Mrs Petya B Somerville
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Allegation
(Allegation as amended on day 1 of the hearing, namely, 19 July 2021)
As a registered Radiographer (RA55225) your fitness to practise is impaired by reason of misconduct and/ or lack of competence. In that:
1. You did not apply the necessary safety measures when undertaking diagnostic Magnetic Resonance Imaging (MRI) procedures, in that:
(a) On or around 4 February 2019, you did not select “normal mode” to scan a patient with sternal wires in situ who had informed you prior to the scan that they had undergone open heart surgery;
(b) On or around 4 February 2019, you did not check on SECTRA to ascertain if the patient (who had metal staples in situ) had previous scans and/or whether there were any alerts and/or whether they were safe to be scanned;
(c) On or around 7 February 2019, you did not identify a patient’s nose and ear piercings as a safety risk prior to a scan;
(d) On or around 19 February 2019, you simultaneously commenced moving the table up, whilst instructing the patient to lie flat on the table.
(e) On a date between 04 January 2019 and 11 January 2019 you did not advise a patient to remove her boots prior to a scan
(f) On or around 26 March 2019, you failed to ask the patient to remove their metal dental plate prior to the scan and a colleague had to intervene.
(g) You failed to recognise that a patient with a drain in situ would need to be checked to ensure that it was safe to proceed
2. You did not communicate effectively with patients in that:
(a) On or around 4 March 2019, you did not communicate effectively with a patient who was showing signs of distress
(b) On or around 4 March 2019, you had the intercom system on so that the patient could hear you say that you needed to include the mass, which is information that should not be shared in this manner.
(c) On or around 8 March 2019, you did not inform a patient that you were going to remove an Electrocardiogram (ECG) lead and proceeded to pull off the electrode from the patient’s chest and replace it with another, without advising the patient of your actions.
(d) On or around 27 February 2019, you were unable to correctly ascertain the patient’s pregnancy status during completion of a safety questionnaire and/or inappropriately advised the patient that they needed to see their GP to obtain an ultrasound scan
3. You did not adhere to safe practice when preparing patients, in that:
(a) On or around 11 March 2019, you did not get a patient to sign their completed MRI safety questionnaire before conducting an MRI scan.
(b) On or around 14 March 2019, following a failed attempt at cannulation you did not discard the used cannula and instead intended to re-use the cannula for your second attempt.
(c) On or around 14 March 2019, you did not fill the pump injector in a safe and/or proper manner in that you purged air bubbles with contrast instead of saline.
(d) On or around 26 March 2019, you did not document that the patient had bilateral hip replacements on the MRI safety questionnaire.
4. On or around 14 March 2019, following being signed off as being competent using SECTRA, you were unable to access a previous report on SECTRA.
5. On or around 4 March 2019, when imaging, you did not identify the need to perform Short-TI Inversion Recovery (STIR) and/or in/out phase imaging.
6. You did not treat patients with dignity and respect in that:
(a) On 25 January 2019 when placing ECG stickers on a female patient in the scan room, you completely exposed her chest to complete this activity;
(b) On 01 February 2019 you removed ECG stickers from a female patient’s chest whilst she was sitting in a wheel chair with her top rolled up in view of the main waiting area and/or corridor;
(c) On 08 March 2019, you ripped a patient’s disposable top in order obtain access to apply the ECG electrodes;
7. On or around 26 March 2019, you did not identify on one or more occasion that the status of stents should be established prior to completing an MRI
8. You struggled to maintain competency and/or anatomical knowledge associated with Magnetic Resonance Cholangiopancreatography (MRCP) studies in that:
(a) [Not Proven]
(b) On one or more occasions, you demonstrated an inability to appreciate which field of view needed to be increased to ensure the accurate region of interest was captured.
(c) [Not Proven]
9. On 20 February 2019 you were undertaking a cardiac scan whilst under supervision and a wrap appeared on your LVOT2 view which you were unable to identify and/or you had to be prompted to repeat the image.
10. You demonstrated difficulties in completing liver scans in that:
(a) You experienced difficulty in identifying breathing artefact on liver sequences and thus when to repeat scans;
(b) HCPC Offered No Evidence
(c) On one or more occasions when completing a liver scan with Gadivist contrast agent, you were unable to detect motion artefact on the coronal images and/or the need to redo the images.
11. The matters set out in allegations 1 to 10 above constitute misconduct and/or lack of competence.
12. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
Finding
Preliminary Matters at today’s review hearing
Service
1. The Panel had information before it that Notice of today’s hearing dated 27 June 2022 was sent to the Registrant’s email address shown on the Register on the same date. The Panel accepted the advice of the Legal Assessor and was satisfied that service had been effected in accordance with Rules 3 and 6 of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (the Rules).
