Mr Ovie A Agbagidi

Profession: Radiographer

Registration Number: RA45223

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 15/02/2022 End: 17:00 15/02/2022

Location: Virtual hearing - Video conference

Panel: Conduct and Competence Committee
Outcome: Conditions of Practice

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Allegation

On 17 February 2012, a panel of the Conduct and Competence Committee heard evidence and the following allegation was found proved against the Applicant:

In the course of your employment as a Sonographer at Homerton University Hospital NHS foundation Trust, and whilst registered as a Radiographer:

1. [NOT PROVED]

2. On 29 April 2008, whilst carrying out an obstetric scanning on a patient you failed to identify an abdominal wall defect containing liver and bowel;

3. On 12 June 2008, failed to maintain adequate records, in that you entered a patient's report onto another patient's demographics;

4. On 24 February 2009, you failed to maintain adequate records, in that you entered a patient's report onto another patient's demographics;

5. Between 8 July 2009 and 2 September 2009, you performed at least two scans on Patient A who was pregnant at the time and, you:

a) failed to accurately scan Patient A

b) failed to identify the foetal abnormalities, in that you missed the lower limbs deformity;

c) failed to prepare an accurate report of Patient A's foetal images in that you inaccurately documented that both feet were visible during the scan.

Finding

Background

1. The Panel took account of the background to this matter.

2. On 15-17 February 2012, a panel of the Conduct and Competence Committee heard evidence and the following allegation was found proved against the Registrant:

“In the course of your employment as a Sonographer at Homerton University Hospital NHS foundation Trust, and whilst registered as a Radiographer:

1. [NOT PROVED]

2. On 29 April 2008, whilst carrying out an obstetric scanning on a patient you failed to identify an abdominal wall defect containing liver and bowel;

3. On 12 June 2008, failed to maintain adequate records, in that you entered a patient's report onto another patient's demographics;

4. On 24 February 2009, you failed to maintain adequate records, in that you entered a patient's report onto another patient's demographics;

5. Between 8 July 2009 and 2 September 2009, you performed at least two scans on Patient A who was pregnant at the time and, you:

a) failed to accurately scan Patient A

b) failed to identify the foetal abnormalities, in that you missed the lower limbs deformity;

c) failed to prepare an accurate report of Patient A's foetal images in that you inaccurately documented that both feet were visible during the scan.

3. The panel on that occasion found that the Registrant's fitness to practise was impaired because it did not have any information about the Registrant's insight or remediation. This is because the Registrant did not attend the hearing to give evidence or provide any written submissions. That panel imposed a sanction of 12 months’ suspension from the HCPC Register.

4. The substantive order was reviewed on 28 February 2013 by another panel of the Conduct and Competence Committee. On that date the Registrant again did not attend, nor had he engaged since the imposition of the Suspension Order.

5. The panel on 28 February 2013 determined that in the light of the lack of engagement by the Registrant, it had no information which could satisfy it that the Registrant's fitness to practise was no longer impaired. It also determined that a further period of suspension would serve no useful purpose and imposed a Striking Off Order.

6. The Registrant subsequently applied to be restored to the Register. That application was heard on 19 August 2020 by another panel of the Conduct and Competence Committee, which heard oral evidence on affirmation from the Registrant. He told that panel that he accepted the findings of the previous panels and said that he did not engage with the process at the time because he was so ashamed of his lack of competence and the impact it had upon his patients and his colleagues, to whom he had apologised personally for the shortcomings in his practice. He stated that he recognised that his actions meant that patients had been deprived of options that might have been open to them and also brought his profession and his department into disrepute. He told that panel that part of the reason for the lack of diagnosis in the two cases was because he lacked confidence and experience at the time to make such a diagnosis.

7. The Registrant further confirmed to the Restoration panel that since his striking off he had been working at improving his knowledge, experience, and confidence in Sonography. He outlined that, since his registration was removed, he had worked as a radiographer since 2011 in Nigeria, where he has been living until 2019 when he returned to the United Kingdom. He confirmed that he had found a supervisor to supervise his work as a radiographer. He also said that he had been undertaking some Sonography work in Nigeria, albeit limited to watching and observing experienced sonographers and having them test his knowledge before they would allow him to carry out limited work, which was always supervised.

8. The Registrant also produced evidence that he had completed an MSc in Medical Ultrasound with Bournemouth University in 2014, which course included both theoretical elements and practical elements where he was required to observe practitioners. He had also received supervision from a sonographer who was registered with the HCPC.

