Mrs Aminah Migisa

Profession: Radiographer

Registration Number: RA71727

Interim Order: Imposed on 03 Apr 2018

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 04/03/2019 End: 17:00 06/03/2019

Location: Health and Care Professions Tribunal Service (HCPTS), 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

(As amended at the final hearing commencing 4 March 2019).

Whilst registered as a Radiographer and employed by Sussex University Hospitals NHS Trust you:

1. Failed to reach the level of competence expected of a newly qualified sonographer during a clinical assessment on:

a) 6 June 2016

b) 29 June 2016

c) 13 October 2017

d) 14 December 2017

2. The matters described in paragraph 1 constitute lack of competence.

3. By reason of your lack of competence your fitness to practise as a Radiographer is impaired.

 

Finding

Preliminary Matters

Service and Proceeding in Absence

1. The Registrant was neither present nor represented at the hearing. The Panel were shown evidence that the Registrant had been served with a properly formulated Notice of Hearing at her registered address and found that good service had been made. Ms Sharpe applied for the hearing to proceed in the absence of the Registrant, given that despite attempts to contact her, no response regarding the hearing today had been received. The Panel accepted the advice of the Legal Assessor and took into account the Practice Note “Proceeding in the Absence of the Registrant”.

2. The Panel took into account that the Registrant:

- Had provided no explanation for her absence;

- Had not requested an adjournment;

- Had not indicated that she wanted to be represented;

- Had given no indication that if the hearing was adjourned that she would attend in future;

- That some of the events to which the Allegation relate date back to June 2016.

3. The Panel found that any disadvantage to the Registrant in proceeding without her or any representative attending, was outweighed by the public interest in a timely disposal of the case. Multiple attempts had been made to contact the Registrant without eliciting a response about the fitness to practise hearing. The Panel determined that the Registrant had voluntarily decided not to attend and waived her right to be present. It decided that it was in the interests of justice for the case to proceed without further delay or adjournment.

Application to Amend the Allegation

4. Ms Sharpe applied for amendments to be made to the Allegation as drafted. There were several amendments but these were broadly divided into two categories: a) form and b) substance. The proposed amendments of form suggested replacing the word “Registrant” with “you” and, the word “actions” with “matters”. The Panel were content to allow these changes to be made on the basis that these were not prejudicial to the Registrant.

5. The substantive change proposed to amend the Allegation concerned replacing the date of “4 June 2016” with “6 June 2016”; this change more closely reflecting the evidence. Accordingly, it is more likely to be found proved and the Registrant’s position was considered. Ms Sharpe indicated that the change was intended to clarify matters and that the Registrant had been written to and informed of the proposed amendments; no issue with the suggestions had been made by the Registrant. The Panel accepted the advice of the Legal Assessor.

6. The Registrant has not entered any formal response to the Allegation or taken issue with the dates alleged. She would be well aware that her assessment had taken place on one date rather than another. Indeed the Registrant refers to the date of 6 June 2016 in her representations for an earlier hearing. Accordingly, the Panel accepted that this amendment was not prejudicial to the Registrant.

7. The revised Allegation was changed to be formulated as set out above.

Written Representations by the Registrant

8. Ms Sharpe invited the Panel to consider written representations provided by the Registrant for a hearing on 3 April 2018. While the Registrant had not indicated that she wanted these representations to be put before the Panel in determining her fitness to practise this represented the best information that the Panel had about the Registrant’s views and attitude. The advice of the Legal Assessor was accepted. The document was helpful to the Panel and beneficial to the Registrant in reflecting what the Registrant might have said had she been present. While it was a historical document, no other up to date information had been provided on behalf of the Registrant.


Background

9. The Registrant was employed by Brighton and Sussex University Hospitals NHS Trust (the “Trust”) in March 2016, as a Band 7 Sonographer. She had reported having completed a Diploma in Diagnostic Ultrasound in 2014 in Uganda, but had not worked as a Sonographer in the UK. As the Registrant had not worked before in the NHS as a Sonographer, she was initially placed under the Trust’s four week preceptorship programme in order to provide additional support and direct supervision.

