Philip Greenfield

Hearing partly in private

1. The Panel was invited by Ms Hewitt to conduct the hearing partly in private in relation to health matters, to protect the private life of the Registrant and other witnesses. The Panel considered the HCPTS Practice Note on Proceeding in Private before granting the application to proceed partly in private, in relation to health matters.

Amendment of allegation

2. At the commencement of the hearing Mr Barnfield made an application to amend particular 3b of the Allegation, on the grounds that the Panel has an inherent power to amend an allegation, if there would be no injustice in doing so. The application to delete the word “omitted” and add “vomited” was not opposed. The Panel granted the application and made minor amendments to the stem and particular 3b to replace “I have here” with “I had given her”. There is no prejudice to the Registrant and these minor amendments reflect the evidence that is in the documentation.

Background

3. The Registrant is a paramedic who was employed by the South East Coast Ambulance Service (SECAM) from 7 October 2002.

4. On 15 December 2020 a complaint was made by the wife of a patient attended by the Registrant on 3 December 2020. The concerns relate to the Registrant’s discharge of Patient A in circumstances where Patient A had stated that their GP had advised that they needed to attend hospital. This gives rise to particular 1. On 15 January 2022, the Registrant attended Patient B’s home and failed to identify that they had a cardiac issue, and sent Patient B to a Clinical Assessment Unit; Patient B later suffered a cardiac arrest. The concerns relate to the Registrant’s assessment/treatment of Patient B. This gives rise to particular 2. Also concerns were raised about the Registrant’s communication with colleagues on 15 January 2022. This gives rise to particular 3.

5. The Registrant made a self-referral to the HCPC. He provided a written report of the incident on 15 January 2022 stating he said he was distracted and so did not see the ECG. He said, “the outcome would have been the same” but accepted that “this patient should have not been sent to the urgent treatment centre but should have been transferred to the cardiac centre”.

6. The HCPC called the following witnesses to give live evidence at the hearing: Person O, Colleagues A and B and PS. The Registrant also gave evidence and produced documents, including testimonials. Submissions were made on behalf of both parties.

Legal Assessor’s Advice at Facts Stage

7. The Legal Assessor advised the Panel to consider the HCPTS Practice Note entitled Drafting Fitness to Practise Decisions. When the Panel is considering whether an alleged fact is proved, the standard of proof required is on the balance of probabilities. In other words, the Panel must be satisfied that the act or omission alleged is more likely than not to have occurred before it can find it proved. The burden of proof is on the HCPC in respect of the factual particulars.

8. The Panel should set out the undisputed facts, the facts in dispute and the findings of fact which it made.

9. The courts have expressed concern over reliance on the demeanour of witnesses in the assessment of credibility. The case of Khan v GMC, (2021), decided that it was wrong to make a global assessment of credibility based on demeanour. The Panel may take into account everything which they have heard about the Registrant and should make allowance for the difficulty for the Registrant in giving evidence, as he has the pressure of being the person who is the subject of the Allegation.

Decision on Facts

10. The Panel accepted the Legal Assessor’s advice and sought to look at the objective facts and contemporaneous documents. When considering whether an alleged fact is proved, the standard of proof required is on the balance of probabilities. In other words, the Panel must be satisfied that the act or omission alleged is more likely than not to have occurred before it can find it proved. The burden of proof is on the HCPC in respect of the factual particulars.

Findings in respect of particular 1

11. On 3 December 2020 Patient A’s wife Person O was advised by his general practitioner (GP) to telephone 999 immediately due to patient A being unable to speak to the GP, in order to admit him to hospital. The Registrant was dispatched to Patient A’s home. When he arrived the Registrant was informed by Person O that a GP had advised that Patient A should go to hospital. The Registrant discussed hospital admission with Patient A but did not speak to his GP. Based on the Registrant’s advice Patient A was not taken to hospital and the Registrant went back to his vehicle. Person O was unaware that the Registrant waited outside her property in his vehicle. She telephoned the GP again and was advised by a receptionist to call 999 because the doctor was adamant that Patient A should go to hospital. Person O called 999 again and was surprised when the Registrant returned to take Patient A to hospital. Person O subsequently made a complaint to SECAM about the Registrant’s behaviour and attitude.

