David Landey

 

 

1. The Panel determined that service of notice of the hearing had been effected by an email dated 21 June 2022 that was sent to the Registrant’s registered email address. The Registrant replied by email on 14 July 2022 and stated that he was no longer working as a Paramedic, so he would not attend the hearing.

 

2. The Registrant did not therefore appear nor was he represented. On behalf of the HCPC, Mr Bridges applied for the hearing to be conducted in the absence of the Registrant on the basis that the Registrant had been notified of the date and time of the hearing at his registered email address, that he had acknowledged receipt but confirmed he would not attend, and that it was in the public interest for the hearing to proceed expeditiously. Mr Bridges therefore submitted that there was no benefit or logic to adjourning this hearing.

 

3. Having considered the HCPTS Practice Note on proceeding in absence and the advice of the Legal Assessor on the case of GMC v Adeogba [2016] EWCA Civ 162 (“the fair, economical, expeditious and efficient disposal of allegations against medical practitioners is of real importance”), the Panel noted that the Registrant had confirmed that he was aware of the hearing but that he did not intend to attend. The Panel was therefore satisfied that the Registrant had voluntarily absented himself from the hearing. There was no indication that he would attend at a later date if today’s hearing were to be adjourned. 

 

4. The Panel had in mind that the Registrant had engaged constructively with the HCPC in agreeing to bring the proceedings to an agreed conclusion and that the purpose of this hearing was to give effect to that agreement. The Panel determined that adjournment would serve no useful purpose and that it would be unfair to both parties not to proceed in the circumstances.

 

 

5.The Registrant is registered with the HCPC as a Paramedic. At the relevant time the Registrant was working for the West Midlands Ambulance Service NHS Trust (The Trust).

 

6. On 3 July 2020, the Registrant was referred to the HCPC by Person B, who works at the Trust and is the Granddaughter of Patient A. It is alleged that on 13 January 2020, the Registrant, accompanied by another Paramedic (Colleague B), attended on an 82-year-old patient (Patient A) with chest pain. It is alleged that several clinical failings occurred, including the fact that an Electrocardiogram (ECG) was completed at the scene, but neither the Registrant nor his colleague reviewed the ECG adequately, each assuming, without discussion, that the other had already done so.

 

7. It is alleged that the Registrant and Colleague B failed to follow the correct procedure of Primary Percutaneous Coronary Intervention (PPCI) Management of STEMI; “the ST elevation was not identified as meeting the STEMI criteria…the clinical record had minimal observations recorded and the history of the patient’s pain had not been explored in depth and the pain had not been accessed using SCO”.

 

8. Consequently, Patient A was transported to a local hospital without PPCI facilities, thus delaying PPCI treatment. Several hours later, Patient A was transferred to a PPCI unit where he “underwent PPCI treatment and had two stents fitted.” Patient A remained in hospital until 17 January 2020, he was discharged from hospital and suffered a cardiac arrest that evening. At 01:58 on 18 January 2020, Patient A was transported to hospital where he was pronounced dead shortly after arrival.

 

9. A Coroner’s enquiry ruled the cause of death as Acute Myocardial Infarction, Coronary Artery Atheroma and Hypertensive Heart Disease.

 

10. A Serious Incident Investigation was undertaken by the Trust and the ensuing report, dated 23 June 2020, concluded that “the patient was having a STEMI which met the criteria for admission to a PPCI hospital”. Neither of the clinicians reviewed the ECG whilst on scene, which led to the patient being taken to a hospital with no PPCI facilities. This delayed the patient receiving PPCI treatment. The level of harm was scored as ‘severe’.

 

11. On 19 August 2020, the Registrant informed the HCPC that he had decided to step down as a Paramedic after 17 years in the profession and to work instead as an Ambulance Technician with the same line manager and employer. He reported that he was entirely comfortable with this decision and had no intention of returning to work as a Paramedic in the future.

 

12. On 17 December 2020, a Panel of the HCPC Investigating Committee concluded that the Registrant had a case to answer in respect of the allegation that had been raised.

