Ifenyinwa Chizube Ndulue-Nonso

Preliminary Matters

Admission

1.          At the outset of the hearing Ms Chowdhury provided the Panel with a two-page document setting out the Registrant’s position with regard to the Allegation (no witness statement or other documentation having been served on her behalf). That included, and Ms Chowdhury confirmed orally, that Particular 1 of the Allegation was admitted in relation to matters 1 - 21 of Schedule A. It was only experience and knowledge of Microsoft Word that was disputed. Particular 2 was denied.

2.          On day three of the hearing the Registrant served a witness statement prior to giving evidence to the Panel. That included: “When I said I had experience with certain conditions and specialties, I was thinking of the fact that I had seen those types of patients and provided dietetic care within my role there.”

3.          This appeared inconsistent with the admission and the Panel requested clarification.

4.          Ms Chowdhury sought to clarify the matter saying that the Registrant’s admission was that she did not have knowledge and experience of the matters in Schedule A at Band 6 level. This was how Particular 1 had been interpreted by the Registrant and her legal team. She has some knowledge and experience by virtue of her qualification and the work she did in Nigeria.  Ms Molyneux responded that this was not how the Particular read, and that she had not covered the matters in Schedule A in any detail with her witnesses in view of the admission.

5.          The Chair stated that the Panel’s view was that Particular 1 of the Allegation did not make reference to knowledge and experience at Band 6 level.

Application to withdraw admission

6.          Ms Chowdhury made an application to withdraw the Registrant’s admission. She submitted that the understanding of the Registrant’s legal team had been that the Registrant admitted that she did not have understanding of the matters in Schedule A at Band 6 level. She had not admitted to having no knowledge or experience of those matters. She clarified that the Registrant’s case is that she had some knowledge of the matters in Schedule A save for 8b, 8d, 8e, 8h, 17, 28, 20 and 21. She had no experience of matters set out at 8a, 8b, 8c, 8d, 8e, 17, 18, 20 and 21.

7.          Ms Molyneux on behalf of the HCPC wished to put on record that the case had changed significantly by virtue of the withdrawal. Given that the HCPC now needed to prove Particular 1 she had considered whether she needed to recall the HCPC’s witnesses. On balance, as the Panel had their statements and exhibits, she would rely on those and deal with the matter by way of cross examination of the Registrant and in submissions

8.          The Panel had heard live evidence from four HCPC witnesses and could make an assessment of their credibility and reliability by cross referencing that with their witness statements and the contemporaneous documentary evidence. The HCPC’s case was not therefore prejudiced to any significant extent, in that the Panel had before it the evidence the HCPC relied on, which it would evaluate alongside the Registrants’ evidence, in order to reach its decision on the facts.

9.          The Panel granted the Registrant’s application to withdraw her admission. It was important to understand the Registrant’s position. It noted in doing so that there was potential unfairness to the HCPC because of the misunderstanding. The HCPC had not had the opportunity to put its full case to its witnesses. However, the Panel had their witness statements and exhibits and considered that it could proceed fairly on that basis.

Recusal Application

10.       Ms Chowdhury made an application for the Panel to recuse itself on the basis that there was a real possibility of bias in view of the admission and its subsequent withdrawal. The matter had proceeded on one interpretation of the facts, and it had since been clarified that the Registrant had some knowledge and experience of the matters in Schedule A. She submitted that in view of the allegation of dishonesty, the Registrant’s credibility was a central issue, as was the consistency of the Registrant’s account. There was a risk of the Panel viewing the case through the original lens. The HCPC would be suggesting that the change of position reflected further dishonesty. This was not a matter that the Panel members could put out of their minds.

11.       Ms Molyneux submitted that the Panel members were more than qualified and able to put out of their minds any suggestion that the admission and its subsequent withdrawal should go against the Registrant. She submitted that the Panel would be entitled to hold it against the Registrant, but to say it was thereby biased was not correct. It was a failure on the part of the Registrant or her legal team that this confusion had arisen; the HCPC had not been at fault. It was in the interests of justice that the case proceeds and further delay be avoided.

12.       The Panel noted that the withdrawal of the admission had included clarification of the Registrant’s case and an explanation of how the admission came to be made. Her case had, until this point, been somewhat unclear, in that there was a disconnect between the admission (that she stated she had knowledge and experience that she did not actually have) and a denial that this amounted to dishonesty.

13.       The Panel took into account that an informed observer would be aware of the reason for the withdrawal (misinterpretation of the Allegation). This misinterpretation was attributable to the Registrant’s legal team. An informed observer would be aware that the Panel members are all experienced decision-makers and have received training on, and are well able to use relevant evidence to reason their findings, whilst putting irrelevant information aside. The Panel determined that it would treat the admission as irrelevant information.

14.       As to relevance of this change in position to the allegation of dishonesty, the Panel accepted that the Registrant’s legal team had misunderstood the remit of Particular 1, and she had been misadvised accordingly. The Panel determined that it would therefore proceed as if the admission had not been made. In these circumstances an informed observer would not take the view that there was a real possibility of bias. As such, the Panel had no basis to recuse itself.

Background

15.       The Registrant is a registered Dietitian. In August or September 2023, she applied for a Band 6 Rotational Dietitian position with Manchester University NHS Foundation Trust (the Trust). She was the only person interviewed for the role. She attended a remote interview on 25 September 2024. The Registrant was assessed as having suitable skills and knowledge based on her application and answers at interview, where she came across as confident, scoring 28 out of a possible 45 points (62.2%). The Registrant was offered the role subject to references. The Trust received satisfactory references, and the Registrant began her employment on 19 February 2024, having moved from Nigeria to the United Kingdom.

16.       The Registrant’s line Manager, Curtis Roberts, returned from a period of annual leave on 28 February and met the Registrant. They had an induction discussion during which the Registrant described her job in Nigeria. Her description of this did not appear consistent with the description of her previous role that the Registrant had described in her application form. By this point, a supervision log had been started by Ms Haywood, the other Band 7 Dietitian in the team, due to concerns about the Registrant’s knowledge and ability to carry out the role. Mr Roberts recorded detail of the conversation in the log.

17.       The Registrant attended a probation review meeting with Ms Haywood, Band 7 Critical Care Dietetic Clinical Lead, and Ms Barker, Dietetic Team Lead, on 28 February 2024 after her first two weeks in the role. Concerns about the Registrant’s knowledge relating to anatomy, biochemistry, pharmacology and in turn lack of ability to formulate treatment plans were explained to the Registrant during the meeting.

