Mr Michal Szczytynski

Profession: Paramedic

Registration Number: PA44528

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 04/03/2021 End: 17:00 04/03/2021

Location: Virtual hearing - Video conference

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

During the course of your employment with East of England Ambulance Service, you:

1. Failed to pass your ECG exam to become a Student Paramedic, on:

a) 12 June 2017

b) 13 November 2017

 

2. Acted in an unprofessional manner, in that you:

a) [not proven]

b) on 10 August 2017, did not act appropriately on the scene of a deceased patient in that you:

(i) swung on a seat near to the deceased;

(ii) [not proven]

c) on 5 September 2017, you

i. did not wear the correct Personal Protective Equipment to deal with an incident;

ii. removed a one use neck collar from a bin to send to Ukraine;

iii. went for a cigarette when you were still in charge of looking after Patient A.

d) [not proven]

e) on or around 20 October 2017, did not treat a patient with care when you dropped her down a flight of stairs in the carry chair despite her having hip problems

f) On or around 03 November 2017

i.hit a wing mirror of a car whilst driving an ambulance and did not stop at the scene

ii. [not proven]

iii. drove the wrong way round a roundabout.

iv. slept in the front seat of the ambulance in public view

v. did not prepare the ambulance for the next call out

vi. [not proven]

g) on or around 14 November /2017, did not pre-alert a time critical patient to the receiving hospital

h) on or around 14 November 2017, did not treat Patient G with respect by rolling your eyes at him, telling him to hurry up and get in the ambulance so you could take them to A&E

i) [not proven]

 

3. On or around 22 September 2017, when attending Patient H, you:

a) did not communicate your observation with Patient H and/or your colleague;

b)assessed Patient H without obtaining their consent

c) Took blood from Patient H without

i. Patient H's consent

ii. cleaning Patient H’s finger

d) did not apply pressure to the wound caused by taking Patient H’s blood

 

4. In November 2017, while the Trust was listed as your place of employment on your Facebook profile, you did not use Facebook appropriately in that you:

a) Posted a Facebook Status on your profile, the content of which was offensive;

b) Posted a meme on your profile aimed at your colleagues at the Trust.

 

5. [not proven]

 

6. The matters set out in particulars 1 – 5 constitute misconduct and/or a lack of competence.

 

7. By reason of your misconduct and/or lack of competence your fitness to practise is impaired

Finding

Preliminary Matters

Service

1. The Panel was informed that the notice of this hearing was sent to the Registrant’s registered email address on 2 February 2021 informing him that the HCPC intended on proceeding by having his substantive order review heard by way of “a virtual hearing”. The HCPC has produced confirmation of delivery of the email in the Panel’s bundle.


2. Having heard and accepted the advice of the Legal Assessor, the Panel was satisfied that notice had been properly served in accordance with the Rules and that the 28 day notice period had been complied with.

Proceeding in the absence of the Registrant

3. Miss Sampson on behalf of the HCPC made an application to proceed in the Registrant’s absence. She submitted that the Registrant was served with a Notice of Hearing sent to his registered email address, which advised him of the date, time and nature of the hearing. The email was confirmed to be delivered. She submitted that the Registrant has not indicated that he wished to attend this hearing, nor has he asked for the hearing to be adjourned and no response to the email had been received from the Registrant. Miss Sampson pointed out that the Registrant did not attend the previous hearing and there had been no communication with him since January 2020.


4. Miss Sampson submitted that the Registrant has been given sufficient notice of the proceedings and that reasonable steps have been taken to serve the Notice of Hearing on the Registrant and alert him to the opportunity to attend or prepare written submissions. She therefore submitted that the Registrant has chosen to voluntarily absent himself from this hearing.


5. Furthermore, Miss Sampson submitted that as this is a mandatory review of the current order, it is in both the Registrant’s interests and in the public interest for a review of the statutory order to take place as scheduled before expiry.


