Collins Esona

Preliminary Matters
 
Proceeding in Private
1.          The Panel noted the application by the HCPC for this hearing to be heard in private under Rule 10(1)(a) of the Health and Care Professions Council (Conduct and Competence) (Procedure) Rules 2003, which provides that “proceedings shall be held in public unless the Committee is satisfied that, in the interests of justice or for the protection of the private life of the health professional... the public should be excluded from all or part of the hearing”.

2.          The HCPC, represented by Mr Justyn Singlehurst, only applied for part of the hearing to be in private in so far as any issues arising in relation to the Registrant’s private life. Mr Singlehurst updated the Panel that the Registrant had mentioned to him that the previous hearing had led to an invasion of his private life resulting in Police being involved and thus had impacted his health. Mr Singlehurst submitted there was no reason those matters could not be separated out from the rest of the matters and thus there was no need for the whole hearing to be in private.

3.          The Registrant wanted the whole hearing to be in private because a past hearing had been reported in the media and his daughter had shown him the reports. He submitted his daughter would also be impacted. He had shut down his social media to protect himself and his family.

4.          The Panel received and accepted the advice of the Legal Assessor who referred the Panel to the HCPTS Practice Note on Conducting Hearings in Private. Although hearings are usually heard in public, the Rules allow for the hearing to be in private where this would protect the private life of the Registrant. The starting point is the “open justice principle” in that hearings should be in public. Prior to deciding the whole hearing  should be in private, the Panel considered if it is feasible to have only part of the hearing in private and considered proportionate steps including anonymising information, concealing identities and redacting. 

5.          The Panel was satisfied that the Registrant’s interests in maintaining his privacy in relation to his private life justified hearing that part of the proceedings in private. This could be separated out from the rest of the hearing. The rest of the hearing would remain in public.

Background

6.          The Registrant started work as a Band 6 Biomedical Scientist for the Royal Liverpool and Broadgreen University Hospital NHS Trust (the Trust) in April 2016. He was undertaking routine haematology laboratory work and was responsible for processing patient samples and authorising results. 

7.          On 6 April 2018, a referral was made to the HCPC by the Trust. This set out a number of concerns in relation to capability issues and disciplinary matters in relation to the Registrant.

8.          There was an incident on 1 August 2016 where the Registrant had failed to follow the Standard Operating Procedures in regards to the  authorisation of patient results.  As a result, time was lost in the treatment of an unwell patient.

9.          A second incident occurred on 5 September 2016 when the Registrant authorised a number of results which he was not entitled to do without supervision.

10.       The Trust investigation included other concerns to do with complaints that the Registrant was responsible in relation to the bullying of work colleagues and sexually motivated inappropriate comments to female colleagues.

11.       The Trust investigation concluded that the Registrant had a case to answer in respect of those bullying allegations. However, on 1 March 2018, the Registrant resigned from the Trust before it was possible to schedule a disciplinary hearing.

The Substantive Decision 9 – 19 November 2020

12.       The particulars of the Allegation as set out above were considered in November 2020 by a panel of the Conduct and Competence Committee of the HCPC.

13.       During the course of the Final Hearing, the panel heard evidence from several work colleagues and the Registrant himself. The Registrant initially made no admissions. Indeed, he claimed that the witnesses had conspired to damage his career and to get rid of him from the Trust. However, the Registrant was recalled and made belated admissions to particulars 1, 4 and 5. He stated that, having heard evidence and reflected over the weekend, he acknowledged that the problems he encountered were partly of his own making.

14.       Although the panel gave some credit for his change of heart, it took the view that the Registrant could have reached this conclusion months earlier and that his original evidence must have been untruthful with respect to those particulars he later admitted.

15.       The panel also commented that the Registrant’s evidence had been underpinned by an air of unwarranted superiority and that he had appeared to show arrogance about his own capabilities.

16.       In reaching its findings, the panel stressed that the Registrant’s clinical misconduct in respect of particulars 4 and 5 had been serious and had put patients at risk of harm.

17.       Furthermore, the panel commented that the Registrant had shown very little, if any, genuine insight into his misconduct and had not begun to recognise the seriousness of his behaviour towards his colleagues.

18.       In finding the Registrant’s fitness to practice impaired on both the personal and public components, the panel imposed a Suspension Order for a period of 12 months. It added that any further reviewing panel might be assisted by, amongst other things, the following:
a.     a reflective piece addressing the deficiencies in the Registrant’s insight in relation to the boundaries of his scope of practice; the boundaries of his working in partnership with colleagues; working within a team setting.
b.     evidence of CPD or other actions taken by the Registrant to maintain his knowledge and skills as a Biomedical Scientist;
c.     evidence of CPD or other actions taken by the Registrant to address the concerns in this case;
d.     references or testimonials from people for whom the Registrant may be working in paid or unpaid employment, or from other people of good standing who are aware of the allegations in this case during the period of his suspension;
e.      the Registrant’s attendance in person or remotely, at the review hearing to assist the reviewing panel in relation to his insight

19. About 3 weeks after imposition of the Suspension Order, on 5 December 2020 the Registrant set up a GoFundMe page online seeking to raise funds for himself and claiming he had been forced to resign from the NHS “due to a toxic environment as a result of his race”.

