Code of Professional Conduct and Ethics – Consultation
At the beginning of the summer — in Registrar Circular All 08/1 — a revised Code of Professional Conduct and Ethics was circulated to all registered practitioners. The reason for the revision was to make provision for issues such as practitioners joining the Register from outside the state where issues such as language and/or CPG competency need to be addressed as well as training issues and scope of practice.

There were no dissenting submissions to the revised Code; there were, however, other responses and comments. The following is a sample of some of the submissions and associated responses.

Article 1.2 – “‘have the welfare of patients as their primary concern at all time’. I would like it to state ‘look after yourself your partner and your vehicle and all other road users and only then look after the patient.”

Registrar Response – All practitioners are expected to ensure scene safety, once this has been confirmed then their primary concern is the welfare of the patient.		  
Article 1.3 - The issue of giving your name to members of the public was an issue for some respondents.

“I strongly disagree with section 1.3 and think the wording should be changed. With the dynamics of every incident I do believe the Paramedic should have the right to choose to give his/her name to the patient, the situation or incident should dictate whether or not the paramedic should give his or her name. If there is a problem with an incident there is enough information on the side and front of the ambulance to ID the crew. I do believe it should be at the crew’s discretion whether to use their names or not. As you know at the coal face of Paramedic work, giving your name to some patients can only cause problems for the paramedic not professionally but personally.” 

Registrar Response – Yes of course, it is at the crew’s discretion what information they give, common sense should apply. However at a ‘non-threatening’ event or incident good manners should dictate that you introduce yourself to your patient. 		  

Article 1.5 – “remove ‘in full’ as there are many situations to provide care in full - document where aspects of care are not done ref. item 3.6.”

Registrar Response – Practitioners are only expected to document what they have done, if an intervention is not done then obviously it should not be record on the PCR.


  
Articles 3.1 to 3.4 – There were a lot of comments regarding this. Some of the comments were: “I would suggest that funding be granted and secured for the upskilling of all EMT's and Paramedics throughout the country as to date.” “With regard to training and education:- Is there an onus or requirement on PHECC-registered training sites/institutions/employers to provide education and training, particularly ongoing CPD, in order for registered practitioners to maintain PHECC and personal/professional standards?” 

Registrar Response – Training and access to upskilling is a significant issue throughout the HSE ambulance service. There are inconsistencies in the approach being adopted and access to training depends on where you work. This is an issue that is causing great frustration among practitioners who have embraced professionalism in order to improve patient care. It is expected that the new Council will continue to promote an upskilling programme commensurate with the requirements of the Register.
  
 
Conclusion

             
In a follow-up to this consultation exercise it is proposed to amend the Code of Professional Conduct and Ethics to all registered practitioners when they are invited to renew their membership of the Register with the amendments outlined in the consultation document in addition to amending Article 1.3 to read -

Each PHECC registered practitioner “will identify themselves by first name to patients in their care, unless they are in a threatening environment.”

Article 3.13 – “makes no reference to how the employer may treat the practitioner - is this covered/to be covered under an employer’s code of professional conduct and ethics”

Registrar Response – PHECC’s remit refers to clinical matters, employer/employee relationships are the subject of the HR/IR forum.

  
Article 3.13 – “With voluntary and auxiliary organisations signing up to PHECC these bodies should have a representative on the various PHECC committees particularly Fitness to Practice.” 

Registrar Response – PHECC does not distinguish between organisations. Once an individual is a registered practitioner they are entitled to put their name forward for consideration for membership of relevant committees.
  

Article 3.5 – “I feel Article 3.5 directly conflicts with Article 1.2 given that the current volume of paperwork (PCR) is taking valuable time to complete and when you have a short transit time it is resulting in a diminished rapport with the patient.” 

Registrar Response – Patient care will always take priority over documentation, however, a record of medications administered to a patient must be recorded by law. A properly completed PCR will give you, the practitioner, protection and it facilitates the continuity of care. The call isn’t over until the documentation is complete. Finish the PCR before going to the next incident.
    
Article 3.9 – “An up-to-date clinical handbook should be issued to all PHECC-registered providers. After all one cannot be expected to comply with current CPGs when the last handbook issued is out of the date and guideline for CPR have changed. The last book I received is the 2nd edition (2004).” 

Registrar Response – The revised CPG handbook has been approved and is being prepared for publication. It is proposed to distribute the new version at the end of October this year.

  
     
Article 3.3 – “Some overseas paramedics are educated, trained and competent in skills at ‘Paramedic’ level on PHECC Register e.g. Narcan, Adrenaline, IM in section, LMA's, Glucagon, Diazepam - Does this point (3.3) mean that they maintain their skills or must they await upskilling to train over again. I refer to practice in Queensland at ‘Advanced Paramedic Level’ which ‘Paramedic’ level in Ireland is beginning to match.”

Registrar Response – All practitioners are expected to maintain their skills in accordance with their status on the PHECC Register and not according to qualifications obtained in another jurisdiction.