Judith Rosalind Chadwick

Profession: Radiographer

Registration Number: RA21124

Hearing Type: Review Hearing

Date and Time of hearing: 12:30 03/02/2016 End: 14:00 03/02/2016

Location: Health and Care Professions Council, Park House, 184 Kennington Park Road, London, SE11 4BU

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

 


During the course of your employment as a Radiographer with University Hospital of South Manchester between October 2007 and July 2013, you:


1. Re-used single use masks on patients;


2. Used out of time isotopes on patients;


3. On or after 8 March 2013 you carried out a clinical procedure on a patient whilst your hand and/or finger was bleeding;


The matters set out in paragraphs 1-3 constitute misconduct and/or lack of competence.


4. By reason of your misconduct/lack of competence your fitness to practise is impaired.

Finding

Preliminary Matters

Service of Notice

1.             The Notice of today’s hearing was sent to the Registrant at her address as it appeared in the register on 15 December 2015 by first class post. The Notice contained the date, time and venue of today’s hearing.

2.             The Panel accepted the advice of the Legal Assessor. The Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (“the Rules”) require that a Notice of Hearing must contain the above information and be sent to the Registrant at her address not less than 28 days before the date of the hearing starting.

3.             Accordingly, the Panel is satisfied that Notice of today’s hearing has been served in accordance with the Rules.

Proceeding in the absence of the Registrant

4.             The Panel then went on to consider whether to proceed in the absence of the Registrant. In doing so, it considered the submissions of Ms Higham on behalf of the HCPC.

5.             Ms Higham submitted that the HCPC has taken all reasonable steps to serve the Notice on the Registrant. She further submitted that the Registrant has engaged with the process and is aware of today’s proceedings. She drew the Panel’s attention to an email, dated 18 December 2015, where the Registrant states that she did not intend to attend today’s hearing. Further, the Registrant’s implicit expectation is that today’s hearing proceed in her absence and she has not sought an adjournment. Ms Higham submitted that the Panel can be satisfied that the Registrant’s absence today is voluntary and she has waived her right to attend and/or to be represented. An adjournment would serve no useful purpose and there was a public interest in this matter being dealt with expeditiously.

6.             The Panel accepted the advice of the Legal Assessor. He advised that if the Panel is satisfied that all reasonable efforts have been made to notify the Registrant of the hearing then the Panel has the discretion to proceed in the absence of the Registrant. Clearly in this case the Registrant is aware of today’s hearing by reason of her email. He reminded the Panel that it should exercise that discretion with the utmost care and caution. He drew the Panel’s attention to the principles to be considered when exercising the discretion to proceed in the absence of the Registrant as outlined in the case of R v Jones [2002] UKHL 5. He further advised that the Panel should take into consideration the email from the Registrant when considering the nature and circumstances of the Registrant absenting herself, in particular whether the decision was voluntary and, if so, whether the Registrant has waived her right to be present and/or represented. He reminded the Panel that it should also remember the general public interest that the Substantive Order is reviewed today.

7.             The Panel was satisfied that all reasonable efforts had been made by the HCPC to notify the Registrant of today’s hearing. It is also satisfied that the Registrant is aware of today’s hearing.

8.             In deciding whether to exercise its discretion to proceed in the absence of the Registrant, the Panel took into consideration the HCPC Practice Note entitled “Proceeding in the Absence of a Registrant”. The Panel weighed its responsibilities for public protection and the expeditious disposal of the case with the Registrant’s right to a fair hearing.

9.             In reaching its decision, the Panel took into account the following:

               The Registrant has not made an application to adjourn today’s hearing and implicit in her email dated 18 December 2015 is an expectation that proceedings today proceed in her absence;

               The Registrant has engaged with the process and has made further representations in the above email which this Panel can take into consideration on review of this Order;

               There is a public interest that this substantive order is reviewed before it expires.

10.           The Panel was satisfied that the Registrant had voluntarily absented herself from the hearing and has waived her right to be represented. It determined that it was unlikely that an adjournment would result in her attendance at a later date. The Panel concluded that the Registrant had waived her right to attend the proceedings and it would not draw any adverse inference from her non-attendance. It determined that there would be no injustice to the Registrant with proceeding in her absence. Having weighed the public interest in the expeditious disposal of this case with the Registrant’s own interest, the Panel decided to proceed in the Registrant’s absence.