First Substantive Review Hearing – 15 November 2021

20. On 15 November 2021, a panel of the Conduct and Competence committee reviewed the Suspension Order as it was due to expire on 17 December 2021.  That panel suspended the Registrant for a further 12 months and the Suspension Order was applicable from 17 December 2021 with an expiry date of 17 December 2022.

21. At that hearing, submissions were heard from both the HCPC and the Registrant. The Registrant also had provided CPD certificates, references, and a reflective piece.

22. The panel concluded the Registrant was still impaired as little understanding was shown into the impact of his actions on colleagues and the wider profession. The Registrant was unable to articulate how he was able to maintain professional boundaries in his role at the time as a member of a Covid task force. The Panel was not persuaded the Registrant had understood the impact of his actions on the public, patients and colleagues. The CPD courses taken were found not to be relevant to the allegations. The testimonials did not evidence the author was aware of the proven allegations. The panel found there was a risk of repetition due to the limited insight and found him still to be impaired.

23. In terms of the sanction, conditions were found not to be workable and a strike off was ruled out as there had been some attempt to engage with the matter. As mentioned earlier, the Suspension Order was made for 12 months.

24. Finally, the panel suggested the next reviewing panel would be assisted by:
a.     a reflective piece addressing the deficiencies in the Registrant’s practice, specifically in relation to breaching professional boundaries with colleague and an understanding of the impact of his behaviour on his colleagues, service users and the wider profession;
b.     evidence of training and/or courses undertaken to address the concerns regarding maintaining appropriate professional relationships and boundaries;  
c.     evidence of CPD which relate directly to maintaining and developing his knowledge and skills as a Biomedical Scientist;
d.     relevant references or testimonials from people from whom the Registrant may be working in paid or unpaid employment, or from other people of good standing who state that they are aware of the allegations in this case and can comment on the Registrant’s conduct in this regard during the period of suspension;
e.     the Registrant’s attendance, in person or remotely, at the review hearing to assist the reviewing panel in relation to his insight.

Today’s hearing
25. The Panel had before it the HCPC bundle.

26. Additional documents were submitted by the Registrant, which were only provided to the Panel on the day of the hearing. This included:

a.     a transcript issued on 26 November 2022 from the University of Sheffield to evidence the successful completion of Master of Science (MSC) Clinical Research by the Registrant;
b.     the same documents submitted before the last panel review hearing in November 2021 (CPD certificates, references, and a reflective piece). The documents from last year including the reflective piece had not been updated.

Impairment

27. Mr Singlehurst for the HCPC submitted the persuasive burden was on the Registrant to demonstrate he was no longer impaired and to show that he had addressed the concerns sufficiently. He submitted that the last reviewing panel had suggested certain information be made available to the next reviewing panel and none had been provided. He stated the documents submitted were the same as from the last hearing, which did not address the concerns in the allegations.

28. Mr Singlehurst submitted that neither of the character references indicated that the authors were aware of the allegations against the Registrant. His view was the CPD documents did not deal with the issues of failing to follow standard operating procedures or the serious behavioural concerns proven; namely bullying behaviours and sexually inappropriate comments. Accordingly, Mr Singlehurst submitted there had been no evidence to indicate the Registrant was no longer impaired.

29. The Registrant submitted the allegation related to matters from 6 years ago in 2016. He was apologetic and stated no such incident had happened again and told the Panel that they would not be repeated. He sought to address the gaps in his knowledge by undertaking an additional Masters degree full time over the past year. He stated the finding of impairment meant he was unable to access laboratory work and no job offers were made despite countless applications. He had also failed in attempting to secure a job in France due to the impairment finding.

30. The Registrant also added that he undertook a laboratory technician role and worked in other departments without any issues of conduct or bullying being raised. He stressed he wishes to remain in the Biomedical Scientist profession.

31. In considering impairment, the Panel took advice from the Legal Assessor and accepted this. The Panel’s function is to review and determine whether the Registrant’s fitness to practice is still impaired. The Panel would consider the current fitness to practice by considering how the Registrant had acted in the past and then looking forward to consider if the ability to practice safely is compromised.

32. The Panel concluded the Registrant’s fitness to practice is still impaired.

33. The Panel accepted that there was some remorse as the Registrant was apologetic. However, it considered that the Registrant had had sufficient opportunities in the 12 months since the last review to produce evidence to demonstrate insight. The Panel had concerns that the Registrant appeared not to understand this stipulation despite him being an intelligent individual as evidenced by his recent Masters degree.

34. At the last review hearing in November 2021, the previous Panel’s written determination clearly outlined the documents that would assist a future reviewing panel, but the Registrant had failed to engage with this. The documents provided have not been updated and were the same documents that the previous reviewing panel had considered, and found unsatisfactory, when finding impairment still stood.

35. The Panel considered the documents and submissions at today’s hearing and concluded they did not deal with the issue of breaching professional boundaries.

