Miss Anesu Dodzo

Preliminary Matters

Application for hearing in private
1. Having heard and accepted the advice of the Legal Assessor, the Panel acceded to Mr D’Alton’s application for the entirety of the case to be heard in private, as the allegation which was found against the Registrant related solely to health. The Panel was satisfied that in order to protect the private life of the Registrant, and in particular to prevent matters around her health being ventilated in public, the whole case should be heard in private.

Background

2. On 28 June 2010, the Registrant commenced employment at the Barking, Havering and Redbridge University Hospitals NHS Trust (the Hospital) as a senior Radiographer (Band 6). Her job, at the material time, involved assessing the condition of cancer patients. It required skill and precision in the operation of sophisticated machinery and the administering of high dosage radiation with a high degree of accuracy. Her job description included the supervision of junior and less experienced staff.

History of the case
Substantive Hearing of 4-5 December 2017
3. The panel at this hearing did not have the benefit of hearing from the Registrant who did not attend. However, they were assisted by Dr C, who assessed the Registrant by a “Face Time” interview and was provided with her medical records. That panel concluded that the fitness to practise of the Registrant was impaired on both the personal and public components. It was satisfied that on the available evidence there was a high risk of recurrence/relapse of the adverse medical conditions found proved. It found that the Registrant could present a significant risk of causing harm to those in her case and a finding of impairment was required not to undermine confidence in the profession and the regulatory process, and to declare and uphold proper standards of conduct and behaviour. While sympathetic to the Registrant, the panel set out the expectation that professionals put their patients first and manage any health condition that may impact on their fitness to practise.

4. The panel suspended the Registrant’s registration for 12 months, finding that this was the only appropriate sanction in all the circumstances. It took the view that this period of time was required for the Registrant to engage with a treatment plan and demonstrate substantial progress, given the severity of her conditions and the nature of the risks involved in allowing her to practise. The panel also set out what evidence might assist a future reviewing panel.
First Substantive Review Hearing: 27 November 2018

5. The reviewing panel did not have the benefit of hearing from the Registrant or any written submissions from her at the substantive review hearing of 27 November 2018. No contact had been made with the HCPC by the Registrant since December 2017. Although this was a comprehensive review, the panel had regard to the decision of the earlier panel. It noted that the concerns which existed in December 2017, included little evidence of insight by the Registrant into her problems and attempts to minimise their seriousness. That panel noted that there was no evidence of meaningful remorse from the Registrant or concern expressed for patients potentially placed at risk. In all the circumstances, without any new information, the reviewing panel found that the Registrant was still impaired, on both the grounds of public protection and public interest. It directed a further period of suspension for 12 months.

Second Substantive Review Hearing: 29 November 2019
6. The panel noted that there was no new evidence and information about the state of the Registrant’s circumstances and health condition since the substantive hearing in 2017. The panel concluded that the Registrant demonstrated little evidence of insight into her problems or meaningful remorse. She had been less than frank and sought to minimise problems, which were apparent through medical records and witness testimony.

7. Considering the Registrant’s health conditions, the panel considered that there remained a high risk of repetition by the Registrant and consequently of harm to patients, the public and to the Registrant herself. The panel therefore concluded that the Registrant’s fitness to practise remained impaired by reason of her physical and/or mental health.

8. The reviewing panel directed a further period of suspension for 4 months. When imposing this period of suspension, it observed that “A review prior to the expiration of the order would leave all options open to a future panel, by which time the Registrant would have been suspended for a period of more than two years. Alternatively, it should provide sufficient time for the Registrant to engage with the HCPC and demonstrate progress in respect of her health condition”.

Third Substantive Review Hearing: 24 April 2020

9. The panel again noted that there was no new evidence or information about the Registrant’s circumstances or health. This review hearing was conducted as a hearing on the papers due to the COVID-19 pandemic. The HCPC submitted that the panel should find that the Registrant’s fitness to practise remained impaired. Although a striking off order was available, the panel noted that the correspondence sent to the Registrant on 1 April 2020 and the subsequent written submissions of the HCPC were likely to have left the Registrant with the impression that a striking off order would not be imposed.

10. The panel decided that the Registrant’s fitness to practise remained impaired by reason of her physical and/or mental health. The panel considered the appropriate sanction and decided that a further suspension order for a period of six months was appropriate. The panel reminded the Registrant that a striking off order remained a possible sanction at the next review.

Fourth Substantive Review Hearing: 26 October 2020

11. This was the first occasion that the Registrant attended a hearing in respect of this case. She gave evidence and also provided information which included a personal statement, a CPD summary, a letter confirming employment as an Administration Officer, a letter from a sponsor, a report dated 22 October 2020, and evidence relating to personal matters.

12. The fourth reviewing panel was of the view that the Registrant had demonstrated insight into the seriousness and impact of the events of 2015 and 2016. It also considered that the Registrant recognised that the risk of relapse could not be excluded, and that there was an ongoing need for her to take action to minimise the risk and take action if the risk materialised.

13. The fourth reviewing panel found that the Registrant’s fitness to practise remained impaired on both the personal and public components, due to an ongoing risk of relapse and her skills and knowledge not being sufficiently up to date. That panel considered that a Conditions of Practice Order could be formulated to address the risk of relapse sufficiently in order to protect the public. It had sufficient confidence that the Registrant would comply with conditions.

Decision on Impairment of Fitness to Practise

14. After Mr D’Alton, on behalf of the HCPC, had taken the Panel through the history of the case, the Registrant gave evidence. She accepted that she had not provided any documentation to evidence her compliance with the Conditions of Practice. She explained that after the last review, she had had every intention of returning to the UK to comply with the conditions, but she had been unable to return as she now had a young child for whom she had been unable to get a passport due to Zimbabwe being in lockdown.

