Jayne M Denton

Preliminary Matters

Service

1. The Panel was provided with evidence that that the Notice of Hearing had been emailed to the Registrant on 09 April 2024. The Panel was also provided with an email notification confirming delivery to the Registrant’s email address was complete.

2. The Panel noted that there was a response from the Registrant’s email address sent at 2.06pm on 9 April 2024, which stated ‘I have received this email.’ The Panel noted that the email had been sent to Registrant’s correct email address as it appears on the HCPC Register, and that the Registrant had acknowledged safe receipt.

3. It was acknowledged by the Panel that the Health and Care Professions Council (Coronavirus) Amendment Rules Order of Council 2021 allowed the notice of hearing to be served by electronic mail. Accordingly, the Panel found that the Registrant had been served with the Notice of Hearing in accordance with Rule 3(1) of the HCPC Conduct and Competence Committee (Procedure) Rules 2003 (the Rules) and that she had been given the requisite 28 days notice in accordance with Rule 13 (4) of the Rules.

Proceeding in Absence

4. The HCPC applied for the hearing to proceed in the absence of the Registrant.

5. The Registrant had been in contact with the HCPC on several occasions. On 24 January 2023 the Registrant sent an email advising of her intention to ‘de-register.’ On 25 January 2024 there was an email exchange between the Registrant and the HCPC confirming the HCPC’s agreement to the Registrant’s Voluntary Removal. On 28 April 2024, the Registrant correctly returned the signed VRA to the HCPC by email.

6. The HCPC submitted that good service has been effected, the Registrant has been given sufficient notice of the proceedings and reasonable efforts had been made to alert the Registrant of the opportunity to attend the hearing remotely to give oral evidence. The HCPC submitted that the Registrant was fully aware of the proceedings and had made no request for the hearing to be postponed.

7. The HCPC highlighted that the Registrant was neither present nor represented at the substantive hearing or the subsequent review hearings. There had been no application to adjourn and no indication that the Registrant would be willing to attend on an alternative date. The HCPC submitted that the Registrant had waived her right to attend and that an adjournment would serve no useful purpose.

8. The Panel accepted advice from the Legal Assessor, who referred them to the HCPTS Practice Note ‘Proceeding in the Absence of the Registrant’ dated June 2022. It was confirmed by the Legal Assessor that Rule 11 of the Rules permits proceedings to continue in the absence of a Registrant in certain circumstances. The Legal Assessor summarised the case law, including the cases of GMC v Adeogba (2016) EWCA Civ 162, GMC v Visvardis (2004) EWCA Civ 162 Ramaswamy v GMC (2021) EWHC (1619) (Admin) and R v Jones (Anthony William) HL 20 Feb 2002.

9. The Panel determined that the Registrant had voluntarily absented herself. The Registrant had it made it clear in correspondence that she would not be attending and that she was supportive of the application to proceed in her absence. The Panel decided that an adjournment would serve no useful purpose, the Registrant had not requested one and this would not secure the Registrant’s attendance at a future date. It was in the public interest to conclude the proceedings expeditiously, particularly because the current Suspension Order was due to expire in two days. It was also in the Registrant’s own interests for the proceedings to be concluded. The Panel therefore determined to proceed in the absence of the Registrant.

Background

10. The Registrant is a registered Paramedic. At the time of the relevant events the Registrant was working as a self-employed Emergency Care Practitioner (ECP) for Care UK Ltd (which is now trading as Practice Plus Group).

11. The Registrant’s ECP role involved participation in the out of hours’ service during periods in the evening, overnight, at weekends and on bank holidays when GP services are not available.

12. In February 2020, the Registrant moved from the Gloucestershire out of hours’ service to the Worcestershire out of hours’ service. She ceased to work for Care UK in April 2020. As a self-employed ECP the Registrant was not subject to line management, but the quality of her work was overseen and monitored by LB, the Lead Nurse at Care UK/Practice Plus Group.

