Mr Anthony Morris

Profession: Paramedic

Registration Number: PA40198

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 16/09/2021 End: 17:00 16/09/2021

Location: Virtual hearing - Video conference

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

Allegation against the registrant are as follows:

On 26 August 2016, whilst registered as a Paramedic and employed by the North West Ambulance Service, you attended Service User A and you:

 

1. Made the following inappropriate comments: a) You requested an amber level ambulance backup ‘for my own sanity’, or words to that effect;

b) Regarding not lifting Service User A, you asked if Service User A’s family would pay your mortgage if you hurt your back, or words to that effect;

c) You made comments to the effect that Service User A was not unwell, or was feigning illness;

d) [Not proven]

e) You made a comment to the effect that it did not matter how long it took to treat Service User A as you would be paid until the end of your shift anyway;

f) You made a comment to the effect that you could be helping others and that Service User A was wasting your time.

2. Did not communicate appropriately with Service User A and/or her family, in that:

a) [Not proven]

b) [Not proven]

3. Did not complete and/or record an adequate clinical assessment and/or examination.

4. Walked Service User A to the ambulance, despite her being tachypnoeic and/or without offering appropriate assistance.

5. Did not provide a wheelchair to Service User A despite this being requested by Person B.

6. Did not assist Service User A to stand when she collapsed on multiple occasions.

7. Did not provide care to Service User A in a timely manner following her collapse.

8. Did not transport Service User A to the hospital in a timely manner despite Service User A hyperventilating.

9. [Not proven]

10. Did not complete and/or record regular observations of Service User A.

11. Did not assist Service User A to travel down the stairs, including by not using a track chair.

12. Informed your employer that care was provided to Service User A in a timely manner following her collapse, when this was not the case.

13. [Not proven]

14. Your actions as described at paragraphs 1 – 11 above amounted to misconduct and/or lack of competence.

15. Your actions as described at paragraphs 12-13 above amounted to misconduct.

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

Finding

Background

1. The Registrant was employed by North West Ambulance Service NHS Trust (“NWAST”) as a Paramedic.

2. On 26 August 2016, he attended to Service User A in response to an emergency 999 call made by Person C. The Registrant subsequently contacted the Ambulance control room and requested an ambulance crew as backup. Ms Chadwick and Colleague A were dispatched to assist him and arrived in an ambulance. Ms Chadwick was a paramedic also employed by NWAST and Colleague A was an Emergency Medical Technician (“EMT”). Service User A died shortly after her arrival at the hospital.

3. Person B, Service User A’s mother, submitted a written complaint to NWAST on 22 March 2017 with regard to the care that Service User A received from the Registrant and Ms Chadwick. PC, a Patient Experience Manager at NWAST, subsequently completed an investigation. JP, who was an Advanced Paramedic, conducted a clinical review of the incident.

4. A referral was made to the HCPC by NWAST on 25 July 2017 in regard to the Registrant’s fitness to practise.

5. At the Substantive Hearing, the original panel determined that the matters found proved amounted to misconduct and the Registrant’s fitness to practice to be impaired.

6. In regard to sanction, the panel imposed a Conditions of Practice Order for a period of 12 months to enable the Registrant to address the deficiencies that were identified in his practice, thereby, protecting service users and maintaining public confidence in the profession.

7. That panel did consider whether to impose a Suspension Order but concluded that this would be disproportionate to the deficiencies identified and would not enable the Registrant to resume practice and to address the matters of concern.

Submissions

HCPC

8. Mr D’Alton on behalf of the HCPC submitted that the Registrant, who has been unable to obtain employment as a Paramedic, since the original order was imposed, has clearly been unable to comply with the Conditions of Practice Order and that his fitness to practice therefore remains impaired.

9. Mr D’Alton further submitted that in the circumstances, the Conditions of Practice Order should be extended for a further period of 12 months. He suggested however, that some modification to the conditions could be made which would facilitate the Registrant in finding work as a Paramedic, thereby enabling him to comply with the conditions designed to address his deficiencies.

Registrant

10. The Registrant, who gave evidence, conceded that his fitness to practice remained impaired as he had been unable to address the deficiencies identified, because of his inability to obtain employment as a Paramedic. He said that he wished the Conditions of Practice Order to continue but with some variations to Conditions 1 and 2 which might facilitate his obtaining employment.

Decision

11. In reaching its decision, the Panel considered all the information before it together with the submissions of Mr D’Alton and the evidence and submissions of the Registrant. It accepted the advice of the Legal Assessor. It had regard to the HCPC ‘Standards of Conduct Performance and Ethics’, the HCPTS Practice Note on Review of Article 30 Sanction Orders and the HCPC Indicative Sanctions Policy. It has exercised the principle of proportionality at all times. It has accepted the advice of the Legal Assessor.

12. The Panel had regard to the decision of the Substantive panel but it has comprehensively reviewed the matter and has exercised its own judgment in reaching its decision.

