Anoop Padmavathy Sundara Raj

Preliminary Matters:
Application to amend the Allegation

1. On behalf of the HCPC Mr Collins made an application to amend the Allegation as set out within the HCPC statement of case. He submitted that the proposed amendments better reflected the underlying evidence and did not increase the seriousness of the concerns. He also proposed a minor typographical amendment.

2. The Registrant initially stated that he opposed the proposed amendments, but when each proposed amendment was discussed with him, he indicated that he did not oppose the application to amend.

3. The Panel accepted the advice of the Legal Assessor. She advised that the Panel may exercise its discretionary power to make amendments to the Allegation. When considering whether to exercise its discretion it should consider whether the proposed amendment creates unfairness for the Registrant and whether the proposed amendments are appropriate.

4. The Panel decided that the proposed amendments did not prejudice the Registrant. Although the Registrant had short notice of the proposed amendments, they did not increase the gravity of the allegation, and they were consistent with the evidence which is relied on by the HCPC. The Panel considered that the amendments clarify and better particularise the Allegation. The Panel did not identify any unfairness for the Registrant that might result from the proposed amendments.

5. The Panel therefore agreed to the HCPC application to amend the Allegation.

6. A further application was made to correct a typographical error and add missing words in Particular 7 of the Allegation. Mr Raj did not object to the proposed amendment, and the Panel was satisfied that it did not create any unfairness. The Panel therefore agreed to the further application to amend the Allegation.
Panel directions

7. During the Panel’s discussion with the Registrant about his response to the Allegation, the Panel, of its own motion, invited both parties to make comments and submissions on the potential need for an interpreter.

8. On behalf of the HCPC Mr Collins informed the Panel that the HCPC took a neutral position. This was a matter for the Panel’s judgment having regard to the requirement for a fair hearing and the public interest in ensuring that there was an appropriate regulatory outcome. He outlined for the Panel factors that it might take into account when deciding whether a direction was required.

9. The factors that might suggest that the Panel should not direct that an interpreter was required were:

• the Registrant’s position (he had indicated that he did not require an interpreter);

• the Registrant’s previous participation in HCPC hearings (of a different nature)

• the HCPC will call four witnesses who are ready to give their evidence to the Panel;

• the impact of potential delay, the case was referred by the ICP in 2023;

• the uncertainty as to when an interpreter might be available;

• the option for making adjustments to accommodate the potential concerns identified;

• impact on future listing and the availability of alternative dates;

10. The factors that might suggest that an interpreter was required were:

• the wide role of an interpreter in assisting the Registrant to understand the process, but also to assist the Registrant in presenting his evidence/submissions;

• the Allegation includes language difficulties and an interpreter was used by the Registrant’s employer in local meetings;

• the allegations include one of serious dishonesty;

• the Allegation includes one of lack of competence relating to language difficulties and there is an inherent sensitivity in the Registrant, representing himself, appearing to request an interpreter;

• there are currently no witness engagement issues;

• in the Panel’s engagement and exchanges with the Registrant he changed his position a number of times, and in relation to some of the questions he gave responses which appeared to be disconnected (the Registrant stated that this was due to technical issues)

• the objective evidence of the Registrant’s English language ability by his own account – in his most recent IELTS test he scored 5.5 indicating that he is a “modest user” with a partial command of English, likely to make mistakes, and able to handle basic communication in his own field.

11. In his response the Registrant stated that he did not wish to have an interpreter. He also stated that an interpreter may be useful.

12. The Panel accepted the advice of the Legal Assessor. She advised that the Panel may exercise its case management powers to direct that an interpreter is required. In the exercise of its discretion the Panel should take into account the requirement for a fair hearing for both parties. It should also take into account the public interest in ensuring that the allegations are fully addressed. The public interest includes the Panel’s duty to ensure that the case is conducted with due expedition. The Panel is not at this stage addressing the competency issues which form part of the Allegation, and it should ensure that it has an open mind in relation to those issues.

13. The Panel agreed that all the factors highlighted by Mr Collins were relevant. In addition, the Panel considered that it was in the interests of the HCPC witnesses that cross-examination from the Registrant should be through an interpreter rather than direct questions from the Registrant.

14. The Panel acknowledged the potential for delay and the consequent impact on the progress of the hearing if it were to make a direction for an interpreter. However, the Panel’s progress of the hearing without an interpreter had been slow, and this was during the relatively straightforward part of the hearing in addressing the application for an amendment and the Registrant’s response to the Allegation. The Panel noted that the Registrant’s employer had arranged for an interpreter for some of its meetings, and that this was at local level dealing with competency issues, rather than the wider range of allegations, including the serious allegation of dishonesty, which is before the Panel.

15. The Panel took into account the Registrant’s position that he does not require an interpreter. However, the Panel considered that it was important for the fairness of the hearing and the public interest that the Registrant understands everything that is said, and the Panel can understand the Registrant’s responses to questions, his cross-examination questions, and his evidence or submissions.

16. Having carried out a careful balancing exercise, the Panel decided that it was appropriate to direct that the HCPTS should make arrangements for an interpreter for the hearing. The Panel decided that while the Registrant does not consider that he needs an interpreter, an interpreter is required to ensure that the hearing is fair, and to act in accordance with the overarching objective of protecting the public.

Application for an adjournment

17. In discussions about his availability the Registrant had told the Panel that he would be able to attend the hearing at 9.45 a.m. on Wednesday 30 April, Thursday 1 May and Friday 2 May 2025.

18. On Wednesday 30 April 2025 the Registrant made an application to adjourn the hearing until 1 p.m. on 1 May 2025. He informed the Panel that his employer expected him to attend work due to a shortage of staff.

19. Mr Collins had no instructions from the HCPC, but highlighted a number of factors which he submitted were relevant to the Panel’s exercise of its discretion.

20. The Panel accepted the advice of the Legal Assessor. She referred the Panel to the HCPTS Practice Note “Postponement and Adjournment of Proceedings” and the factors derived from the case of CPS v Picton (2006) EWHC 1108. She advised that the Panel should take into account the requirement for the hearing to be fair to both parties and the public interest in conducting the proceedings expeditiously.

21. The Panel decided not to agree to the Registrant’s application to adjourn the hearing until 1 p.m. on Thursday 1 May. The Panel considered the reason for the proposed adjournment, and it did not consider that it was sufficient to justify the Registrant’s lack of availability. The Registrant was provided with notice of the hearing on 19 February 2025 and had the opportunity to make arrangements to request leave from his employer. He told the Panel that he did not request leave for any days for which the hearing was scheduled. If there had been any lack of clarity about the requirement for him to attend the hearing on each day, that had been addressed within the discussions on Tuesday 29 April 2025 about the Registrant’s availability. The Registrant had then given a reassurance to the Panel that he would be able to attend on each day at 9.45 a.m.

22. The Panel acknowledged that if the Registrant did not attend the hearing his ability to present his case may be compromised. The Panel was due to continue to hear evidence from HCPC witnesses and, depending on the timetabling, the Registrant may not have an opportunity to cross-examine some or all the remaining witnesses. The Panel had in mind the guidance in General Medical Council v Adeogba [2016] EWCA Civ 162 that there is an obligation on Registrants to engage with their regulator in relation to the resolution of allegations made against them. The Panel considered that this obligation required the Registrant to prioritise his attendance at the hearing and to inform his employer as necessary. There was not a good and compelling reason for an adjournment.

23. The Panel considered that there was a strong public interest in the hearing proceeding. The Panel has an obligation to proceed with the hearing expeditiously and time had already been lost. The decision of the Panel to require an interpreter impacted on the timetable for the HCPC witnesses who were endeavouring to make themselves available to give evidence to the Panel outside the times to which they had committed.

24. In the circumstances the Panel decided that the potential prejudice to the Registrant was outweighed by the public interest in expedition and did not agree to the Registrant’s application to adjourn the hearing until 1 p.m. on Thursday 1 May 2025.

Service of notice

25. When the Panel reconvened on 1 May 2025 it considered whether the Registrant had been served notice of the hearing in accordance with the requirements of the HCPC Conduct and Competence (Procedure) Rules 2003 (the “Rules”).