15. Also, as a result of lockdown whilst in Zimbabwe, she said that she had been unable to obtain a placement to undertake the return to practice course as required under the conditions. She explained that she was not registered with a GP, as that was not the system in Zimbabwe, although she did have a GP but had not informed him of the conditions as she had been intending to inform her registered GP on her return to the UK.

16. The Registrant acknowledged that in terms of all of the conditions, it looked as though she had done nothing as she could provide no evidence, but her plan had been to achieve compliance with the conditions in the UK, and she had never thought that she would still be in Zimbabwe. In hindsight she recognised that she should have communicated with the HCPC and communicated all her difficulties with compliance, particularly when the HCPC wrote to her in April and on 14 September 2021 asking whether she had any material to provide.

17. Mr D’Alton submitted that in the absence of any independent evidence to support the Registrant’s position she had not discharged the persuasive burden on her to demonstrate that she was fit to practise. He submitted that her fitness to practise remained impaired on both the personal and public components. In terms of sanction, Mr D’Alton explained that the HCPC was neutral on which sanction was appropriate, although he submitted that there were a number of the conditions which the Registrant could have complied with but did not, which may be a significant concern regarding future compliance.

18. The Registrant accepted that the conditions were all reasonable given her history, but asked the Panel to consider extending the Conditions of Practice Order by around 18 months to enable her to comply once she returned to the UK, which she anticipated would be in around January 2022. She acknowledged that she was completely in error in not communicating with the HCPC and apologised for this. She said that she had been working hard in the background, but understood that if she did not communicate, no one would see her intentions and she had missed the importance of updating the HCPC with her situation.
19. The Panel heard and accepted the advice of the Legal Assessor, whose advice included that there was a persuasive burden on a Registrant to demonstrate that they were fit to practise (Abrahaem v GMC [2008] 182 (Admin)). The Panel exercised its independent judgement in determining whether the Registrant’s fitness to practise remains impaired. It had regard to the HCPTS Practice Note on Impairment.

20. The Panel noted the Registrant’s position that she had remained working for the same employer over the previous 12 months. However, it had no independent evidence to reassure it that this was the position. The Conditions of Practice Order had set out clearly the types of independent evidence which were expected from the Registrant, allowing her GP to exchange information about her with the HCPC. However, a combination of the challenges of being in Zimbabwe during lockdown as well as her own lack of proactivity, meant that the Registrant had not discharged the persuasive burden of demonstrating that she had indeed remained abstinent, or had kept her knowledge and skills up to date.

21. The Panel had regard to the previous concerns when there had been relapses which included presenting herself at work when impaired. In the absence of independent evidence the Panel concluded that the risk of relapse remained, with its consequent risk to patients. Accordingly, the Panel concluded that the Registrant’s fitness to practise remains impaired on both the personal and public components.

Decision on Sanction

22. The Panel had regard to the Sanction Policy. It was the Panel’s view that there was a need to impose a sanction which would provide public protection and would otherwise address the public interest of maintaining public confidence. The Panel therefore concluded that taking no further action and allowing the Order to lapse would not achieve this.

23. The Panel was also of the view that a Caution Order would not restrict the Registrant’s practice and, so would also fall short of protecting both the public and the wider public interest. As such, the Panel concluded that a Caution Order would be neither appropriate nor proportionate in the circumstances of this case.

24. In respect of a Conditions of Practice Order, the Panel was of the view that many of the conditions, as currently drafted, were unworkable given the Registrant’s current position. It also noted that there were several conditions which she could have complied with, but had not, including keeping a reflective practice profile in relation to CPD; informing her GP in Zimbabwe of her conditions and allowing them to exchange information with the HCPC.

25. The Panel had also been concerned at what had appeared to be a lack of engagement with the HCPC during the currency of the Conditions of Practice Order. This included a lack of response to correspondence sent to her in April and earlier in September 2021 requesting information about her compliance with the conditions, which the Registrant acknowledged and apologised for.

26. The Panel concluded that the Registrant was not in a position to comply with conditions, and it needed reassurance that she could be trusted to comply with conditions in the future. It noted that at this time, the Registrant did not anticipate being able to return to the UK before January 2022, and saw this as a significant hurdle in being able to comply. Given the previous lack of compliance, the Panel was of the view that the public would expect independent evidence before a Registrant was permitted to practise, even under conditions. In light of this, the Panel considered that a Conditions of Practice order was no longer appropriate or proportionate at this time.

27. The Panel decided that a Suspension Order for a period of 6 months was the appropriate and proportionate order. In determining this length, the Panel had regard to the Registrant’s engagement at this review, and also noted that she did not anticipate being in the UK until January 2022.

28. The Panel considered a Striking-Off Order, but was of the view that this would be disproportionate at this time.

29. A future panel, may be assisted by:
• The Registrant’s attendance at the next review;

• [Redacted]
• Evidence of relevant continuing professional development (CPD); and
• Relevant current references or testimonials in relation to paid or unpaid work.

ORDER: The Registrar is directed to suspend the Registration of Ms Anesu Dodzo for a period of 6 months, to come into effect at the expiry of the existing Order.

The Order imposed today will apply from 2 November 2021.

This Order will be reviewed again before it is due to expire, which will be on 2
May 2022.

Right of Appeal

You may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made against you.

Under Articles 30(10) and 38 of the Health Professions Order 2001, any appeal must be made to the court not more than 28 days after the date when this notice is served on you.

History of Hearings for Miss Anesu Dodzo