Impairment

13. The Panel has determined that the Registrant’s fitness to practice remains impaired.

14. In his evidence, the Registrant described his several attempts to obtain employment as a Paramedic. He said that, although he had been interviewed on some two or three occasions, prospective employers were not prepared to offer him employment because of the conditions on his practice, particularly in regard to supervision.

15. In regard to remediation, the Registrant said that he had engaged to some reading relevant to the deficiencies but that in his current employment as a heavy goods vehicle driver, he was limited in the amount of time available to take further steps. He said however that he had just received an offer of employment as a heavy goods vehicle driver closer to his home and with fewer hours than currently which would enable him to devote more time to taking remedial steps. Further, that he wished to seek part time work in a healthcare field where registration as a Paramedic is not required, to gain some clinical exposure.

16. The Registrant also said that he remained very conscious of the serious nature of the incident and its consequences.

17. Although the Registrant has developed a degree of insight, this is still developing and is as yet not fully developed. Although in his evidence the Registrant expressed remorse for his misconduct, the Panel would have benefited from a reflective piece addressing the consequences to the service user and her family and also to the reputation of the profession.

18. In these circumstances, there being very limited remediation, the Panel cannot be satisfied that there would not be repetition of the Registrant’s failings and the consequent risk to service users. Moreover, the public would be concerned if the Registrant were unable to demonstrate that he can practice safely and uphold appropriate professional standards.

19. The Panel has therefore concluded that the Registrant’s fitness to practice remains impaired on both the personal and public interest grounds.

Sanction

20. The Panel has approached the question of sanction from the least restrictive upwards. It has exercised the principle of proportionality at all times. It has accepted the advice of the Legal Assessor.

21. The Panel first considered whether to revoke the existing order or to allow it to lapse. It has concluded that this would be wholly inappropriate and insufficient to protect the public. Furthermore, for the same reasons, a Caution would be insufficient.
22. Although the Registrant has been unable to comply with the current Conditions of Practice Order in regard to clinical matters, he has informed prospective employers of the conditions imposed. Furthermore, the Panel were satisfied from his evidence of his wish to comply and his acceptance of the need to do so.

23. In the circumstances, the Panel has concluded that appropriate Conditions of Practice would be sufficient to protect the public against the risk posed by the Registrant and would also address the wider public interest.

24. The Panel did consider a Suspension order but decided that this would be disproportionate as it would not provide the Registrant with the opportunity to remedy his failings and return to safe practice.

25. It is therefore determined that the current Conditions of Practice Order should be extended for a further period of 12 months subject to variations which might facilitate the Registrant in finding employment as a Paramedic.

Order

The Registrar is directed to vary the Conditions of Practice Order for a further period of 12 months, you Mr Anthony Morris must comply with the following conditions of practice:

1. You must work as a registered Paramedic only where you are directly working with another registered healthcare professional.

2. You must place yourself and remain under the indirect supervision of a supervisor who is a registered Paramedic.

3. You must supply details of your supervisor to the HCPC within 14 days of the commencement of your employment under these conditions.

4. You must attend upon that supervisor as required and follow any advice and recommendations.

5. Informing the HCPC and others:

i. You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.
ii. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.
iii. You must inform the following parties that your registration is subject to these conditions:
A. any organisation or person employing or contracting with you to undertake professional work;
B. any agency you are registered with or apply to be registered with (at the time of application); and
C. any prospective employer (at the time of your application).

6. You must work with your supervisor to formulate a personal development plan designed to address the deficiencies in the following areas:

• Managing challenging and non-compliant service users;
• Treating service users and their families/others with respect and dignity;
• Clinical assessment and examination;
• Baseline observations;
• Communicating with service users and carers;
• Appropriate extrication and conveyance of service users;
• Timeliness of interventions;

7. Within two months of commencing employment as a Registered Paramedic you must forward a copy of your Personal Development Plan to the HCPC.

8. You must meet with your supervisor fortnightly for the first two months, and on a monthly basis thereafter to consider your progress towards achieving the aims set out in your Personal Development Plan.

9. You must allow your supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan every three months and prior to any review of this order.

10. You must undertake the process and meet the requirement for Return to Practice set out by the HCPC.

11. You will be responsible for meeting any and all costs associated with complying with these conditions. Any condition requiring you to provide information to the HCPC is to be met by you and sent to the offices of the HCPC, marked for the attention of the relevant Case Manager.

Notes

No notes available

Hearing History

History of Hearings for Mr Anthony Morris

Date Panel Hearing type Outcomes / Status
04/02/2022 Conduct and Competence Committee Review Hearing Conditions of Practice
16/09/2021 Conduct and Competence Committee Review Hearing Conditions of Practice
22/09/2020 Conduct and Competence Committee Final Hearing Conditions of Practice
22/06/2020 Conduct and Competence Committee Final Hearing Adjourned part heard
03/02/2020 Conduct and Competence Committee Final Hearing Adjourned part heard