6. The Panel heard and accepted the advice of the Legal Assessor who advised that the Panel’s discretion to proceed in the Registrant’s absence should only be exercised with the utmost care and caution. She referred the Panel to the cases of R v Hayward, Jones & Purvis in the Court of Appeal ([2001] EWCA Crim 168), and GMC v Adeogba and Visvardis [2016] EWCA Civ 162. She advised that the Adeogba case reminded the Panel that its primary objective is the protection of the public and the public interest and that the “fair, economical, expeditious and efficient disposal of allegations made against medical practitioners is of very real importance”. That case further stated that, “where there is good reason not to proceed, the case should be adjourned; where there is not, however, it is only right that it should proceed”.


7. The Panel has also taken into account the HCPTS’s Practice Note on Proceeding in the Absence of the Registrant.


8. The Panel was satisfied that notice of this hearing was sent to the Registrant’s registered email address on 2 February 2021. The Panel was satisfied that the HCPC had taken all reasonable steps to make the Registrant aware of today’s hearing. He had not expressly sought an adjournment or indicated he would be willing to attend in the future. The Panel therefore concluded that the Registrant had voluntarily decided not to attend this hearing.


9. The Panel was satisfied that there would not be a significant risk of unfairness to the Registrant if it decided to proceed in the Registrant’s absence, and further recognised that there was a public interest in conducting a statutory review of the Order currently in place.


Background

10. The Registrant had worked as a qualified Paramedic in Poland, since 2010. The Registrant became a HCPC registered Paramedic on 22 February 2018.

11. At the time of the events which lead to the Allegation, the Registrant was a student Paramedic. He was employed by the East of England Ambulance Service NHS Trust (hereafter “the Trust”) between 27 March 2017 and 28 February 2018.


12. The Registrant was part of a small cohort of 8 Paramedics recruited from Poland and Latvia. A 4 - 6 week programme was designed by the Trust, to facilitate the Paramedics with the requirements to practice in the NHS and the Trust. It was essentially a conversion course aimed at those who were already in practice outside the UK.


13. The Registrant was employed through a conditional contract of employment which required that he pass an Electrocardiogram Examination (ECG examination) to become a fully qualified Paramedic in the United Kingdom.


14. On 23 February 2018, The Registrant self-referred to the HCPC, after he failed the ECG examination after the second attempt. On 9 March 2018, the Trust notified the HCPC of further issues relating to the Registrant’s conduct and practice. These included allegations of acting in an unprofessional manner, damaging property, poor standards of patient care and inappropriate comments on social media.


15. On 9 – 13 March 2020 there was a substantive hearing of a panel of the Conduct and Competence Committee. The Registrant was not present, nor was he represented. However, he provided written submissions that were seen by the panel.


16. The panel found particulars 2(e), 2(f)(iii), 2(g), 3(b), 3(c)(i),3(c)(ii), 4(a) and 4(b) proved and that the Registrant’s conduct amounted to misconduct in relation to these particulars. The panel also concluded that the Registrant’s fitness to practise was impaired in relation to the personal component having regard to the seriousness of the misconduct and the lack of evidence of insight and/or remediation. In relation to the public component, the Panel concluded that it was clear that the public’s perceptions of the Registrant’s actions would have been negative and may have harmed the reputation of both his employer and his profession.


17. In considering the relevant sanction the Panel concluded that a 12 month Suspension Order, was an appropriate sanction. The Panel considered that this period of time would give the Registrant the opportunity to reflect on his misconduct. That Panel considered a future reviewing Panel may be assisted by the Registrant’s attendance at a review hearing and engagement with the regulatory process and evidence of remediation and/or reflection.

 

Today’s Review Hearing

18. The Registrant has not engaged with the HCPC since sending his submissions for the substantive hearing in January 2020. The evidence from the Registrant suggested that he had returned to Poland in 2018 and was working as an ambulance driver there.


19. It was submitted by Miss Sampson for the HCPC that in the absence of any updating information from the Registrant the Panel could not conclude that the failings that led to the original order had been remediated. Miss Sampson submitted that the Registrant’s fitness to practice remained impaired on both personal and public interest grounds. She submitted there was no evidence before the Panel of insight or remediation and that the Registrant posed a significant risk of repeating the misconduct. 


20. Miss Sampson submitted that if the Panel found that the Registrant’s fitness to practise was currently impaired, it was the HCPC’s primary submission that a Striking Off Order was imposed. Miss Sampson submitted that a further suspension would serve no useful purpose given the Registrant’s apparent unwillingness to engage. Alternatively, she submitted that a further 12 month Suspension Order would be the appropriate sanction to give the Registrant a final opportunity to engage and address the concerns.