26. The Panel was provided with a service bundle which included a copy of the Notice of Hearing dated 19 February 2025 sent to the Registrant’s registered address. The notice included the date, and time of the hearing and informed the Registrant that it would be conducted remotely.

27. Having considered the document in the hearing bundle, and accepted the advice of the Legal Assessor, the Panel was satisfied that good service had been effected.
Proceeding in the absence of the Registrant

28. The Registrant sent an e-mail to the Hearings Officer on 1 May 2025 in which he confirmed that he would not attend the hearing at 9.45 and requested that the start of the hearing be delayed until 12 noon.

29. Mr Collins made an application for the hearing to proceed in the absence of the Registrant.

He highlighted the following:

• the Panel’s decision not to grant the Registrant’s request for an adjournment;

• the Registrant’s duty to engage with regulatory proceedings;

• the impact of the Registrant’s availability on the listing should it be accommodated, the Committee’s duty to proceed expeditiously, the history of the case, the need to juggle witnesses and the impact on the progress of the case;

• the prejudice to the Registrant was more limited than might otherwise appear, Mr Collins stated that he has an awareness of the issues raised by the Registrant and would be able to formulate questions for the witness CP.

30. The Panel accepted the advice of the Legal Assessor. Her advice included reference to the case of General Medical Council v Adeogba [2016] EWCA Civ 162. The Legal Assessor advised that fairness to the Registrant was a feature of prime importance, but that the Panel should also take into account fairness to the HCPC and the public interest.

31. The Panel exercised its discretion with the utmost care and caution. The Panel referred to its decision not to grant an adjournment, and the absence of a good and compelling reason for the Registrant’s absence. The Panel was not satisfied that the Registrant had taken sufficient steps to ensure that he was available for the hearing in accordance with his obligation to engage with the process. The Panel therefore considered that the Registrant had waived his right to attend the hearing in respect of the Panel’s sitting from 9.45 a.m. to 12 noon. The Panel considered that while there might be some prejudice to the Registrant, the prejudice could be mitigated to some extent by the questioning of the witness CP as mentioned by Mr Collins.

32. Although this was a case where an adjournment was likely to secure the Registrant’s attendance, the Panel considered that his interests were outweighed by the public interest in expedition. In considering the public interest the Panel took into account the impact of delay on the HCPC witnesses. As mentioned in its decision on the application for adjournment, the HCPC witnesses had not been called in accordance with the anticipated schedule, and they were making arrangements to be available, at significant professional inconvenience, to assist the Panel. The Panel took into account its obligation to conduct the hearing expeditiously and the potential impact of delay on the progress of the case.

33. In the circumstances, the Panel decided that it was fair and appropriate to proceed with the hearing in the Registrant’s absence.
Background:

34. The Registrant is a registered Radiographer. He obtained a Diploma in Radiological Technology in India. The ‘medium of instruction’ for his education in India was English.

35. The Registrant applied to join the HCPC on 4 September 2020. As part of the Registrant’s application, he confirmed that English was his “first language” and completed a declaration that the information within his application was correct.

36. Following registration, the Registrant commenced a role at Cambridge University Hospitals (“the Trust”) from 30 January 2023 as a junior Radiographer (Band 5). The role included a requirement to ‘work within a team of radiographers to provide accurate and safe planning and delivery of radiotherapy treatment’.

37. Soon after joining, and whilst the Registrant was supernumerary, concerns were raised about the Registrant’s English Language skills and how they impacted upon his performance.

38. The Registrant’s manager sought assistance from the Trust’s Learning and Development team to support the Registrant in developing his English. The Registrant was enrolled on a course named “Speak”, which was due to commence in October 2023, and arrangements were made for the Registrant to access courses on the Trust’s DOT system (learning application).

39. The Registrant’s manager held informal meetings with the Registrant before a formal Performance Improvement Plan (“PIP”) was implemented in April 2023. The Registrant’s English language skills were to be reviewed in the context of ‘first day chats’ (which included confirming a Patient’s identification (“ID checks”).

40. On 18 April 2023, and during the course of the Registrant’s PIP, CP, a Band 7 Radiographer, observed the registrant whilst he was asleep at a workstation. The workstation was described as being within the potential view of patients entering and exiting treatment rooms.

41. The Trust conducted progress report meetings and as a result of these meetings further actions were created. These further agreed actions including the Registrant correctly completing 10 ID checks in line with IR(ME)R Regulations every day.

42. Notwithstanding the PIP, the Trust continued to have concerns in relation to the Registrant’s progress, including that the Registrant’s language skills impacted on his ability to learn and reflect.

43. On 11 May 2023, the Trust held a meeting with the Registrant via a Malayalam interpreter.

During the meeting the Registrant:

• accepted that his level of English language was a patient safety risk;

• that he did not confirm three points of ID for all patients;

• explained that he had not attempted the Trust’s language course which he did not feel was helpful to his communication and that he is ‘more focussed on patient handling’;

• stated that he is not at the level of English language needed to be able to complete and understand tasks but believes he can improve.

44. On 12 June 2023, the Trust held a further meeting with the Registrant via a Malayalam interpreter. It was highlighted to the Registrant during the meeting that he had provided ‘incorrect information’ to ‘patients during rule play or doesn’t understand what is being said but doesn’t acknowledge that he is not understanding’.

45. During this meeting, the Registrant was asked about his application to join the HCPC and if he had declared whether English was his first language. The Registrant stated via a translator that he had ‘told the HCPC English was not his first language and had provided his IELTS certificate to the HCPC’. The Registrant confirmed to the Trust that his IELTS score was 5.5.

46. Whilst the trust noted some improvements in the Registrant’s language skills, including in relation to Patient ID checks within the role play exercises, his language level was still not considered proficient and he was suspended from duties.
Admissions

47. The Registrant admitted the following Particulars: 1(a), 1(c), and 3. These admissions were confirmed by the Registrant with the assistance of the interpreter.

48. The Panel accepted the advice of the Legal Assessor. She referred the Panel to the HCPTS Practice Note on “Admissions”. She confirmed that it is open to the Panel to make findings of fact based on the Registrant’s admissions without hearing evidence on those matters. In considering the admissions, the Panel should bear in mind that the Registrant is unrepresented and should consider whether the admissions were unequivocal.

49. The Panel decided that it was fair and appropriate to make findings of fact based on the Registrant’s admissions for Particulars 1(a), 1(c) and 3. While it made these findings at the outset of the case, the Panel noted the evidence relating to these Particulars within the witness statements, exhibits, and within the oral evidence of the witnesses, which was consistent with the admissions.
Evidence

50. The Panel was provided with a bundle of documents which included:

• Statement of Lolita Eidukaite, Registration Manager at the HCPC, together with her exhibits;

• Statement of CP, a Band 7 Radiographer, together with her exhibits;

• Statement of CF, a Therapeutic Radiographer and Head of Technical Operations in Radiography, together with her exhibits;

• Statement of CK, a Senior Radiographer and team leader, together with her exhibits;

• E-mails from the Registrant containing responses to the allegations, a reference, and CPD certificates.

51. The Panel was also provided with the Registrant’s bundle which included his statements and training certificates.

52. The Panel heard oral evidence from Ms CF and she was cross-examined by the Registrant. Ms CF told the Panel that two other radiographers from India commenced employment at the same as the Registrant and successfully completed the preceptorship programme.

53. In cross-examination Ms CF answered questions from the Registrant about the training and support provided to him. In response, Ms Ferreria outlined the support provided to Mr Raj. This included support from the Trust’s Learning and Development team including contact with Mr Donkor who has a background in teaching English as a second language. Ms Ferreria told the Panel that the Registrant failed to engage with Mr Donkor. The Registrant was also put in contact with the Trust’s cultural ambassador who spoke Malayalam, and in a meeting the Registrant refused to have further contact with him.

54. Ms CF acknowledged that the Registrant was making efforts to improve his English, but when the Registrant was asked to participate in a role play to show a deep understanding of the patient’s treatment information, he was still not able to give the correct information.