10. Early concerns regarding her performance led to the Registrant continuing to be supervised and having to undergo assessments in order to document her progress and provide her with feedback. As the Registrant was not progressing as expected it was agreed with her that she would undergo formal clinical assessment that students undertake before qualifying as Sonographers. The assessments indicated that the Registrant missed pathology and failed to identify relevant anatomy, failed to gain accurate measurements and struggled to stay within the timescales allocated for each patient.

11. More formal performance measures were eventually commenced. The Registrant had taken maternity leave of twelve months during her employment, plus other accrued annual leave, meaning that the time that she was actually at work was limited during her time employed by the Trust and amounted to less than nine months in total. The Registrant tendered her resignation in 19 December 2017.


Decision on Facts

12. Ms Sharpe called two witnesses to give evidence of behalf of the HCPC; JA and EC.

13. JA, was and is, Lead Superintendent Radiographer in Ultrasound at the Trust. She was Line Manager to the Registrant throughout her term of employment at the Trust and was also fully involved in the decision to recruit the Registrant. As JA was involved in the application process, she was aware of the fact that the Registrant had qualified as a Sonographer in Uganda, and had not worked in the UK in this role.

14. JA said that the Registrant was interviewed for a Band 7 qualified Sonographer role in November 2015. “During the interview she said she was capable of performing the responsibilities set out in the job description. We talked about the Registrant working in Uganda and not working in the NHS before. We discussed that there were some differences between the two but the implication was that she was competent to perform obstetrics, gynaecology and abdominal scanning as she said that she had 3 years’ experience in ultrasound. The Registrant also said she underwent a 6 month intensive training course in Uganda and held a Bachelor of Imaging, which she explained, is an Ultrasound Diploma in Uganda.”

15. JA had previously provided a statement dated 25 September 2018 detailing her dealings with the Registrant. In her oral evidence she elaborated on her statement and explained that the Registrant applied for the post of a Band 7 Sonographer and accordingly it was expected that she could perform the requirements of this role.

16. The job description set out the responsibility of the post and the person specification listed the qualifications, knowledge, experience, skills and abilities required. JA said that the Registrant raised no suggestion that she was not capable of meeting these requirements, and that she had done some research into the differences between practice in Uganda and the UK.

17. JA acknowledged that the Trust had not recruited a Band 7 Sonographer who had trained outside the UK before and had struggled to find evidence of parity between the qualification in Uganda and the qualification in the UK. Concerns that the Registrant had not progressed as expected during her time at the Trust, was not able to work unsupervised and her failure of four assessments prompted JA to refer the Registrant to the HCPC.

18. Her evidence was considered by the Panel to be credible, and balanced, as was her clarity in distinguishing facts that she could not remember, from opinions she held, and where she had a basis for these. She was candid and admitted that she had once failed an assessment of the kind that the Registrant had when she was starting out.

19. EC, was at the material time the Lead Superintendent for the Acute Floor and Neuroimaging at the Trust.

20. EC had previously provided a statement dated 2 October 2018 which she adopted as her oral evidence. She worked with the Registrant three or four times at the outset of the Registrant’s employment with the Trust and then as an assessor on 13 October 2017 and 14 December 2017.

21. In her evidence EC said she was not confident that the Registrant would not miss a significant finding when acting as a Sonographer. She explained that, for example, during an assessment she had observed the Registrant failing to note a large ovarian cyst on a mature patient. EC said that had the Registrant acknowledged that she was unsure about a possible pathology, she would have been assisted, without failing an assessment, but ignoring the issue was an automatic fail, no matter how good her scores were, dealing with other issues and patients during an assessment.

22. Her evidence was considered to be credible by the Panel and she admitted making an effort to be fair to the Registrant. She acknowledged that the Registrant was not a good “fit” within the Trust, and that colleagues had resented her being paid a Band 7 salary while having supervision for an extended period of time. She admitted that the period of maternity leave could well have impacted upon the Registrant’s progress and learning.

