Mr Wilson Huelgas

Profession: Radiographer

Registration Number: RA67965

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 12/11/2019 End: 12:30 12/11/2019

Location: HCPTS, 405 Kennington Road, London, SE11 4PT

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

The following allegation was considered by a panel of the Conduct and Competence Committee at the substantive hearing that concluded on 7 November 2017:

Whilst registered as a Radiographer, on 10 July 2013 you attended an interview with Worcestershire Acute Hospitals Trust, at which you:

1) Were unable to demonstrate adequate knowledge of radiography procedures when answering questions in relation to:

a) Ionising radiation

b) MRI contra-indications

c) IV contrasts

d) Creatinine levels

e) Data protection procedures

f) Quality Assurance procedures

2) The matters set out in paragraph 1 constitute a lack of competence.

3) By reason of your lack of competence your fitness to practise is impaired.

The substantive panel found particular 1 proved, that it amounted to the statutory ground of lack of competence, and that the Registrant’s fitness to practise was impaired. The substantive panel imposed a Suspension Order for a period of 12 months. A further Suspension Order for a period of 12 months was imposed by the first review panel.

Finding

Preliminary Matters

Service

1. The Panel was aware that written notice of these proceedings was posted by first class post to the Registrant at his registered address on 09 October 2019. Notice was also served by email on the same day. The Panel was shown documents which established both the fact of the service and the identity of the Registrant’s registered address and also of his email address. In these circumstances, the Panel accepted that proper service of the notice had been effected in accordance with the Rules.

Proceeding in the absence of the Registrant.

2. Ms Simpson, on behalf of the HCPC, submitted that the Panel should consider the case in the absence of the Registrant.

3. Ms Simpson informed the Panel that the Registrant had not engaged with the HCPC as regards this hearing and that the HCPC had not received any communication from the Registrant since the last review hearing in November 2018, at which the Registrant was not present and was not represented. Ms Simpson also told the Panel that she had sent an email to the Registrant on 24 October 2019 to remind the Registrant of this hearing and also to remind the Registrant of the guidance that the last review panel gave as to what he could do to assist a subsequent review panel in its review of the Order. Ms Simpson told the Panel that an error as to the date of the review hearing was contained in her email of 24 October 2019, but was corrected by a subsequent email to the Registrant. Ms Simpson informed the Panel that the HCPC had not received any response to either email.

4. The Panel heard and accepted the advice of the Legal Assessor.

5. The Panel was aware that a decision to proceed in the absence of the Registrant was one to be taken with great care and caution. However, the Panel has decided to proceed in the absence of the Registrant. The reasons are as follows:

• Service of the appropriate notice of this hearing has been properly effected.
• The Registrant has not applied for an adjournment, he has not engaged with the HCPC as regards the present hearing, or engaged at all with the HCPC since the last review hearing in November 2018, at which he was not present and not represented.
• The Registrant has not responded to the email from Ms Simpson dated 24 October 2019 or to the subsequent email correcting the date of this hearing.
• There is no reason to suppose that an adjournment would result in the future attendance of the Registrant.
• There is a public interest in proceeding.
• This review of the Order is mandatory and the Order will expire on 05 December 2019.
• In all the circumstances, the absence of the Registrant should be treated as voluntary.

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 panel at the substantive hearing (the substantive 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 substantive 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 first review panel also noted the evidence of Dr VG, given to the substantive 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 first review 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.

Review Hearing on 01 November 2018

12. At the review hearing on 01 November 2018, the Registrant was not present and was not represented.

13. Having considered all the material before it, the first review panel concluded that the Registrant’s fitness to practise remained impaired. It expressed its reasons in the following terms:

“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’.

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.

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.
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.”

14. Having reviewed all the sanctions available to it, the first review panel decided to make a Suspension Order for a further period of 12 months. It expressed its reasons in the following terms:

“In reaching its decision on how to dispose of the case on this review, the Panel took into consideration [the Presenting Officer]’s 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.

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

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.

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.
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.”

15. The first review panel gave guidance as to what might assist a subsequent review panel. It stated as follows:

“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.”

