John Johnson

Paramedic
Registration Number: PA06778
Allegation Number: FTP00861

Date & Time of hearing: 02/10/2007 - 10:00
Health Professions Council, Park House, 184 Kennington Park Road, London, SE11 4BU, London

Outcome: Suspended

Hearing of the Conduct & Competence Committee

Region: England - London

Registrant Name: John Johnson

Interim Order:
Application for interim order: 02/10/07
Finding: There be an interim suspension order pending the expiry of the period for bringing an appeal, or (if an appeal is brought) until the final disposal of that appeal (subject to a maximum period of 18 months).  This order is necessary in order to protect the public.

Panel: Conduct and Competence Committee

Notice Of Allegation:

Your fitness to practise as a registered health professional is impaired by reason of your misconduct and/or lack of competence whilst employed by Greater Manchester Ambulance Service NHS Trust, in particluar that:

(a) You failed to adequatelely assess and treat a patient on 19th December 2005.

(b) You failed to accurately complete the Patient Report Form relating to the treatment of a patient on 19th December 2005.

Committees Finding:

1. Mr Johnson has not attended the hearing today, nor has he been represented.  The Panel is satisfied that there has been good service of notice of today’s hearing upon him, that accordingly there is jurisdiction to proceed in his absence and that it is appropriate to do so.

2. There are two allegations made against Mr Johnson.  One is that his fitness to practise is impaired by reason of his misconduct.  The other is that his fitness to practise is impaired by reason of his lack of competence.  The particulars of each allegation are identical and are set out at the head of this document.

3. At this stage of the hearing the Panel is deciding whether the allegation is well founded or not.  This task requires the following stages to be followed:

i. To decide what facts falling within the parameters of particulars have been proved.

ii. Having decided the facts, it is then necessary to decide if those facts demonstrate misconduct or lack of competence.

iii. If, and only if, misconduct or lack of competence is demonstrated to decide if that misconduct or lack of competence has the effect that Mr Johnson’s fitness to practise is currently impaired.

4. The Panel has reminded itself throughout that it is for the HPC to prove the case.  It is not for Mr Johnson to disprove the allegation or any element of it.  The standard of the burden of proof resting on the HPC is the civil standard of the balance of probabilities, namely whether is something more likely than not.  Further, to the extent that serious allegations are made (and the misconduct allegation here is one such) it is necessary to look for particularly cogent evidence before finding a matter proved to the civil standard.

5. The HPC has called two witnesses, Mr Edwards (the partner of the patient attended on the relevant occasion) and Mr Blezard who undertook an investigation on behalf of the Greater Manchester Ambulance Service Trust.  The Panel is satisfied that the evidence of these witnesses is admissible but it is important for the Panel to make clear that it is the underlying factual evidence that the Panel has considered to form its own conclusions.  It has not been swayed by the conclusion of the Trust (or of any other person or body) formed on the basis of that, or any other, evidence.

6. It has already been stated that Mr Johnson has neither attended the hearing nor been represented.  He has, however, provided a letter dated 26th September 2007, and the Panel has taken full note of that letter in reaching its decision.

7. The incident underlying the allegation related to an attendance at approximately 7pm on 19th December 2005 made as a result of a 999 call on behalf of a 41 year old female patient who was experiencing severe headaches and vomitting.  Mr Johnson was a Paramedic, having qualified in 1993.  On the day in question he was working with an Ambulance Technician, his role being that of attendant to the Technician who was driving.  On arrival at the patient’s home Mr Johnson discovered that she was upstairs lying on the bed.

8. The Panel found both Mr Edwards and Mr Blezard to be credible witnesses and has accepted the entirety of their evidence.

9. The Panel makes the following findings of fact:

i. Mr Johnson failed to conduct a full primary survey of the patient in the bedroom.  There were clear Trust protocols concerning patient assessment and treatment.  For example, he did not take the patient’s temperature in an acceptable manner and did not assess pupil reaction adequately.

ii. He also failed to conduct any part of a secondary survey, whether in the bedroom or on the way to the hospital.

iii. He handled the patient in a way that failed to acknowledge the seriousness of her condition.  The patient was encouraged by Mr Johnson to walk down the stairs, but when she was unable to complete the descent, and having collapsed, a carry chair was obtained.  She was put in the chair but her rigid state was such that it was difficult for her to be successfully transported in the chair, but the attempt to do so (and the absence of a protective blanket) had the consequence that her clothing was disturbed.

iv. Mr Johnson failed to complete the Patient Report Form to the required standard.  For example, the pain score was not completed and the form indicated that the patient had been able to walk.

10. The reason for this finding is that the Panel has concluded that Mr Johnson, as an experienced Paramedic, clearly knew what was required of him in the circumstances in which he found himself.  To that extent his failure to perform to the required standard was a knowing default on his part.  This finding has the consequence that the facts demonstrate misconduct.

11. As just stated, Mr Johnson failed to perform to a standard he knew he should have been working to.  Clearly that finding results in a situation where his fitness to practise was impaired at the time of the incident.  However, the finding of the Panel is that it has not been provided with any information on which it could sensibly conclude that the current position is different.  It follows that his fitness to practice is still impaired.

12. It follows that the misconduct allegation is well founded.

13. Since announcing the decision on the allegation set out above the Panel has heard submissions on sanction from Ms Norris on behalf of the HPC.  She has reminded us of our sanction powers but has not urged us to find that any particular sanction is appropriate in this case.  In addition to the letter written by Mr Johnson already referred to he has submitted two testimonials written on his behalf, and the Panel has considered all of these documents.

14. The Panel is reminded that the purpose of a sanction is not to be punitive.  Rather a sanction is only to be justified in order to protect the public and to maintain confidence both in the regulated profession and in the HPC’s regulatory function.  As the Panel has found misconduct all the sanction options are available including striking-off.

15. The Panel considers that this case is too serious to result in no further action or a caution order.  As Mr Johnson did not attend the hearing the Panel has not been able to determine whether a conditions of practice order would be feasible.  The consequence of these findings is that the realistic choice is between suspension and striking-off.

16. The Panel has considered that a period of suspension of six months is a proportionate sanction in this case, and that such an order will afford proper public protection.  This suspension order will necessarily be reviewed before it expires.  The reviewing Panel will have available to it all the sanction options this Panel has had (including striking-off).  The issue of the appropriate sanction on that occasion will be a matter for the Panel sitting on that day.  However, it is likely that the reviewing Panel would require evidence that Mr Johnson had received remedial training and that a positive assessment of his Paramedic skills was carried out by his employer or another approved body.

Committees Direction:
That the registrar be directed to suspend the registration of John Johnson for a period of six months.

Notes:
INTERIM ORDER
There be an interim suspension order pending the expiry of the period for bringing an appeal, or (if an appeal is brought) until the final disposal of that appeal (subject to a maximum period of 18 months).  This order is necessary in order to protect the public.