Mr Shane Kennedy

: Paramedic

: PA26391

: Review Hearing

Date and Time of hearing:10:00 06/10/2017 End: 12:00 06/10/2017

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

: Conduct and Competence Committee
: Suspended

Allegation

The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing on 10 – 13 October 2016.

During the course of your employment as a Paramedic with East Midlands Ambulance Service:

1. On 11/12 January 2015 in relation to Patient A:

a) You transported her in the Fast Response Vehicle (FRV) instead of the Double Crew Ambulance (DCA) despite her presentation and/or the risk of repeated seizure:

i)  without any clinical justification
ii) despite a colleague and/or colleagues at the scene offering to take her in the DCA
iii) against trust policy for transporting of patients in FRVs

b) did not transport her to the hospital on blue lights despite the deterioration of her condition.

c) stopped the FRV at approximately:
 
i) 00:15 for approximately 4 minutes; and/or
ii) 00:21 for approximately 26 minutes; and/or
iii) 00:51 for approximately 4 minutes.

d) did not call for assistance from a DCA during the stop at Particular 1 (c)(ii)

e) did not re-check Patient A’s blood glucose levels after administration of oral carbohydrates.

2. On 31 December 2014 in relation to Patient B you:

a) did not carry out a thorough and/or complete assessment
b) as a result of your actions in 2a) you inappropriately discharged Patient B on scene

3. The matters described in paragraphs 1 and 2 constitute misconduct and/or lack of competence.

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

Finding

Preliminary matters

Service of Notice

1. The Panel was satisfied that the notice of hearing had been sent to the Registrant at his registered address on 7 September 2017 in accordance with the Conduct and Competence Procedure Rules 2003. The notice of hearing was also sent by e-mail on the same day.


Proceeding in the absence of the Registrant


2. Mr Pye made an application for the hearing to proceed in the absence of the Registrant.

3. The Panel accepted the advice of the Legal Assessor and applied the guidance in the HCPTS Practice Note “Proceeding in the Absence of the Registrant”.

4. The Panel considered the circumstances of the Registrant’s absence. The Registrant did not attend the Final Hearing and has not engaged with the HCPC at all since the Final Hearing. The Panel decided that the Registrant’s absence is deliberate and that he has waived his right to attend the hearing. The Panel also considered that the Registrant was unlikely to attend a hearing if this hearing was adjourned. The Review Hearing is to conduct a mandatory review which should take place by 10 November 2017 and there is a public interest in the expeditious disposal of the matter. The Panel decided that the public interest outweighs the Registrant’s interests and that it was appropriate to proceed in the Registrant’s absence.


Background


5. The Registrant was employed as a Paramedic by East Midlands Ambulance Service (EMAS) and primarily worked as a solo responder on Fast Response Vehicles (FRV). The FRV is a liveried car, as opposed to an ambulance. Ambulances are usually crewed by two persons, who may both be paramedics, or by a paramedic and a technician or emergency care assistant. They are referred to as DCAs (double-crewed ambulance).

6. On 11 January 2015 the emergency services were called to the home of Patient A, a 21 year old female. The Dispatch Complaint was recorded as “had a fit, left arm dead, can’t move her legs”. The Registrant attended and was backed up by a DCA crewed by a paramedic and an emergency care assistant. Patient A was no longer fitting and was conscious when the Registrant arrived but she was still experiencing numbness in her left arm.

7.  The decision was made that Patient A should be transported to hospital. Although the DCA crew offered to take Patient A to hospital, the Registrant decided that he would transport Patient A in the FRV. This decision was contrary to EMAS policy. There was no clinical justification for the use of the FRV. A DCA was present and would have been able to transport Patient A as quickly as the FRV and in a more appropriate environment. 

8. En route to hospital the GPS tracking system showed that the FRV stopped on three occasions, with one of those stops being for 26 minutes. During the lengthy stop of 26 minutes the Registrant did not ask for back up from a DCA. Following the arrival of the Registrant and Patient A at hospital, ambulance staff had concerns about the transportation of the patient and an investigation was undertaken into the concerns.


9. On 31 December 2014, the Registrant attended the home of Patient B, a 74 year old female, who had fallen and had been on the floor for one to one and a half days. The Registrant assessed Patient B, but his assessment was not thorough or complete. He did not take a clinical history, examine the skin, carry out a head-to-toe examination or a physical examination based on the presentation of the patient. The Registrant assisted in moving Patient B to her bed and advised that she should see her GP in the New Year. The Registrant discharged the patient which was not appropriate. The patient had a pressure sore which needed treatment and she should have been transported to hospital. A few hours later Patient B’s family contacted the emergency services again and another solo responder attended. This time, an ambulance was requested and Patient B was transported to hospital.

10. The Registrant did not attend the Final Hearing on 10 - 13 October 2013. The previous panel found that the Registrant’s conduct in particulars 1(a), 1(c)(ii), 1(d), 2(a) and 2(b) fell well below the standards expected of a registered paramedic and were sufficiently serious to constitute misconduct. That panel found that the Registrant’s actions led to a significant risk of serious harm to both patients. He acted with a reckless disregard for risk. Patient A suffered a fit en route to hospital in the FRV, and there were a number of dangerous and potentially life-threatening risks associated with this. The Registrant’s errors were compounded by his failure to take appropriate steps to provide treatment and call for assistance when Patient A’s condition did in fact deteriorate during the journey. Patient B was at risk of respiratory compromise and dehydration. She could have suffered injury from her fall. She had a serious wound which required urgent hospital treatment. All the risks were entirely avoidable if the Registrant had carried out proper assessments and examinations, and followed EMAS policies.

