Mr Adrian P N Penfold-Ivany

: Paramedic

: PA13065

: Review Hearing

Date and Time of hearing:10:00 05/05/2017 End: 12:30 05/05/2017

: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

: Conduct and Competence Committee
: No further action

Allegation

The following allegation was considered by a panel of the Conduct and Competence Committee at the substantive hearing on 7-8 November 2016.

1. On 24 January 2015, during the course of your employment as a Paramedic at North West Ambulance Service, you used excessive and/or disproportionate physical force towards Person A.

2. The matter described in paragraph 1 constitutes misconduct.

3. By reason of your misconduct, your fitness to practise is impaired.

Finding

Background

1. The Registrant is a Paramedic registered with the HCPC. He started employment with Mersey Regional Ambulance Service (MRAS) on 15 October 2001. He left MRAS in October 2004 and re-joined in April 2005. MRAS then merged with other North West Services to form the North West Ambulance Service (NWAS). At the time of the allegation the Registrant was employed as a Paramedic, based with South Liverpool Ambulance Service (SLAS).

2. On 24 January 2015, the Registrant was in the Accident and Emergency Department (A&E) of the Royal Liverpool Hospital. CCTV located in A&E captured an incident between the Registrant and Person A. There was initial contact between the Registrant, which escalated with Person A standing up and being verbally aggressive and abusive. The Registrant then pushed Person A towards the exit doors and Person A fell and slid along the floor. The Registrant is then seen pulling Person A from the floor and trying to eject him through a set of double doors. Person A resists, and is pulled back to the floor by the Registrant and restrained by him until security staff arrive.

3. At the Final Hearing on 7-8 of November 2016, the Registrant admitted, and the panel found proved, that the Registrant had used excessive and/or disproportionate physical force towards Person A. The panel found that his behaviour towards Person A amounted to misconduct.

4. In respect of the ‘personal component’, the original panel found that this was a single incident in an otherwise unblemished career, and that the Registrant had demonstrated remorse and a developing insight. At the time of the incident he had denied any wrongdoing, seeking to justify his actions, but by the time of the Final Hearing he admitted that his behaviour amounted to excessive force, was embarrassed by how he had behaved and recognised that he risked bringing the profession into disrepute. However, the original panel was concerned that the Registrant, at the time of the Final Hearing, was “overly confident in his assertion that he will never repeat his misconduct and concerned that he has not yet fully understood why he overreacted as he did, nor how he would manage himself in the future”. It found that there remained a risk of repetition, albeit not high, and so found the Registrant’s fitness to practise impaired on the personal component.

5. In respect of the ‘public component’, the original panel also found that the Registrant’s fitness to practise was impaired, as behaviour of that nature, even in the challenging circumstances, risked bringing the profession into disrepute and undermining public confidence.

6. The original panel imposed a Suspension Order of 6 months, saying that such an order was needed to “restore confidence in the profession and emphasise to the Registrant that use of excessive physical force towards any member of the public is not acceptable, even when the member of the public is challenging”. It said that the period of 6 months was “sufficient to meet the public interest and allow the Registrant further time to remediate his misconduct and demonstrate his fitness to practise”.

7. The original panel suggested that a reviewing panel would be likely to be assisted by:

• A further reflective piece;

• [Evidence of attendance on] a course in conflict resolution;

• Concrete examples of when he has managed situations of conflict; and

• Character references.

Decision

8. This is the first review of the Order. This Panel is reviewing the Suspension Order pursuant to Article 30(1) of the Health and Social Work Professions Order 2001.

9. The Panel considered the submissions of Ms Clarke, on behalf of the HCPC, who acknowledged that the Registrant had provided material covering the areas suggested by the original panel. She said that it was a matter for this Panel as to whether or not the Registrant had sufficiently addressed the concerns of the original panel.

10. The Panel considered the written and oral information provided by the Registrant. He had clearly taken on board the recommendations of the original panel and provided today (5 May 2017) to this reviewing Panel: a reflective statement dated 18 April 2017; a report from the Managing Director, DS, of Medical Rescue Ltd, about the conflict resolution training he had provided to the Registrant; a statement comprising two examples of conflict resolution in the work place, one at NWAS and one in his current role as a coach driver, dealing with intoxicated passengers; and four character references attesting to his usual high standards of conduct and behaviour.

11. The Registrant expanded on the conflict resolution training he had received. He explained that it had been suggested to him by colleagues that he may be able to work for Medical Rescue Ltd as a technician. On meeting DS, the Registrant discovered that DS also ran conflict resolution training, which was more in-depth than the training he had received from NWAS. He worked for DS as a technician, during which time he was able to discuss at length aspects of conflict resolution. He also had 3 or 4 specific occasions of conflict resolution training between November 2016 and April 2017, including two sessions in March and April. He said that he was looking to return to practise as a Paramedic, and was currently working as a coach driver, which had been necessary following his suspension.

12. The Panel heard and accepted the advice of the Legal Assessor.

13. The Panel exercised its independent judgement in determining whether the Registrant’s fitness to practise remains impaired. It kept in mind the need to protect the public, to maintain public confidence in the profession, and to uphold proper standards of conduct and behaviour.

14. The Panel first considered whether the Registrant’s fitness to practise was currently impaired. It had regard to the HCPTS Practice Note on “Finding that Fitness to Practise is ‘Impaired’”, and considered the question of impairment both in respect of the ‘personal’ and ‘public’ components.

15. In respect of the ‘personal’ component, the Panel was of the view that the Registrant had continued to develop the insight which had been identified by the original panel. He clearly acknowledged his wrongdoing, as evidenced by his admissions, his remorse and his reflective piece. He had sought out and attended relevant conflict resolution training, and had confirmed to the Panel that he intended to continue with such training. He had clearly reflected on his actions, where he had used excessive force, and specifically in relation to his role as a coach driver. The specific example he had given, of successful conflict resolution in that role, was a situation similar to the one he had experienced in the index incident in January 2015, namely dealing with a verbally aggressive and intoxicated person. This example was subsequent to the index incident. In all the circumstances, the Panel was satisfied that the Registrant had taken steps to successfully remediate his practice, such that the risk of repetition was low. The Panel therefore did not find that the Registrant’s fitness to practise was currently impaired in respect of the ‘personal’ component.

16. In respect of the ‘public’ component, the Panel had regard to the observations of the original panel, where it said that the period of 6 months was “sufficient to meet the public interest and allow the Registrant further time to remediate his misconduct and demonstrate his fitness to practise”. The Panel considered that the misconduct had occurred in January 2015, over two years ago, and the Registrant had in the time period following that, taken responsibility and taken appropriate steps to remediate his practice. The Panel was of the view that a well-informed member of the public would consider that it was appropriate, in those circumstances, for a Paramedic to be permitted to return to unrestricted practice. It therefore found that a finding of current impairment was not required on public interest grounds. As such, the Panel concluded that the Registrant’s fitness to practise was no longer impaired in respect of the ‘public’ component.

17. In all the circumstances, the Panel concluded that the Registrant’s fitness to practice is not currently impaired. It therefore determined to allow the Suspension Order to lapse on its expiry, which is 6 June 2017.

Order

The Registrar is directed to allow the Suspension Order against the registration of Mr Adrian Penfold-Ivany to lapse upon expiry.

Notes

No notes available

Hearing history

History of Hearings for Mr Adrian P N Penfold-Ivany

Date Panel Hearing type Outcomes / Status
05/05/2017 Conduct and Competence Committee Review Hearing No further action
07/11/2016 Conduct and Competence Committee Final Hearing Suspended