Mr Wilson Huelgas

Preliminary matters

Service

1. The Panel has determined that there was good service under the HCPC’s procedural Rules. The appropriate Notice of Hearing of this Review dated 2 October 2018 was sent to the Registrant’s last known registered address by first class post. The letter referred to the time, date, venue and nature of today’s hearing, being a Review of the sanction imposed by a final hearing panel on 7 November 2017.

Proceeding in Absence

2. The Panel took into account the submissions of Ms Wills on behalf of the HCPC and accepted the Legal Assessor’s advice. In reaching its decision the Panel also paid regard to the HCPTS’s Practice Note on Proceeding in the Absence of the Registrant. Although the Registrant had engaged with the proceedings initially, he had ceased communication with the HCPC in about March 2016. The Panel also noted that the Registrant was not present nor was he represented at the final hearing on 6-7 November 2017.  Furthermore, the Registrant has not requested any adjournment.

3. The Panel also took into account the wider public interest in the prompt disposal of hearings, particularly as this is a mandatory review of a sanction, upon the expiry of which, with no other action, the Registrant would be free to return to unrestricted practice. The Panel noted the Order must be reviewed by 5 December 2018. The Panel also noted the numerous unsuccessful efforts made by the HCPC to make contact with the Registrant since the substantive hearing.

4. The Panel has concluded that it seems unlikely that, if this hearing is adjourned, the Registrant would attend on the next occasion. It is the Panel’s judgement that the Registrant has deliberately and voluntarily absented himself from today’s hearing, and has thus waived his right to appear.

5. For these reasons, the Panel has determined that the hearing should take place in the absence of the Registrant.

Background

6. The Registrant obtained a Bachelor of Science in Radiologic Technology in 1994 and worked as a Band 5 Diagnostic Radiographer for the Chest Diseases Hospital in Kuwait from March 1996 until March 2001.

7. In June 2013 he applied for a role as a Band 6 Radiographer in the  X-Ray department at the Alexandra Hospital in Redditch. He attended an interview for the position on 10 July 2013. The interviewers, DT, Site Superintendent Radiographer for Worcestershire Acute Hospitals Trust, and CW, Acting Deputy Site Superintendent, found that the Registrant was unable to answer questions on a number of basic and essential topics which they would expect a qualified Radiographer to be able to answer. For questions relating to key skills and knowledge they gave the Registrant scores between ‘0’ and ‘2’ out of a possible ‘10’ marks.

8. The previous panel accepted that the Registrant’s answers were unsatisfactory and that they had caused DT to have concerns about the Registrant’s competence as a Radiographer. The areas of questions, as identified at (a) to (f) in the allegation, dealt with basic and essential areas of radiography practice which any radiographer should be able to answer. The Registrant was unable to give adequate answers, even when prompted. The Registrant had seemed confident, and unaware that his answers were inadequate. DT’s view was that he presented a potential danger due to his lack of knowledge and lack of awareness. DT had conducted many interviews and had never had such concerns following an interview before, nor had she ever referred anyone to the HCPC. She referred her concerns about the Registrant to the HCPC on 15 July 2013.

9. The previous panel found that on his application for the position at the Alexandra Hospital, the Registrant had referred to having been working as a Band 5 Diagnostic Radiographer at the Royal Orthopaedic Hospital in Birmingham between December 2012 and December 2013. KJ, Superintendent Radiographer at the Royal Orthopaedic Hospital NHS Trust, confirmed that in fact he was employed as a Healthcare Assistant on the wards at that hospital. He had only undertaken two days as a bank Band 5 Radiographer in November 2012 and had appeared to lack experience and needed supervision. He had not been asked to work any further bank shifts.

10. The Panel also noted the evidence of Dr VG, given to the previous panel. She was employed at The Faculty of Health and Applied Sciences at the University of West England. She was instructed by the HCPC to conduct a Test of Competence in respect of the Registrant.  Dr VG’s conclusion was that the Registrant appeared to possess a basic level of radiography. She noted his language skills were “fairly rudimentary”. She stated in her report “it was noted that his understanding of the English language was not good and some sentences had to be repeated to him in order for him to understand. Likewise, it was sometimes difficult to understand his responses, and clarification had to be sought from him on several occasions to ensure appropriate understanding”.

11. The Panel also noted that Dr VG described the Registrant’s level of diagnostic radiography as rated at just below the level of a graduating radiography student. She concluded that the assessment findings and results indicated that the Registrant would benefit from a period of supervised practice in order to ensure that his knowledge and skills were of the required standard to practise as a Radiographer in the UK.

Today’s Hearing

12. The Panel is undertaking a first mandatory review of a Suspension Order, imposed by a previous panel on 7 November 2017 for a period of 12 months. The previous panel found that the Registrant’s fitness to practise was impaired by reason of his lack of competence. 