Decision

16. Ms Simpson summarised the relevant facts and the conclusions of the previous panels. In brief summary, she submitted that the Panel should find that the Registrant’s fitness to practise remains impaired. She said that the Registrant had not addressed any of the failings established at the substantive hearing or in any way engaged with the HCPC since the first review in November 2018. Ms Simpson said that the Registrant had not complied with any of the suggestions made by the first review panel as to what might assist a review panel. She submitted that, in all the circumstances, the Panel should suspend the Registrant for a further period of 6 months.

17. The Panel heard and accepted the advice of the Legal Assessor.

18. The Panel is aware that it has all the powers that are set out in Article 30 (1) of the Health and Social Work Professions Order 2001 (The Order) and which are summarised in the letter dated 09 October 2019 sent to the Registrant and giving notice of this hearing.

19. The Panel is aware that the process under Article 30 (1) of the Order is one of review and not one of appeal and that its function is to determine whether the Registrant’s fitness to practise is still impaired, and, if so, whether the Suspension Order under review remains the appropriate and proportionate means of public protection or should be varied or replaced by some other Order.

Decision on Impairment

20. Having taking account of the submissions made by Ms Simpson, the Panel has concluded that the Registrant’s fitness to practise remains impaired. In coming to this conclusion, the Panel agreed with the reasons set out in the determination of the first review panel. The Panel also noted that the Registrant has not complied with any of the suggestions made by the first review panel as to what would assist a subsequent review panel. The Panel also noted that the Registrant has not engaged with the HCPC since the last review hearing in November 2018. The Panel concluded that, in all the circumstances, a restriction on the Registrant’s ability to practise is still necessary in order to protect service users and also to sustain public confidence in the profession of Radiographer and in the HCPC as its Regulator.

Decision on Sanction

21. In considering the appropriate sanction, the Panel had regard to the Sanctions Policy (SP) published in March 2019, and the advice of the Legal Assessor.

22. The Panel has applied the principle of proportionality. The Panel is aware that the purpose of sanction is not to be punitive and that it must consider the risk the Registrant may pose to service users in the future and determine what degree of public protection is required. The Panel has considered the sanctions available in ascending order of severity. The Panel considered that to take no action or to impose a Caution Order would not be sufficient or appropriate, as neither outcome would afford the necessary public protection or satisfy the public interest.

23. The Panel next considered whether a Conditions of Practice Order would adequately address the concerns identified. For all the reasons identified by the previous panels, and because the Registrant has not complied with any of the suggestions made by the first review panel as to what would assist a subsequent review panel, the Panel has determined that appropriate Conditions of Practice could not be formulated which would protect service users or satisfy public concerns. Moreover, and having regard to the Registrant’s non-engagement with the HCPC, the Panel is not satisfied that the Registrant would comply with any conditions that it might impose.

24. The Panel next considered making a further Suspension Order. It was aware that a Striking Off Order was not presently available to it. The Panel determined to make a Suspension Order for a period of 6 months. Such an order would be appropriate and proportionate and would protect the public and address the public interest.

25. This Order will be reviewed before it expires. Any future panel that reviews this Order will be assisted by the physical presence of the Registrant and evidence of his insight into his deficiencies, with particular reference to any training and Continuing Professional Development he may have undertaken. The review panel would also be assisted by references and testimonials from any employers and evidence as the nature of any work, whether paid or unpaid, that he has undertaken since November 2017. The imposition of a Striking Off Order will be a sanction that is available to the next review panel.

Order

The Registrar is directed to suspend the registration of Mr Wilson Huelgas for a further period of 6 months on the expiry of the existing Order.

Notes

The order imposed today will apply from 05 December 2019.

This order will be reviewed again before its expiry on 05 June 2020.

Hearing History

History of Hearings for Mr Wilson Huelgas

Date Panel Hearing type Outcomes / Status
01/05/2020 Conduct and Competence Committee Review Hearing Suspended
12/11/2019 Conduct and Competence Committee Review Hearing Suspended
01/11/2018 Conduct and Competence Committee Review Hearing Suspended
06/11/2017 Conduct and Competence Committee Final Hearing Suspended