12. The Registrant admitted particular 1 with regard to discharging Patient A. He did not admit particular 1 with regard to not providing adequate care. The Panel finds that the Registrant’s observations suggested it was not clinically indicated that Patient A should be taken to a hospital. However, the Registrant did not have a conversation with Patient A’s GP to rule out the reasons for admission to hospital. PS the Registrant’s manager at SECAM confirmed that the Registrant should have spoken to the GP. The Registrant’s care of Patient A was not adequate because he did not contact the GP before overruling her advice. The Registrant asserted that Patient A refused to attend hospital. The Panel considered the available evidence and determined that Patient A did not refuse to attend hospital but followed advice provided by the Registrant.

13. The Panel finds particular 1 is proved to the requisite standard.

Findings in respect of particulars 2 and 3

14. On 15 January 2022 the Registrant was called to the home of Patient B as a single responder Paramedic. He diagnosed a chest infection and decided an admission to an urgent care centre was indicated. He had requested non-emergency transport (NET) for the patient. Colleagues A and B arrived at the scene in a NET vehicle. The Registrant was dismissive of his Colleague’s concerns. The Registrant was the more senior clinician, and he stated an Electrocardiogram (ECG) was not necessary, despite evidence that Patient B had chest pain. The Registrant did not provide a detailed and accurate handover to his colleagues. Colleague A performed an ECG on Patient B and provided the printout to the Registrant. The ECG appeared to Colleagues A and B to be abnormal, but the Registrant looked at the printout, said “ischaemic” and put it down. The Registrant was belittling towards both his Colleagues. He provided them with a piece of paper containing his observations and this was enough for them to get on with their assessment. Colleague A felt she was being told off by the Registrant and he was abrupt and belittling towards her. She felt she was being shut down and not listened to by the Registrant. She tried to raise her concerns, but the Registrant would not listen, and his tone of voice was that of someone telling off a child. Colleague B described the Registrant as being “hostile”.

15. The Registrant admitted particulars 2a-d. The Panel finds particulars 2a-d proved to the requisite standard. The Registrant did not admit particulars 3a-b.

16. The Panel found particular 3a was not proved to the requisite standard because there was a verbal handover “of sorts”, which was enough for Colleagues A and B to begin their assessment.

17. The Panel found particular 3b was proved in respect of Colleague A to the requisite standard because the Registrant’s behaviour towards her was berating.

18. The Panel found particular 3b was not proved in respect of Colleague B to the requisite standard because she stated in evidence that she was not berated by the Registrant.

Legal Assessor's advice on Grounds and Impairment

19. In relation to the ground of misconduct there is no statutory definition of misconduct, but Lord Clyde in the case of Roylance v General Medical Council (No.2) [2000] 1 A.C. 311 stated that: Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed in the particular circumstances. The Panel should therefore consider if the Registrant has breached any of the HCPC’s Standards.

20. In relation to the facts proved the Panel has to decide whether they amount to the statutory ground. The fact that the Panel has found some facts proved, does not mean that a finding of the statutory ground will follow. Similarly, if the Panel finds the statutory ground applies, a finding of impairment is not automatic. Each stage must be considered separately, and reasons given for the Panel's decisions. Whether any of the proved facts amount to serious misconduct and if so, whether the Registrant is currently impaired, are matters for the Panel's judgement.

21. The Panel should consider the HCPTS Practice Note "Fitness to Practise Impairment". The test of impairment is expressed in the present tense; that fitness to practise “is impaired.” A Registrant may have been impaired at the time of the failing identified in the allegation. However, the Panel’s task is to form a view about the Registrant’s current fitness to practise, by taking account of the way in which the Registrant has acted or failed to act in the past and, looking forwards, whether the Registrant’s ability to practise safely is compromised; and/or whether public confidence in the profession would be undermined, in the absence of a finding of impairment. Thus, in determining fitness to practise the Panel must take account of two broad components: the ‘personal’ component: the current competence, behaviour etc. of the Registrant; and the ‘public’ component: including the critically important public policy issues.

22. When assessing insight, the Panel will need to consider what effect, if any, the fact that the Registrant has denied an allegation has on this assessment. It is wrong to conclude that a Registrant who has denied the facts alleged cannot then demonstrate insight at the impairment stage. Each case must be considered on its own facts, but a nuanced approach should be taken in assessing insight in these circumstances.

23. In Grant [2011] EWHC 927 (Admin) Mrs Justice Cox noted (at Para 74): “In determining whether a practitioner’s fitness to practise is impaired by reason of misconduct, the relevant panel should generally consider not only whether the practitioner continues to present a risk to members of the public in his or her current role, but also whether the need to uphold professional standards and public confidence in the profession would be undermined if a finding of impairment were not made in the particular circumstances.”