55. The Panel heard evidence from Ms CK who was cross-examined by the Registrant. In Ms CK’s experience the Registrant’s communication was far more limited in his speaking and understanding compared to other international recruits.

56. In cross-examination by the Registrant, Ms CK stated that it wasn’t possible to make progress with the Registrant’s training because of the language barrier. Ms CK was also asked whether she was friendly towards the Registrant. She stated that she was friendly, patient, and understanding, and that the Registrant had told her that she was being supportive. CK was also asked about ID checks and stated that she did not see evidence that the Registrant was consistently completing the ID checks. She stated that a form was printed to enable the Registrant to log that he completed ten ID checks a day, but that the Registrant did not achieve the logs each day.

57. The Panel heard evidence from Ms CP. In the absence of the Registrant, Mr Collins asked questions which were based on his understanding of the Registrant’s case. In relation to ID checks Ms CP stated that the Registrant was given multiple opportunities to carry out the ID checks himself. She stated that on a number of occasions the Registrant asked the patient for their ID, but did not verify on the hospital computer system that the ID was correct.

58. The Panel heard evidence from Ms Eidukaite. In cross-examination from the Registrant Ms Eidukaite stated that it is the responsibility of the applicant to inform the HCPC if there is any mistake in their application for membership of the HCPC. She stated that the HCPC relies on the applicant’s self-declaration and does not carry out an investigation into the language of the relevant country or region. Ms Eidukaite confirmed that it was not sufficient if the applicant’s training was delivered in English. When the Registrant made his application to join the HCPC the question asked was whether English was the first language or the language the applicant spoke on a daily basis.

59. The Panel heard evidence from the Registrant. In cross-examination by Mr Collins the Registrant confirmed that at home and with his friends he spoke Malayalam. He agreed that in July 2023 Malayalam was the language in which he felt most comfortable. He agreed that English was not the main or only language he used on a day-to-day basis.

60. The Registrant agreed that in 2020 it was his “dream” to work as a radiographer in the UK. He also agreed that the HCPC application form was important and that he wanted the content to be “just right”. He also agreed that the declaration in the application form highlighted that providing false information could be a criminal offence.

61. The Registrant told the Panel that he had contacted other people who had completed the same application and that he had completed the form after speaking to these people. The Registrant agreed that he had not previously mentioned speaking to other people. The Registrant did not name any individual whom he had spoken to, but when challenged by Mr Collins he said that he was calling Mr Winfield as his witness.

62. In relation to the incident on 18 April 2023 where the Registrant was alleged to have been sleeping on duty, the Registrant demonstrated that he was sitting with his hands by his face and resting his head on his hands. The Registrant disagreed that the computer screen where he was sitting had timed out.

63. The Registrant told the Panel that Ms Powell did not speak to him, but that another radiographer did speak to him and that he was told that it was wrong to be sleeping on duty. When asked whether he had said that he had been struggling to sleep since starting work at the Trust, he agreed he had said this. He also agreed that when he was challenged by another radiographer he did not deny that he was sleeping. He said that he was having difficulty adjusting to sleep because of the time difference. He also said that it was not possible to sleep in the office because staff and patients were moving around all the time.

64. The Registrant was also asked about patient ID checks and he agreed that he was regularly asked to carry out this task. The Registrant said that he did sometimes speak to the patients and check the information against the computer. He said that he checked the information on the “parameters screen”, but he also agreed that he needed to look at the hospital computer system to check for three forms of patient ID.

65. The Registrant agreed that he didn’t have the skills to conduct patient ID’s in February 2023, but stated that from February 2023 he was able to do so.

66. The Panel heard evidence from Mr Winfield. Mr Winfield described his background and his particular interest in India and in Tamil Nadu. Mr Winfield told the Panel that he met the Registrant in India and that he provided support to the Registrant with English language and the Registrant’s preparation for the IELTS examination. Mr Winfield told the Panel that he was aware that the Registrant had submitted an application to register with the HCPC in August 2020 and in 2022 he learned that the Registrant had been offered a post at the Trust. Mr Winfield provided support to the Registrant on his arrival in the UK.

67. Mr Winfield provided a character reference for the Registrant, describing him as trusting, trustworthy, caring and sensitive. He described the Registrant as having a charming personality. Mr Winfield’s view was that the Registrant’s ideas about the world were limited, given his modest background.

68. Mr Winfield was not called as an expert witness, but he outlined for the Panel his understanding of the education system in Tamil Nadu. Mr Winfield provided his opinion on the language question, as summarised within the Allegation, but he also informed the Panel that he had not seen the HCPC application form.

69. The Panel heard evidence from Ms NHB, a Band 7 Radiographer who was employed by the Trust at the same time as the Registrant. Shortly after his departure from the Trust Ms NHB provided a reference for the Registrant, which was included in the HCPC bundle of documents. Ms NHB described the Registrant as “unfailingly hard working, courteous, kind and respectful to both patients and fellow staff at all times”.

70. In her evidence Ms NHB expressed her view that the Registrant had been given insufficient time to demonstrate his abilities, and that it may have been beneficial for him to have been given an opportunity to work in a different team with different radiographers. When questioned, Ms NHB acknowledged that she had not worked alongside the Registrant. Her interactions with him were limited to the online interview, conversations with the Registrant as a colleague, and one or two occasions when the Registrant had shadowed her.

71. Ms NHB also accepted that she may have been mistaken about some of the facts. For example, she understood that the Registrant had been given a very short period of time of only two weeks over which the skills were assessed before he was removed from patient facing duties. She acknowledged that a period of three to four months, which was the timeframe during which the Registrant worked with patients, would have been entirely appropriate and sufficient.
Decision on Facts:

72. The Panel was provided with written submissions on behalf of the HCPC prepared by Mr Collins. Mr Collins also made oral submissions addressing each of the Particulars that had not been found proved. The Panel heard oral submissions from the Registrant.

73. The Panel accepted the advice of the Legal Assessor. The Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything, and the individual Particulars of the Allegation could only be found proved if the Panel was satisfied that this was the case on the balance of probabilities. The Panel has also taken into account the Registrant’s good character in line with the advice given by the Legal Assessor.

74. In reaching its decision, the Panel took into account the oral evidence of the HCPC witnesses and of the Registrant and his witnesses, together with all the documentary evidence provided to it.
Particular 1(b) – found proved

75. The requirement to check the three sources of patient identification information was explained in the witness statements of Ms Powell, Ms CK and Ms Ferreria. It was the Radiographer’s responsibility to ensure that the correct patient was in the room to ensure that the patient was not incorrectly exposed to radiation. This was required under the Trust’s clinical protocols and under the Ionising Radiation (Medical Exposure) Regulations 2017.

76. The HCPC witnesses also explained that the information required to carry out the ID checks was not all contained on the “parameters screen”, and that it would also be necessary to check information on the hospital computer system. The parameters screen did not contain all three points of patient identification because it did not include the first line of the patient’s address.

77. The HCPC witnesses were experienced Radiographers, as was confirmed by the Registrant’s witness Ms NHB, and the Panel accepted their evidence about the requirement for the radiographer to check information contained on the hospital computer system, rather than on the parameters screen, in order to complete an ID check.

78. In his evidence the Registrant accepted that in January and February 2023 he was unable to take Patient ID’s. In respect of the remainder of the period to June 2023 the Registrant stated that he had the ability to take the ID’s, but was not given adequate opportunity to demonstrate that ability. He stated that his colleagues intervened. He also suggested that he was able to check the information required for ID checks on the parameters screen.

79. The Panel was satisfied that the Registrant was provided with a reasonable level of support to enable him to adjust to a new working environment and with his language skills. The support included:

• Working in a supernumerary capacity alongside two Radiographers from the commencement of his employment until his removal from patient facing duties on 1 May 2023;

• Support from the Trust’s Learning and Development team to assist in learning English including an offer for Mr Donkor to provide assistance, and enrolment in courses to assist with learning English;

• Constructive feedback after shifts, tips on ways to improve his English;

• Support from international radiographers who spoke the same language as the Registrant;

• Performance review plans and meetings;

• Performance improvement plan;

• Role play “first day chats” (the initial discussion between Radiographer and patient on the first day of treatment).

