Section 1: Fitness for Practice Policy

1.1 Purpose of the Fitness for Practice Policy

The purpose of this Policy is to make explicit Outreach Rescue’s, expectations and actions with respect to assuring applicants’ and students’ fitness for practice and to comply with the practice agreements with placement providers. This Policy therefore applies to all applicants and students, and all vocational course students during the course of their programme and, where relevant, up to and including the point of confirming eligibility to register with the Health & Care Professions Council (HCPC), or any other professional body.

1.2 Aim of the Policy

The overarching aim of the Policy is to provide clear and transparent information to applicants and students regarding expectations and processes associated with fitness for practice as a Paramedic or (with no legislative requirement) a person engaged in an emergency care role. Outreach Rescue embraces a positive attitude towards the promotion of equality on the basis of age, disability, ethnic origin, gender, religion or belief, sexual orientation, and will offer guidance to applicants and students when cultural beliefs may create difficulties in meeting programme requirements, e.g. dress codes or caring for people of any gender. This Policy and associated procedures comply with ORM’s Equality and Diversity Policy.

A specific aim of the Policy is to unify the Outreach Rescue Fitness for Practice Policy with Qualsafe’s and the HCPC’s Policies for Student Paramedics.

1.3 Health & Care Professions Council’s (HCPC) Requirements for Fitness for Practice

The HCPC’s primary statutory obligation as regulator of a range of health and care professions’ education is to protect the public and maintain public confidence in the profession and that having the skills, knowledge and character to practise their profession safely and effectively are fundamental to fitness for practice as a Paramedic. Programme providers have a responsibility for ensuring that applicants meet the HCPC requirements for entry to and, as students, continued maintenance on approved programmes leading to registration.

Good health means that a person must be capable of safe and effective practice without supervision. It does not mean the absence of any disability or health condition. Many disabled people and those with health conditions are able to practice with or without adjustments to support their practice.

Good character is important in that Paramedics must be honest and trustworthy. It is based on an individual’s conduct, behaviour and attitude. It also takes account of any criminal convictions, cautions, pending charges, a decision by another regulator or other relevant information contained within a Protection of Vulnerable Group’s (PVG) Scheme Record (or similar schemes in England & Wales and Northern Ireland) that are likely to be incompatible with professional registration.

1.4 Applicant and Student Responsibilities

All Paramedics are required to abide by the HCPC (registrant) standards of conduct, performance and ethics (2016). The HCPC also provides guidance for student Paramedics (2016) [link] and students are expected to work to these student standards during study, while working towards being able to apply the registrant standards at the point of registration. Programme providers are responsible for ensuring that applicants are of good health and good character for entry to the programme, while continuing on the programme and at the point of registration with the HCPC.

Outreach Rescue therefore requires that:

Applicants will be open and honest in relation to health, disability and/or any criminal convictions, cautions, pending charges or other relevant information, at the time of applying to the course;
When undertaking the course students will be open and honest in relation to any health, disability and/or any criminal convictions, cautions, pending charges or other relevant information that arise during their course;
When undertaking the course students will require support from a sponsoring organisation (usually their employer) that is able to provide adequate access to experiences necessary for the comletion of the students practice portfolio. If the students cannot evidence this support they will not be allowed to enrol on the course.
Any events or changes of circumstance in relation to the support provided be the sponsoring organisation must be reported immediately to Outreach Rescue for review.
Any improper activity or behaviour by a student which may give that student, or another student, an unpermitted academic advantage in a summative assessment is considered to be an act of academic misconduct and unacceptable in a scholarly community.
Students studying Qualsafe programmes will adhere to the Qualsafe rules with respect to student conduct:

1.4.1 Disclosure statements

Applicants for courses who have previous convictions or cautions, or have charges pending, are assessed on a case by case basis to ensure that neither the applicant, the staff, patients nor students of Outreach Rescue will be put at risk should the applicant become a student of Outreach Rescue. To help establish the circumstances surrounding the recorded offences, we advise applicants to provide a disclosure statement which explains the situations and circumstances that led to the conviction or caution. Guidance on Disclosure Statements are available in B3b: Disclosure Statements and on NACRO’s website: https://www.nacro.org.uk/resettlement-advice-service/support-for-individuals/

1.5 Remit of the Fitness for Practice Committee

Outreach Rescue will establish a Fitness for Practice Committee to establish the facts surrounding any Fitness for Practice issue. At least one member of the Committee will be a Paramedic currently registered with HCPC

1.5.1 Level 6 Paramedic Programme validated by Qualsafe

In the first instance of any Fitness for Practice issues arising on a Qualsafe programme, Outreach Rescue will undertake information gathering without prejudice to assist Qualsafe in arriving at an appropriate decision. This information will be forwarded to the head of the appropriate faculty for further action.

In the event of proceedings being necessary, then Outreach Fitness for Practice Committee will undertake further action in line with Qualsafe’s policies and procedures.

