User talk:HPC Corrupt

== '''Welcome to the HPC website We are a regulator, and we were set up to protect the public. To do this, we keep a register of health professionals who meet our standards for their training, professional skills, behaviour and health. We currently register over 180,000 professionals from 13 professions.''' ==

HEALTH PROFESSIONS COUNCIL CORRUPT What the HPC is involved in, is accepting evidence from NHS Trusts which is to influence the HPC to hear a case. The HPC is being used as an instrument by the NHS Trusts to remove and cast shaddow over registrants that have raised patient harm issues and Protected disclosures. It colludes with legal firms that are masonic. It will not include damming evidence that casts a bad light on the Trusts that the registrant brings up as evidence at there hearings.

The HPC is a tool of the department of health DOH, to remove whistleblowers. HPC there fore is not protecting the public in some cases but is complicit in doing the opposite. The HPC will say that it wants the registrant to show insight, and will remove the right for the registrant to give a true account of the ethics behind any clinical action he /she takes in order to protect the patient.

Insight is saying ,I did wrong. But the HPC wants the registrant to accept blame in order to get a lighter sanction even though his actions were ethical but not policy of the Trust.

Registrant is then faced with going against his judgement and rightful actions that brought him to HPC hearing and forced to tell the HPC that he did wrong (insight) when in fact he was ethically correct at the time of his so called wrong doing.

HPC Funds law firms, Trusts are wasting public money by reporting trivial matters to bully and harrass the registrant that blew the whistle.

HPC needs the Trusts to supply them with cases to justify their purpose.

HPC has in a recent case not reported honestly and factually a case which a operating department practitioner  protected a dying acute subdral haematoma patient in his care. Brighton and Sussex University Hospitals Trust covered up patient harm allegations and allowed physicians who Killed to remain in Post.

Mr Marchants Job description states he may provide advanced vascular access. The HPC and Employment tribunal ignored this, He was refused his witness requests
HPC Paul Marchant. The Detail HPC ommited THE HEALTH PROFESSIONS COUNCIL

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MR PAUL MARCHANT

PROOF OF EVIDENCE OF MR PAUL MARCHANT

1. I am a registered Operating Department Practitioner (ODP). I qualified from Kings College Hospital, London in 1991. I am a member of the British Medical Ultrasound Society and the British Association of Operating Department Practitioners.

2. Following qualification as an ODP, I undertook various jobs as an ODP in the private sector with ROBAC Medical and Corinth Medical. In 1998 I moved to the Netherlands where I worked initially at Spaarne Ziekenhuis in the role of equivalent to Anaesthetic Practitioner administering anaesthesia under a Scottish anaesthesiologist. I then worked at Oudaryne Ziekenhuis in the same role.

3. The Dutch clinics operated a "two-table" system whereby I administered drugs to patients at the outset of anaesthesia under the consultant's supervision. The anaesthetist would then go to another theatre and see to another patient whilst I kept the patient normotensive and pain free under general anaesthetic a very responsible position.

4. In 2000 I returned to the UK and worked as a locum ODP at various sites for a locum provider called Sussex Recruitment Services. One of the locum posts I held was at the Princess Royal Hospital ICU, part of Brighton and Sussex University Hospitals NHS Trust ("the Trust").

5. In 2002, whilst working at the Trust as a locum ODP, I noticed an internal memorandum advertising a substantive ODP post. In early June 2002 I applied for the role and was successful in my application.

6. I enjoyed my work at the Trust. In addition to my everyday work as an ODP I participated in audit. This included a clinical audit for antibiotics in February 2004 in which I was assisted by the lead microbiologist at the Trust. I presented my findings at a clinical governance meeting. I also made a proposal for research into Cefuroxine and Manitol. I found the process of liaison between different professionals interesting.

7. In May 2003 I was appointed as an Educational Facilitator. As part of this role I organised various speakers from companies to come and give educational talks on their products. I also provided talks on arterial blood gas analysis and recovery room emergency drills and introduced computer simulation exercises for staff in ECG interpretation, drug calculations and rhythm recognition.