80. In his cross-examination of Ms CK, the Registrant suggested that she was not friendly towards him and that he did not receive support from her. Ms CK’s response was that there were communication difficulties with the Registrant, but that she was supportive, and she recalled an occasion when the Registrant appeared to be laughing at her when she was trying to give constructive feedback.

81. The Panel noted that Ms CK description of her concerns about the Registrant’s communication skills were the same as those described by Ms Powell and Ms Ferreria. The contemporaneous documents did not detail any concerns raised by the Registrant about Ms CK or any other Radiographer. The Panel did not find evidence to support the Registrant’s assertion that Ms CK was unfriendly, and he did not provide any examples within his evidence to the Panel.

82. Ms CP, Ms CK, and Ms CF provided examples of the Registrant not correctly carrying out ID checks. Ms Ferreria described one example on 3 March when she expected the Registrant to greet the patient and engage with the patient to confirm their ID. Ms CF said that she allowed time for the Registrant to engage with the patient, but that he didn’t ask the patient for ID information until he was prompted to do so. Ms CK similarly described that she would allow pauses in conversations with patients to allow the Registrant to do the ID check, but that very often he would not carry out the required checks.

83. In April 2023, the Registrant was given the task of attempting to ID ten patients a day and required to log his progress. Ms CF considered that the Registrant had made insufficient progress by 1 May 2023.

84. The Panel did not accept that the Registrant was not given sufficient opportunities to demonstrate his ability to conduct ID checks. His colleagues did intervene and prompt him, but this was because he was not pro-actively carrying out the checks himself. The Registrant received feedback after each shift and the Panel was satisfied that he was given sufficient information to enable him to understand the requirement to conduct ID checks.

85. The Registrant was removed from patient facing duties on 1 May 2023 and following this he was invited to practise and demonstrate his skills during role plays of “first day chats”. The confirmation of patient ID was a requirement of each role play exercise. Ms CF noted some improvement in the Registrant’s ability to confirm patient IDs. However, she added that she lacked confidence that the Registrant would be able to engage with patients. She said that the Registrant always asked for a day’s notice prior to each role play to prepare. This was not a realistic scenario because in a real world setting the Radiographer would sometimes have only ten minutes to read the patient information to be ready to greet the patient and conduct the first day chat. Additionally, queries arising from patients would often be spontaneous and could not be prepared for in advance of speaking with them.

86. The Panel was satisfied that the Registrant was not able to carry out ID checks as required between January and June 2023.

87. The evidence of the HCPC witnesses Ms CF, Ms CK, and Ms CP was that the Registrant’s inability to conduct ID checks arose, at least in part, as a result of his inability to communicate effectively due to his poor understanding of the English language.

88. Ms CK stated that the Registrant’s English language abilities had an impact both in terms of his confidence to approach a situation and to ask for the patient details. She also considered that the Registrant lacked an understanding of why the radiographers were carrying out the ID checks despite her attempts to tailor her communication and to explain this in different ways. In answer to questions from the Panel, Ms CK stated that ultimately the language barrier was the reason the radiographers supporting the Registrant were unable to progress with his training package.

89. There were other examples of the Registrant’s communications difficulties described in the witness statements, including difficulties in conventional conversation and examples relating to Particulars 1(a) and 1(c), both of which were admitted by the Registrant. For example, Ms CF described that she had to change phrases in a sentence because the Registrant did not appear to understand what she was asking him. Ms CF’s first language is not English and she tried to assist the Registrant so far as she was able to do so. She stated that the Registrant’s facial expressions appeared to be confused and he usually responded with one-word answers. The Registrant also told Ms CF at a meeting on 10 May 2023 that he was struggling with the English language courses he was completing.

90. Ms CF met with the Registrant and a Malayalam interpreter on 11 May and at that stage Ms CF considered that the Registrant’s understanding of English was a serious issue.

91. The Panel was satisfied that between January and June 2023 the Registrant was unable to communicate effectively as his spoken/written understanding of the English Language was poor in that he was unable to complete ID checks.
Particular 2 – found proved

92. The Panel found particular 2 proved by the evidence of Ms Powell and the documentary evidence.

93. The Registrant’s evidence was that he was not sleeping, but was resting his eyes and that the computer had not “timed out”.

94. This incident was amongst a list of events recorded by Ms Powell as follows:
“Radiographer caught [the Registrant] asleep at PC screen that had timed out – screen was in full view of patients”.

95. A second record of the incident stated:
“[the Registrant] was discovered asleep at a computer with the screen timing out due to inactivity, in visible sight of patients being brought through to the treatment room. Radiographer spoke with [the Registrant] and advised that it is unacceptable to fall asleep at work and that there is always something to be working on. [the Registrant] said that he is struggling to sleep since starting work here…”

96. The incident occurred in an office containing workstations used by radiographers for tasks such as completing online paperwork and offline image reviews. The Registrant was on duty rather than taking a break from his duties and he was in uniform. The office was not a rest room. A large staff room was available to enable staff to sit and rest. The office where the Registrant was sitting was in view of patients entering and exiting the treatment rooms. In cross examination the Registrant agreed the door of the office was open and that he would be visible to patients.

97. Ms CP was alerted by another member of staff who believed that the Registrant was asleep. In her oral evidence Ms Powell described the Registrant setting with his hands in his lap and his eyes closed. In her statement Ms Powell explained that the computer screen had timed out and this indicated that the Registrant had not used the computer for at least five minutes.

98. In cross-examination the Registrant denied that he had been asleep. However, he agreed that he was spoken to about this incident. He recollected that another Radiographer spoke to him and told him that it was wrong to be sleeping. The Registrant agreed that his response was that he had been having trouble sleeping and that he also had not denied that he had been sleeping. He said that he had not explained at that time that he was resting his eyes because he was upset by what had been said.

99. The Panel considered that this conversation, as described by the Registrant, was more consistent with Ms CP’s description of the Registrant’s behaviour, than with the Registrant’s account that he was resting his eyes. Ms Powell’s account was also consistent with the written records which were made within a short time of the incident.

100. The Panel found Ms Powell’s evidence to be credible, and consistent with the Registrant’s account of the conversations that had taken place after the incident.

101. The Panel therefore found that it was more likely than not that the Registrant had been asleep.

Particular 4 – found proved

102. In considering this allegation the Panel had regard to the guidance in the HCPTS Practice Note “Making Findings on a Registrant’s state of mind” and to the advice of the Legal Assessor.

103. The Panel asked two questions:

(a). What did the Registrant know or believe as to the facts and circumstances in which the alleged dishonesty arose?

(b). Given the Registrant’s knowledge and belief of the circumstances they were in, was the Registrant’s conduct dishonest by the standards of an “ordinary decent person”

104. The Registrant has accepted that there was an error in his application form. The issue for the Panel to consider was whether he had lied on the form to avoid having to prove his English proficiency through an IELTS examination.

105. The Registrant’s explanation was that he was not lying, but had declared that English was his first language because he had conducted his studies in English.

106. The Panel considered the surrounding circumstances. It noted the oral evidence of Mr Winfield and Ms NHB who both had a favourable view of the Registrant’s character.

107. The Panel gave limited weight to Ms NHB’s character evidence because Ms NHB had not worked with or supervised the Registrant and her interactions with him were limited to the occasion when she interviewed him online, conversations with him, and one or two occasions when the Registrant had shadowed her. Ms NHB was also mistaken as to relevant facts, including the extent to which the Registrant had been given an opportunity to demonstrate his skills and abilities.

108. Mr Winfield found the Registrant to be trustworthy and a “charming personality”. Mr Winfield outlined in detail the circumstances in which he met the Registrant and provided mentoring support and conversation in English. Mr Winfield was motivated to support the Registrant because of his personal interest in education in southern India. The Panel considered Mr Winfield’s assessment of the Registrant’s character, but it also noted that Mr Winfield had no involvement in the Registrant’s completion of the HCPC application form. The Panel gave no weight to Mr Winfield’s evidence in respect of the HCPC’s application form because he had not been provided with a copy of that form.