Evidence

23. In addition to the oral evidence before the Panel, there was documentary evidence to be considered, including assessment sheets for the first three assessments. These assessments are of a type which are usually used to assess student sonographers at the end of their training, using the King’s College Template. These assessments measure the level of competence demonstrated for different skills in a systematic approach whist scanning real patients in a clinical setting. Each assessment is conducted by two assessors. An email detailing the outcome of the final assessment in December 2017, supported by the witnesses JA and EC, confirmed that the Registrant had failed all four assessments.

24. Whilst there is no definitive pass mark, both witnesses were satisfied that the standard of the Registrant’s practical work overall was not sufficient to pass in any of the four assessments. The oral evidence which the Panel accepted was that some of the fails related to mandatory requirements which made the scores themselves largely irrelevant. The main causes for concern that were identified repeatedly were, missing pathology and anatomy, keeping to time and the quality of report writing.

25. There was supporting evidence that explained why the assessments had been considered necessary for the Registrant. These were in the form of concerns raised in feedback by sonographers who had supervised the Registrant’s practice. Such was the lack of progress demonstrated by the Registrant in her role as a Sonographer, the Trust decided that she should not undertake obstetric scans before she went on maternity leave. The Trust considered that focusing on one area at a time, namely non-obstetric scanning might be beneficial to the Registrant, meaning that she did not do the job which she had been employed to do but only part of it.

26. There were other supporting documents that the Panel was provided with. These were weekly reports from the Registrant’s Line Manager, letters to the Registrant detailing the outcome of the assessments and a Performance Improvement Plan.

27. In addition the Panel took into account the representations from the Registrant submitted for an earlier hearing in which she agreed with the results of the assessments and acknowledged “that the competence concerns raised are serious and I have no difficulty in admitting that I am unable to work unsupervised as a Sonographer in an NHS setting at present.”

Particular 1(a) – Found Proved

28. JA gave evidence that the practical skills assessment carried out on 6 June 2016 was one that the Registrant failed. This first assessment was carried out three months after the Registrant commenced work as a Sonographer at the Trust. The assessment failure was reflected in the paperwork indicating the assessment scores by way of a mark sheet. The failure was mandatory because the Registrant did not complete certain mandatory requirements, including demonstrating relevant anatomy and / or pathology and completing examinations in the allotted time.

Particular 1(b) – Found Proved

29. The second assessment took place three weeks later. Mandatory failings similar to those in the first assessment were identified. There were also concerns about inaccuracies in the Registrant’s report writing and poor-quality images being taken.

30. The Registrant was written to in a letter dated 30 June 2016 from her Line Manager JA, to inform her that the training, support and supervision that she had since her commencement at the Trust would continue post her return from maternity leave.

Particular 1(c) – Found Proved

31. The third assessment took place shortly after the Registrant had returned from maternity leave on 4 September 2017. Again, the Registrant failed to comply with mandatory requirements relevant to both pathology and anatomy, as found by both assessors.

Particular 1(d) – Found Proved

32. No assessment documentation was provided to the Panel regarding the assessment on 14 December 2017 but a summary of feedback detailing the main points raised in the clinical skills assessment contained in an email dated 19 December 2017 was seen. Both HCPC witnesses confirmed the accuracy of the email, which reflected their professional opinion that the Registrant had not reached the level of competency expected of a newly qualified Sonographer. The Panel noted that the concerns raised in the fourth assessment were consistent with the earlier failings regarding the identification of pathology.

33. In conclusion, the Panel accepted the evidence of the score marking sheets and summary of the feedback, and the oral evidence of the witnesses who had been assessors.

34. The Panel also took into account the Registrant’s submissions in which she agreed with the concerns identified. She stated that: “I will say that at no time have I sought to disagree with the opinions of my supervisors and colleagues.”

35. In light of the information before it, the Panel concluded that all parts of Particular 1 of the Allegation were found proved.