 

Background

11.           The Registrant commenced employment at South Manchester NHS Foundation Trust (“the Trust”) on 3 July 1978. She was appointed to the role of Band 7 Clinical Manager for Nuclear Medicine on 18 October 2007.

12.           On 30 April 2013, an Incident Report was completed by SC, Directorate Manager for Radiology. The report was completed following concerns raised by ED, Radiographer and Student in Nuclear Medicine, that Judith Chadwick had re-used a single use mask on a patient. It was also identified that there were a number of out of date items found in the cupboards within the Nuclear Medicine Department. JH, Matron, was appointed to undertake a formal investigation in relation to the Registrant’s actions. At the conclusion of the investigation, the allegations were referred to a Disciplinary Hearing.

13.           On 18 July 2013, a Disciplinary Hearing was convened to consider the allegations in respect of the Registrant. At the conclusion of the hearing, the Registrant was dismissed from her employment at the Trust.

14.           The matter was referred to the HCPC and the substantive hearing was held on 2-3 February 2015.

15.           Having found Particulars 1, 2 and 3 proved, the Panel determined that Particulars 1 and 2 were sufficiently serious to amount to misconduct. Taking the circumstances of particular 3 into consideration, the Panel did not consider that particular to amount to misconduct. Further, that Panel did not consider any of the Particulars amounted to lack of competence on the part of the Registrant. That Panel found the Registrant’s fitness to practise to be impaired by reason of her misconduct, and imposed a Conditions of Practice Order on the Registrant’s practice.

16.           In coming to its decision on sanction, that Panel took into account the aggravating and mitigating features of the case.

17.           That Panel considered that the aggravating factors were:

               The Registrant was a senior and highly experienced practitioner;

               She had less than full insight into why her conduct was unacceptable;

               Her professional shortcomings took place over a substantial period, albeit sporadically.

18.           That Panel considered that the mitigating factors were:

               The Registrant had a long and unblemished professional record of some 35 years;

               She was working at times under significant pressure and without the sort of effective supervision which would have identified her lapses in good practice at a much earlier stage;

               There was no evidence of patient harm;

               The risk to patients was low;

               The Registrant believed she was acting in the best interests of the patient, even though her judgement in this respect was flawed; and

               The Registrant had shown some insight and had accepted that she may have a need for some retraining.

19.           That Panel was clear that the evidence showed a clear picture of an otherwise capable and experienced Registrant who, by the specialised nature of her work and her position had allowed unacceptable elements to enter her practice when she thought it would be helpful to preclude delays in treatment.

20.           That Panel had no doubt the Registrant’s motivation was good but was equally in no doubt that her judgement was flawed. It found that the Registrant had gone some way to recognise that she was wrong but it was that Panel’s view that her understanding of why she was wrong needed to be reinforced to provide reassurance that her lapses would not be repeated. That Panel considered that with some further training and a period of supervision it could be confident that any further risk to public safety could be precluded and the public interest would be served by permitting the return to practice of a competent and experienced Radiographer, if that is what the Registrant should wish.

Terms of the Conditions of Practice Order:

1)             You must promptly inform HCPC if you take up employment as a radiographer.

2)             You must promptly inform HCPC of any disciplinary proceedings taken against you by your employer.

3)             Within 6 weeks of taking up employment you must satisfactorily complete a refresher training course on Infection Control (this could be a repeat of the relevant component of standard mandatory training) and forward a copy of your results to the HCPC.

4)             You may only work for an employer who is prepared to appoint a supervisor who will be able to supervise your work for a minimum period of 6 months. You may not undertake Agency, Bank or Locum work where this condition cannot be met. The supervisor does not need to oversee your day to day work but should be in a position to be aware of your professional performance.

5)             You must meet with your supervisor and formulate a PDP designed to address your attitude to full compliance with your employer’s policies on infection control and safe and effective use of radio-isotopes, if appropriate.

6)             Within 3 months of obtaining employment you must forward a copy of your PDP to the HCPC.

7)             You must meet with your supervisor on a monthly basis to consider your progress towards achieving the aims set out in your Personal Development Plan.

8)             You must provide a report from your supervisor about your progress towards achieving the aims set out in your PDP not later than 28 days and not earlier than 56 days before this order is reviewed.