24. In Yeong [2009] EWHC 1923 (Admin) Mr Justice Sales said at paragraph 21: “It is a corollary of the test to be applied and of the principle that a FTPP is required to look forward rather than backward that a finding of misconduct in the past does not necessarily mean that there is impairment of fitness to practise - a point emphasised in Cohen...In looking forward, the FTPP is required to take account of such matters as the insight of the practitioner into the source of his misconduct, and any remedial steps which have been taken and the risk of recurrence of such misconduct. It is required to have regard to evidence about these mattes which has arisen since the alleged misconduct occurred.”

Decision on Grounds

25. The Panel considered whether the Registrant’s behaviour in respect of the proved facts amounts to misconduct. The Panel accepted the Legal Assessor’s advice that misconduct is a matter for the Panel’s judgment and has been defined as a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a practitioner in the particular circumstances and the conduct complained of must be serious.

26. Mr. Barnfield submits that the behaviour outlined in the factual particulars does amount to misconduct in that it constitutes a serious falling short of what would be proper in the circumstances and what the public would expect of an HCPC registered Paramedic.

27. Ms Hewitt submits that the purpose of these proceedings is not to punish the Registrant. There have been no previous regulatory findings against him and the conduct complained of must be serious. He has explained the health issues which affected him in December 2020. He self-referred these matters to be HCPC and no further action has been taken by his employer. He has engaged with the HCPC process and given evidence. The glowing testimonials he has supplied demonstrate evidence of his communication skills and that he is a caring member of the profession.

28. The Panel noted that the standards ordinarily required to be followed by the Registrant would have been those that were in force at the relevant time, namely: the HCPC Standards of Conduct, Performance and Ethics. The Panel highlighted the following standards as being applicable in this case.

Standard 1.1: You must treat service users and carers as individuals, respecting their privacy and dignity.

Standard 2.1: You must be polite and considerate

Standard 2.5: You must work in partnership with colleagues, sharing your skills, knowledge and experience where appropriate, for the benefit of service users and carers.

Standard 2.6: You must share relevant information, where appropriate, with colleagues involved in the care, treatment or other services provided to a service user.

Standard 6.1: You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible.

Standard 9.1: You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

29. In respect of particular 1: the Registrant’s decision to discharge Patient A was contrary to the GP’s request that he be conveyed to hospital as she was calling a medical team to assess him on arrival. The Panel has taken into account the impact of the Covid pandemic in December 2020. However, there was no due diligence by the Registrant, in failing to contact Patient A’s GP. The Registrant has provided evidence which is not consistent with information from his colleague Person B. The Registrant states he was tired and had health issues at the time. His attitude was highly inappropriate, for example he told Patient A and Person O in respect of a hospital admission that: “if you think it might get him to jump the queue ahead of your appointment next week, it won’t, it’ll probably put him even further down the list”.

30. The evidence of Person O given at the hearing is consistent with her contemporaneous complaint letter to SECAM, in which she stated the Registrant said "Bloody GPs" which was totally inappropriate. Person O concluded: “I feel if I left this unsaid, the next unfortunate family will face the same indifference and show boating that I feel happened that evening”.

31. The Registrant did not seek to ascertain the GP’s concerns when he should have done so. This was a serious attitudinal error, particularly when viewed in the overall context of the Registrant’s behaviour towards Patient A and Person O, as described by Person O, which taken together amounts to misconduct. The Panel does not accept the Registrant’s account that Patient A refused to be taken to hospital. The Panel finds the consistent evidence of Person O is true, namely: that Patient A accepted the advice of the Registrant and would have agreed to go to hospital initially but was deterred from doing so by the Registrant. The Registrant’s inadequate patient care and highly inappropriate behaviour on 3 December 2020, in breach of the HCPC standards set out above, amounts to serious misconduct.

32. In respect of particulars 2a-d and 3b (in part) the Registrant is in breach of the fundamental tenets of the profession; in that he ignored the “red flags” and serious concerns of his Colleagues A and B, with regard to Patient B, on 15 January 2022.

33. The witness evidence supplied by the Registrant in particular with regard to his health has been considered by the Panel. The Panel does not accept the Registrant’s account with regard to his assessment and treatment of Patient B, or his behaviour towards Colleagues A and B.