Decision on Grounds

36. Ms Sharpe submitted that should the Panel find the factual particulars proved, such facts amounted to the statutory ground of a lack of competence. She submitted that lack of competence is a question of judgment for the Panel. She drew the Panel’s attention to a number of legal cases and the principles they supported. It was her submission that the Registrant’s standard of work as a Sonographer was unacceptably low, and the assessments, taken over a period of time, represent a fair sample of the Registrant’s work, notwithstanding that the Registrant had been absent from work on maternity leave and spent just under nine months at work.

37. The Panel accepted the advice of the Legal Assessor and noted that while there was no relevant practice note drafted by the HCPC on the statutory ground of a lack of competence, case law was helpful, albeit that different professions used different wording and terms for sub-standard performance.

38. In Holton v General Medical Council, the High Court held that in assessing lack of competence the standard to be applied was that applicable to the post to which the registrant had been appointed and the work she was carrying out. The public was entitled to expect that the work of a registrant who performed in any speciality was at the standard applicable to that post in that speciality. The Panel therefore considered whether a Band 7 Sonographer who was working as the Registrant was, would have the level of competence to practice safely.

39. The case of Holton was considered particularly pertinent because the case concerned a doctor who was working in a specialism that was different to the training he had had. In the current case the Registrant is before the Panel as a registered Radiographer. That is the protected title. However, it is not the Registrant’s skill, knowledge or practice as a Radiographer that is in question, and in fact the HCPC witnesses have stressed this in their evidence. The Registrant without familiarity of practising as a Sonographer in the UK applied for this post as a Band 7 practitioner. There was evidence that she understood at least some of the differences between practice and protocols in the UK and Uganda where she had initially trained and qualified two years previously.

40. Having found that the assessments, which involve some professional subjectivity, as the different scores by different professionals attest, were properly failed, the Panel went onto consider whether these failures demonstrate a lack of competence. The Panel were mindful that these assessments were not staged but involved real patients attending for their appointments and were pitched at a level for those students who had just completed their training.

41. The Panel applied two of the five principles that were identified in the case of Calhaem, namely that deficient professional performance … is conceptually separate both from negligence and from misconduct. It connotes a standard of professional performance which is unacceptably low and which (save in exceptional circumstances) has been demonstrated by reference to a fair sample of the doctor's work, and that a single instance of negligent treatment, unless very serious indeed, would be unlikely to constitute "deficient professional performance".

42. In considering whether the four assessments are a fair sample of the Registrant’s practice as a Band 7 Sonographer, the Panel was conscious that the assessments took place at different times and each included three separate patients who presented with different conditions for investigation.

43. The rules and standards required to be followed by the Registrant would have been the Standards of Proficiency for Radiographers in force at the time, published in 2013. Given the facts found proved, the Panel was of the view that there have been breaches of the standards, in particular:

-  Standard 1: Registrant radiographers must be able to practise safely and effectively within their scope of practice;

-  Standard 4: Registrant radiographers must be able to practise as an autonomous professional, exercising their own professional judgment;

-  Standard 8: Registrant radiographers must be able to communicate effectively;

-  Standard 10: Registrant radiographers must be able to maintain records properly, (in so far as the Registrant’s report writing element of her assessments was concerned);

-  Standard 13: Registrant radiographers must understand the key concepts of the knowledge base relevant to their profession;

-  Standard 14.1: Registrant radiographers must be able to draw on appropriate knowledge and skills to inform practice, being able to conduct appropriate diagnostic or monitoring procedures, treatment, therapy or other actions safely and accurately;

- Standard 14.2: Registrant radiographers must be able to formulate specific and appropriate management plans including the setting of timescales.

44. The Panel measured the Registrant’s standard of practice against the requirements of the Band 7 Sonographer post that the Registrant applied for and worked at. These would have been known to the Registrant before she applied given the Job Description and Person Specification which were attached to her completed application form. As a result of the failed assessments which were designed to assess the competency of a student in order to qualify as a sonographer, the Panel has no difficulty in finding the standard of the Registrant’s performance as a Sonographer was unacceptably low as demonstrated by a fair sample of her work. It took into account both the individual marks that the Registrant scored, and the feedback provided by her assessors and supervisors.