18.       Ms Barker held a further one to one meeting with the Registrant the following day, 29 February. The Registrant reported feeling overwhelmed and scared in view of the concerns that had been discussed the previous day. Ms Barker went through the differences between the Registrant’s application and interview and compared these to the knowledge that she had demonstrated since starting the role. She thought it was unlikely that the Registrant could be brought up to Band 6 level during the probationary period. Ms Barker said she would need to seek advice from Human Resources (HR).

19.       During the meeting on 29 February, Ms Barker asked the Registrant to go through a Band 5 job description and write on in it what she could do and what she could not do. When asked to explain a number of the requirements that the Registrant had written ‘I know’ next to, the Registrant was unable to do so. Ms Barker therefore asked the Registrant to repeat the task with a view to getting to the bottom of the Registrant’s experience and abilities.

20.       Ms Barker undertook a fact-finding investigation with a view to establishing the extent of the Registrant’s knowledge and skills and comparing this to her application and interview. She passed that to Ms Alderdice.

21.       On 12 March 2024 Ms Alderdice, Divisional Professional Lead for Adult Dietetics, met with the Registrant. The Registrant was informed that she was to be suspended pending the outcome of an investigation into the concern that she had falsified information used to support her application and in doing so breached the HCPC’s Code of Conduct. In addition, her colleagues felt she was unsafe to practise.

22.       Ms Dixon, Children’s AHP Directorate Manager and Professional Lead for Paediatric and Neonatal Dietetics was appointed to investigate the concern. She was provided with Ms Barker’s initial fact-finding investigation report along with the Registrant’s application, interview notes and the Band 6 job description. She additionally had sight of the supervision log and the case studies that the Registrant had been asked to complete during the initial part of her induction.

23.       Ms Dixon conducted an investigatory interview with the Registrant on 25 March 2024. The notes of this meeting record that the Registrant stated she had the experience detailed in her application, including experience in critical care. At the same time, she had said she predominantly worked in the outpatient department.

24.       Over two days, 15 July and 7 August 2024, the Trust held a disciplinary hearing, the outcome of which was communicated to the Registrant by letter dated 8 August 2024. The allegation was found proved. There had been contradictions in what the Registrant had said to different people about her experience. In view of the concerns recorded and reported by the clinical supervisors (Lorna Haywood, Curtis Roberts and Amy Barker), it was determined that the information contained in the Registrant’s application and that given at interview was not a true reflection of the Registrant’s knowledge and previous experience.

25.       A finding of gross misconduct was made and the Registrant was dismissed. Her appeal was unsuccessful.

26.       Witnesses who gave evidence for the HCPC were:

a.     Amy Barker, Clinical Team Leader for the Critical Care and Oncology Team

b.     Lorna Haywood (now Traynor), Band 7 Critical Care Dietetic Clinical Lead

c.     Curtis Roberts, Senior Specialist Dietitian

d.     Jane Alderdice, Professional Lead for Adult Dietetic Services

 

27.       In addition, a witness statement had been obtained from Moira Dixon, Children’s AHP Directorate Manager and Professional Lead for Paediatric and Neonatal Dietetics. She did not attend to give evidence. Her statement was not contested on behalf of the Registrant and was agreed evidence before the Panel.

28.       The Registrant gave evidence. The relevant parts of the evidence of all witnesses are referenced in the Panel’s determination below.

29.       The Panel heard submissions from the parties and accepted the Legal Assessor’s advice, which included the burden and standard of proof; that contemporaneous documents are generally more reliable than memory (Dutta v GMC [2020] EWHC 1974); the approach to assessment of credibility and reliability of witnesses; the approach to determining the weight to attach to hearsay evidence and the test for dishonesty as stated in Ivey v Genting Casinos UK Ltd [2017] UKSC 67. The Panel was additionally advised that evidence of good character is relevant at the facts stage where dishonesty is alleged: Donkin v Law Society [2007] EWHC 414 (Admin).

Decision on Facts

Particular 1 - In or around August and September 2023, during your application to the Manchester University NHS Foundation Trust for the position of Band 6 Dietitian, you stated that you had experience of and/or knowledge of one or more matters set out in Schedule A when you did not.

30.       The Registrant admitted that she has some knowledge in the areas referred to in Schedule A except – 8b, 8d, 8e, 8h, 17, 18, 20, 21. She has no experience in 8a, 8b, 8c, 8d, 8e, 17, 18, 20, 21.

31.       Ms Barker interviewed the Registrant on 25 September 2023 and said she came across as very confident. She was offered the role. A satisfactory reference was obtained (clarification and additional information having been sought) and the Registrant’s offer was confirmed.

32.       The Registrant’s application had included the following:

I provide medical Nutrition Therapy through nutrition care process for the management of health conditions such as: diabetes, eating disorders, malnutrition, gastrointestinal diseases, obesity, food allergies and intolerance. And also with chronic diseases such as cancer, heart and kidney disease, as well as patient with sudden illness such as burns to various parts of the body…

Make use of nutrition analysis programs such as to assess nutritional status, analyse food intake records, recipe and interpret results…

I provide a rotational service in a wide range of specialties which has helped me in developing in-depth knowledge and skills in the field of nutritional support. These specialties include but are not limited to; Neurology, General and Colorectal Surgery, Endocrinology, Gastroenterology, Respiratory Medicine, Care of the Elderly, Oncology, Artificial Feeding, Cardiologist, and Orthopaedics…

I have good clinical knowledge in general dietetics to provide medical nutrition therapy through the nutrition care process to patients of all age groups who have nutrition-related diseases such as non-communicable diseases, malnutrition, HIV/AIDs, gastrointestinal diseases, cancer, CVDs, renal disease, coeliac disease, irritable bowel syndrome, dysphagia, liver disease, allergies, learning disabilities, eating disorder, mental health, etc. by established dietetic department protocols, code of conduct and standards. I practice independently to use my professional knowledge, skills, and experience to make reasoned decisions to initiate, continue, modify, or cease nutritional interventions…

I use an electronic medical record system to keep track of my patient’s information…

I liaise with hospital staff such as doctors, nurses, pharmacists, medical lab scientists…

I liaise with and advise the nursing staff and dietetic cooks to ensure that appropriate nutrition support is provided to ensure patients’ nutritional needs are individualized and met especially for patients on PN/Enteral feed and nutritional supplements…

I am proficient in the use of Microsoft Office applications like PowerPoint, Excel, Word…

33.       Ms Barker’s evidence was that she spoke to the Registrant by phone on 19 December and asked about her experience with enteral feeding. The Registrant said that she was familiar with that.