8. In around 2003 I began to actively pursue an interest in the insertion of intravenous lines. I had previously inserted IV cannulae in the Netherlands. I undertook training in the insertion of intravenous lines which included an IV study day run by the Institute of Nursing and Midwifery at the University of Brighton. On 28 August 2003 I attended a course dealing with venupuncture and cannulation. This was also run by the Institute of Nursing and Midwifery. Between February and September 2004 my practice in intravenous cannulation was assessed by Dr H K Heer, a consultant anaesthetist. I refer to the assessment of practice document which shows the number of supervised cannula insertions I carried out and the performance criteria for insertion of the cannulae. At the conclusion of this assessment I was signed off as competent to insert IV lines.

9. I was trained by the Trust to insert peripherally inserted central catheters or PICC lines which is a 60 cm catheter that leads to the patients heart. Following my sign-off I became a PICC line placer at the Trust. I inserted a very considerable number of PICC lines over the years as evidenced by the 'PICC placement tracker'. I continued to record my PICC line placements on the 'PICC placement tracker'. The insertion of PICC lines formed part of my job description in 2005. On the first page of my role description under the heading 'Role Summary' the last bullet point states that my role was to provide advanced vascular access, assessment and consultation for PICC lines. My role as a PICC line placer is set out at the top of the third page of my job description. I was also involved in training and assessing others in the insertion of the lines.

10. In 2006 I attended a course on ultrasound guided vascular access, which is particularly useful in patients who have no palpable veins. I subsequently undertook some research and found that in the USA, ultrasound was used for providing arterial access also. As part of my PICC placement at the Trust I placed regularly placed venous cannulae using ultrasound guidance. I chaired and set up a course for the Trust in 2006 called Advanced Vascular Access Seminar. I assessed and coached multidisciplinary participants form all over the UK on ultrasound guided vascular access and devised an assessment document for US guided peripheral vascular access. I introduced into the Trust Ultrasound for use in gaining safer peripheral vascular access in patients with no palpable or visible veins. This then led to 4 new ultrasound monitors being acquired under NICE guidelines and funding.

11. As part of my role as an ODP assisting anaesthetists, I was occasionally asked to insert arterial lines into patients, as were other ODPs across the Trust for example at the cardiac surgical centre. Arterial lines are thin catheters inserted straight into a patient's artery to monitor blood gasses and blood pressure in real time. They are not used for administering drugs or medication. During my five years working at the Trust I inserted numerous arterial lines and became experienced in their insertion. Originally, I was trained in inserting arterial lines at College as part of my initial ODA qualification. Subsequent training was practical, on the job. Arterial lines were always inserted under the supervision of medical staff and the medical staff were always in the same room. I would say that I inserted around 10 or so arterial lines per year. Later, when I began using the ultrasound technique, I inserted more, about 15 to 20 such lines per year. I would insert lines when asked to by medical staff. Canulation of the artery is similar to canulation of a vein but with other considerations.

12. I was not however signed off by the Trust to insert arterial lines unsupervised, as no course existed. I have seen as part of the disclosure from the HPC a Trust protocol for signing off non-medical staff. However this was not in existence whilst I was working at the Trust. A policy clarifying this grey area was put in place 7 months after my exclusion.

Events of 24 January 2007

13. On 24 January 2007, I came on duty in the theatres at Hurstwood Park at 1.00 p.m. At this time the patient was already in the anaesthetic room for 10 minutes according to the patient documents. I came on duty and I walked past the coffee room and saw anaesthetists Dr Fumigali and Dr Rouse. The coffee room is a short distance from the anaesthetic room. I did not see Dr Haliosus, the surgeon who was to carry out the procedure.

14. Shortly after I came on duty I was asked by a Senior ODP colleague, Daniel Rieley to take over the care of the patient in the anaesthetic room. The patient was due to undergo an emergency evacuation of an Acute Subdural Haematoma. I then went into the anaesthetic room. I waited there, and after a while left the anaesthetic room and saw the surgeon, Dr Haliosus, in the corridor. He was keen to proceed with the procedure and appeared flustered, asking where the anaesthetists were. I checked but they were no longer in the coffee room so I went back into the anaesthetic room and waited. According to SODP D. Rieley's statement there has been some dispute between the anaesthetists and the surgeon over sending for the patient and that the anaesthetists had returned to the anaesthetic department in protest. The anaesthetic department at the Trust is in another building, in fact a separate hospital.