34. The evidence of Colleagues A and B given at the hearing is consistent and supported by the contemporaneous documentation. Colleague B recorded in the “datix” record: I then said to the paramedic that the pain was on the left side so it wasn't consistent with a right sided chest infection/consolidation. The paramedic didn’t respond me. I thought perhaps I had annoyed him since we had done an ECG whilst he was out of the room and he had said not to do one. My crewmate asked the paramedic if he had given the patient any pain relief. He responded saying something along the lines of “if you were listening you would have heard that she vomited the pills I had given her". The paramedic looked at the ECG and my crewmate questioned the elevation and the depression. The paramedic said this was probably normal for her. I didn't feel like I could question the paramedic since he didn't seem open to a discussion.

35. Before leaving the room the paramedic whispered loudly to my colleague 'she's winding me up'. I thought perhaps he was talking about me because of the fact that I was questioning his diagnosis so I decided to ask him who he was talking about. The paramedic said 'the patient'.

36. The Registrant’s conduct and behaviour on 15 January 2022, in breach of the above HCPC standards, is serious enough to amount to misconduct. His assessment of Patient B was blinkered in that he refused to consider the information before him and ignored the best interests of the patient. His behaviour towards his Colleagues was “hostile”, dismissive and belittling and he berated Colleague A.

37. In his evidence to the Panel the Registrant was generally deflecting and minimising with regard to his behaviour giving rise to the Panel’s above findings of misconduct. As regards the proved factual particulars 1, 2a-d, 3b (in part) the Panel is satisfied that these particulars are sufficiently serious to amount to misconduct.

Decision on Impairment

38. The Panel next considered whether the Registrant’s fitness to practise is currently impaired. The HCPTS Practice Note on Finding that Fitness to practise is “Impaired” states there are two components:

39. The personal component, which includes looking at the current competence, behaviour etc. of the individual registrant.

40. The public component which includes the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

41. The test of impairment is expressed in the present tense, that fitness to practise is impaired at the current date. The Panel has taken into account the lapse of time since these matters occurred but has also looked at the Registrant’s past actions in order to assess his likely future conduct. The Panel considered the need to uphold the HCPC Standards of Conduct and public confidence in the profession, in deciding whether a finding of impairment should be made.

42. Whether a Registrant’s fitness to practise is impaired is a matter for the Panel’s judgment. There is no burden of proof on the HCPC or the Registrant at this stage.

43. The Registrant denied factual particulars 1 (in part) and 3b, which have been found proved. He has generally demonstrated limited insight into the inappropriate nature and extent of his misconduct. The Registrant still has limited understanding of the impact of his misconduct. Further remediation is required because of this limited insight.

44. The Registrant has supplied strong character references and testimonials.

45. The Panel is satisfied his misconduct is remediable. There are attitudinal issues and failings with regard to communication and listening skills. The Registrant has undertaken courses and CPD training to improve his clinical decision-making, teamwork and communication skills. His reflections include reasonable adjustments regarding night shifts, ensuring he is not distracted when reviewing information to make a clinical decision and the dangers of tunnel vision. His written reflections also state: I have spent a lot of time reflecting on the allegations both separately and collectively and I can see themes emerging from this.

46. An appraisal in July 2023 noted he is: “a steady paramedic and is good at both theoretical and practical abilities, his communication skills were good both with patients and his peers. Generally, very competent although consideration of differential diagnosis could improve also a little more thought about his questions when talking to patients, also on a couple of occasions came across as being abrupt.”

47. The Registrant’s account is that he is no longer working alone in a single responder car and that he has overcome significant difficulties to achieve the status of a Band 6 paramedic. He has enjoyed team working with his regular crewmate for the last 12 months and he states his practice has changed dramatically since 2022. He says he has removed the blinkers and now sees the wider picture. He prepared a reflective piece as part of an ongoing learning action plan, undertaking four shifts with critical care paramedics. In his written reflections on the HCPC allegations he states: In conclusion I have learned from this situation that good communication and good teamwork between single responders and ambulance crews is vital to protect each other and the patients and relatives.

48. His witness statement dated April 2024 states: I have made concerted efforts to improve my communication skills and to ensure that I always work in an inclusive and collaborative approach with colleagues and professionals alike.

49. He states he never cuts corners and will never make the same mistakes. If he is not 100% sure he seeks advice. Being a paramedic means everything to him and he loves his job. He hopes to become an operational team leader and takes the opportunity of “acting up” in a more senior post when this is available.

50. There is a risk of repetition, despite the Registrant’s character references and testimonials. The Panel finds the Registrant is currently impaired under the personal component. He has denied the proved facts 1a (in part) and 3b and has shown insight, but this is limited. There is a risk of repetition because he has not yet fully remediated so as to address the root causes of his misconduct.