34.       When the Registrant commenced her role, after two days, her supervisor, Ms Haywood, spoke to Ms Barker as she had a number of concerns. Ms Haywood’s evidence, based on her statement made for the internal investigation, was that on 20 February, the Registrant informed her that she had never done parenteral (PN) feeding or used supplement drinks. She raised this with Ms Barker as a concern.

35.       Two days later, Ms Haywood raised with Ms Barker her concern that the Registrant “did not know the fundamentals of dietetics such as medical conditions, biochemistry and medications”.

36.       Ms Barker, having expressed her concerns to the Registrant at the two-week probation review on 28 February, spoke to her again on 29 February. Ms Barker said that the Registrant stated she knew the majority of the clinical requirements of the Band 5 job description, but when asked to explain things, admitted she did not know them. Ms Barker also stated that the Registrant informed her during this meeting that there was not a critical care unit at the hospital where she had worked in Nigeria.

37.       Ms Haywood’s evidence was that on 22 February she went through enteral feeding with the Registrant. The Registrant was asked which part of the intestine comes after the stomach, and she incorrectly replied that it was the large intestine.

38.       Ms Haywood also stated on this date that the Registrant “could not calculate a BMI correctly, she did not know what the signs or symptoms of dysphagia were, she could not tell me the risks of allowing somebody with dysphagia to eat standard diet, she did not know how to dietetically manage refeeding syndrome, she could not interpret biochemistry and she could not interpret symptoms…”

39.       Ms Haywood had recorded in the supervision log for 28 February that the Registrant had asked her how to open Microsoft Word and had also asked how to save files.

40.       Mr Roberts said in evidence that the Registrant was able to open word, but not able to use its features, such as change font, edit or create a table.

41.       Mr Roberts gave evidence as to his significant concerns with the Registrant’s knowledge. He recorded in the supervision log for 28 February that the Registrant was unable to tell him about coeliac disease, eating disorders, cancer, irritable bowel syndrome or gastro-intestinal disease and surgery for it. He recorded that the Registrant had no experience of patients with burns. He said the Registrant told him she had no experience of parenteral nutrition, and that she had not worked in critical care. He further said that when the Registrant was completing a case study, she was googling dietetic terms that he would have expected her to know.

42.       The Registrant’s evidence was that she was aware she did not meet the standards required at Band 6 level. She did not accept she had no knowledge, having worked as a Dietitian in Nigeria.

43.       It was put to the Registrant that Ms Haywood’s evidence was that she did not know how to interpret biochemistry, but that she says in her application that she can. Further, the Registrant initially said to Ms Haywood that she could do this, and only when she had not been able to demonstrate this skill, admitted that she could not. The Registrant’s evidence was that she said she could do it based on how they work in Nigeria, where the doctors deal with medical matters and then refer patients to dietitians.

44.       Under cross-examination the Registrant was asked what the gallbladder does. Her reply was that it is part of the kidney, where urine is stored. When asked what haemoglobin does, the Registrant took a long time to answer and eventually responded that it is a blood test sample to know the level of blood in a cell, used to test for anaemia.

45.       With regard to the matters set out in Schedule A:

1 – Eating disorders - Proved

46.       In her application the Registrant stated: I provide medical Nutrition Therapy through nutrition care process for the management of health conditions such as: diabetes, eating disorders…

47.       In the supervision log on 28 February Mr Roberts recorded: She Wasn’t able to tell me about Coeliac dx, ED’s (eating disorders).

48.       This was also reflected in Mr Robert’s witness statement. The Panel considered that Mr Roberts was well placed to make an assessment of the Registrant’s knowledge as he was providing close supervision. Indeed, he said that he wished to make his own assessment of the Registrant’s skills and identify areas for improvement. He had therefore spoken to the Registrant in some depth on this date. Having spent the day with the Registrant he concluded that she was not safe to practise as a dietitian, such were the gaps in her knowledge. Mr Roberts noted the significant difference between what was written in the application, and how the Registrant presented.  

49.       The Panel found Mr Roberts to be a credible and reliable witness as his statement was based on contemporaneous documentation he had made. His oral evidence was consistent with his written statement. On the other hand, the Panel found that the Registrant both when working and in evidence had sought to minimise or underplay the gaps in her knowledge. She did not accept she did not know something until this was demonstrated by her inability to answer questions about it. Her presentation as portrayed by Mr Roberts and Ms Haywood was reflected in the Registrant’s presentation at the hearing.

50.       As such, the Panel accepted the unchallenged evidence of Mr Roberts and found that the Registrant did not have knowledge or experience of eating disorders yet had stated on her application that she did.

2 – Gastrointestinal diseases - Proved

51.       The Registrant included this after ‘eating disorders’ in her application.

52.       Ms Haywood recorded in the supervision log, as an area for improvement, on 22 February: Learning the GI anatomy (was unsure what came after the stomach, with some prompting was able to say the intestine, when asked if it was the small or large intestine, stated it was the large intestine.

53.       In her witness statement Ms Haywood referred to this and continued: This is incorrect, which I found extremely concerning as this is basic anatomy which is fundamental to the role of dietitian. I asked the Registrant why we would want to bypass the stomach and the Registrant said due to injury. She could not expand on this further or explain. Ms Haywood was not challenged on this under cross-examination.

54.       The Panel found Ms Haywood to be a reliable witness because her statement and oral evidence were consistent with the contemporaneous documents.

55.       On 28 February Mr Roberts recorded in the log: She Wasn’t able to tell me about Coeliac dx, ED’s, Cancer, IBS, or GI disease and surgery. When I asked her about the above, she wasn’t sure on the difference between Coeliac IBS or any GI disease.

56.       The Panel accepted the evidence of Ms Haywood and Mr Roberts and found that the Registrant did not have knowledge or experience of Gastrointestinal diseases.

3 – Obesity – Not Proved

57.       The HCPC’ witnesses did not provide any evidence to support this condition and the HCPC had not therefore discharged the burden of proof.

4 – Cancer - Proved

58.           The Registrant stated in her application: I provide a rotational service in a wide range of specialties which has helped me in developing in-depth knowledge and skills in the field of nutritional support. These specialties include but are not limited to; … Oncology

59.           On 27 February Ms Haywood recorded in the supervision log: I asked ‘what is Radiotherapy used to treat?’ she replied, ‘heart failure, to help his chest’. We discussed that radiotherapy is a cancer treatment.