9. The Restoration panel decided to allow the Registrant’s application to restore him to the Register. It gave the following reasons for its decision:

“15. The Panel carefully considered the evidence and the submissions of both parties. It determined that there was limited independent evidence verifying the Applicant's radiographic work in Nigeria or his learning. The Panel also determined that the Applicant had demonstrated insight and remorse but there was limited evidence to demonstrate that he had fully resolved the shortcomings in his practice. There were no character or work references provided to the Panel by the Applicant. Furthermore, the Applicant has not met the current Return To Practice requirements of the HCPC.

16. However, the Panel determined that conditional registration could adequately address the risk presented by the lack of evidence of full remediation, and would also provide the Applicant with the opportunity to obtain such evidence.

17. Therefore, the Panel determined that the Applicant has met the requirements of article 33 (5) of the 2001 order and that he be restored to the HCPC's register, subject to him meeting the Return To Practice requirements of the HCPC and further subject to conditions imposed upon his registration”.

10. The Restoration Panel therefore made the following order:

“The Registrar is directed to restore the name of Mr Ovie Agbagidi (the Applicant) to the Radiographer Part of the Register, but restoration is only to take effect once the Applicant has:

(a) provided the Registrar with the information and declarations required for admission to the Register; and (b) paid the prescribed restoration fee.

AND

The Registrar is further directed to annotate the Register to show that, from the date that this Order takes effect, the Applicant must:

(a) undertake a 60 day period of professional updating in accordance with the HCPC Standards for Return to Practice; and

(b) limit his practice to the completion of that updating until such time as the Applicant provides evidence which satisfies the Registrar that the Applicant has successfully completed that period of updating.

FURTHERMORE

The Registrar is further directed to annotate the Register to show that, for a period of 18 months from the date that this Order takes effect, and once the Applicant has successfully completed that period of updating, the Applicant must comply with the following conditions of practice:

1. You must not carry out Sonography work unless directly supervised by a HCPC registered Radiographer who is qualified to practise as Sonographer.

2. You must place yourself and remain under the supervision of a workplace supervisor registered by the HCPC or other appropriate statutory regulator and supply details of your supervisor to the HCPC within 14 days of starting any role that requires registration with the HCPC. You must attend upon that supervisor as required and follow their advice and recommendations.

3. You must work with your workplace supervisor to formulate a Personal Development Plan designed to address the deficiencies in the following areas of your practice:

a) ultrasound scanning; and

b) interpretation of scan results

4. Within three months of starting a role as a Radiographer you must forward a copy of your Personal Development Plan to the HCPC.

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

6. You must allow your workplace supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

7. You must maintain a weekly reflective diary detailing every occasion when you carried out Sonography during that week and must provide a copy of that diary to the HCPC on a monthly basis or confirm that there have been no such occasions in that period, the first diary or confirmation to be provided within one month of starting any radiographer role after completion of the period of updating.

8. You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.

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

10. 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 radiography work;

B. any agency you are registered with or apply to be registered with (at the time of application) as a Radiographer; and

C. any prospective employer seeking to employ you as a Radiographer (at the time of your application).”

Evidence before this Panel

11. The Panel noted that, following the previous panel’s decision, the Registrant had complied with the first part of the Order and had been restored to the Register. Furthermore, the Registrant had engaged with the HCPC. On 7 April 2021, the Registrant emailed the HCPC as follows:

“I have NOT started practice yet as a Radiographer / Sonographer as I am completing my induction as a Newly Qualified Science Teacher in a secondary school. While I was preparing and awaiting the FTP hearing, I retrained as a Science teacher, qualified in July 2020 and started my Newly Qualified Teachers induction (NQT) in September 2020 for a year. Hence, I couldn’t practice Radiography / Sonography until I have completed the NQT induction year.

I will update you promptly immediately as I return to practice just as in the condition of my readmission to the register of HCPC.

I have been attending Fetal Medicine Foundation webinars every forth nightly on Sundays with certification.”

12. On 25 January 2022, the Registrant wrote to the HCPC as follows:

“I write to update you on developments post my return to practise hearing.