13. On 30 April 2020, the HCPC received a referral from Care UK. LB had undertaken a routine audit of the Registrant’s work for March 2020. This routine audit involved a review of a randomly selected single case, Patient A. There were concerns arising from this single case, and therefore an enhanced audit was undertaken of five further randomly selected cases (Patients B-F). In all five cases, further concerns were highlighted and none of the cases were assessed as meeting a satisfactory standard. LB invited another manager, CP, the Medical Lead, to conduct a “blind” audit without sight of LB’s comments. In this further review, CP had similar concerns to those of LB.

14. The concerns related to a poor standard of history taking and lack of attention to and awareness of “red flag” symptoms. The Registrant’s examination skills or her completion of documentation reflected a lack of ability to confirm or exclude red flag symptoms and then to act upon them. The audit also found consistent and concerning prescribing errors.

15. A Final Hearing took place between 10-12 January, before a panel of the Conduct and Competence Committee.

16. That panel found all the factual particulars of the Allegation proved except for 8c and 8d.

17. That panel concluded that the Registrant had demonstrated no understanding of the seriousness of her lack of competence and its potential impact on patients, her colleagues, the public or the profession. It also found that the Registrant had not demonstrated a sufficient level of insight. It determined that the Registrant’s actions amounted to a lack of competence and that her fitness to practise was impaired in relation to the personal and public components. A 12-month Suspension Order was imposed.

18. At paragraph 101 of its decision, that panel noted that a future reviewing panel would be assisted by:
• the attendance of the Registrant to provide an update on her circumstances.
• a written reflective piece from the Registrant including consideration of the impact of her acts and omissions on patients, colleagues, and the profession.
• evidence of remedial action e.g. any Continuing Professional Development and/or relevant training.
• references or testimonials from employment (paid or unpaid) [38].

19. On 06 January 2023, the Suspension Order was reviewed at the first substantive review hearing. The reviewing panel noted that the Registrant had “stated that she has retired from the profession and is enquiring about voluntary removal from the HCPC register”. The reviewing panel also noted that it was “unable to deal with voluntary removal and the Registrant [was] yet to make such an application to the HCPC.” It found that the Registrant had “not shown evidence of remediation or a sufficient level of insight, nor has she engaged in Continuing Professional Development and/or relevant training.”

20. The first reviewing panel concluded that the Registrant’s fitness to practise remained impaired and extended the suspension order for a further 12-month period.

21. On 08 January 2024, a second review hearing took place. The second reviewing panel noted that “the Registrant has stated that she has retired from the profession and is now working in retail. It appeared from the Registrant’s correspondence that she had no desire to return to the profession.” Further, this panel noted that the Registrant had not provided any evidence of remedial steps, despite clear guidance. It concluded that the Registrant’s fitness to practise remained impaired and extended the suspension order for a further 3-month period.

22. That panel noted that a longer period of suspension would serve no useful purpose as the Registrant had already been suspended for almost two years.

23. Following this, there was agreement between the Registrant and the HCPC that a VRA was a suitable disposal. The Registrant returned the signed VRA agreement, complete with the necessary ‘wet’ (rather than typed) signatures on 28 April 2024.

HCPC Submissions.

24. The HCPC submitted that the Registrant’s voluntary removal from the Register would be an appropriate means of resolving this matter. It submitted that it was evident from the Registrant’s email correspondence and her VRA supporting statement that she has no desire to practise as a Paramedic in the future.

25. Additionally, the HCPC submitted that in signing the Voluntary Removal Agreement, the Registrant has accepted and acknowledged that her fitness to practice is impaired by reason of the allegation set out in Schedule A of the Voluntary Removal Agreement.

26. The HCPC confirmed that the Registrant had been provided with detailed information about the consent process and the effect of voluntary removal from the Register. It submitted that the Registrant has been consistent in her desire to come off the register since she first wrote to the HCPC on 24 January 2023 explaining that she had “filled in the de- registration form on the HCPC website.” More recently, by email on 07 January 2024, the Registrant confirmed her wish to “seriously explore voluntary removal from the Paramedic register”.