60.           The Panel also considered that the Registrant’s oral evidence in relation to her knowledge and understanding of cancer demonstrated she was not familiar with the condition and had no dietetic clinical knowledge regarding cancer support. The Registrant was only able to provide general answers about the effects of chemotherapy on the human body which she said included hair loss and a change in skin colour. The Registrant failed to mention any impact of chemotherapy on taste changes and swallow challenges that may accompany treatments.

61.           The Panel accepted Ms Haywood’s unchallenged evidence and found that the Registrant had no knowledge or experience of cancer patients but had recorded an in-depth knowledge within her application.

5 – Burns – Proved (in relation to experience)

62.           The Registrant wrote on her application that she had experience of treating patients with sudden illnesses such as burns. She had recorded that she undertook a 1-day CPD course in 2022 on Medical Nutrition Therapy for Burns and ICU Patients Using NCP Approach.

63.           The Registrant was not asked about this course in cross-examination and the Panel accepted that she would therefore have had some knowledge of burns.

64.           In relation to experience, Mr Roberts recorded in the supervision log on 28 February: Has no experience with patient who have burns. This was in the context of a conversation about the Registrant’s past experience and the Panel inferred that the Registrant told Mr Roberts this which led to the note being made. This evidence was not challenged and the Panel accepted it. It found that the Registrant had no experience of treating patients with burns.

6 – Nutrition analysis – Not proved

65.           The HCPC’s witnesses provided no evidence in relation to this area of the Registrant’s knowledge and experience. As such, the Panel found this aspect not proved.

7 – Research projects – Not proved

66.           The Registrant described at interview and in her evidence that she had worked on an iron deficiency anaemia project involving making a smoothie with combinations of kiwi and watermelon with beetroot. Whilst the evidence of Mr Roberts was that the Registrant was unable to give much detail on this, the Panel was satisfied that the Registrant had some knowledge and experience of research. She described this project in her evidence to the Panel.

8a – Neurology - Proved

67.           The Registrant admitted she had no experience of this. She stated in her application that she had in-depth knowledge and skills in this specialty. The Panel found this proved by admission.

8b – General and Colorectal Surgery - Proved

68.           The Registrant admitted that she had no knowledge or experience in this specialty. In her application she stated that she had in-depth knowledge and skills in this field. The Panel found this proved by admission.

8c – Endocrinology - Proved

69.           The Registrant admitted she had no experience of this. She stated in her application that she had in-depth knowledge and skills in this specialty. The Panel found this proved by admission.

8d – Gastroenterology - Proved

70.           The Registrant admitted that she had no knowledge or experience in this specialty. In her application she stated that she had in-depth knowledge and skills in this field. The Panel found this proved by admission.

8e – Respiratory medicine - Proved

71.           The Registrant admitted that she had no knowledge or experience in this specialty. In her application she stated that she had in-depth knowledge and skills in this field. The Panel found this proved by admission.

8f – Care of the Elderly – Not proved

72.           The Registrant stated in her application that she had knowledge and skills in this area. She talked in evidence about creating dietary plans for elderly patients. The HCPC provided no evidence in relation to this specialty, and the Panel found this aspect not proved.

8g – Oncology - Proved

73.           This is a repeat of ‘cancer’ above in paragraphs 58- 61.

8h – Artificial feeding - Proved

74.           The Registrant admitted she had no knowledge of this. In her application she said she had in-depth knowledge and skills.

75.           On 6 March Ms Haywood recorded in the supervision log: I asked Ifeyinwa to identify the feeding route she was able to tell me he was ‘enterally fed’ she was not able to identify the feeding tube placed in the patient’s nose. She told me that the tube he had in his nose was his breathing tube. She was not aware that the patient would have to be nil by mouth… I informed her that I was worried that she was unable to identify the NGT feeding tube in the patient’s nose, despite this being very visible. She told me she was confused as she isn’t used to seeing feeding tubes, despite tell me previously she has had lot of experience with feeding tubes. She then told me that the feeding tubes are different in Nigeria. I asked her to explain the feeding tubes and she reported that the difference was they were not fixed with tape to the nose, but the tubes were the same.

76.           The Panel was satisfied that this was a reliable account as it was contemporaneous. It was not challenged in cross-examination. As such, the Panel found that the Registrant did not have experience of artificial feeding, in addition to having no knowledge.

9 – Coeliac disease - Proved

77.           In her application the Registrant said she had good clinical knowledge of diseases including coeliac disease.

78.           On 28 February Mr Roberts recorded in the supervision log that the Registrant was not able to tell him about coeliac disease and: she wasn’t sure on the difference between Coeliac IBS (Irritable Bowel Syndrome) or any GI disease – understands what a GF (Gluten Free) diet is but doesn’t know the mechanism in the gut and the difference between IBS or coeliac dx (disease).

79.           Mr Roberts referenced this conversation in his witness statement. He said he had recorded his concern about the Registrant’s lack of knowledge in these areas. His evidence was not challenged. The Panel accepted his evidence and found this part of the Particular proved.

10 – Irritable bowel syndrome - Proved

80.           The Registrant said she had good clinical knowledge of this in her application. Mr Roberts recorded on 28 February that the Registrant was not able to tell him about this illness. Mr Roberts was not challenged on this and the Panel accepted his evidence. The Panel found this aspect of the Particular proved accordingly.

11 – Dysphagia - Proved

81.           The Registrant stated in her application that she had a good clinical knowledge of this.

82.           Ms Haywood identified this as an area for improvement in the training log on 22 February. In her witness statement she said, referring to a case study that the Registrant had done: she did not know what the signs or symptoms of dysphagia were, she could not tell me the risks of allowing somebody with dysphagia to eat standard diet…

83.           Later in her statement Ms Haywood said: Another example is the Registrant could not provide a safe care plan for a patient with dysphagia at risk of aspiration, she could provide the wrong consistency nutrition resulting aspiration and a chest infection, which is life threatening.

84.           This evidence was not challenged and the Panel accepted it. It found this part of the Particular proved.

12 – Liver disease – Not proved

85.           The Registrant referred to this in her application. The HCPC produced no evidence that the Registrant lacked knowledge or experience and the particular was not proved.

13 – Learning disabilities – Not proved

86.           The Registrant referred to this in her application. The HCPC produced no evidence that the Registrant lacked knowledge or experience and the particular was not proved.

14 – Eating disorder - Proved

87.           This is a duplication of item 1 in the Schedule, paragraphs 46- 50.

15 – Mental health – Not proved

88.           The Registrant referred to this in her application. The HCPC produced no evidence that the Registrant lacked knowledge or experience and the particular was not proved.

16 – An electronic medical record system - Proved

89.           The Registrant stated in her application: I use an electronic medical record system to keep track of my patient’s information.