1.5.2 Other Outreach Rescue programmes

Outreach Rescue’ Fitness for Practice Committee is responsible for all other issues of a student’s fitness for practice on other programmes. At least one member of the Committee will be a Paramedic currently registered with HCPC. The committee consists of;

Cresto Senior Manager
Clinical Education Manager
Operations Manager
Outreach Rescue tutor
Investigating officer

The remit of the committee is to;

Ensure the Policy and associated procedures are understood and made available to students and staff.
Ensure that Outreach Rescue staff adhere to the Equality Act, Rehabilitation of Offender’s Act, Data Protection, and HCPC standards in relation to good health and good character.
Consider and make decisions in individual cases where there are concerns about the health of an applicant and/or the implementation of reasonable adjustments for a disabled
Consider and make decisions in individual cases where there are concerns about the character suitability of an applicant to enter a course or programme.
Consider and make recommendations to the Course/Programme Leader in individual cases where there are concerns about the health of a student and/or the implementation of reasonable adjustments for a disabled student.
Consider and make recommendations to the Course/Programme Leader in individual cases where a student has been withdrawn from a practice area following concerns in relation to patient safety/care.
Consult with the Course/Programme Leader in individual cases where there is a concern about health or character suitability of an applicant or student who is registered with the HCPC.
Consult with the Outreach Rescue Legal Advisor in complex individual situations, for example when a student is also an employee within a health care role.
Consider and make recommendations to the Education Director where there is an allegation of student misconduct.

Section 2: Health and Disability

2.1 Assessment of health conditions and/or disabilities

Opportunities for declaring a health condition and /or disability are available within the Outreach Rescue, Course and Qualsafe course application forms. Applicants who are offered a conditional place on any programme that has a direct healthcare component are also required to provide evidence of compliance with Outreach Rescue occupational health requirements (appendix 2) Additionally personal tutors, academic advisers and Practice Placement Educators associated with Outreach Rescue provide a supportive environment to enable students to share health or disability concerns, and all students are provided with information on the Disability and Dyslexia Service during Induction and within the Student Handbook.

Many people with a health condition and/or disability do not require any adjustments to support their learning however where it applies the assessment will focus upon what reasonable adjustments can be made to support the applicant or student to achieve entry to or, for students who are already HCPC registrants, maintenance on the HCPC register.

For Outreach Rescue’ other programmes, Outreach Rescue will liaise with the student and their employer/sponsoring organisation regarding declarations of health conditions or disabilities to ensure student safety, confidentiality and fitness for practice appropriate to the needs of the programme concerned.

2.2 Reasonable adjustments

All staff within Outreach Rescue have a responsibility to ensure that they fulfil their duty to make anticipatory adjustments to teaching, learning and assessment practices and promote positive attitudes towards applicants and students with a disability. In addition to anticipatory adjustments applicants may require individual reasonable adjustments to the interview and selection process, and students may also require individual reasonable adjustments to the academic and/or practice based learning environment.

The HCPC state that their concern when considering reasonable adjustments is “whether, with these adjustments in place, the applicant would meet our standards of proficiency at the end of the programme.”

The HCPC also list these factors to take into when determining if an adjustment is reasonable:

how effective the adjustment would be in avoiding the disadvantage the disabled student would otherwise experience;
how possible the adjustment is;
the cost of the adjustment;
the institution’s size and resources; and
the availability of any sources of financial support.
Outreach Rescue would also consider;
Health and safety of the individual, patients and clients, fellow students, placement team members.

2.3 Process following assessment of health and /or disability that requires individual reasonable adjustments

Information about health and/or a disability is regarded as confidential and as such Outreach Rescue respects the sensitive nature of the information. Agreement with, and consent from the student will be sought on how his/her requirements will be communicated to academic staff, mentors and practice staff.

2.4 Referral to the Fitness for Practice Committee

The following situations will be referred to the Fitness for Practice Committee:

Where there are professional concerns about the implementation of adjustments;
Where there are professional concerns that a lack of consent to communicate reasonable adjustments to practice staff could compromise the safety of the student, patients/clients and/or practice staff;
Where there are professional concerns that an applicant or student’s health or disability is likely to compromise, or has compromised his/her ability to meet the required competence standards including practicing safely without direct supervision at the point of entry to the nursing or midwifery register.

The following flowchart provides an outline of the process to be followed and the personnel involved:

Section 3: Evidence of Good character

3.1 Disclosure and Barring Service (DBS)

The DBS scheme helps ensure that those who have regular contact with vulnerable groups (Children or Protected Adults) do not have a history of inappropriate behaviour.

Applicants are made aware through marketing literature and Outreach Rescue’ website that a DBS Scheme Record is required, and that in line with the Rehabilitation of Offender’s Act 1974 (Exclusions) Order 1975, applicants are not entitled to withhold information about convictions which for other purposes are ‘spent’.