Decision 

21. The Panel considered the submissions of Miss Sampson together with all of the evidence it had before it. The Panel accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Note ‘Finding that Fitness to Practice is Impaired’.


22. The Panel exercised its own professional judgement when considering whether the Registrant’s fitness to practice is currently impaired.


23. The Panel considered that it had no evidence upon which to conclude that the Registrant had sufficiently addressed the concerns that led to the imposition of the Suspension Order. The Registrant has not engaged with the HCPC since the substantive order was made and the Panel had no information about his current circumstances.


24. The Panel considered that it was possible to remedy the concerns. It noted that the Registrant had only had a very short induction to working in the UK and there were clearly cultural differences from his previous working environment. The Panel noted that some of the misconduct relating to the discriminatory Facebook posts was serious, but could have been satisfactorily addressed with appropriate reflection and insight.


25. The Panel considered that without any evidence from the Registrant it was unable to be satisfied that he had developed any remediation or insight into his misconduct. The Panel noted the persuasive burden on a Registrant at a review hearing to demonstrate to the Panel that the concerns have been addressed. The Panel had no evidence from the Registrant that he had taken any steps to engage with the findings of the previous Panel and address the concerns found proved.


26. In the absence of any evidence of remediation and insight or any evidence that the Registrant has fully addressed all of the concerns in his practice the Panel considered that there remains a risk of repetition of the concerns that led to the substantive order. The Panel determined that the Registrant’s fitness to practise is currently impaired on public protection grounds.


27. The Panel also considered the public interest in upholding proper professional standards and considered that a finding of current impairment on public interest grounds was also required. The public would expect the regulator to act in circumstances where there was a risk of repetition of concerns that had the potential to cause patient harm and where a Registrant had provided no evidence that those concerns had been addressed and failed to engage with the regulator.


28. Having determined that the Registrant’s fitness to practise remains impaired the Panel went on to consider what order was appropriate. It had regard to the need to act proportionately and to balance the public interest with the Registrant’s own interests.


29. The Panel first considered allowing the order to lapse but considered that this would be inappropriate given the risk of repetition identified. A caution Order would not restrict the Registrant’s practice and the Panel therefore considered this was also not appropriate to protect the public.


30. The Panel then considered whether a Conditions of Practice Order was appropriate. The Panel considered that the concerns were wide ranging and for the same reasons as the substantive order Panel it considered that it was unable to identify suitable conditions that would address the discriminatory aspects of the misconduct. In addition, it had no information that the Registrant would be willing to comply with any such conditions.


31. The Panel next considered whether to extend the Suspension Order to afford the Registrant a further opportunity to demonstrate that he could remediate the concerns and return to safe practice.


32. The Panel considered that a further Suspension Order would serve no useful purpose in these circumstances. The Registrant has had 12 months to address the concerns and has not engaged in the process. The Registrant has not attended the virtual hearing today and provided no evidence about his current circumstances. The Panel considered that without such engagement it had no evidence that the Registrant was willing to address the concerns or take steps to remedy them. The Panel considered that the Registrant had shown no evidence of any insight and it had no confidence that this would change were a further Suspension Order to be imposed. The Registrant had failed to engage with the regulator to address concerns despite being given a significant period of time to do so. The concerns date back to 2017.


33. The Panel considered that the appropriate and proportionate sanction to impose in these circumstances is a Striking Off Order. The Panel had regard to the impact a striking off order may have on the Registrant and the potential impact on his current job in Poland. Nevertheless, it considered that this was the appropriate and proportionate sanction in circumstances where the Registrant had not addressed concerns and showed no willingness or insight to do so in the future.

Order

Order: The Registrar is directed to strike the name of Mr Michal Szczytynski from the Register on the date this Order comes into effect.

Notes

The Order imposed today will apply from 10 April 2021

Hearing History

History of Hearings for Mr Michal Szczytynski

Date Panel Hearing type Outcomes / Status
04/03/2021 Conduct and Competence Committee Review Hearing Struck off
09/03/2020 Conduct and Competence Committee Final Hearing Suspended