45. It finds that the statutory ground of a lack of competence is made out as a result of the facts found proved.


Decision on Impairment

46. The Panel considered submissions from Ms Sharpe on behalf of the HCPC and considered material submitted on behalf of the Registrant in April 2018. It accepted the advice of the Legal Assessor. The Panel also considered the Practice Note “Finding that Fitness to Practise is Impaired”.

47. In considering impairment, the Panel took into account that the purpose of these procedures is not to punish the Registrant for past misdoing but to protect the public against the acts and omissions of those who are not fit to practise. In this case there is an important distinction to be made between the roles of radiographer and sonographer which are distinct in the UK. Radiographer is a protected title and the reason that the Registrant is registered with the HCPC. The role of sonographer is not regulated as a protected healthcare profession in the UK currently. Sonographers are not required as a matter of UK law to have a specific qualification, or registration. They may have another healthcare profession registration, (and for the NHS are required to have this), but it is possible for a person without any qualification to call themselves, and practice as a sonographer.

48. The Panel were mindful of this distinction but took into account that the Registrant had applied for and was working in a Band 7 Sonographer role on the basis of her registration as a Radiographer. It asked itself whether the Registrant’s fitness to practise was impaired by reason of her lack of competence as a Sonographer.

49. Sonography can be an advanced practice for radiographers. For the post at the Trust it was an essential requirement that the applicant was a graduate, qualified in radiography, or had another relevant qualification such as midwife. The Registrant according to her application was a qualified Radiographer. In addition, an essential requirement was registration with the HCPC in the Radiographer part of the Register or an equivalent professional body. The Registrant is registered as a Radiographer on the HCPC Register. It follows that the Registrant obtained the post of a Band 7 Sonographer on the basis of her registration with the HCPC as a Radiographer.

50. The Panel considered that following the approach in Holton, in order to form a view as to the current fitness to practice of the Registrant today as a Radiographer, it was appropriate to take into account the way in which she has acted or failed to act in the past as a Sonographer, given that the primary purpose of fitness to practice proceedings is to protect the public.

51. It took into account what the Registrant had said in her written statement in considering whether there was evidence that she has sufficient insight into her competence. The Panel has doubts as to whether the Registrant has acknowledged that further education would be required to build up the relevant level of competence rather than simply just practical experience.

52. The Panel recognised that the Registrant worked in a busy Trust and had a substantial period of leave, which could have impacted upon her ability to benefit from on the job training and supervision and consolidate her knowledge. However, the Panel noted that the Trust’s Preceptorship was extended for the Registrant and there have been repeated failures of mandatory requirements.

53. The Panel noted that time management and communication skills had improved but there remained concerns about the Registrant’s ability to follow Trust protocols, identify pathologies and scan different parts of the anatomy properly. These are serious and wide-ranging failings, which could have left patients at significant risk of harm if the Registrant was permitted to work unsupervised.

54. The Panel found that the Registrant has demonstrated some insight into her failings but not how to remedy them. Her insight is therefore limited. While she never challenged any of the findings of her assessors and her supervisors, she believes that simply “more practice” and “more time” are necessary.

55. EC gave evidence that the lack of knowledge and experience of the Registrant could not be remedied by supervised practice alone but required a programme of further study. In contrast, the Registrant appears to consider that continuing with her Personal Improvement Plan would be sufficient. The Panel preferred the evidence of EC that a UK based programme of study is required.

56. The Panel have no current information as to the practice of the Registrant since she resigned from the Trust in 2017. The Panel has considered that the Registrant appears to have worked as a Radiographer without complaint or issue being raised and has seen feedback from 2015 in which her work has either been described as “Excellent” or “Good”. Notwithstanding that there have been no issues with the Registrant’s practice as a Radiographer, her competence as a Band 7 Sonographer was shown not be acceptable in 2016 and 2017 and the Panel has no evidence before it to suggest that these deficiencies have been remedied.