Proceeding in Absence
2. Ms Sampson, on behalf of the HCPC, applied for the Panel to proceed today. She referred to the Panel to an email which she had sent to the Registrant on 18 July 2022 regarding today’s hearing, and various material which would assist her before this Panel. On 21 July 2022 the Registrant emailed the HCPTS stating:
“I will not be able to attend the hearing.
I will not be represented.
I had access to the hearing bundle.
I will not submit any documents.”
3. On 28 July 2022 Ms Sampson sent a further email to the Registrant encouraging her to attend today’s hearing, and giving her notice that if she failed to attend or submit any documents, the HCPC would ask the Panel to consider a Striking Off Order.
4. Ms Sampson submitted that the Registrant was aware of today’s hearing and had chosen not to attend. She reminded the Panel that this is a mandatory review of a substantive order which expires on 25 August 2022, and therefore it is in the Registrant’s interests as well as the public’s interests for it to proceed expeditiously.
5. The Panel took into account the HCPTS Practice Note entitled “Proceeding in the Absence of the Registrant” and accepted the advice of the Legal Assessor.
6. The Panel was aware that the discretion to proceed in the absence of a Registrant should be exercised with the utmost care and caution. The Panel took into account that the Registrant has stated clearly that she would not be attending today or submitting any documents. The Panel also took into account that the Registrant did not attend the final substantive hearing in 2021 when considering her lack of engagement as a whole.
7. The Panel was of the view that there is no indication that an adjournment would secure the Registrant’s attendance at a future date on the basis of the absence of a request for an adjournment from the Registrant. The Panel took into account the potential disadvantage to the Registrant if it were to proceed. However, taking into account the Registrant’s email dated 21 July 2022, the Panel was satisfied that she had waived her right to attend, and that it was in the public interest, as well as being fair to the Registrant, for today’s mandatory review to proceed expeditiously.
8. The Panel therefore decided to proceed today.
Background
9. The Registrant is a registered Radiographer. She was employed as a Band 6 MRI Radiographer at the Belfast Health and Social Care Trust (“the Trust”) between 26 November 2018 and 19 April 2019 at the MRI Department at Mater Hospital. The Registrant was employed on the basis that she had, prior to commencing her employment, 20 years’ experience as a Radiographer, and 4 years’ MRI experience.
10. Concerns were raised about the Registrant’s competence, skills and training from December 2018, and it was considered that the induction and training were not meeting the Registrant’s needs. The Registrant was placed on an informal Capability Process on 4 February 2019 for a period of 4 weeks. She was assigned two mentors, CD, Band 6 MRI Radiographer, and MS, Band 6 MRI Radiographer, each of whom spent time working alongside the Registrant. The Registrant always worked under supervision, and following the instigation of the informal Capability Process, she predominantly worked with either CD or MS. There were also weekly meetings held with LMCK, MRI Lead Radiographer, the Registrant, and either CD or MS. On 11 March 2019 the informal stage of the Capability Process was extended by 4 weeks. On 25 March 2019, the Registrant emailed her resignation to LMCK.
Decision
11. Ms Sampson submitted that, in light of the lack of any evidence from the Registrant to address the concerns found, and the lack of evidence of insight before the Panel, the Registrant remained impaired. Ms Sampson submitted that on the basis of a lack of demonstration of insight and remediation, and an unwillingness to resolve the matters found proved, a Striking Off Order was the appropriate order in this case. Ms Sampson submitted in the alternative, that if the Panel did not agree, a short further period of suspension of between 3 and 6 months was appropriate to enable the Registrant to show that she was willing to engage and start remediation.
12. There were no submissions from the Registrant before the Panel.
13. The Panel accepted the advice of the Legal Assessor.
14. The Panel was aware that its purpose today was to conduct a comprehensive review of the Registrant’s fitness to return to unrestricted practice and considered the HCPTS Practice Note entitled “Review of Article 30 Sanction Orders”.
15. The Panel must exercise its own independent judgement with regard to impairment.
16. The Panel noted that the final hearing Panel concluded as follows:
“222. The Panel was of the view that the Registrant’s written submissions do not suggest any insight into the matters found proved. Nor is there any evidence of reflection. However, there was some insight shown by her at the meetings with her manager and mentors in that she often accepted feedback and stated that she would make changes going forward. However, there is no evidence before the Panel of any steps taken by the Registrant to address the matters found proved, for example such as undertaking further training, since she resigned from the Trust."
17. There has been no evidence before today’s Panel from the Registrant demonstrating the level of her insight into the misconduct. Further, there is a lack of any evidence that she has taken any steps to address the misconduct. She has not sought to avail herself of the recommendations of the final hearing Panel as to what information from her may assist this Panel today. This absence of such evidence is despite the Registrant having had 12 months to consider her position, to reflect on what occurred, to engage with the regulatory process, and to demonstrate evidence of remedial steps. Taking into account the lapse of time since the substantive hearing, the Panel concluded that a real risk of repetition remained in respect of the misconduct.