15. I soon became concerned for the patient's state of health. Recovery staff Nurse Helen Becket was asked to receive the patient into her care because of the delay, but refused because of the patient's condition. My recollection is that the patient was drooling and non-responsive. He was being monitored using non-invasive techniques including blood pressure, ECG and oxygen saturation. I recorded and observed the patient as being Hypertensive. I was aware that the patient would require a canula to be inserted, to measure real time arterial blood pressure and that this was standard procedure for the evacuation of Acute Subdural Haematoma procedures. I believed that the insertion would save critical time, enabling the surgical procedure to start sooner upon the arrival of the anaesthetists moreover that an arterial line would better allow real-time monitoring and blood pressure and arterial blood gas sampling whilst the patient was in the anaesthetic room, enabling any deterioration in the patient's condition to be picked up sooner and better manage the patient's care. I had previously been involved in an incident where I was transferring a patient with an Acute Subdural Haematoma who went into cardiac arrest between the ITU and the operating theatre that patient died before surgery could commence. This incident was very much in my mind at the time.

16. I decided to insert the arterial line. Daniel Rieley came back into the anaesthetic room and I then went to the next room to get the ultrasound machine to enable safe insertion. At no time the patient was left alone. Whilst I was out I checked again with staff whether contact had been made with absent anaesthetists. They confirmed that there was not response from the bleep or anaesthetic department, this added to the pressure and was felt by all the staff.

17. The equipment for the insertion of the line had already been set up by my colleague Daniel Rieley before I came on duty. I inserted the line without difficulty, using the ultrasound technique and Allen's test, a test, which confirmed that both arteries were patent. This is a test that only those who have been taught would know how to carry out. And is taught at ODP training school. The entire procedure lasted less than 1 minute and was mostly set up by my colleague, as I explain above.

18. All the while I was waiting in the anaesthetic room I was aware that help was being sought from the anaesthetic department by bleep and by telephone. I did not try and telephone personally as I knew, it was being done by the whole team.

19. I recall that the anaesthetists took approximately 40 minutes to attend. They arrived at about 1.35 p.m. When they came, the operation started and no mention or criticism was made of the arterial line insertion by the anaesthetists. In fact I was thanked for my assistance. Management sought to complain some days later.

20. I considered at the time that the patient was gravely unwell and that to take no action would have exposed the patient to a risk of cardiac arrest due to the pressure on the brain stem. I was the only current Advance Life Support Provider on duty at the time and calling a crash team (by pushing the orange alarm in the room) would not have been appropriate given that the patient was not in cardiac or respiratory arrest. The alarm would have resulted in a crash team attending, but what I really thought the patient needed was to get on with the procedure as soon as possible. I did not ask the surgeon, Dr Halios, to supervise my insertion of the arterial line because I was not convinced whether he would have had the appropriate skills to insert an arterial line himself. He was also very anxious at the time. Dr Haliosus, and other team members had tried all methods to locate the anaesthetists, but to no avail. I knew that the patient's condition carried an extremely high mortality rate if not treated rapidly and that the patient needed rapid surgical resuscitation and the assistance of the absent anaesthetists.

21. My actions on 24 January 2007 were motivated by an honest and genuine belief that they were in the best interests of the patient.

22. On 1 February 2007 I was excluded from my post as ODP. The stated reasons for my exclusion were that I had inserted an arterial line without permission or supervision.

23. Eventually I was asked to attend a disciplinary hearing. In respect of the arterial line, I acknowledged to the Panel that what I had done was not customary. When I was asked the by Joanne Thomas whether I would do the same if put in the same position, I said that I would have asked one of my colleagues to look after the patient and gone to look for an anaesthetist. I said that with hindsight I would have telephoned the anaesthetic department to ask whether it was appropriate to insert an arterial line. That said, I believe that the situation that I was faced with on 24 January 2007 was completely unique and I think I have very good skills in obtaining advanced vascular access. In summary, I accepted that it was wrong to insert the arterial line have not been requested and unsupervised. I was dismissed from employment on the grounds of gross misconduct. I appealed the decision unsuccessfully at a Trust hearing. I am also claiming against the Trust in the employment tribunal, which is on going. I have dropped part of the claim under the Protected Disclosures Act 2000 that I had made 4 weeks before my exclusion. The employment tribunal appeals process is outstanding and Acas are mediating.

Acute subdural hematoma (ASDH) has a high mortality rate and is a severe medical emergency.
Acute subdural hematoma (ASDH) has a high mortality rate and is a severe medical emergency.