Mr Maksym Wojcieszek

Preliminary Matters
Service
1. The Panel read in the hearing bundle provided that notice of hearing had been sent to the Registrant by email on 14 July 2023. Mr Wojcieszek had attended the hearing today in response to the notice. The Panel was satisfied that he was therefore given an opportunity to attend and address the Panel, in accordance with Article 30(9) of the Health Professions Order 2001 (as amended)(“the Order”).

2. The Panel had been provided with a hearing bundle by the HCPC including the previous determinations and notice of hearing. It had also been provided with an addendum bundle of documents provided on behalf of the Registrant.

Background
3. The Registrant was employed as a Band 5 Paramedic by East Midlands Ambulance Service (EMAS) from 27 March 2017 to 25 January 2018. During his employment the Registrant had regular probation reviews and concerns about his competence were raised.

4. EMAS decided to investigate the concerns further, including by means of a ‘ride out review’ on 25 October 2017 and an assessment day on 20 November 2017. The events identified continuing concerns regarding the Registrant’s ability to practise safely.

5. The Registrant’s probationary period was extended following a meeting on 21 November 2017 and an action plan was provided.

6. Concerns regarding the standard of the Registrant’s practice continued. On January 2018 the Registrant attended a probationary review and a decision was taken to terminate the Registrant’s employment with effect from 25 January 2018.

7. Following an appeal against dismissal, however, the employing Trust decided to offer the Registrant alternative employment. He was offered a place on an Ambulance Technician/Associate Ambulance Practitioner course due to start on 23 April 2018. The Registrant accepted the offer of further employment.

8. The matter of the Registrant’s competence was brought to a hearing by the HCPC in 2020. The Panel of a Conduct and Competence Committee found that the Registrant’s fitness to practise was impaired on the basis of lack of competence, as set out above.

9. The Order was subsequently reviewed and extended on 29 January 2021 and 14 February 2022 and 30 August 2022 and the Registrant’s registration remained suspended.

Submissions on behalf of the HCPC
10. Ms Welsh submitted that the Panel had to consider whether the Registrant had sufficiently addressed the past concerns. She reminded the Panel of the evidence as to the Registrant’s professional history and submitted that he was still at a very early stage of a proposed return to being a paramedic.

11. Ms Welsh submitted that it was still necessary for a sanction to be imposed on the Registrant’s registration, in order to ensure an appropriate transitional period to a return to practice. She submitted that the Registrant’s request for an unrestricted return demonstrated a degree of lack of insight into his readiness. He had made some commendable progress, but needed to demonstrate his competence.

12. Ms Welsh submitted that a conditions of practice order would allow a further period of paramedic education and personal development to occur. She suggested a period of 12 months was appropriate.

Submissions on behalf of the Registrant
13. The Registrant gave oral evidence to the Panel. He submitted that his training program in Poland had been the same as he would have had in England. He maintained that he had an appropriate knowledge of physiology and biology. He ascribed some of his problems to an initial lack of ability in the English language.

14. The Registrant referred the Panel to the support he received from his paramedic mentor. He submitted that he believed he could work safely as a paramedic. There was a need for a shift of mindset, from having worked now as an ambulance technician, to that of a paramedic. He felt that this could be accomplished after a few sessions.

15. The Registrant submitted that he preferred to have no order in place but, if necessary the Registrant said that he could work with some restrictions. The Registrant submitted that there were some tasks which he could not train for whilst not being on the register as a paramedic, due to the requirements of his employer to maintain effective insurance.

Legal advice
16. The Legal Assessor advised the Panel that its purpose at this review was to determine whether the Registrant was fit to return to unrestricted practice, or whether his fitness to practise remains impaired. He advised that although this was a matter for the Panel’s judgement, there is a persuasive burden on the Registrant to demonstrate that he had dealt with past concerns and the impairment. If the panel determined that the Registrant’s fitness to practise remained impaired it had a range of powers to exercise at its discretion under Art 30(4) of the Order (as amended).

17. The Panel bore in mind that at this review, the persuasive burden lies on the Registrant to demonstrate that he had dealt with past concerns. The Panel therefore considered with care the evidence provided by the Registrant, including his oral evidence.

18. The Panel was mindful that it was considering the Registrant’s current impairment. The Panel considered that, being due to competence concerns, the impairment was capable of being remediated. The Panel considered that the Registrant had addressed, by training, all areas of practice that were available to him in his current scope of practice.

19. The Registrant had successfully performed a role with EMAS as an ambulance technician since 2018. He also had given evidence that he had maintained his learning, providing certificates at the level of ambulance technician. It accepted the Registrant’s evidence that he had attempted some courses at the level of paramedic, although not formally certified as such.

20. The Panel considered that the Registrant appropriately articulated in the hearing his reflections over the issues with his competence. He also accepted that there would be some further development necessary to resume working as a Paramedic.

21. The Panel considered that the Registrant displayed some insight into the issues for the safety of the public from the Registrant’s previous lack of competence.

22. The Panel considered that it was relevant that there had been a five-year gap from the Registrant completing training in Poland and commencing his post with EMAS. In addition, there had been some issues in the Registrant’s English Language ability in the initial years. Further, the Registrant had not undergone the period of supervision in Poland which would have followed, had the Registrant remained there after qualification.