109. Mr Winfield’s evidence confirmed that the Registrant wished to move away from India and work in the UK and that the Registrant felt that his opportunities in India were limited.

110. The Panel carefully considered the HCPC application form which states as follows:
“Is English your first language? You should only indicate that English is your first language if it is the main or only language you use on a day to day basis. Having studied English or undertaken education or training at an institution where the medium of instruction is English does not necessarily mean that English is your first language”

111. In answer to cross-examination questions about whether he answered the question incorrectly to improve his chances of getting on the HCPC register, the Registrant stated that if the HCPC had asked for clarification he would have provided it. This response does not address why he answered “yes” to the question, when the content of the question clearly distinguished between English as a “first” language and English used within education or training. In cross-examination the Registrant confirmed that he had read the question

112. The Registrant was making the application for registration to the HCPC and formally declaring that the information within the form was true. The content of the form was important, and if the Registrant had any uncertainty about how he should answer the question, it was his responsibility to seek further guidance from the HCPC. He did not seek guidance.

113. The Registrant confirmed that in 2020 it was his “dream” to work as a Radiographer in the UK.

114. The Registrant confirmed in cross-examination that he knew that if he ticked “no” on the form, he would have had to submit an English language certificate and the score would need to be above 7.

115. In cross-examination the Registrant was asked direct questions about his motivation. He agreed that it would have cost money to obtain an IELTS certificate. He was also asked whether he was aware that his English language in 2020 may not have been good enough. The Registrant’s response was that the IELTS is an exam that requires study.

116. The Panel noted that while the Registrant has consistently given the same explanation for his completion of the form to the HCPC, he made an inconsistent statement to the Trust. At a meeting on 12 June 2023, at which a translator was present, the Registrant stated that “he had told HCPC English was not his first language and had provided his IELTS certificate to the HCPC.”

117. In cross-examination the Registrant stated for the first time that he had spoken to other people and that is why he understood how to answer the question. When questioned further he acknowledged that he had not previously stated that he had spoken to other people and he did not identify individuals, except to say that he would call Mr Winfield as a witness. In his evidence Mr Winfield did not state that he had had any discussions with the Registrant about the content of the application form or how to answer the question about English language in 2020.

118. The Panel found the Registrant’s statement that he had spoken to other individuals lacked credibility.

119. The Panel noted that the Registrant completed the HCPC application form correctly without errors, other than the question about English as a first language.

120. Having carefully considered the surrounding evidence, the Panel concluded that:

(a) The Registrant understood the significance of the “first language” question. He knew that if he did not tick “yes” he would be required to provide an IELTS certificate of the required grade.

(b) The Registrant knew that English was not his “first” language and that his education/study in English were not sufficient to enable him to answer “yes”. He knew this because this was explained within the question on the form.

(c) The Registrant’s command of English was sufficient to enable him to understand and complete the form correctly. There were no other errors in the form.

(d) The Panel inferred that the Registrant answered the question in the way that he did to avoid the need to submit an IELTS certificate, knowing that if he ticked “no”, it would involve expense and a requirement to achieve a sufficient IELTS grade.

121. The Panel therefore concluded that the Registrant had lied on the form to avoid having to prove his English proficiency.

122. Given the above findings the Panel had no reservation in concluding that this conduct would be considered to be dishonest by the standards of “an ordinary decent person”.
Registrant’s application for an adjournment

123. At the conclusion of Mr Smith’s submissions on 12 August 2025, the Registrant made an application that the start of the hearing on 13 August and subsequent days be changed to 11 a.m. He told the Panel that he had made arrangements with his employer for leave to enable him to attend the hearing but that unfortunately there were staff shortages at his employer and due to staff emergency leave he was required to work. He would therefore not be able to attend at 9.30 as scheduled. He stated that he worked in a very small department with a few members of staff and that the staff shortage put a lot of pressure on patients.

124. Mr Smith, on behalf of the HCPC, opposed the application for an adjournment. He submitted that the Registrant had been on notice of the hearing for a significant period of time and that there was an obligation on him to attend the hearing. He referred to the protracted history of the case and submitted that it was in the public interest that the case should proceed at 9.30 a.m.

125. The Panel accepted the advice of the Legal Assessor and had regard to the guidance in the HCPTS Practice Note “Postponement and Adjournment of Proceedings”. The Panel carefully balanced the requirement of fairness for the Registrant against the public interest that the case should proceed as scheduled.

126. The Panel was of the view that there was not a good reason for the proposed adjournment. The Registrant has had ample notice of the hearing and an opportunity to make arrangements with his employer to enable him to attend the hearing as scheduled.

127. However, in relation to the Registrant’s statement that he would not be able to attend the hearing at 9.30 a.m. on 13 August 2025, the Panel considered that this would have a detrimental impact on the Registrant’s ability to present his case. The request for an adjournment was made at the point where Mr Smith had concluded his submissions on the statutory grounds and impairment, and the Registrant was due to make his submissions in response at 9.30 a.m. Given that the Registrant had requested time to prepare his submissions, there were no steps the Panel could take to mitigate the disadvantage to the Registrant of not being able to present his submissions to the Panel.

128. In relation to the Registrant’s request that the hearing should begin at 11 a.m. on 13 August 2025 the Panel decided that the requirement for fairness for the Registrant outweighed the public interest in the expeditious disposal of the case. The Panel told the Registrant that it expected the Registrant to have prepared his submissions and to be ready to present them at 11 a.m.

129. However, in relation to the Registrant’s request that each subsequent day of the hearing should begin at 11 a.m., the Panel did not agree to the Registrant’s request for an adjournment. The Panel bore in mind that that the Registrant has had ample notice of the hearing, the likelihood that the case might not be completed if the adjournments were to be granted, and the public interest that the case should be concluded as scheduled.

130. The Panel therefore informed the Registrant that his request to adjourn the hearing to 11 a.m. on 13 August 2025 was agreed, but that his request in respect of subsequent days was refused.
Decision on Grounds:

131. The Registrant provided an additional document for this stage of the hearing. This was a reference from Ms Howe dated 22 September 2023.

132. The Panel heard submissions from Mr Smith. Mr Smith referred to the HCPC’s case summary. He submitted that the facts in Particular 1 amounted to the statutory ground of lack of competence and the facts in Particulars 2-4 amounted to the statutory ground of misconduct.

133. The Panel heard submissions from the Registrant. His submissions included reference to his criticisms of the training and support provided by the Trust and the HCPC witnesses. The Registrant continued to deny that he had acted dishonestly when he completed his application for HCPC registration. The Registrant also addressed the Panel in relation to the facts, although he was reminded by the Panel that findings of fact had already been made.

134. The Panel first considered whether the facts found proved in particular 1 amounted to a lack of competence. It took into account all the evidence together with the submissions made by Mr Smith on behalf of the HCPC and the submissions made by the Registrant.

135. The Panel accepted the advice of the Legal Assessor. She advised that a lack of competence was a standard of work or performance that that was unacceptably low and was demonstrated with reference to a fair sample of the Registrant’s work (Calhaem v General Medical Council). The Registrant should be judged by the standards applicable to the post to which he was appointed (in this case a Band 5 Radiographer) and the work he was carrying out (Holton v General Medical Council).

136. The Panel considered that in respect of Particulars 1(a), (b) and (c) the sample of the Registrant’s work was fair. The sample was fair for the following reasons:

(i) In its findings of fact the Panel addressed the Registrant’s criticisms of the support and training provided by the Trust. The Panel found that the Registrant was provided with a reasonable level of support.

(ii) In its findings of fact the Panel addressed the Registrant’s assertion that Ms CK was unfriendly towards him. The Panel did not find this to be the case.

(iii) The Panel was satisfied that for each sub-particular (a), (b), and (c) there were multiple examples of the Registrant’s acts or omissions as set out in the HCPC witness statements.