27. The HCPC submitted that the Panel may reasonably conclude that the Registrant’s consent to voluntary removal was informed and that she has maintained her intention to remove herself from the HCPC register since 24 January 2023.

28. The HCPC submitted that it authorised the VRA between itself and the Registrant. It applied to have the Suspension Order revoked. The HCPC referred the Panel to the Practice Note, ‘Disposal of Cases by Consent.’ It submitted that the VRA was an appropriate means of resolving the matter in this case, because the Registrant had stated she has no desire to continue in practice as a paramedic and now works in the retail sector. The HCPC put on record that the Registrant has acknowledged her fitness to practice is impaired.

29. Further, the HCPC submitted that public protection was served by the VRA. The Registrant would be subject to an order that was the equivalent of a striking off order. She would not be permitted to work as a Paramedic and would not be registered as such.

30. It was stated by the HCPC that the public interest was also served by the VRA. The HCPC submitted that public confidence would be maintained by the findings of fact that had been made against the Registrant, and that there had been suspension orders in place to prevent the Registrant from practising. Public confidence would not be put at risk if the matter was disposed of by way of consent, and in fact the VRA was a suitable, cost effective and pragmatic way of dealing with the matter.

31. The Legal Assessor referred the Panel to the HCPTS Practice Note ‘Disposal of Cases by Consent’ dated March 2018. She reminded the Panel of the overarching objective of the HCPC as set out in Article 3(4) of the Health Professions Order 2001.

32. The Legal Assessor also drew the Panel’s attention to case law in relation to the withdrawal of proceedings, as a draft notice of withdrawal was included as part of the HCPC’s case. The cases of PSA v NMC and X [2018] EWHC 70 (Admin), Ruscillo v CHRE and GMC (2004) EWCA Civ 1356 and The Professional Standards Authority for Health and Social Care v The Nursing and Midwifery Council, Ms Winifred Nompumelelo Jozi (2015) EWHC 764 (Admin) were summarised for the benefit of the Panel. The Legal Assessor reminded the Panel that findings of fact had already been made in this case.

Decision on Application

33. The Panel took the view that the VRA was a sensible and pragmatic solution to the proceedings. The Registrant has had serious clinical findings made against her and since this time the Registrant’s position that she wants to move out of the profession has been maintained.

34. The Panel found that, in this case, public protection was served not by the Registrant’s remediation but by her removal from the Register. This would have the same effect as if there was had been a striking off order. The Registrant would no longer be on the Register and would not be able to work as a Paramedic. The Panel found there was no reason not to consent to what was being proposed by both the HCPC and the Registrant.

35. The Panel was mindful that a Paramedic must sign up to standards of proficiency which must be maintained. The Registrant has not maintained these standards, accepted her fitness to practice is impaired and has indicated clearly that she does not want to be part of the profession any longer.

36. The Panel took the view that the findings of previous panels have marked the clinical failings of the Registrant and the continued lack of remediation with regards to her clinical practice and competence. The wider public interest was served by the process of the regulatory proceedings and the sanctions that the Registrant had already been subject to.

37. The Panel was mindful that it had a greater role in ensuring the protection of the public than other, non-regulatory legal bodies such as courts. It noted that the Registrant had not taken evasive action to avoid a sanction, and that the findings made against her had been published and were a matter of public record. If the Registrant did try to re-apply to the Register in future, a record of the previous decision would be available. The Panel noted that a VRA is also the equivalent of a striking off order in respect of any further re-application process.

38. Accordingly, the Panel determined that the proposed VRA was a fair, pragmatic and proportionate resolution. Confirming the VRA complied with the overarching objective of HCPC regulatory proceedings. 

The Panel therefore consented to the revocation of the current Suspension Order and to the proposed VRA.

No notes available

History of Hearings for Jayne M Denton