51. In considering the public component, as identified in the HCPTS Practice Note, there is a need to declare and uphold proper standards of conduct and behaviour, so as to maintain public confidence in the profession. The Registrant’s behaviour fell far short of what is to be expected and it is necessary to maintain public confidence in the profession and the regulatory process, by finding that there is a current impairment of his fitness to practise.

52. Public confidence would be undermined if a finding of impairment of fitness to practise was not made in this case. He failed to communicate with colleagues and put patients at risk of harm. There was a breakdown of trust between the Registrant and Colleagues A and B.

53. Accordingly due to the need to uphold proper professional standards, the Panel finds that the Registrant’s fitness to practise is also currently impaired under the public component.

Decision on Sanction

54. The Panel considered the submissions made by Ms Hewitt and Mr Barnfield and accepted the advice of the Legal Assessor.

55. In accordance with the Legal Assessor’s advice the Panel has had regard to the HCPC Sanctions Policy (the Policy), which states that any sanction must be proportionate, is not intended to be punitive and should be no more than is necessary to meet the legitimate purposes of providing adequate protection to the public, to protect the reputation of the profession, maintain confidence in the regulatory system and declare and uphold proper professional standards.

56. The Panel’s primary function at this stage is to protect the public, while deciding what, if any, sanction is proportionate, taking into account the wider public interest and the interests of the Registrant. The Panel should start by considering the least restrictive sanction first, working upwards only where necessary. The final sanction should be a proportionate approach, and will therefore be the minimum action required to protect the public.

57. The Panel identified the following mitigating factors:

• Significant remediation has been undertaken.
• The Registrant has engaged with the regulatory process.
• He has engaged with his employer’s training and appraisal process.
• He is willing to remediate his current impairment and address his failings.
• His positive character references and testimonials and CPD achievements.
• The lack of previous regulatory findings and his admissions.
• His health issues.

58. The Panel identified the following aggravating factors:

• The Registrant’s insight is limited in respect of the impact of his misconduct.
• He has not fully acknowledged that his communication failings, inappropriate behaviour and lack of empathy affected his colleagues and service users.
• There is a risk of repetition and a lack of self-awareness and self-control.
• The remediation undertaken has not all been focused on the areas of his practice which are of most concern.
• He did not demonstrate that he has fully reflected on the concerns raised in his evidence to the Panel.
• The Registrant is impaired under the personal and public components.

59. The Policy states:

61.The Standards of conduct, performance and ethics require registrants to ‘work in partnership with colleagues for the benefit of service users (Standard 2.5). As a result registrants must share their skills, knowledge and experience with colleagues, and, where appropriate, relevant information about the care, treatment or other services provided to a service user.

62. Cases where a registrant has therefore refused to cooperate with colleagues, whether that be the result of bullying, discrimination or dishonesty, are likely to result in a more serious sanction.

60. The Panel finds that due to the nature and extent of the current impairment in this case, taking no further action or mediation is not appropriate.

61. A Caution Order is not an appropriate sanction in this case as the issues are not isolated, limited, or relatively minor in nature. A Caution Order would be insufficient to mark the significance of the Panel’s findings. It would offer no restriction on the Registrant’s practice and would therefore be insufficient to protect the public and uphold the wider public interest. There is a risk of repetition. Some of the Registrant’s failings were attitudinal and he does not fully understand the effect of his behaviour on others, particularly when he is under pressure. His level of remorse is also qualified. He has sought to excuse his inappropriate behaviour, for example by diverting blame at the review meeting in 2020.

62. The Policy states:

108. Conditions are also less likely to be appropriate in more serious cases, for example those involving: …failure to work in partnership

109.There may be circumstances in which a panel considers it appropriate to impose a conditions of practice order in the above cases. However, it should only do so when it is satisfied that the registrant’s conduct was minor, out of character, capable of remediation and unlikely to be repeated. The panel should take care to provide robust reasoning in these cases.

63. In this case, after very careful consideration of all the evidence before it, the Panel determined that it can formulate workable and practicable conditions of practice that adequately address the risks and are proportionate to the proved facts and do not amount to suspension. The Registrant’s failures are capable of being remedied and the Panel considers that although a risk of repetition remains, it is not a high one. Therefore, allowing the Registrant to remain in practice subject to conditions for a substantial period, will adequately protect the public. Furthermore, the Panel is confident that he will comply with conditions. This will also enable a future reviewing panel to determine whether sufficient remediation has been completed.