While waiting for hearing date, I enrolled for PGCE in Science which I completed in July 2020 and immediately started my Newly Qualified Teacher’s (NQT) program which I also completed July 2021. I have been working as a science teacher since then whilst applying for Sonographer’s trainee roles to no avail. I have enrolled and attended regular online courses of Fetal Medicine Foundation since my conditional reinstatement till date (see program information and certificates attached herewith).

My job search for role as trainee sonographer/ radiographer have not successful, I have not been invited for any interview however, I have been doing some hands-on scans with Dr [AM].

I submitted my resignation letter to enable me focus on Radiographer / sonographer job on 10th November 2021, giving my school’s governing board / principal the required two months’ notice. However, the principal refused and would not let me go till end of this term – 31st March 2021 (see copy of resignation letter attached herein).

I will be attending the hearing on 15th February 2022.”

13. At the hearing, the Registrant gave evidence under Oath and confirmed what he had stated in his letter of 25 January 2022, in particular that he would finish working as a teacher on 31 March 2022 and would then devote his time to undertaking the Return to Practice course. He further stated that: he had not been successful in obtaining any employment as either a radiographer or a sonographer – he had spoken to a few prospective employers who had noted his conditions and said they would revert to him, but he had heard nothing further; he now wanted to pursue “my one love” of being a sonographer and had now decided that he would concentrate on applying for training posts which would automatically involve supervision; apart from the online courses that he had disclosed in his letter, he had read articles online; he did not consider the “hands-on” training from Dr AM (which involved both Radiography and Sonography together with supervised scanning or examinations) to be sufficient to amount to the same as the Return to Practice course, and accepted that he needed more training; and he would consider employment in both Radiography and Sonography – he last practised as a Radiographer in 2019.

Submissions

14. Ms Khorassani confirmed that the HCPC regarded the Registrant’s fitness to practise as still impaired since he had not completed the Return to Practice course, nor obtained any employment. She stated that the HCPC would, however, support an extension of the current Conditions of Practice Order to enable the Registrant to do so and to demonstrate his competency by abiding by the Conditions of Practice.

15. The Registrant had nothing to add save to agree with Ms Khorassani.

Decision

16. The Panel noted the above submissions and considered the advice of the Legal Assessor, who confirmed that it was entitled to use the previous panel’s findings as a starting point and to presume impairment, but to consider whether there had been any changes in the Registrant’s situation since the last hearing in deciding whether there was any current impairment. It also had regard to the HCPTS Practice Notes entitled “Fitness to Practise Impairment” and “Review of Article 30 Sanction Orders”. The Panel was aware that, in determining whether fitness to practise is impaired, it had to take account of a range of issues which, in essence, comprised two components, namely the ‘personal’ component (the current competence and behaviour of the individual Registrant) and the ‘public’ component (the need to protect service users, declare and uphold proper standards of behaviour, and maintain public confidence in the profession).

Current Impairment

17. The Panel first considered whether the Registrant’s fitness to practise remained impaired. It concluded unhesitatingly that it was. In respect of both components, it noted that the Registrant had not undertaken the Return to Practice course (which was required since the Registrant had not practised in the UK as a radiographer or a sonographer since 2011) and therefore had not had an opportunity to practise under the current conditions in order to demonstrate that he was competent to do so. Accordingly, there had been no change in his situation since August 2020.

18. Having said that, the Panel took account of and accepted the Registrant’s evidence, which it considered demonstrated his continued passion for sonography and radiography and his determination now to remediate his practice by resigning from his current teaching job to concentrate on doing so.

Sanction

19. The Panel paid careful regard to the HCPC Sanctions Policy (appreciating that it was guidance and could be departed from for good reason and with explanations) and the advice of the Legal Assessor that it should apply the principle of proportionality, weighing the interests of the public with those of the practitioner. The public interest includes not only the protection of patients, but also the maintenance of public confidence in the profession, and the declaring and upholding of proper standards of behaviour.

20. The Panel approached its task by considering the sanctions in order of seriousness, starting with the least onerous sanctions.

21. Given the nature of the Registrant’s current impairment and his lack of remediation, the Panel was of the view that it would not be sufficient to conclude this case by taking No Action or by referring it for Mediation. Neither course would serve to protect patients or maintain the standing of, and public confidence in, the profession.

22. The Panel then moved on to consider whether to conclude this case with the imposition of a Caution Order. It noted that a Caution Order was:

“…likely to be an appropriate sanction for cases in which:

• the issue is isolated, limited, or relatively minor in nature;

• there is a low risk of repetition;

• the registrant has shown good insight; and

• the registrant has undertaken appropriate remediation.”