23. The Panel noted that the Registrant tended to place emphasis on the language issue. In this respect, the Panel considered that there was some limitation on the Registrant’s insight into the issues. It considered that some elements of training required to be undertaken.

24. The Panel considered that the Registrant had taken some significant steps towards remedying his past lack of competence. However, he still required to undergo some further training and supervision in work. Therefore, the Panel concluded that the Registrant’s remediation was not yet complete and it was not yet able to say that the lack of competence was ‘highly unlikely’ to be repeated. The Panel concluded that this therefore involved some risk of repetition.

25. On the basis that there was a risk of repetition, this also involved a risk to public confidence in the profession. The Panel concluded therefore that the Registrant’s fitness to practise is currently impaired, whilst he continues on the path to full remediation.

26. The Panel determined that the Registrant’s fitness to practise is currently impaired.

27. The Panel next considered what steps it should take in terms of the current order, in accordance with Article 31(4) of the Order. The Panel decided against extending the current order, as it considered that this would not allow the Registrant to take the next steps necessary in his journey of remediation.

28. The Panel considered replacing the order with another order which the Panel could originally have made. It considered the possible orders in ascending seriousness and first considered taking no action or imposing a caution order. The Panel had decided that the Registrant is still in a process of remedying his lack of competence. It therefore considered that it would not be appropriate to take no action or impose a caution order, as this would not protect the public.

29. The Panel next considered imposing a conditions of practice order. It noted that this would have the advantage of allowing the Registrant to continue his remediation, undergoing further training and could also provide for him to be supervised. Therefore, the public could be protected whilst the Registrant continued his remediation.

30. The Panel took into account that Ms Welsh had submitted that this course might be appropriate and noted that it also satisfied the Registrant’s wish to be able to resume working as a paramedic.

31. The Panel considered that it would be possible to devise workable and enforceable conditions of practice which were realistic, verifiable and directed at the Registrant.

32. The Panel noted that the Registrant now had the benefit of a support network, assisting him in his remediation. It therefore considered that the Registrant should be given the opportunity to continue with his journey of remediation, which could not be completed without working as a paramedic.

33. The Panel considered that any conditions had to provide for oversight of the Registrant’s development and practice. The conditions should provide for him to carry out the specific training that had been identified for him at the Nottingham Trent University. Further, the Registrant’s work as a paramedic should be supervised, with reports provided to the HCPC, as required.

34. The Panel settled on a set of conditions as set out below in its Order.
35. The Panel considered that it would take a reasonable period for the Registrant to be in a position to demonstrate his remediation. It also considered that it was necessary for the Registrant’s progress on an order to be reviewed after a reasonable time. It therefore determined to make the conditions of practice order for a period of twelve months.

36. The Panel considered that, at around twelve months after this review, the Registrant ought to be in a position to demonstrate that he had made further significant progress in his professional development.

37. The Panel decided that, since the Registrant should be given the opportunity to continue with his remediation and because the public could be adequately protected by a package of conditions, it would be disproportionate to go further and continue to suspend the Registrant’s registration.

38. The Panel noted that this order will be reviewed shortly before its expiry. At that review another Panel may impose a further order or take any other action permitted by the relevant provisions of the Order as amended.

39. At that review, the panel will be assisted by the Registrant’s attendance. In addition to any other material that the Registrant wishes to provide, the Panel may be assisted by the following:
a. A reflective piece of writing detailing the Registrant’s reflections on the issues relating to the Panel’s findings;
b. Details of the Registrant’s activities in relation to Continuing Professional Development and Professional Education;
c. Testimonials and References from relevant persons.

The Registrar is directed to annotate the HCPC Register to show that, for twelve months from the date that this Order takes effect (“the Operative Date”), you, Mr Maksym Wojcieszek must comply with the following conditions of practice:

Education and training requirements

1. Within 12 months of the Operative Date you must:

A. satisfactorily complete the Additional Skills Gap Analysis course provided by Nottingham Trent University, as directed by East Midlands Ambulance Service (EMAS); and

B. forward a copy of your results to the HCPC.

Practice restrictions

2. You must not carry out paramedic procedures unless directly supervised by a Paramedic of at least equivalent grade to yourself registered by the HCPC.

Supervision requirements

3. You must place yourself and remain under the supervision of a workplace supervisor, registered by the HCPC or other appropriate statutory regulator and supply details of your supervisor to the HCPC within 14 days of the Operative Date. You must attend upon that supervisor as required and follow their advice and recommendations.

Informing the HCPC and others

4. You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.

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

6. 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).

Personal development

7. You must work with workplace supervisor etc. to formulate a Personal Development Plan designed to address your further professional development and forward a copy of your Personal Development Plan to the HCPC, within three months of the Operative Date.

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

9. You must allow your workplace supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

10. Any condition requiring you to provide any information to or obtain the approval of the HCPC is to be met by you sending the information to the offices of the HCPC, marked for the attention of or obtaining written approval from the relevant Case Manager of the HCPC.

The Suspension Order is revoked, and the Conditions of Practice Order imposed in its place with immediate effect.

This Order will be reviewed again before its expiry on 01 August 2024.

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 30(10) and 38 of the Health Professions Order 2001, any appeal must be made to the court not more than 28 days after the date when this notice is served on you.

History of Hearings for Mr Maksym Wojcieszek