13. In undertaking the review, the Panel has considered carefully Article 30(1) of the Health and Social Work Professions Order 2001, the HCPTS Practice Note Finding that Fitness to Practise is ‘Impaired’ and the HCPC’s Indicative Sanctions Policy (March 2017).

14. The Panel has carefully considered all the documents in the bundle and Ms Wills’ submissions. Ms Wills submitted that the Registrant’s fitness to practise remained impaired and that the Panel should consider extending the existing Suspension Order by a further 12 months.

15. The Panel has accepted and applied the advice it received from the Legal Assessor as to the proper approach it should adopt in considering this Review. In particular:

• The present Panel is required to accept the decision of the substantive hearing panel as final, with regard to the decisions made on 7 November 2017.

• The task for the Panel is, having accepted the settled decisions of the previous panel, to decide whether the Registrant’s fitness to practise remains impaired.

• If the conclusion reached by the Panel is that the Registrant’s fitness to practise is not currently impaired, then the Suspension Order should be revoked forthwith.

• If, however, the conclusion reached is that the Registrant’s fitness to practise is still impaired, then the Panel is required to decide whether a further sanction is necessary.  In making this decision the Panel should refer to the HCPC’s Indicative Sanctions Policy.

• As the finding made by the previous panel was one of lack of competence, the sanction range available to the present Panel is the entire sanction range up to suspension, but excluding the sanction of Strike Off.

Decision

16. The Panel has taken into account Ms Wills’ submissions. It has accepted the Legal Assessor’s advice. The Panel has accepted the previous panel’s findings, but, as a review Panel, it has fully reviewed the case.

17. In the Panel’s judgement this was a serious matter. The previous panel concluded that although the interview in this case was a single occasion, the issues demonstrated ‘a lack of knowledge across a range of the basic and essential skills and knowledge required for competent and safe radiography practice…the Panel found the circumstances were exceptional, in that the serious inadequacies observed by the witnesses…led them to express concern that there was a potential for risk of harm to patients of which the Registrant appeared to be unaware’.

18. In the absence of any information since the substantive hearing  in respect of the Registrant’s remediation and insight, or evidence of any steps taken to improve his level of competence, such as further training and continuing professional development, this Panel has concluded that the Registrant’s fitness to practise remains impaired. Following the previous Panel’s finding of impairment, the onus is on the Registrant to demonstrate that he is no longer impaired. Having failed to engage with the HCPC, the Registrant has not done so.

19. The Panel has determined that if the Registrant were to be found unimpaired today, this would undermine public confidence in the profession and in the regulatory process. This is because, in the Panel’s judgement, the matters raised in this case have the potential to put members of the public at risk.

20. For these reasons, the Panel has determined, having considered carefully both the ‘personal’ component and the ‘public’ component, that the Registrant’s fitness to practise remains impaired by reason of lack of competence.

Sanction

21. In reaching its decision on how to dispose of the case on this review, the Panel took into consideration Ms Wills’ submission and accepted the Legal Assessor’s advice. The Panel also exercised the principle of proportionality and took into account the general principle that a sanction should not be punitive. The Panel approached each of the available options for sanction on review in ascending order.

22. The Panel first considered taking no action, mediation or a Caution Order. It rejected those options. They would not restrict the Registrant’s practice and would therefore not provide any protection to the public

23. The Panel next considered replacing the existing Suspension Order with a Conditions of Practice Order, but determined that, at this time there were no workable and enforceable conditions which would address the allegation found proved. In particular, in the absence of engagement by the Registrant, the Panel could not be satisfied that the Registrant would comply with any conditions.

24. The Panel next considered extending the existing Suspension Order on its expiry and determined that an extension of 12 months to the existing order on its expiry is the only proportionate outcome. The Panel is concerned that the Registrant has not practised since 2013 and that he has displayed a lack of awareness of his deficiencies. The Panel concluded that those deficiencies, as identified by the previous panel, have not apparently been addressed in any way by the Registrant.

25. The period of twelve months will give the Registrant the time and opportunity to engage in this process and to satisfy a future panel that he has remedied his deficiencies.

26. The Panel considered that a future panel would be assisted by the attendance of the Registrant and evidence of his reflection, learning and insight in respect of his deficiencies, with particular reference to any training and continuing professional development he may have undertaken. It would also be assisted by references or testimonials from any employers.

27. Therefore, for these reasons, the Panel has determined that, on the grounds of public protection and the wider public interest, the appropriate sanction is an extension to the existing Suspension Order, upon its expiry, for a period of 12 months.

Order: The Registrar is directed to suspend the registration of Mr Wilson Huelgas for a further period of 12 months on the expiry of the existing order. 

The order imposed today will apply from 5 December 2018.

This order will be reviewed again before its expiry on 5 December 2019.

History of Hearings for Mr Wilson Huelgas