding which was 6-pages in which she set out in further detail the difficulties that had been encountered in complying with the current rules during the COVID-19 pandemic. 

12. Ms Fielding stated, in those written submissions that the amendments being sought were:

• Clarification of the effect of paragraph 1, that Ms Millen must confine her professional practice to her current employer, the Maassarani Group, and amendment of that paragraph if necessary to allow necessary training; and
• Confirmation that paragraph 2 which requires Miss Millen to complete a period of not less than 20 days of supervised practice with a registered paramedic, is sufficiently complied with by the supervision provided by Mr. Tollitt as set out in his statement which is now before the Panel.

13. The Panel also received at the hearing the  3 page statement of Mr Paul Tollitt, a serving ‘Senior Paramedic Team Leader’ with North West Ambulance Service (NWAS). In his statement he identified the work he had completed and was to undertake with the Registrant to provide the evidence required for fulfilment of Condition 2.

14. Ms Fielding in her oral representations referred to the arrangements which had, since the original request for a review, been put in place for supervision by Mr Tollitt. Mr Tollitt had, during the month of March 2021, completed 7 days supervision of the Registrant’s practice, and was in the process of identifying further dates to complete the required 20 days as required within Condition 2, In light of this, it would not now be necessary to amend Condition 2 as there was some confidence that it could be fulfilled.

15. In relation to Condition 1, Ms Fielding in her written submissions highlighted the problems being encountered with the Registrant being engaged in an honorary contract with Aintree Hospital to shadow Dr Wong in A&E, MAU and the Operating Theatre, as this appeared to be in breach of the current wording. In her oral representations she confirmed that it would be necessary for Condition 1 to be amended to allow outside organisations to be engaged in the process without being in breach of the restrictions on employment as set out in Condition 1.

16. The HCPC stated that it was neutral on the proposals made by Ms Fielding and suggested the expansion of Condition 1 to include the Registrant being able to undertake ‘secondments’ in outside organisations.

Decision

17. This Panel has taken into account all documentation placed before it and has heard and given appropriate weight to the fresh evidence of performance supplied by the Registrant and noted the difficulties with  compliance identified by Ms Fielding. 

18. It has heard the parties’ submissions; taken and accepted the advice of the Legal Assessor; and it has reminded itself of the terms of the relevant HCPTS Practice Note relating to early reviews of a substantive order and variation of conditions of practice.

19. The Panel notes that the Registrant’s Application now relates solely to the consideration of Condition 1.

20. The Panel noted the extent of the work undertaken by Mr Tollitt with the Registrant in relation to Condition 2, supervision arrangements which appear to the Panel to be satisfactory. In this context of undertaking 20 days supervision, the Panel noted that the Return to Practice Booklet identifies 7 hours as being equivalent to one day.

21. The matter before the Panel today therefore relates solely to the consideration of the wording of Condition 1, and how it may be amended to allow the Registrant to fulfil the terms of her retraining with the participation of outside organisations.

22. The Panel considered that adopting the wording ‘secondment’ may be restrictive in relation to making arrangements for shadowing, supervision or training.

23. The Panel has concluded that the appropriate amended wording, as a variation to Condition 1, which will still ensure that the Registrant’s employment within the Maassarani Group remains clear, but permits the participation of other organisations in the Registrant’s retraining is:

1. You must confine your professional practice to your current employer, the Maassarani Group, with the exception of training, supervision and shadowing opportunities at other organisations as approved by your Workplace Supervisor/Mentor as identified in Condition 3.

Order

The Registrar is directed to vary the terms of Condition 1 of the Conditions of Practice Order imposed on the 23 October 2020 to read.

1. You must confine your professional practice to your current employer, the Maassarani Group, with the exception of training, supervision and shadowing opportunities at other organisations as approved by your Workplace Supervisor/Mentor as identified in Condition 3.

Notes

The order imposed today takes immediate effect.

This order will be reviewed before its expiry on 25 November 2021.

Hearing History

History of Hearings for Miss Lesley A Millen

Date Panel Hearing type Outcomes / Status
30/03/2021 Conduct and Competence Committee Review Hearing Conditions of Practice
23/10/2020 Conduct and Competence Committee Voluntary Removal Agreement Restored