(iv) The conduct in each sub-particular (a), (b), and (c) took place over a period of time from January 2023 to June 2023 as set out within Particular 1

137. The Panel had regard to the HCPC Standards of Conduct, Performance and Ethics and to the Standards of Proficiency for Radiographers. It considered that the matters in Particular 1 amounted to a breach of the following standards:
Standards of Conduct, Performance and Ethics

1.2 Promote and protect the interest of service users and carers

2.3 Communicate appropriately and effectively

3.1 Work within the limits of your knowledge and skills

9.1 Ensuring that your conduct justifies the public’s trust in you and your profession
Standards of Proficiency for Radiographers

1.1 know limits of practice and when to seek advice

8.1 be able to demonstrate effective and appropriate verbal and non-verbal skills in communicating information, advice, instruction and professional opinion to service users, colleagues and others

8.2 be able to communicate in English to the standard equivalent to level 7 of the International English Language Testing System, with no element below 6.5.

138. The Panel considered that the Registrant’s standard of performance was unacceptably low. The required standard for ability in the English language is grade 7 IELTS or the equivalent, and the evidence before the Panel, in the form of the Registrant’s IELTS certificates, indicated that the Registrant did not meet that standard.

139. The tasks set out in Particulars 1(a), 1(b), and 1(c) are fundamental and basic tasks for a radiographer at Band 5 level in providing information to patients and carrying out ID checks. They are required to ensure that the correct patient is treated. They are also required to ensure that patients have sufficient information to enable them to provide informed consent, and that potential side effects are explained.

140. The Panel therefore found that the Particulars 1(a), (b) and (c) amounted to the statutory ground of lack of competence.

141. The Panel next considered whether the facts found proved in Particulars 2-4 amounted to misconduct. It took into account all the evidence together with the submissions made by Mr Smith on behalf of the HCPC and the submissions made by the Registrant.

142. When considering whether the factors proved amounted to misconduct, the Panel noted that not all breaches of the HCPC’s “Standards of Conduct, Performance and Ethics” need amount to a finding of misconduct.

143. The Panel noted the advice provided in respect of Roylance v General Medical Council (No 2) [2000] 1 A.C. 311 and Nandi v GMC [2004] EWHC 2317 (Admin) in which the Court referred to Roylance and described misconduct as “a falling short by omission or commission of the standards of conduct expected among medical practitioners, and such falling short must be serious”.

144. The Panel next considered whether the Registrant’s conduct in particular 2, sleeping on duty, was sufficiently serious to amount to misconduct. The Panel considered that the conduct amounted to a breach of the HCPC’s “Standards of Conduct, Performance and Ethics” as follows:

9.1 Ensuring that your conduct justifies the public’s trust in you and your profession.

145. The Panel noted that there was a single instance of the Registrant sleeping on duty. However, the Panel was satisfied that this conduct was serious. Registrants have a responsibility to ensure that when performing their professional duties, they are alert and able to respond to any emergencies. The Registrant was working in a hospital environment where there was the potential for an emergency situation to arise. While there was no risk to an individual patient, because the Registrant was working in a supernumerary capacity, the Registrant’s inability to respond quickly to events or incidents around him placed patients and colleagues at potential risk of harm.

146. The Registrant’s conduct in sleeping on duty also fell well below the standards required for radiographers because of the potential for such conduct to damage the reputation of the profession. The Registrant was asleep while on duty, in uniform, and in potential sight of patients. This behaviour undermines public confidence in the Registrant and in the profession.

147. Having considered the context and the surrounding circumstances, the Panel found that the Registrant’s conduct in Particular 2 was sufficiently serious to amount to misconduct.

148. The Panel next considered whether the Registrant’s conduct in lying on his application for membership of the HCPC, which was dishonest behaviour, (Particulars 3 and 4) was sufficiently serious to amount to misconduct. The Registrant’s dishonest conduct amounted to a breach of the HCPC’s “Standards of Conduct, Performance and Ethics” as follows:

9.1 Ensuring that your conduct justifies the public’s trust in you and your profession.

9.2 You must be honest about your experience, qualification and skills.

149. The Panel considered the seriousness of the Registrant’s conduct. The Panel considered that the Registrant’s behaviour was demonstrative of conduct that fundamentally undermines the public’s trust in the both the Registrant and in the profession generally. It undermined the system of registration which is in place for the protection of members of the public.

150. The Registrant lied on his application form to gain registration with the HCPC when he did not meet the requirements for such registration. The Registrant put his own interests, his “dream to work as a radiographer in England”, above his responsibility to be honest and to protect the reputation of the profession.

151. The Registrant’s dishonest behaviour is directly related to his profession. It was a deliberate act, and not a momentary lapse in judgment. The importance of the content of the application form and the consequences of providing inaccurate information were clearly highlighted in the declaration signed by the Registrant.

152. The Registrant exposed patients to a risk of harm because his dishonesty enabled him to practise as a Radiographer in UK when he did not meet the requirements for HCPC registration. The requirement to satisfy the English language requirements for HCPC registration is in place to ensure that radiographers can effectively communicate with patients and colleagues.

153. In the evidence of the HCPC witnesses there were many examples of the potential risks that may arise from inadequate communication skills in English. The view of the HCPC Trust witnesses, who were experienced radiographers, was that the Registrant’s poor English language skills presented a risk to patients. For example, Ms Ferreria explained her concern that the Registrant was unable to adequately explain to her the emergency procedures.

154. Having considered the context and surrounding circumstances, the Panel found that the Registrant’s dishonest behaviour, Particulars 3 and 4, was sufficiently serious to amount to misconduct.

Decision on impairment

155. The Panel went on to decide whether the Registrant’s fitness to practise is currently impaired by reason of his lack of competence and misconduct.

156. Mr Smith submitted that the Registrant’s fitness to practise is impaired. He submitted that there was no evidence to demonstrate that the Registrant has remediated the conduct found proved or that there is no longer a risk of repetition. He referred to the test for fitness to practise in the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011] EWHC 927 (Admin) and submitted that all four limbs of the test were engaged.

157. The Registrant submitted that he is capable of safe practise as a radiographer. He stated that he was currently working as a senior radiographer and that the requirements for a radiographer are the same in all countries. The Registrant stated that he was willing to submit an IELTS certificate or whatever was required by the Panel or the HCPC.

158. The Panel noted the content of the additional reference provided by the Registrant. This reference was written by Ms Howe, an Advanced Practice Radiographer and was dated 22 September 2023. The Panel gave little weight to this reference. Ms Howe qualified her reference stating: “I would be unable to comment on interactions with patients and staff on the treatment unit as my role is removed from this setting”. It was unclear whether the reference was provided for the purpose of the HCPC proceedings and there was no indication in the reference that the writer was aware of the allegations against the Registrant. This reference did not assist the Panel in assessing whether the Registrant is fit to practise at today’s date.

159. The Panel had regard to all the evidence presented in this case, together with the submissions of Mr Smith and the submissions of the Registrant.

160. The Panel accepted the advice of the Legal Assessor. It also had regard to the guidance in the HCPTS Practice Note “Fitness to Practise Impairment”. The Panel considered the Registrant’s fitness to practise at today’s date. It bore in mind the HCPC overarching objective of protecting the public.

161. The Panel considered whether the lack of competence and misconduct were remediable. The Panel considered that the lack of competence was potentially remediable. The remediation might include steps taken by the Registrant to educate himself to the required standard of English together with evidence demonstrating achievement of that standard. The Panel was of the view that the misconduct in sleeping on duty was also potentially remediable, but that the dishonest conduct would be difficult to remedy. Dishonesty is more difficult to remediate because it is attitudinal in nature.

162. The Panel considered the evidence provided by the Registrant. This included certificates of attendance at training courses. The certificates included completion of a course on “communicative English” dated 6 December 2024, and a course “English for Radiography dated 21 February 2024. The completion of these courses was insufficient evidence to demonstrate that the Registrant had attained the required level of proficiency in the English language. The certificates did not reference any standard of English language proficiency. The Panel was not provided with an up to date IELTS certificate and it was not satisfied that the Registrant has remediated his lack of competence.

163. The Panel was not provided with any evidence that the Registrant has remediated the misconduct found proved. The Registrant continues to deny that his conduct was dishonest. This denial does not prevent him remediating his conduct or demonstrating insight, but the Registrant’s evidence and submissions to the Panel did not provide it with any reassurance that the Registrant understands the gravity of the conduct found proved, its impact on patient safety, or its impact on public confidence in the profession.