90.           In the supervision log on 27 February Ms Haywood recorded: She reports she only used paper notes, no electronic systems. In her witness statement, Ms Haywood noted that this was a discrepancy with the Registrant’s application form.

91.           In her evidence the Registrant said she used both paper and electronic patient records and that she used Microsoft Word to document when she saw patients.

92.           The Panel noted that the Registrant’s evidence at the hearing was inconsistent with what she had reported to Ms Haywood. Ms Haywood was not challenged on this aspect of her evidence. The Panel found that Ms Haywood’s account was more likely to be reliable than the Registrant’s as it was based on contemporaneous records. As such, the Panel found that the Registrant did not have knowledge or experience of electronic medical record systems, and that this aspect of the Particular was proved.

17 – Pharmacists - Proved

93.           The Registrant admitted she had no knowledge or experience, and the Panel found this proved by admission.

18 – Parenteral nutrition - Proved

94.           The Registrant wrote in her application: I liaise with and advise the nursing staff and dietetic cooks to ensure that appropriate nutrition support is provided to ensure patients’ nutritional need are individualized and met especially for patients on PN/Enteral feed and nutritional supplements.

95.           Ms Haywood recorded in the supervision log on 20 February that the Registrant had told her that she had no experience of parenteral nutrition. At the hearing, the Registrant admitted to having no knowledge or experience of this. The Panel found the Particular proved accordingly.

19 – Enteral feeding - Proved

96.           This was referenced in the Registrant’s application as noted above.

97.           On 6 March Ms Haywood noted in the supervision log: Then we walked to the HDU unit. I asked her if she had been to an ITU and HDU before, she reported yes, she also said she had experience on enteral feeding in this patient group… I asked Ifeyinwa to identify the feeding route she was able to tell me he was ‘enterally fed’ she was not able to identify the feeding tube placed in the patient’s nose.

98.           The Panel accepted Ms Haywood’s unchallenged evidence in this respect and found this aspect of the Particular proved. It considered that anyone with knowledge and experience of enteral feeding would have been able to identify a feeding tube. It did not consider the Registrant’s explanation to be plausible in that the tape used to secure the tube misled her.

20 – Nutritional supplements - Proved

99.           This was referenced in the Registrant’s application, and she admitted at the hearing having no knowledge or experience. The Panel therefore found this proved by admission.

21 – Medical lab scientists - Proved

100.       This was referenced in the Registrant’s application, and she admitted at the hearing having no knowledge or experience. The Panel therefore found this proved by admission.

22 – Microsoft Word Applications – Not proved

101.       The Registrant stated in her application that she was proficient in the use of such applications, including Word. Ms Barker, Ms Haywood and Mr Roberts all stated that the Registrant struggled with the basics such as opening Word and saving documents. Mr Roberts stated she did not know how to create a table.

102.       The Registrant gave evidence that she had undertaken a three-month course in Microsoft applications after her degree. The Panel did not find this credible given her very limited knowledge as outlined by reliable witnesses and based on notes of their contemporaneous supervision of the Registrant. However, the HCPC had not proved that the Registrant had no knowledge or experience, and as such, the Particular was not proved.

Particular 2 - Your actions at Particular 1 were dishonest in that you knew that you did not have the experience and/or knowledge referred to on your application form and/or during your job interview - Proved

103.   Ms Barker’s evidence was that when the Registrant said to her, during their one-to-one meeting on 29 February that there was no critical care unit in the hospital in Nigeria, she was worried about the Registrant’s honesty. She then went through the Registrant’s job application and compared that to the supervision log kept by Ms Haywood and Mr Roberts. Ms Barker highlighted sections of the application which did not match the Registrant’s knowledge and abilities as assessed by her supervisors. The Registrant denied that she had been assisted by a recruitment agency. Ms Haywood’s evidence was that the Registrant was silent when asked about the authenticity of her application.

104.   According to Ms Barker, the Registrant informed Ms Barker on 29 February that she had previously done 15 NHS job interviews and had learnt the correct answers based on the feedback she received. Ms Barker’s evidence was that in addition, the Registrant told her that the audit she had referred to in the interview was a project she had heard about, and not one she had organised.

105.   Ms Haywood’s evidence was that when she went through case studies with the Registrant, she would confidently say she knew something, and when she gave an incorrect answer, would admit that she did not know it. In Ms Haywood’s view this demonstrated that the Registrant actively tried to conceal her lack of knowledge.

106.   Mr Roberts’ evidence included that after the probation review meeting on 28 February, the Registrant was asked to write down medical diagnoses from a surgical list and say whether or not she knew what it was. She had written ‘cerebrovascular accident’ and told Mr Roberts that she knew what it was. However, he could see that the Registrant had googled this, and when challenged, admitted that she had googled it and did not know what it was.

107.   Mr Roberts’ evidence was that on several occasions the Registrant had said she understood medical conditions, but when asked, her answer demonstrated that she did not. This led to a conversation around honesty, with Mr Roberts asking her if the information in her application was incorrect. The Registrant confirmed this. She told Mr Roberts that she wrote things in her application knowing that she did not know them. She went on to admit, according to Mr Roberts, that she did not understand biochemistry or pharmacology and only had a basic understanding of human anatomy.

108.   The Registrant in evidence said that she overstated or exaggerated her knowledge and experience ‘a bit’ in her application, but that it was not her intention to mislead or deceive anyone. She said she had seen some of the conditions she referred to, but not ‘in depth as a specialist’. She had written her application based on her Nigerian experience and perspective.

109.   The Panel began by assessing the Registrant’s actual state of knowledge and belief at the time she wrote her application. In doing so it took into account the limited admissions made at the hearing. The Registrant had admitted, for example, having no knowledge of artificial feeding. In her application she wrote that she had in-depth knowledge. She wrote that she had in depth knowledge and skills in the specialities set out at 8a to 8e of Schedule A, but admitted in the hearing that she had no knowledge or experience of General and Colorectal Surgery, Gastroenterology or Respiratory medicine and no experience in Neurology or Endocrinology.

110.   The Panel found that the Registrant was aware when she wrote and submitted her application that she did not have this knowledge and experience. In stating that she had in-depth knowledge and skills she intended to give a misleading impression of her skills and abilities with a view to obtaining a role which required a high level of knowledge and skill. The Panel was satisfied that the Registrant believed she would not get the role if she limited the description of her responsibilities to the more accurate version that has become apparent through the hearing. While she stated in her application form that she worked in a hundred bed unit, she confirmed in her oral evidence that she saw only 3-5 patients per week in the outpatient clinic and advised as to dietary plans.