64. In the judgement of the Panel a Suspension Order would be disproportionate and unduly punitive, in the current circumstances. Accordingly, the Panel has determined that a Conditions of Practice Order is the necessary and proportionate order to ensure the safety of the public. This Order will be reviewed before it expires. A period of 18 months is required to reflect the seriousness and extent of the Registrant’s failings.

The Registrar is directed to annotate the Register to show that for 18 months from the date that this Order comes into effect (the operative date) you Mr Philip Greenfield must comply with the following Conditions of Practice:

Practice restrictions

1. You must confine your professional practice to employment with the South East Coast Ambulance Service NHS Foundation Trust unless you notify the HCPC of a change of employer. The HCPC must be informed of the change within seven days.

2. You must not work on a solo response vehicle but limit your practice in a response role to that as a crew member in a double crewed ambulance, except in a life-threatening emergency.

Supervision requirements

3. You must place yourself and remain under the supervision of a workplace manager who is a paramedic registered by the HCPC and of at least Band 7 and supply details of your manager to the HCPC within 14 days of the Operative Date. You must attend upon that manager as required and follow their advice and recommendations.

4. Within 21 days of the Operative Date you must arrange with your work place manager for direct workplace assessments, on a monthly basis, of observed clinical encounters in the following areas of practice:
• Clinical assessment
• Differential diagnosis
• Communication with colleagues, service users and cares and healthcare professionals.
• Clinical handovers

Education and training requirements

5. Within 6 months of the Operative Date you must:

A. satisfactorily complete the CPD programme for paramedics on the NHS England website and submit a reflective statement, as part of your Personal Development Plan, to your manager which explains your learning and changes to practice.
B. forward a copy of your results to the HCPC within four weeks of completing the CPD Programme.

Personal Development

6. You must work with your workplace manager to formulate a Personal Development Plan designed to address the deficiencies in the following areas of your practice:
· Communication with colleagues.
· Communication with service users and carers.
· Communication with other health professionals.
· Clinical assessment and diagnosis.
· Clinical handovers.
7. Within two months of the Operative Date you must forward a copy of your Personal Development Plan to the HCPC.

8. You must meet with your workplace manager 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 manager to provide information to the HCPC, on a three-monthly basis, about your progress towards achieving the aims set out in your Personal Development Plan.

10. You must work with your workplace manager to fully engage with Occupational Health Support to identify and comply with working adjustments that ensure your safe and effective practice.

Informing the HCPC and others

11. You must inform the HCPC within seven days if you cease to be employed by your current employer.

12. You must inform the HCPC within seven days if you take up any other or further professional work.

13. You must inform the HCPC within seven days if you take up work requiring registration with a professional body outside the United Kingdom

14. You must inform the HCPC within seven days of returning to practice in the United Kingdom.

15. You must inform the HCPC within seven days of becoming aware of:

A. any patient safety incident you are involved in;
B. any investigation started against you; and
C. any disciplinary proceedings taken against you.

16. 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 as a paramedic;
B. any agency you are registered with or apply to be registered with to undertake professional work as a paramedic (at the time of application);
C. any prospective employer for professional work as a paramedic (at the time of your application);
D. the occupational health provider for your current employer.

17. You will be responsible for meeting any and all costs associated with complying with these conditions.

18. 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 the relevant Case Manager

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 Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you. The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

Reasons for the making of an Interim Conditions of Practice Order:

The Panel considered the submissions from Mr Barnfield and Ms Hewitt. The Panel accepted the advice of the Legal Assessor to consider whether an interim order was necessary under Article 31, to protect the public or in the public interest or the Registrant’s own interest, because of the nature of the findings made in this case. The HCPC submitted that an interim order is necessary. Ms Hewitt submitted that an order is not necessary and that the conditions of practice could not be mirrored in an interim order. The Panel is satisfied that it is necessary to direct that the Registrant’s registration should be subject to conditions on an interim basis, in the same terms as the substantive order set out above.

For the purposes of this interim conditions of practice order “the operative date” in paragraphs 3,4, 5 and 7 in the Conditions of Practice Order is defined as “13 June 2024”. This order is necessary for the protection of the public and is in the public interest. The Panel concluded that the appropriate length of the Interim Order is 18 months, as an Interim Order would continue to be necessary pending the resolution of an appeal, in the event of the Registrant giving notice of an appeal within 28 days.

History of Hearings for Philip Greenfield