57. The Panel has considered the circumstances of the Registrant. It took into account her recent arrival in the UK at the time she worked in the Trust, (albeit two short periods as a locum Radiographer appear to have been without incident and would have allowed some familiarisation with the NHS). It also accepted that she had not worked as a sonographer in the UK previously before accepting a position at the Trust and had made this clear at interview. The concerns regarding the Registrant are based on a lack of competence as a sonographer. The Panel accept that whilst the Registrant was subject to the Trust’s capability measures, this must have been stressful for the Registrant, which was also acknowledged by EC.

58. In conclusion, the Panel cannot be satisfied that the Registrant has the knowledge, skills and experience to ensure that patients would receive an effective and safe service from her as a Sonographer were she to work in an unsupervised capacity. Accordingly, if left to work unsupervised as a Sonographer, patients would unnecessarily be placed at risk, given the Registrant’s lack of competence to perform the job of Sonographer. While the Registrant has said that she would not seek to work as a Sonographer without supervision, the Registrant’s absence meant that the Panel could not explore with her the Panel’s identified requirement for further training before applying for a Band 7 Sonographer post.

59. Having regard to the critically important public protection and public interest issues, the Panel can only conclude that the Registrant’s current fitness to practise remains impaired. Confidence in the profession would be undermined if the Registrant were to practise without restrictions on her registration, as members of the public will be concerned about her failure to work competently and adhere to the relevant protocols as a Sonographer. There is a need to maintain confidence in the profession and to declare and uphold proper standards, send a clear message to other health and social care professionals and to maintain confidence in the regulatory process. In the Panel’s assessment, critically important public protection issues are engaged and continue to subsist in this case.

60. The HCPC case is well founded and the Panel finds current impairment.


Decision on Sanction

65. In considering what sanction, if any, to impose, the Panel has taken account of the submission of Ms Sharpe, the HCPC “Indicative Sanctions Policy” (“ISP”) and the advice of the Legal Assessor.

66. The Panel accepted the advice of the Legal Assessor that the Panel must at all times bear in mind that the primary purpose of imposing a sanction is to protect the public in accordance with the over-arching exercise of the HCPTS powers as set out in Article 3(4) of the 2001 Order as amended. This includes promoting and maintaining the public’s confidence in the profession and promoting and maintaining proper standards of conduct rather than punishing the Registrant, although it is conceded that a restriction on the Registrant’s registration may have a punitive effect.

67. The Panel considered that any sanction should be no more restrictive than necessary to achieve the objective of public protection. In applying the principle of proportionality the Panel also took into account the wider public interest, such as maintaining public confidence in the profession. However, it has sought to strike a proper balance between the protection of the public and the rights of the Registrant. Accordingly, the Panel considered its options in ascending order of seriousness.

68. An important factor in this case is the extent to which the Registrant recognises her failings and is willing to address them. Notwithstanding the fact that the Registrant is not present at this hearing, the Panel has been assisted by her previous written representations. These have indicated readiness and motivation to address her deficiencies.

69. The Panel did not consider that this is a case in which it is appropriate to take no action. There are no exceptional issues that exist and it has found that there is a risk that the Registrant in having qualifications as a Sonographer obtained in Uganda, could find herself in a position where she was expected to undertake such work. In view of the seriousness of the case, to take no further action, would not be appropriate as it fails to address the serious issues raised, the risk to prospective service users and the public interest.

70. The Panel next discounted mediation, as this is not a case where there is only a dispute between two parties.

71. Imposing a Caution Order would be inappropriate given the Registrant’s failure to evidence full insight or to demonstrate that remedial action to fully address the deficiencies noted in her sonography practice in 2016 and 2017 has been taken. The Registrant’s breach of professional standards is serious and such an order would be insufficient to protect the public, maintain confidence in the profession and maintain confidence in the regulatory process. A Caution Order would be inadequate to restrict the Registrant’s ability to practise as a Sonographer on the basis of her registration as a Radiographer. The Panel considered that the Registrant’s identified failings are not relatively minor in nature, have not been remedied, and consequently there is a risk of repetition with an associated risk of harm to patients.