36. The Panel concluded there was an absence of breadth and depth in the evidence presented. There was no updated reflective piece. The character references give no indication that the authors were aware of the allegations. The CPD courses did not deal with the allegations proven in the substantive hearing. No further relevant courses had been attended since the last review a little over a year ago.

37. The Registrant’s oral submissions were considered but he offered no information on how he had attempted to remedy the bullying behaviour or sexual comments that were found in the 2020 substantive hearing. The Registrant had now had a little over 2 years since the substantive hearing and had still failed to address the issues. Accordingly personal impairment was found by the Panel.

38. Turning to the public component, the Panel concluded a well informed  member of the public would be concerned with the Panel if it were to find the Registrant is not currently impaired, especially given there is little to no change since the last review hearing in November 2021.

39. In summary, the Panel found that the Registrant remains impaired on both the personal and public components.

Sanction

40. The Panel next considered what sanction, if any, to impose. Submissions were invited from the HCPC and the Registrant.

41. The HCPC submitted it would be inappropriate to apply no sanction as there had been a finding of impairment. Mr Singlehurst submitted conditions would only be appropriate where insight had been shown and he considered it would be difficult for conditions to deal with matters related to the Registrant’s attitude. He left the decision to the Panel in considering a suspension or striking off.

42. Mr Singlehurst highlighted the aggravating factors as follows; failing to address, or recognise the severity of, the proven allegations, lack of remediation, lack of insight,  attempts to minimise concerns when referring to the allegations as an isolated incident and not engaging in steps outlined by the previous Panel.

43. He also highlighted the mitigating factors as follows; the Registrant was not denying the allegations as he accepted them in general terms, he attended today and engaged throughout the hearing.

44. The Registrant submitted he recognised the problems, apologised and told the Panel there would be no repetition. His view was that in order to implement the last reviewing panel’s recommendations, he would have to be in practice and thus impairment works against him being able to do this. He also submitted that he tried to access some courses by a specific provider but a lack of professional references proved to be a barrier to this. He also mentioned that he had just spoken to a former colleague who could provide a positive testimonial in support of him but didn’t request an adjournment to obtain this. The Registrant said he was open to cooperating and doing what is required.

45. In considering sanction, the Panel took advice from the Legal Assessor and accepted this. In deciding what sanction, if any, to impose, the Panel referred to the HCPTS Sanction Policy. The Panel reminded itself that the purpose of sanctions is to protect service users, to maintain confidence in the Biomedical Scientist profession and to uphold standards of conduct and behaviour. It was aware that the purpose of sanctions is not to be punitive, although a sanction may have a punitive effect.

46. In terms of the approach, the Panel was aware it should only take the minimum action necessary to ensure the public is protected. This means considering the least restrictive sanction available to them first, and only moving on to a more restrictive sanction if it is necessary to protect the public. The Panel kept proportionality at the forefront of its mind at every stage of its decision making.  

47. The Panel first considered whether taking No Further Action would be appropriate but this was rejected in light of the seriousness of the proven allegations and the finding of impairment.

48. The Panel next considered a Caution Order but did not feel this was appropriate. There remained a risk of repetition, very limited insight had been shown, it was not a single isolated incident and there was a lack of remediation.

49. The Panel next considered a Conditions of Practice Order. Conditions have to be realistic and workable but the Panel concluded they would not work here. Conditions were appropriate where the failure was capable of being remedied. The Panel considered this matter involved attitudinal issues, which by their nature are more difficult to remedy. The Panel also had concerns whether any conditions would be complied with by the Registrant, in light of him not availing of the opportunity to commit to the suggestions of the previous Panels.

50. The Panel then had to consider between a Suspension Order and a Striking off Order.

51. The Panel considered a Suspension Order would be appropriate where the incident is unlikely to be repeated. The Panel had no evidence before it to demonstrate that there had been insight or learning. Thus, the Panel considered that the risk of repetition remained. The Panel’s view, based on the lack of meaningful engagement for the past 2 years, was that the Registrant is unlikely to be able to recognise, much less resolve or remedy, the failings identified.

52. A Strike Off Order was thus deemed appropriate under the circumstances. To do otherwise would not be seen to be upholding standards and would send the wrong message to other registered professionals. The Registrant had been given a detailed indication of the type of documents that would assist him to demonstrate that his Fitness to Practice was no longer impaired in both November 2020 and which were emphasised in November 2021. However, he had chosen to have no meaningful engagement with the process, shown limited insight and had not addressed the core concerns. The Panel could not be satisfied that a further period of suspension would achieve any meaningful progress.   

53. Therefore, the Panel concluded any lesser sanction would not be appropriate. This sanction was necessary and proportionate to protect the public, maintain public confidence in the profession, and maintain public confidence in the regulatory process.

54. The Panel decided the Strike Off Order would come into effect at the expiry of the Interim Suspension Order that is in place until 17 December 2022.

ORDER: The Registrar is directed to impose a Strike Off Order. 

The Order imposed today will apply from 17 December 2022.

History of Hearings for Collins Esona