18. With regard to the wider public interest which included public confidence in the profession, the Panel was of the view that in light of the numerous and wide-ranging concerns which have not been addressed, and the consequent risk to patients’ safety, the Panel was satisfied that a fully informed and fair minded member of the public would be gravely concerned if the Registrant were returned to unrestricted practice. The Panel was therefore satisfied that the need to maintain public confidence in the profession and to uphold proper standards, would be undermined if a finding of impairment were not made in the particular circumstances.
19. The Panel therefore found that the Registrant’s fitness to practice remained impaired in respect of the personal and public components.
20. The Panel next went on to consider sanction, and took into account the Sanctions Policy (SP). The Panel bore in mind that what sanction, if any, to impose, was a matter for its own independent judgment, and that the purpose of a sanction was not to punish the Registrant but to protect the public. Further, any sanction must be proportionate, so that any order made was the least restrictive order necessary to protect the public interest, including public protection.
21. The Panel first considered taking no action. The Panel concluded that, in view of the nature and seriousness of the Registrant’s misconduct, which has not been remedied, and the ongoing risk to public protection, it would be inappropriate to take no action. It would be insufficient to protect the public, maintain public confidence and uphold the reputation of the profession. The Panel concluded that a Caution Order would be inappropriate and insufficient to protect the public and meet the public interest for the same reasons.
22. The Panel next considered a Conditions of Practice Order. However, on the basis of the Registrant’s lack of substantive engagement since the final substantive hearing, there was no indication that she would be willing to comply with conditions. In any event, the Panel decided that due to the number of, and wide-ranging nature of the instances of misconduct, most of which related to basic and fundamental skills expected of a Registrant, conditions could not be formulated which would be sufficient to protect the public, and the wider public interest.
23. The Panel next considered a Suspension Order and considered para. 121 of the SP which states as follows:
“A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register. These types of cases will typically exhibit the following factors:
⦁ the concerns represent a serious breach of the Standards of conduct, performance and ethics;
⦁ the registrant has insight;
⦁ the issues are unlikely to be repeated; and
⦁ there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings.”
24. The Registrant has not shown any insight apart from some insight shown by her at meetings with her manager and mentors while still employed by the Trust. However, there was no evidence of remediation before the Panel. Therefore there remained a real risk of repetition of the misconduct. In light of the Registrant’s lack of engagement in respect of today’s hearing, the Panel concluded that she was not willing to resolve her failings. The underlying issues of a lack of engagement with the regulatory process, the lack of indication that the Registrant wished to return to the profession, and the ongoing risk of repetition, led the Panel to conclude that Suspension would not be appropriate or sufficient to protect the public or uphold the wider public interest.
25. The Panel considered the following paragraphs of the SP:
“131. A striking off order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process. In particular where the registrant:
⦁ lacks insight;
⦁ continues to repeat the misconduct or, where a registrant has been suspended for two years continuously, fails to address a lack of competence; or
⦁ is unwilling to resolve matters.”
26. The misconduct found proved was serious, and gave rise to a real risk to patients. There was a lack of evidence of insight into, or remediation of, the Registrant’s misconduct, before the Panel today. This is to be seen within the context of the continuing lack of any meaningful engagement during the period of Suspension over the last year, and in the Panel’s view this suggested an unwillingness to resolve matters. There was a lack of any indication from the Registrant that she wished to return to the profession, as well as the ongoing significant risk of repetition of the misconduct. The Registrant was in the Panel’s view, taking into account all the circumstances, unwilling to resolve the concerns. All of these factors led the Panel to decide that a Striking Off Order was the only way in which the public could be protected, and which could uphold the wider public interest.
27. In coming to its decision, the Panel took into account the principle of proportionality, and the impact that such a sanction will have on the Registrant’s right to practise her profession, as well as the likely reputational and financial impact. However, the Panel decided that the need to protect the public and uphold the public interest outweighed the Registrant’s interests in this regard.
28. The Panel therefore decided to impose a Striking Off Order which will come into effect on the expiry of the current Order.
Order
ORDER: The Registrar is directed to strike the name of Mrs Petya Somerville from the Register on the date that this Order comes into effect.
Notes
The Order imposed today will apply from 25 August 2022.
Hearing History
History of Hearings for Mrs Petya B Somerville
| Date | Panel | Hearing type | Outcomes / Status |
|---|---|---|---|
| 29/07/2022 | Conduct and Competence Committee | Review Hearing | Struck off |
| 19/07/2021 | Conduct and Competence Committee | Final Hearing | Suspended |