164. The Panel considered that the Registrant lacked an understanding or awareness of why he is before the Panel. The Registrant made some admissions and he also agreed, when questioned, that it was inappropriate to sleep while on duty. However, the Panel was of the view that his level of insight was very limited.

165. The Panel was concerned that the Registrant did not accept responsibility or accountability for any of the conduct found proved, including the conduct which he admitted. Although he admitted that his English language skills were poor (Particulars 1(a) and 1(c), the Registrant blamed others for his failure to meet the required standards. He was critical of his colleagues, his employer, and of the HCPC.

166. The Panel considered that the Registrant tended to deflect responsibility towards others. For example, he was critical of the HCPC for not seeking clarification from him about his self-declaration that English was his first language, and for what he said was a lack of clarity in the application form. He appeared not to understand that his answer on the application form was relied on by the HCPC and that there was no reason for the HCPC to investigate. He did not appear to acknowledge his personal responsibility for providing honest answers in his application form.

167. Given its conclusion on the absence of remediation and the Registrant’s very limited insight, the Panel could not be satisfied that there would be no repetition of the lack of competence and conduct found proved.

168. The Panel therefore found that the Registrant’s fitness to practise is impaired on the basis of the personal component.

169. The Panel considered the test formulated by Dame Janet Smith in the 5th Shipman Report, which was adopted by Mrs Justice Cox in the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011] EWHC 927 (Admin) as follows:

“Do our findings of fact in respect of the doctor’s misconduct, deficient professional performance, adverse health, conviction, caution, or determination show that his/her fitness to practise is impaired in the sense that s/he:

a. has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or

b. has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or

c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or

d. has in the past acted dishonesty and/or is liable to act dishonesty in the future”

170. The Panel considered that all four limbs of this test were engaged. In respect of risks to patients, the Registrant was acting in a supernumerary role at all times, and this mitigated the risk of harm to patients arising from his poor language skills. However, the Registrant considered that he was capable of practising safely as a radiographer. The Panel considered if he had done so without the supervisory arrangements that were in place, patients would have been placed at risk of significant harm.
The risks included:

(i). Risk that patients may not give valid informed consent due insufficient ID checks, or wrong/insufficient information;

(ii). Risk of harm to patients due to failure to identify potential side effects;

(iii). Risk of irradiation to the wrong patient if insufficient ID checks;

(iv). Risk to patients when the Registrant was asleep on duty and unable to respond in the event of an emergency;

(v). Risk of harm to patients due to practising as a radiographer with poor English language skills as a result of his dishonesty in his HCPC application form.

171. The Panel has found that there is a risk of repetition and therefore the Registrant is liable to put patients at potential risk of harm.

172. The Registrant’s misconduct, both his dishonesty and his sleeping on duty, brought the profession into disrepute. Members of the public rightly expect Radiographers to be honest when completing an application form for membership of the HCPC and to be alert when on duty. The integrity of the register, as listing only those who satisfy the requirements for registration, is essential to maintain the reputation of the profession.

173. The Panel has found that there is a risk of repetition and therefore the Registrant is liable in the future to bring the profession into disrepute.

174. The Registrant acted in breach of a fundamental tenet of the profession to act honestly, and the Panel has found that he is liable to do so in the future.

175. The Panel found that the Registrant acted dishonestly, and that he is liable to do so in the future.

176. The Panel referred to its decision on misconduct. Within that decision it concluded that the Registrant’s dishonesty was serious and it identified a number of aggravating features. Given that it involved dishonesty relating to professional practice and the integrity of the register, the Panel’s view was that the dishonesty was towards the higher end of the scale of seriousness for dishonest conduct. The Panel has also found that the Registrant has demonstrated very limited insight and that he lacks a basic understanding of the seriousness of the conduct found proved.

177. Given its findings, the Panel considered that an informed reasonable member of the public would be very concerned about the Registrant’s lack of competence and misconduct, and would not expect the Registrant to be permitted to practise as a radiographer in the UK without restriction. The Panel considered that public confidence in the profession would be seriously undermined if the Panel did not find that the Registrant’s fitness to practise is currently impaired.

178. The Registrant’s conduct also involved a serious departure from expected professional conduct and standards, as set out within the Panel’s decision on the statutory grounds. The Panel considered that a finding of current impairment was required to emphasise the importance of those standards and that the Registrant’s behaviour was entirely unacceptable for a registered Radiographer.

179. The Panel therefore found that the Registrant’s fitness to practise is impaired on the basis of the public component.
Decision on Sanction:

180. The Panel took account of the submissions made by Mr Smith on behalf of the HCPC. Mr Smith did not invite the Panel to impose a particular sanction. He highlighted parts of the HCPC Sanctions Policy and made submissions on mitigating and aggravating features.

181. The Panel also took account of the Registrant’s submissions. He asked the Panel to impose a sanction which would enable him to retain his registration and would relieve him from the current suspension. The Panel understood that the Registrant was referring to an Interim Suspension Order. The Registrant asked the Panel that he should be given an opportunity to demonstrate his ability.

182. In his submissions the Registrant continued to refer to a “mistake” he had made in his application for HCPC registration. He said that he had taken everything seriously. He said that he was confident that he was capable of working as a radiographer to the standards of the profession and that he was willing to take remedial action.

183. Towards the end of his submissions the Registrant stated that he “accepted that he had done wrong”. He did not elaborate and his submissions did not appear to differ significantly from those he had previously made to the Panel. The Registrant also said that he apologised to the HCPC and to the Panel.

184. The Panel accepted the advice of the Legal Assessor and referred to the HCPC Sanctions Policy.

185. In considering sanction, the Panel was mindful that a sanction is not intended to be punitive. However, a sanction may be necessary in the public interest, and may have a punitive effect. The Panel bore in mind that any sanction must be proportionate, that is, it must only restrict the Registrant’s right to practise to the extent necessary to protect the public and the public interest.

186. The Panel bore in mind that the HCPC’s overriding objective is to protect the public. A panel must consider the risk the Registrant may pose in the future and decide what degree of public protection is required. The Panel must also give appropriate weight to the public interest, which includes the deterrent effect on other registrants, the reputation of the profession and public confidence in the regulatory process.

187. The Panel had found that there were future risks in this case in that the Registrant would practise as a radiographer despite being unable to effectively communicate with patients due to the level of his ability in the English language.

188. The Panel has also found in its decision on current impairment that the Registrant was admitted to the HCPC register on the basis of his dishonestly completed application form and that his dishonest conduct was towards the high end of the scale of dishonesty. In respect of this assessment the Panel reiterates its earlier findings in relation to the nature of the Registrant’s dishonesty as set out within its decision on misconduct.

189. The Panel noted that dishonesty involving a registrant lying about their qualifications when applying for a professional medical position is considered to be serious because honesty is integral to the process of job applications. The Panel was of the view that dishonesty in the completion of an application for HCPC registration is more serious. Honesty is also integral to the registration process. That system depends on the integrity of the applicants when they declare that the information in their application for registration is correct. The Registrant’s dishonesty in his application for HCPC registration gave him access to professional status, which he could rely upon in many potential job applications.

190. The Panel also took into account that the Registrant took an active rather than a passive role in his dishonesty, and that he continued to conceal his dishonesty while working at the Trust, until the matters came to light when he was referred to the HCPC. There was no admission of dishonesty at any stage.

191. The Panel referred to the guidance in the HCPTS Sanctions Policy concerning serious cases. The Panel concluded that the Registrant’s conduct involved dishonesty. The Panel’s conclusion, applying the Sanctions Policy, was that the Registrant’s case clearly fell into the category of serious cases.

192. The Panel considered carefully the Registrant’s statement to the Panel in which he apologised and stated that he accepted that there were things that he had “done wrong”. The Panel gave little weight to this apology. It did not consider that the Registrant had expressed genuine remorse for the following reasons:

• The apology was made at a very late stage and it appeared to the Panel that it was made for the purpose of those submissions, rather than forming part of a genuine self-critical reflective statement.