23. The Panel considered that none of these criteria applied to the Registrant’s case and therefore concluded that a Caution Order was not an appropriate sanction in this case.

24. The Panel then moved on to consider a Conditions of Practice Order. It noted the following paragraphs from the Sanctions Policy:

“106. A conditions of practice order is likely to be appropriate in cases where:

• the registrant has insight;

• the failure or deficiency is capable of being remedied;

• there are no persistent or general failures which would prevent the registrant from remediating;

• appropriate, proportionate, realistic and verifiable conditions can be formulated;

• the panel is confident the registrant will comply with the conditions;

• a reviewing panel will be able to determine whether or not those conditions have or are being met; and

• the registrant does not pose a risk of harm by being in restricted practice.

25. The Panel considered that all these criteria applied to the Registrant, who had demonstrated a determination to now concentrate on doing everything that he could to return to unrestricted practice. It also took account of the HCPC’s view that a Conditions of Practice Order was the appropriate outcome. The Panel therefore decided that a Conditions of Practice Order was appropriate in this case and saw no reason not to adopt most of the previous conditions. However, it has amended the current conditions to reflect the fact that the Registrant has yet to complete the HCPC’s Return to Practice course. Moreover, it considered that some of the current conditions were potentially confusing since they did not reflect the fact that the Registrant was registered with the HCPC as a Radiographer who was qualified to practise sonography. The Panel therefore amended the current conditions to clarify the position.

26. This Order will be reviewed again before its expiry. The next reviewing panel would be assisted by:

• Up-to-date information from any workplace supervisor;
• Professional references;
• Further evidence of the Registrant’s reflection and learning;
• Details of any further or additional training undertaken.

Order

The Registrar is further directed to annotate the Register to show that, for a period of 18 months from the date that this Order takes effect, the Registrant must comply with the following conditions of practice:

1. Before returning to practise as a Radiographer who is qualified to practise as a sonographer (undertaking either sonography or any other activities requiring HCPC registration), you must:

(a) undertake a 60-day period of professional updating in accordance with the HCPC Standards for Return to Practice; and

(b) limit your practice to the completion of that updating until such time as you provide evidence which satisfies the Registrar that you have successfully completed that period of updating.

2. You must not carry out sonography work unless directly supervised by a HCPC-registered Radiographer who is qualified to practise as a sonographer, until such time as your supervisor certifies to the HCPC that you are competent to conduct such work unsupervised and the HCPC confirms that you may conduct such work unsupervised.

3. You must place yourself and remain under the supervision of a workplace supervisor registered by the HCPC or other appropriate statutory regulator and supply details of your supervisor to the HCPC within 14 days of starting any role that requires registration with the HCPC. If you intend to practise sonography, this workplace supervisor must also be appropriately experienced. You must attend upon that supervisor as required and follow their advice and recommendations.

4. If you undertake work as a sonographer, you must work with your workplace supervisor to formulate a Personal Development Plan designed to address the deficiencies in the following areas of your practice:

a) ultrasound scanning; and

b) interpretation of scan results.

5. Within three months of starting a role as a Radiographer practising sonography you must forward a copy of your Personal Development Plan to the HCPC.

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

7. You must allow your workplace supervisor to provide information to the HCPC about your progress towards achieving the aims set out in your Personal Development Plan.

8. You must maintain a weekly reflective diary detailing every occasion when you carried out sonography during that week and must provide a copy of that diary to the HCPC on a monthly basis or confirm that there have been no such occasions in that period, the first diary or confirmation to be provided within one month of starting any radiographer role after completion of the period of updating.

9. You must promptly inform the HCPC if you cease to be employed by your current employer or take up any other or further employment.

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

11. 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 radiography or sonography work;

B. any agency you are registered with or apply to be registered with (at the time of application) as a Radiographer; and

C. any prospective employer seeking to employ you as a Radiographer (at the time of your application).

Notes

The order imposed today will apply from 15 March 2022.

This order will be reviewed again before its expiry on 15 September 2023.

Hearing History

History of Hearings for Mr Ovie A Agbagidi

Date Panel Hearing type Outcomes / Status
15/02/2022 Conduct and Competence Committee Review Hearing Conditions of Practice
19/08/2020 Conduct and Competence Committee Restoration Hearing Restored
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