72. The Panel next considered a Conditions of Practice Order on the basis that this is most appropriate where a failure or deficiency is capable of being remedied and where the Panel is satisfied that allowing the Registrant to remain in practice, albeit subject to conditions, poses no risk of harm or future harm to patients. Such an order recognises that beyond the specific restrictions imposed by a Conditions of Practice Order, the Registrant is being permitted to remain in practice. Consequently, the Panel’s decision will be regarded as confirmation that, beyond the conditions imposed, the registrant is capable of practising safely and effectively.

73. The Panel has concluded that given that there are recognised courses in sonography, the lack of competence identified is capable of being remedied. It is satisfied as there are no clinical concerns regarding the Registrant’s practice as a Radiographer, allowing the Registrant to remain in practice, subject to conditions, posed no risk of harm in the future.

74. From the Registrant’s written representations the Panel is satisfied that the Registrant is genuinely committed to resolving the identified failings, although the Panel does not accept that further time in supervised practice is a realistic and workable proposition. However, the Panel was heartened that the Registrant has shown some insight in accepting the criticisms of her practice, and her acknowledgement that she is not fit to practise unsupervised as a sonographer in the NHS at present.

75. Accordingly, the Panel concluded that the following Conditions of Practice Order would be a proportionate, verifiable, workable and suitable way of satisfactorily dealing with both patient protection and public interest functions.

76. The Order is for three years because recognised sonography courses can take up to two years to complete and would need to be arranged. The three years is to allow the Registrant sufficient time to identify and complete the requisite educational programme. However, the Registrant is permitted to seek an early review.

77. The Panel did consider a Suspension Order, but concluded that such an order would be disproportionate because it would deprive the Registrant from working as a Radiographer in circumstances when no concerns with her work as a Radiographer have been placed before it, and a Conditions of Practice Order can provide sufficient protection for patients and the public interest.

78. The Panel therefore determined a Conditions of Practice Order for three years was the appropriate order in this case.

Order

The Registrar is directed to annotate the Register to show that, 3 years from the date that this Order comes into effect (“the Operative Date”), you, Ms Aminah Migisa, must comply with the following conditions of practice:

Whilst undertaking any employment in respect of which you are required to be a registered Radiographer:

1. You must not work as a Sonographer unless directly supervised at all times until you have successfully completed a course in sonography accredited by the Consortium for the Accreditation of Sonographic Education, (“CASE”).

2. Before starting work as a Sonographer without supervision, you must forward to the HCPC a copy of your results from the course referred to in Condition 1 above.

3. The person supervising your work as a Sonographer must be registered with a UK healthcare regulatory body recognised by the HCPC, with a qualification in Sonography, accredited by CASE, or an equivalent.

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

5. 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); and

C. any prospective employer (at the time of your application).

Notes

Interim Order

1. Ms Sharpe applied to proceed in the absence of the Registrant to make submissions for the imposition of an interim order.  She pointed out to the Panel that the Registrant had been written to in her Notice of Hearing, which the Panel had found to be properly served that the possibility of an interim order being imposed had been highlighted. 

2. The Panel accepted the advice of the Legal Assessor and allowed Ms Sharpe to proceed in the absence of the Registrant, given that the latter had already been put on notice of the imposition of an interim order.  Her absence was regarded as voluntary and a waiver of her right to appear.

3. Ms Sharpe applied for an interim order to be imposed to cover any period of appeal, given that the Panel considered that the Registrant’s practice needed to be restricted.  She said that this was necessary to protect members of the public and was also otherwise in the public interest, given the Panel’s substantive decision and reasoning.

4. The Panel accepted the advice of the Legal Assessor and the Practice Note on Imposing Interim Orders.

5. The Panel makes an Interim Conditions of Practice Order under Article 31(2) of the Health and Social Work Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest. 

6. The Interim Conditions of Practice Order is in the same terms as the substantive order and is for 18 months.

7. This Order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

Hearing History

History of Hearings for Mrs Aminah Migisa

Date Panel Hearing type Outcomes / Status
04/03/2019 Conduct and Competence Committee Final Hearing Conditions of Practice