111.   Further, the Panel noted that the Registrant admitted to Mr Roberts that she wrote things in her application that she did not know about. The Panel accepted Mr Roberts’ evidence in relation to this.

112.   The Panel then considered the view that would be taken of such conduct by ordinary decent people. It determined that such people would view the Registrant’s actions as dishonest because she wrote that she had knowledge, skills and experience in areas that she did not. Such people could only conclude that this was with a view to misleading the reader, because there has been no other rational explanation given. The Panel did not accept that the Registrant did not intend to mislead, when as she says, she was viewing matters through a Nigerian perspective, because she has admitted or been found to have no knowledge or experience in many of the areas that she said she was a specialist in or had significant experience of.

113.   In reaching this finding that the Registrant was dishonest, the Panel had regard to the limited evidence before it as to the Registrant’s good character. Neither referee stated they were aware that the Registrant was facing an allegation of dishonesty and as such the Panel gave very little weight to them. The Panel had had the opportunity of assessing the Registrant’s credibility and found that she was not credible when she said she did not intend to mislead, for the reasons given above. Additionally, there were various inconsistencies in the versions of events given by the Registrant at different times, such as in relation to electronic records and her dietetic knowledge. She was not, in the Panel’s view, a reliable witness.

Decision on Grounds

114.   Ms Molyneux submitted that whilst an indication had been given that the Registrant accepted misconduct secondary to a finding of dishonesty, misconduct required a finding of fact. She submitted that in accordance with Schodlok v General Medical Council [2015] EWCA Civ 769 non-serious misconduct findings should not lead to a finding of impairment and the Panel should look at the overall picture. She further submitted that Calhaem v General Medical Council [2007] EWHC 2606 (Admin) was authority for the proposition that if someone is only dishonest for a short time and then does all the right things, dishonesty is at the lower end of the scale.

115.   Ms Chowdhury submitted that whilst misconduct was a finding for the Panel to make in view of the facts as found proved, it was accepted by the Registrant.

116.   The Panel accepted the Legal Assessor’s advice and was aware that whether the facts found proved are sufficiently serious to amount to misconduct was a matter for its professional judgment. It was guided by caselaw including Roylance v General Medical Council (No 2) [2000] 1 AC 31; Doughty v General Dental Council [1988] AC 164 which confirmed that any falling short of standards must be serious; and Nandi v General Medical Council [2004] EWHC 2317 which described it as 'conduct which would be regarded as deplorable by fellow practitioners’. The Legal Advisor informed the Panel the submission made by Ms Molyneux in relation to the case of Calhaem was incorrect as a matter of law.

117.   The Panel’s starting point was that it had found dishonesty proved. The Registrant had stated within her application that she had a significant amount of knowledge and experience which she did not have. She therefore knew that she was not qualified for the role she applied for. She maintained the misleading picture she had painted of her skills at interview, where she concealed the reality of the significant limitations of her role in Nigeria. Further, when the Registrant commenced her position with the Trust, she said she knew about an extensive range of conditions and that she understood and had done enteral feeding, but was then forced to admit that this was not the case. The Panel found that the Registrant’s dishonesty had been pre-meditated and sustained. It was conduct that would be considered deplorable by fellow practitioners.

118.   The Panel next considered the standards that had been breached by the Registrant’s dishonesty. Beginning with the Standards of Conduct, Performance and Ethics, it determined that the Registrant’s conduct had fallen short of:

·       3.1 - You must only practise in the areas where you have the appropriate knowledge, skills and experience to meet the needs of a service user safely and effectively.

·       9.1 - You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

·       9.2 - You must be honest about your experience, qualifications and skills.

119.   Having regard to the Standards of Proficiency for Dietitians, the following standards had been breached:

·       1.1 - identify the limits of their practice and when to seek advice or refer to another professional or service.

·       2.1 - maintain high standards of personal and professional conduct.

·       2.2 - promote and protect the service user’s interests at all times.

·       2.4 - understand what is required of them by the Health and Care Professions Council, including, but not limited to, the standards of conduct, performance and ethics.

·       4.1 - recognise that they are personally responsible for, and must be able to justify, their decisions and actions.

·       8.10 - act as a role model for others.

120.   The Panel determined that the Registrant’s conduct had fallen far short of each of these standards. She was aware that she did not have the knowledge and experience to, for example, treat critical care patients effectively but gave the impression that she did. In being dishonest about her skills there was a significant risk of causing serious harm to patients which in turn meant that the public’s trust in her was misplaced. Members of the public expect Dietitians to be suitably knowledgeable for their roles and lying about this in order to obtain a role that then cannot be performed safely or at all was necessarily going to seriously damage public trust. The Registrant in her evidence had not demonstrated an understanding of the HCPC’s standards, nor had she accepted responsibility for her actions. Instead, she had sought to minimise them, for example through repeatedly stating in evidence that she had perhaps overstated her experience, when in reality the Panel found that she had no meaningful knowledge or experience in a number of areas beyond those where she made admissions.

121.   The Panel considered that dishonesty is always serious, and the nature and extent of the Registrant’s serious dishonesty meant that a finding of misconduct was required.

Decision on Impairment

122.   Ms Molyneux reminded the Panel that it was making an assessment of current impairment, which she submitted could be assessed by asking whether a right-minded person could have faith in the profession, or whether that would be undermined if no finding of impairment were made. She submitted that if the Panel found there were competence issues, it should also consider public protection. The Registrant was, in her submission, untrained and the Panel could only imagine how much harm could have been caused, potentially death. With regard to the public interest, the Registrant had been dishonest on many levels.

123.   Ms Chowdhury reminded the Panel that the purpose of fitness to practise proceedings is not to punish but to protect the public. She submitted that impairment is a forward-looking exercise which should take into account both public protection and the public interest.

124.   Ms Chowdhury submitted that the Registrant’s conduct was remediable. As to whether it had been remedied, the Registrant had undertaken training courses, apologised and had demonstrated insight through the making of early admissions. She recognises that her actions fell below the expected standards of a dietitian in the UK. She had demonstrated an understanding of what led to that behaviour. Ms Chowdhury invited the Panel to take into account cultural differences in relation to the expressions the Registrant may have used in demonstrating insight and the way she apologised.

125.   Ms Chowdhury submitted that there was no evidence of harm to service users and that the matters in the allegation arose from a specific set of circumstances. There was no pattern of behaviour or likelihood of repetition. As such, there were not, in her submission, ongoing risks to service users. Ms Chowdhury invited the Panel to make no finding of impairment and submitted that doing so would not undermine public confidence in the profession.