9)             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

b)             any agency you are registered with or apply to be registered with (at the time of application)

c)             any prospective employer ( at the time of application)

10)           You will be responsible for meeting any and all costs associated with complying with these conditions

Submissions at the hearing today (3 February 2016)

21.           Ms Higham drew the Panel’s attention to the email from the Registrant in which she stated “...I have not been employed as a radiographer since July 2013 and do not intend to do so in the future. I have retired and taken my pension since last [sic] hearing and do not intend to work in the future as a radiographer.”

22.           Ms Higham submitted that in the light of the comments made by the Registrant, there is no evidence to show that the Registrant’s fitness to practise is no longer impaired. She submitted that an Order remains necessary to protect the public and is otherwise in the public interest. Further, Ms Higham submitted that conditions of practice now serve no useful purpose and the HCPC are therefore asking the Panel to consider suspending the Registrant’s practice.

 

Decision

23.           The Panel accepted the advice of the Legal Assessor. The Legal Assessor reminded the Panel that its purpose today was to conduct a comprehensive appraisal of the Registrant to determine if she is fit to return to unrestricted practice. Its role is not to conduct a rehearing of the allegations nor is it to go behind the previous findings. He advised that in carrying out this assessment, the Panel must exercise its own independent judgment. He advised them that they are to make their determination based on the evidence before the Panel today.

24.           The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired all the options under Article 30 of the 2001 Order could be exercised by the Panel. He advised the Panel that it should bear in mind the principles of fairness and proportionality and have regard to the “Indicative Sanctions Policy” document issued by the HCPC. He reminded the Panel that any order that it makes under Article 30 should not be punitive in purpose, and that it should be the least restrictive order that would suffice to protect the public and/or is otherwise in the public interest.

25.           The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Panel took into consideration all the documentation before it, and the submissions of Ms Higham. In particular it noted contents of the Registrant’s email which set out her current situation as above and her future intention not to practise as a radiographer.

26.           The Panel also noted that this is a case of misconduct and there is no suggestion that the Registrant lacked the requisite competence to carry out the role of a radiographer. Hence this is a case where the Registrant’s insight and remediation is of greater importance.

27.           Taking all of the above into consideration, the Panel determined that there is no new evidence upon which the Panel can judge the level of insight the Registrant has into her failings or assess the steps she has taken to remediate them.

28.           Therefore, the Panel determines that the Registrant’s fitness to practise remains impaired.

29.           The Panel then went on to consider what action, if any, it should take in light of its finding of current impairment. In doing so, it had regard to the HCPC “Indicative Sanctions Policy”.

30.           The Panel first considered whether it would be appropriate to take no further action and to allow the current Conditions of Practice Order to lapse at its expiry. The Panel is of the view, given the seriousness of the matters and the lack of evidence of insight and remediation on the part of the Registrant, that it would not be appropriate to allow the Order to lapse.

31.           The Panel next considered whether a caution order would be an appropriate order. However, given the same reasons for not allowing the Conditions of Practice Order to expire, the Panel concluded that a caution order would not be sufficient to address all the issues raised.

32.           The Panel next considered whether a Conditions of Practice Order would be an appropriate order in this case. However, it determined that, in the light of the representations from the Registrant that she has retired and does not wish to return to the profession, a Conditions of Practice Order would be unworkable and serve no useful purpose. The Panel is satisfied that this is a genuine indication of her settled intention not to practise as a radiographer.

33.           The Panel then considered a Suspension Order. In the circumstances, the Panel considered that a Suspension Order would serve no useful purpose other than to extend these proceedings, there being no realistic likelihood of the Registrant changing her mind with a view to returning to practice.

34.           In the light of the above, the Panel are satisfied that the appropriate and proportionate response to protect the public and being otherwise in the public interest in these circumstances is to make a Striking Off Order.

35.           The Striking Off Order is imposed pursuant to Article 30(1) of the Health and Social Work Professions Order 2001 and will come into effect upon the expiry of the current Conditions of Practice Order.

Order

The Registrar is directed to strike the name of Judith Rosalind Chadwick from the Register on the expiry of the existing order.

Notes

The order imposed today will take effect upon the expiry of the current Order on 3 March 2016.

Hearing History

History of Hearings for Judith Rosalind Chadwick

Date Panel Hearing type Outcomes / Status
03/02/2016 Conduct and Competence Committee Review Hearing Struck off