11. In relation to particulars 1(b), 1(c)(i), 1(c)(iii) and 1(e), the previous panel did not find the Registrant’s actions amounted to misconduct.


12. The previous panel found that the Registrant’s fitness to practise was impaired by reference to the personal component and the public component. That panel had no information about the Registrant’s employment or activities since his resignation from EMAS in July 2015. That panel considered that the Registrant had not demonstrated remorse or recognition of the risks to which he had exposed his patients in his written statement and interview responses. That panel identified only limited insight on the part of the Registrant. In the internal investigation, he acknowledged that with regard to the transportation of Patient A in the FRV and his failure to identify Patient B’s pressure sore, he should have acted differently and would do so in the future. However, he only made these concessions when he was prompted to do so.

13. The previous panel decided that the appropriate and proportionate sanction was a Suspension Order for 12 months with a direction that the Registrant is not permitted to seek an early review before the expiry of 10 months.

14. The previous panel stated that a Reviewing Panel may be assisted by the following:

• the Registrant’s personal attendance at the Review Hearing;


• evidence of the Registrant’s reflections on the findings made against him;


• evidence of insight and remedial steps;


• references or testimonials in respect of paid or voluntary work;


• evidence that the Registrant has kept his knowledge of paramedic practice up to date through relevant CPD;


• any other evidence that the Registrant considers being relevant.

Decision


15. Mr Pye submitted that the Registrant’s fitness to practise remained impaired and that the minimum sanction which was sufficient was a continuation of the interim Suspension Order. He further submitted that in all the circumstances nothing would be achieved by a further period of suspension and that the Panel might therefore consider a Striking Off Order.

16. There were no written representations or documents provided by the Registrant.

17. The Panel accepted the advice of the Legal Assessor.

18. The Panel found there had been no change in the circumstances since the Final Hearing and that the Registrant’s fitness to practise remains impaired. There has been no engagement at all by the Registrant and he has not addressed any of the matters set out in paragraph 110 of the decision of the previous panel. He has not provided written submissions for the Panel. The Registrant’s misconduct placed two vulnerable patients at risk and the Registrant has not demonstrated that he is now safe to practise.

19. The Panel considered the option of a Caution Order, but decided that it would not provide adequate protection for the public. It would not address the ongoing risk to the public identified by the Final Hearing Panel.

20. The Panel next considered the option of replacing the Suspension Order with a Conditions of Practice Order. The Panel decided that conditions would not be appropriate or sufficient because of the Registrant’s failure to engage with the HCPC. The Panel does not have the required degree of confidence that the Registrant would be willing or able to comply with conditions.

21. The Panel next considered the most serious sanctions of a continuation of the current Suspension Order or a Striking-Off Order. The Panel noted the mitigating factors identified by the Final Hearing Panel. These included the Registrant’s admissions made during the EMAS process. The Panel also noted the decision of the Final Hearing Panel that there was no evidence of psychological or other difficulties which would prevent the Registrant from understanding and seeking to remedy the failings.

22. The Panel considered whether to draw an inference that the Registrant has no interest in remedying his failings from his failure to engage with the HCPC. The Panel have no information about the Registrant’s current circumstances or whether there might be a good reason for his failure to engage, such as personal or health circumstances.  At this first Review the Panel decided not to draw the inference that the Registrant does not wish to remedy his failings and has no continuing interests in the matter. The Panel therefore took the view that there had been no change at all in the circumstances since the decision of the Final Hearing.

23. The Panel considered very carefully the option of a Striking-Off Order. The Panel decided that it would be disproportionate, taking into account all the reasons and circumstances outlined by the Final Hearing Panel.

24. The Panel considered Mr Pye’s submission that nothing would be achieved by an extension of the Suspension Order, but decided that there remained a prospect that the Registrant would engage and take the necessary steps to persuade a Review Panel that there is no longer an ongoing risk to the public.

25. The Panel therefore decided that the appropriate and proportionate Order is to extend the current Suspension Order. The Panel decided that this should be for the maximum period of twelve months to allow the Registrant time to reflect and to demonstrate remediation of his misconduct. The Registrant may apply for an early review of the Order if his circumstances allow him to demonstrate that remediation before the expiry of the Suspension Order.

26. The Panel also considered that a review panel may be assisted by the following:

• the Registrant’s personal attendance at the Review Hearing;


• an explanation for the Registrant’s non-engagement with these proceedings to date.


• evidence of the Registrant’s reflections on the findings made against him;


• evidence of insight and remedial steps;


• references or testimonials in respect of paid or voluntary work;


• evidence that the Registrant has kept his knowledge of paramedic practice up to date through relevant CPD;


• any other evidence that the Registrant considers relevant.

Order

Order: That the Registrar is directed to suspend the Registration of Mr Shane Kennedy for a further period of 12 months from the date of the expiry of the current Order.

Notes

The order imposed today will apply from 10 November 2017. This order will be reviewed again before its expiry on 10 November 2018.

Hearing history

History of Hearings for Mr Shane Kennedy

Date Panel Hearing type Outcomes / Status
06/10/2017 Conduct and Competence Committee Review Hearing Suspended
10/10/2016 Conduct and Competence Committee Final Hearing Suspended