All applicants who accept a place on an Outreach Rescue course that involves placement in a clinical practice area will undergo a criminal record check through the DBS scheme. Once applicants join the DBS scheme, their membership records will be automatically updated if any new vetting information arises. This criminal record check must be completed prior to commencing placement in a clinical practice area.

Vetting information is conviction information retrieved from the criminal justice systems and non- conviction information held by the police that are considered relevant.

European and overseas clearance is required from applicants who have stayed out with the UK for 13 weeks duration or longer. It is the applicants’ responsibility to provide evidence of good character from another country.

All students who undertake a 6 month or longer break from a course that involves placement within a clinical area will undergo a criminal record check through the DBS scheme record update prior to re-entering the programme.

We encourage students register with the online Disclosure and Barring Service (DBS) update service, which allows applicants and current students to keep their DBS certificates up to date, and for Outreach Rescue to check a DBS certificate. Details of the DBS update scheme and prices can be found by following this link

3.2 Declaration of good health and good character

Students undertaking a pre-registration Paramedic course are required to declare their good health and good character on an annual basis. Students are also informed, within the Student Handbook and verbally by Course Leaders and Personal Tutors, that it is their responsibility to inform the personal tutor immediately if they have a charge, conviction or caution during the course.

Individual situations, which lead to the involvement of police or criminal proceedings, or call into question good character, may effect progression on the programme and these situations will be considered in accordance with Outreach Rescue’ Misconduct and Conduct policies.

3.3 Referral to the Fitness for Practice Committee:

The following list is not exhaustive however indicates situations that will be referred to the Fitness for Practice Committee:

Traffic offences that have involved substance abuse or loss of human life,
Offences that are punished by fines, community service, or a term in prison,
Vetting information recorded by the Police,
Information that the individual is under consideration for listing,
Failure to disclose information or lack of openness and/or non-truth telling.
When advice from the Fitness for Practice Committee is required.

The Fitness for Practice committee will review the information and undertake a risk assessment. Offences which involve physical, mental and/or sexual harm to another person are not considered by Outreach Rescue as ever being eligible for Paramedic education.

3.4 Process following disclosure of information in relation to a conviction, caution, pending charges or other relevant information

In line with Part V of the Police Act (1997), Outreach Rescue complies fully with the Revised Code of Practice for Disclosure and Barring Service Registered Persons for the correct handling, holding and destruction of DBS information.

On the disclosure of information, the Admissions Adviser will ask applicant to provide in writing:

Details of the offence or other relevant information
The name of a responsible independent person for a personal reference.

The information will be sent to a member of the Admissions Team.

Applicant invited to interview (face to face or telephone) with two members of FFP committee
Applicant may be accompanied by one other person

FFP committee reviews information and undertake risk assessment based on HCPC guidance:

Whether the information was disclosed
Explanation for non-disclosure (where relevant)
Degree of risk posed to patients and service users
Length of time since the offence
Whether the applicant has a habit of re-offending
How the applicants situation has changed since the offence
Circumstances surrounding the offence
Evidence submitted by applicant or referees of good character

If the outcome is accepted, the application to the course continues to be processed.

If the outcome is not acceptable, application to the course is rejected
The Applicant will be informed that if they wish to appeal, to write to the Education Director within 20 working days.

3.5 Process for reviewing information of a conviction, caution, pending charges or other relevant information obtained during the admissions process

Student invited to meet with the FFP committee
Student may be accompanied by one other person
If the student is on practice placement, the student will be placed on authorised absence

FFP Committee reviews information and undertake risk assessment based on HCPC guidance

Whether the information was disclosed
Explanation for non-disclosure (where relevant)
Degree of risk posed to patients and service users
Nature of the concern and any documentary evidence
Any mitigating circumstances in relation to the conduct
Students attitude towards the conduct
Evidence submitted by student or referees of good character
Personal tutor progress report

Outcome acceptable: Student continues on the course

Outcome not acceptable: Advise Education Director with respect to student non-academic misconduct

See C2: Outreach Rescue Student Conduct Policy

Appendix 1 – Occupational Health Approval of Fitness for practice

On receiving a conditional offer to study on any Outreach Rescue programme that requires a practice placement within a healthcare setting or that would result in qualification that places the individual into a healthcare setting, applicants must provide evidence of their compliance with the Outreach Rescue health requirements ensuring they are fit for practice.
All individuals must comply with the Outreach Rescue Occupational Health (OH) Compliance and Monitoring process.
On receiving a Conditional Offer of a space on the programme the individual must complete Parts A and B of the Process:
1. Part A = Self-Declaration of Fitness for Practice (Health)
2. Part B = GP / OH Verification
After completion and acceptance onto the programme, the individual must then confirm that they continue to meet the OH requirements of the programme by completing Part A on an annual basis.
In the event of any Cause for Concern (e.g. needlestick) then the individual is required to complete parts A and B again.

Link to Outreach Rescue Occupation Health Compliance and Monitoring Form.