 

13. The Allegation that was referred to the Conduct and Competence Committee and a notice of the allegation was sent to the Registrant on 4 January 2021. He has since confirmed to Kingsley Napley solicitors, instructed on behalf of the HCPC, that he no longer works as a Paramedic, having stood down from his position in August 2020.

 

 

14. On 20 December 2021, Kingsley Napley emailed the Registrant with information and guidance relating to voluntary removal from the register and the terms of such an agreement. On 3 March 2022, the Registrant confirmed his request for voluntary removal and that he admitted the allegation. He also confirmed that he did not wish to return to the profession. He subsequently signed and witnessed a Voluntary Removal Agreement (VRA) on 30 June 2022. The operative date, if approved by the Panel, is 20 July 2022.

 

15. In signing the Voluntary Removal Agreement, the Registrant confirmed his understanding that the HCPC will not consider any future application for restoration to the register for a period of at least five years as a consequence of the agreement. The HCPC has agreed that this is an appropriate case for such a disposal, subject to the final approval of the Panel.   

 

16. For the HCPC, Mr Bridges referred the Panel to the written submission outlining the history of the case. The submission drew the Panel’s attention to the HCPTS Practice Note on Disposal of Cases by Consent in which it states that the Panel should not agree to the removal from the register unless it is agreed that a VRA achieves the appropriate level of public protection and that doing so would not be detrimental to the wider public interest. 

 

17. Mr Bridges submitted that the Voluntary Removal Agreement would adequately protect the public because the Registrant has left the profession, does not wish to resume practice as a Paramedic, and would not be able to re-apply to return to practice for five years. 

 

18. The HCPC further submitted that the proposed VRA was in the public interest for the following reasons:

 

⦁ The Registrant has admitted the substance of the factual allegation and that his fitness to practise is currently impaired by reason of his misconduct.

⦁ He has given his informed consent to disposal of this case by way of voluntary removal. 

⦁ It would not be contrary to the public interest to proceed in this way and it is not necessary to proceed to a final hearing when he has already made it clear that he has no intention of returning to practice.

 

 

19. The Panel considered the public protection and public interest tests, as set out in the HCPTS Practice Note on the Disposal of Cases by Consent and accepted the advice of the Legal Assessor. 

 

20. The Panel determined that this was an appropriate case for voluntary removal from the register. The Panel noted that the Registrant had engaged constructively with the regulatory process and that he had admitted the allegation. He had reflected on his position and had demonstrated insight and understanding. He has not practised as a Paramedic since August 2020 and he has confirmed his intention not to return to the profession. The Panel was satisfied that he had given his informed consent to the proceeding with the proposed VRA. 

 

21. If proved, the allegation may or may not have resulted in striking off but the Panel accepted that that was no bar to proceeding in this way. The Panel determined that there was no useful or practical purpose in proceeding to a final hearing in these circumstances.

 

22. The Registrant had signed the VRA in which he undertook not to practise as a Paramedic or to use any protected title associated with the profession. 

 

23. The Panel concluded that the public would be protected by the Registrant’s agreement to his removal from the register. In signing the agreement, the Registrant also understood that any application for restoration to register would be treated as if he had been struck off the register as a result of the allegation. The practical effect of the agreement was that he could not re-apply to the HCPC for registration for at least five years. The Panel determined that that safeguard provided proper protection for the public.

 

24. The Panel was satisfied that a voluntary removal from the register was in the wider public interest in the circumstances. A reasonable member of the public with knowledge of the facts of the case would agree that the public interest was served by resolving the matter by agreement without further unnecessary hearings. The Panel therefore determined that proceeding in this way would not undermine public confidence in the profession or the

regulator. There was no detriment to the public interest.  

 

25. The Panel therefore approved the agreement as an appropriate and practical means of disposal of the case that was consistent with public safety and the public interest in upholding and declaring proper standards.

 

26. On that basis, the Panel approved the VRA that was signed by the Registrant on 30 June 2022 and the Panel Chair signed the Notice of Withdrawal.