• Within his submissions the Registrant did not appear to retract in any way from his previous submissions; he continued to describe his completion of his application for HCPC registration form as a “mistake”. He also said that he had never done anything to cause issues for his colleagues and that he was confident he is capable of working as a radiographer to the required standards.

• The Registrant did not expand on what he had “done wrong”, or speak about the potential impact of his behaviour on patients, his colleagues, or the reputation of the profession.

193. The Panel was also referred to an e-mail dated 29 February 2024 sent by the Registrant to his HCPC case manager. In this e-mail the Registrant stated that he had misunderstood the question on the application form for HCPC registration and he therefore “mistakenly answered the question”. He added “I extend my apology for the mistake I have made in this regard”. The apology extended by the Registrant was limited to the mistake he said he had made. It was not an apology for the misconduct found proved in this case.

194. The Panel therefore concluded that there was no genuine apology or expression of remorse from the Registrant.

195. The Panel considered that the following aggravating factors were present;

• Potential harm to service users;

• Failure to fully engage with support provided by the Trust (for example the Registrant did not make full use of support available through the Trust’s Learning and Development Team);

• The Registrant’s very limited insight as described in the Panel’s decision on impairment, and very limited evidence of remediation;

• The dishonesty deceived the HCPC and was to enable the Registrant to derive a personal benefit (enabling him to realise his “dream of working in England”)

196. The Panel considered that the following mitigating factors were present:

• The Registrant’s admission of Particulars 1(a), 1(c), and 3;

• Evidence that the Registrant made some attempt to strengthen his English language skills (2 certificates of completed training)

• Positive character references.

197. The Panel concluded it could give very limited weight to the mitigating factors and was mindful that mitigation is of considerably less significance in regulatory proceedings where protection of the public is the overarching consideration.

198. The Panel gave little weight to the references provided by the Registrant because the individuals providing the references had not worked with the Registrant. Although the Registrant made admissions to some of the factual particulars, he did not demonstrate to the Panel that he has taken personal responsibility for that conduct and addressed the issues which underlie the admitted facts. The Panel also gave little weight to the training completed by the Registrant, as there was no indication of the level or grade achieved by the Registrant in relation to the standard of English Language proficiency required for a registered radiographer.

199. The Panel concluded that the gravity of the aggravating factors in this case far outweighed the mitigating factors.

200. The Panel considered the sanctions in ascending level of severity in order to ensure that its approach was proportionate.

201. The Panel decided that neither mediation nor taking no action would be appropriate. The Panel decided that due to the gravity of its findings in this case a sanction was necessary.

202. The Panel considered the factors in the Sanctions Policy in relation to a Caution Order. It concluded that the issues in this case were not minor in nature. There was very limited insight and the Panel had concluded that there remained a risk of repetition and a risk of harm to service users.

203. The Panel concluded that a Caution Order was not sufficient or appropriate in the circumstances.

204. The Panel next considered a Conditions of Practice Order. The most serious matter in this case is the Panel’s finding that the Registrant acted dishonestly, and the Panel was unable to formulate conditions of practice which could address the risk that he would repeat dishonest conduct.

205. The Panel was also of the view that conditions of practice would not reflect the gravity of its findings in this case, nor would such an order address the concerns regarding the wider public interest.

206. The Panel referred to paragraph 109 of the Sanctions Policy. It was not satisfied that the Registrant’s conduct was minor, out of character, capable of remediation and unlikely to be repeated. These factors indicated that a conditions of practice order was not appropriate in this case.

207. The Panel carefully considered whether an order of suspension would be sufficient to protect the public and address the public interest concerns in this case.

208. The Panel referred to paragraph 121 of the Sanctions Policy. The concerns represent serious breaches of the HCPC’s Standards of Conduct, Performance and Ethics. The Panel has found that the Registrant has demonstrated very limited insight and that there is a risk of repetition. The Registrant had expressed his willingness to address his ability in the English language, but there was no evidence before the Panel to suggest that the Registrant was likely to be willing or able to resolve or remedy the misconduct (dishonesty or sleeping on duty).

209. The Panel also had regard to the aggravating features and considered that a Suspension Order would be insufficient to uphold and maintain professional standards and to maintain confidence in the profession.

210. The Panel concluded that a Suspension Order would not be sufficient to protect the public and the wider public interest.

211. The Panel concluded that the only appropriate and proportionate sanction in this case was a Striking Off Order. The Panel had regard to paragraphs 56-58 of the Sanctions Policy. The Panel reminded itself that dishonesty undermines public confidence in the profession, that it can impact public safety, and had the potential to do so in this case, and that it can have a significant impact on the trust placed in the Registrant.

212. The Panel also considered paragraph 130 of the Sanctions Policy. A striking off order is the sanction of last resort for serious, persistent, deliberate or reckless acts and this may involve dishonesty.

213. The Panel also considered 131 of the Sanctions Policy. This was a case whether the Registrant had demonstrated very limited insight. Although the Registrant has expressed his willingness to resolve the matter of his English language ability, there was nothing before the Panel to indicate he is willing to engage in the difficult task of remedying his misconduct.

214. Given the gravity of the Registrant’s misconduct together with the very limited insight, the Panel considered that the Registrant’s dishonesty was fundamentally incompatible with registration as a health professional on the HCPC register.

215. The Panel bore in mind the requirement that the sanction it imposes must be proportionate. The Registrant informed the Panel that he is currently working as a senior Radiographer in India. He also provided the Panel with a written statement in which he expressed his desire to remain on the register and to be permitted to practise as a Radiographer in the UK. The Panel acknowledged that a Striking Off Order is likely to have a negative impact on the Registrant. He will not be able to realise his dream of practising as a Radiographer in the UK. However, the Panel concluded that any lesser sanction would be insufficient to uphold and maintain public confidence in the Radiography profession and the regulatory process. The Panel therefore decided that the public interest outweighed the Registrant’s interests.

216. The Panel considered that it would be proportionate to impose a Striking Off Order in this case given that the Registrant had achieved registration through his dishonesty in his application for registration.

217. The Panel concluded that the appropriate and proportionate order was a Striking Off Order.

Order: The Registrar is directed to strike the name of Anoop Padmavathy Sundara Raj from the Register on the date this Order comes into effect

Interim Order

Application

1. Mr Smith made an application for an Interim Suspension Order for up to eighteen months, to cover the appeal period before the Sanction becomes operative and the time that any appeal might take to be concluded.

2. The Panel accepted the advice of the Legal Adviser and considered whether an order was necessary for the protection of the public, otherwise in the public interest, or was in the Registrant’s own interests. It applied the principle of proportionality, balancing the Registrant’s interests against the need to protect the public.

 

Decision 

3. The Panel considered whether to impose an interim order. In its findings on impairment the Panel concluded that there remains a risk of repetition of similar conduct and a need to protect the public from the risk of harm. The Panel decided that it would be wholly incompatible with those earlier findings and the imposition of a Striking Off Order to conclude that an Interim Suspension Order was not necessary for the protection of the public and to maintain public confidence in the profession.

4. The Panel took into account the Registrant’s interests, but decided that his interests were outweighed by the need to protect the public and the wider public interest. The Panel concluded that an Interim Suspension Order should be imposed on public protection and public interest grounds.

5. The Panel decided that it was appropriate to impose the Interim Suspension Order for a period of eighteen months to cover the appeal period. When the appeal period expires this Interim Order will come to an end unless there has been an application to appeal. If there is no appeal the substantive Suspension Order shall apply when the appeal period expires.

The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest.

This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Anoop Padmavathy Sundara Raj

Date	Panel	Hearing type	Outcomes / Status
07/08/2025	Conduct and Competence Committee	Final Hearing	Struck off
28/04/2025	Conduct and Competence Committee	Final Hearing	Adjourned part heard
19/12/2024	Conduct and Competence Committee	Interim Order Review	Interim Suspension
30/09/2024	Conduct and Competence Committee	Interim Order Review	Interim Suspension
20/06/2024	Conduct and Competence Committee	Interim Order Review	Interim Suspension
15/03/2024	Conduct and Competence Committee	Interim Order Review	Interim Suspension
04/09/2023	Investigating Committee	Interim Order Application	Interim Suspension