126.   The Panel accepted the Legal Assessor’s advice. It was aware that in assessing impairment, it was looking at the past to assess the present; Meadow v General Medical Council [2007] 1 QB 462. When assessing the personal component of impairment, it may be assisted by the three-fold test set out in the case of Cohen v General Medical Council [2008] EWHC 581 (Admin): Is the conduct remediable? Has it been remedied? Is it highly unlikely to recur? It must also address he public interest and whether this requires a finding of impairment. To that end it may be assisted by the guidance provided in CHRE v Nursing and Midwifery Council and Grant [2011] EWHC 927 (Admin).

127.   The Panel began by assessing what the Registrant has done since the Trust made the referral to the HCPC. She had given evidence that she had been suspended and working in a care home as a care assistant. In that capacity the Registrant had undertaken some training which included diabetes awareness and dysphagia. This training was online in a wide range of areas, aimed at care assistants (generally band 3 NHS equivalent). As such, the Panel did not consider this to have been at dietetic level. The Registrant had also told the Panel that she had been reading the Manual of Dietetic Practice. However, she had not given evidence on what she had learned or how any learning would impact on her practice going forward. Indeed, the Panel had been surprised by the Registrant’s lack of clinical knowledge demonstrated during cross-examination, having, she said, undertaken self-directed learning. Further, the Registrant had provided no evidence of work to gain an understanding of the importance of candour or similar. Indeed, the Registrant’s denial of dishonesty, which the Panel had found proved, was evidence of an ongoing lack of candour.

128.   The Panel further considered that the Registrant had not been open and honest in some of her evidence, for example when asked about research she had been involved in. The Registrant gave the same example she had used in interview about an iron deficiency project (which in itself suggested very limited experience). The evidence before the Panel was that at interview the Registrant suggested she led on this, but subsequently admitted that she had not, and Ms Haywood considered her involvement had been limited as she had been unable to give much detail.

129.   The Panel had, at the facts stage, found that the Registrant was not credible when she said that she had exaggerated her previous experience ‘a bit’. Having found dishonesty for the reasons above, the Panel was of the view that the Registrant’s approach to this hearing was highly relevant to its assessment of impairment.

130.   The Panel considered that the Registrant’s conduct was not remediable, because her deception was planned, wide-ranging and persistent. She evidently had no regard to the impact on patients or colleagues of securing a role that she did not have the knowledge and experience to undertake safely or effectively. Even if the conduct were remediable, which would always be difficult given its attitudinal nature, the Registrant had, in the Panel’s view, demonstrated very limited insight and little genuine remorse. There was a clear focus in her account of her personal difficulties in view of her move to the UK. Whilst the Panel did not underestimate the significance of such a move, and the need to acclimatise to a different way of life, the Panel found that the Registrant had not focussed on the broader picture and the significant impact on others of her dishonesty.

131.   Ms Haywood’s evidence was that the Registrant did not appreciate her lack of knowledge or understand the impact of that in terms of risk to patients. Her concern was that the Registrant would attempt a dietetic assessment and implement a plan that would cause serious harm. Having said she had knowledge of parenteral nutrition, she could have been left to prescribe that, which would in all likelihood have resulted in a high-level patient incident, as the Registrant subsequently admitted no knowledge in that area.

132.   The Registrant did not acknowledge when giving evidence that her deception could have directly led to patient harm. The fact that no harm was in fact caused was, in the Panel’s view, purely due to the precautions taken by her supervisors who did not permit her to be patient facing, because of the very significant risk of harm they considered the Registrant posed.

133.   The Panel was satisfied, exercising its professional judgment, that the Registrant posed a very significant risk of harm to patients. For example, the evidence was that she did not understand what it meant for a patient to be nil by mouth. Giving such a patient oral nutrition carries the risk of aspiration pneumonia, which can be life threatening.

134.   The Registrant’s lack of insight both into the consequences of her dishonesty in terms of the trust placed in her by colleagues, and the risks to patients, led the Panel to conclude that there was a significant risk of repetition. The Registrant had demonstrated no regard for colleagues, who were removed in part from their patient facing roles due to the significant level of support and supervision she required. The Panel has no confidence that the Registrant today understands the seriousness of her misconduct or its far-reaching risks, examples of which have been outlined in this decision.

135.   The Panel found that the Registrant is currently impaired on the personal component and that a finding of impairment is required to protect the public. In reaching this finding the Panel took into account that the Registrant’s cultural background is different to their own but did not see how that has any bearing on the substance of the Registrant’s evidence as to remorse or insight. The finding has been made not based on how the Registrant expressed herself, but on the lack of underlying insight or evidence of genuine remorse, in large part demonstrated by her denial of matters found proved.

136.   Moving to the public component, the Panel determined that the Registrant has not only put patients at risk of harm in the past and is liable to do so in the future, but that she is liable to be dishonest again in the future if she perceives that doing so will benefit her personally. She had much to gain personally from securing employment in the UK, including the right to reside here with her family. She prioritised that over patient safety when she dishonestly misrepresented her knowledge and experience to secure employment. The Registrant has thereby breached a fundamental tenet of the profession, namely the requirement to put the interests and safety of patients first.

137.   The Panel therefore determined that a finding of impairment is required in the public interest to mark the unacceptability of the Registrant’s misconduct. Her planned and persistent dishonesty seriously undermines the trust that members of the public should be able to place in the profession. If members of the public were aware that a registered professional secured employment by such a significant level of deception, they would have serious reservations about being treated by dietitians should the need arise. They would be concerned for their safety. Members of the public expect registered Dietitians to be honest and trustworthy and if the Regulator did not make a finding of impairment to mark the unacceptability of this conduct and in turn uphold standards in the profession, their confidence in the regulatory process would be seriously undermined.

Decision on Sanction

138.   The Panel took into account the submissions of Ms Molyneux on behalf of the HCPC and Ms Chowdhury on behalf of the Registrant. Ms Molyneux submitted that sanction was a matter for the judgement of the Panel. She referred the Panel to the range of options available to it under Article 29 of the Health Professions Order 2001 and reminded the Panel that, in serious cases, it should take into account the relevant factors when determining the appropriate sanction

139.   Ms Chowdhury submitted that a Suspension Order is the most appropriate and proportionate Order in this case in light of her previous unblemished record and the mitigating factors in the case. She advised the Panel that the Registrant wished to apologise for her conduct, that it was out of character and she accepts that she breached professional standards.

140.   Ms Chowdhury reminded the Panel of the significant financial and emotional impact that the proceedings have had on the Registrant, including the impact on her children. She submitted that the Registrant remains ashamed and anxious about the uncertainty surrounding the future.

141.   The Panel was guided by the HCPC’s updated Sanctions Policy which came into effect on 2^nd March 2026. The Panel accepted the advice of the Legal Assessor who referred the Panel to the guidance surrounding sanctions in serious cases and reminded the Panel that the purpose of a sanction is to protect the public and the wider public interest. The Legal Assessor referred the Panel to the cases of Igboaka v General Medical Council [2016] EWHC 2728 (Admin) and Lusinga v Nursing and Midwifery Council [2017] EWHC (Admin) 1458.

142.   The Panel was mindful that the purpose of a sanction is not to punish the Registrant but to protect the public and the wider public interest in upholding proper standards and maintaining the reputation of the profession. The Panel applied the principle of proportionality, balancing the interests of the Registrant with those of the public, and considered the available sanctions in ascending order.

143.   With regard to mitigation, the Panel acknowledged the Registrants difficult personal circumstances and the impact on her children. However, the Panel considered that, on balance, given that the overarching concern is the protection of the public rather than the imposition of a punitive sanction, this should not be regarded as a mitigating factor. The Panel did acknowledge the Registrants apology and remorse as mitigating factors.

144.   By way of aggravating factors, the Panel noted as follows:

·       The Registrant’s conduct was premeditated

·       There was a longstanding pattern of dishonesty

·       The Registrant demonstrated limited insight into the potential harm that may have been caused and the importance of ensuring that knowledge and experience are described accurately

·       Lack of meaningful remediation

·       Potential for very serious patient harm

 

145.   The Panel considered the updated guidance which includes guidance for Sanctions in relation to serious cases including dishonesty. The Panel noted that cases involving dishonesty are likely to result in more restrictive sanctions.

146.   In considering the nature of the dishonesty, the Panel determined that it was serious and not an isolated incident. The evidence indicated a pattern of consistent dishonest behaviour. The Panel concluded that the Registrant’s conduct was highly self-serving and demonstrated no regard for the potential impact on service users and colleagues. She played a central role in the dishonest actions, actively misrepresenting her knowledge for personal benefit. The Panel also noted that her conduct created a significant potential risk of harm.

147.   The Panel determined that, given the gravity of the Registrant’s conduct, this case was too serious for the Panel to consider mediation or to take no further action.

148.   A Caution Order would not reflect the seriousness of the Registrant’s misconduct and dishonesty. The dishonesty was repeated and occurred over a prolonged period of time. In the absence of any evidence of remediation, the Panel determined that there was a high risk of repetition.

149.   The Panel determined that a Conditions of Practice Order would not be appropriate or proportionate in the circumstances of this case. The Panel noted that such conditions are generally appropriate where a registrant has demonstrated insight and where the concerns are capable of remediation. However, the Panel considered that conditions are not suitable where there are serious or persistent concerns. In this case, the Panel found that the deficiencies were too wide-ranging, there was a lack of insight, and there were deep-seated attitudinal issues. The Panel also noted that dishonesty is fundamentally incompatible with the imposition of conditions of practice. The Panel concluded that it would not be possible to formulate conditions that would adequately protect the public and address the underlying concerns arising from the Registrant’s dishonest conduct.

150.   The Panel considered whether to impose a Suspension Order. However, having considered the guidance and in light of its conclusion regarding the seriousness of the concerns, the attitudinal nature of the Registrant’s misconduct, and lack of evidence of any insight or remediation and the consequent risk of repetition, the Panel decided that a Suspension Order would not be appropriate. The Panel determined that the Registrant’s deliberate and persistent dishonesty constitutes a serious breach of professional standards and fundamentally undermines the trust that the public is entitled to place in the profession. Having regard to the gravity and persistence of the misconduct, the Panel is satisfied that a Suspension Order would be wholly inadequate to protect the public interest, maintain confidence in the profession, and uphold proper professional standards.

151.   The HCPC updated Sanctions Policy states that a Striking Off Order will be appropriate for serious, persistent, deliberate or reckless acts which include dishonesty.

152.   A Striking Off Order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process to include:

·       Lack of insight

·       Repeated misconduct

·       Lack of remediation

153.   In the Panel’s judgement, all of the criteria for a Striking Off Order were applicable in this case. The public is entitled to expect members of the profession to behave with decency, honesty, and integrity.

154.   In the Panel’s judgement, the Registrant’s misconduct was so serious as to be incompatible with her remaining on the Register. The Panel concluded that a Striking Off Order was required to protect the public, declare and uphold proper standards of behaviour, and maintain confidence in the profession and its Regulator. The Panel concluded that the Registrant’s behaviour was wholly unacceptable and was incompatible with registration.

155.   The Panel concluded that the appropriate and proportionate sanction in the circumstances of this case was a Striking Off Order.

ORDER: The Registrar is directed to strike the name of Mrs Ifeyinwa Chizube Ndulue-Nonso from the Register on the date this Order comes into effect.

 

Right of Appeal

 

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

 

Under Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you.  The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

Interim Order

1.     As the Striking Off Order cannot take effect until the end of the 28-day appeal period, the Panel has considered whether an interim order is required in the specific circumstances of this case. It may only make an interim order if it is satisfied that it is necessary for the protection of the public, is otherwise in the public interest or in your own interest until the sanction takes effect.

 

Application

2.     Ms Molyneux, on behalf of the HCPC, applied for an Interim Suspension Order to cover the appeal period before the substantive Suspension Order came into effect or, if the Registrant appealed, until such time as the appeal was withdrawn or otherwise finally disposed of. Ms Chowdhury did not make any submissions regarding the imposition of an interim order.

Decision and reasons on interim order 

3.     The Panel carefully considered the submissions on behalf of the HCPC. Having heard and accepted the advice of the Legal Assessor, the Panel was satisfied that an Interim Order was required on both public protection and public interest grounds. The Panel had regard to the facts found proved and the reasons set out in its decision for the substantive order in reaching its decision to impose an interim order.

 

4.     The Panel concluded that an Interim Conditions of Practice Order would not be appropriate or proportionate in this case, due to the reasons already identified in the panel’s determination for imposing the substantive order. 

5.     The Panel therefore makes an Interim Suspension Order for a period of 18 months under Article 31(2) of the Health Professions Order 2001. 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; or (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal.

 

 

 

 

 

 

 

 

History of Hearings for Ifenyinwa Chizube Ndulue-Nonso

Date	Panel	Hearing type	Outcomes / Status
02/03/2026	Conduct and Competence Committee	Final Hearing	Struck off