Conduct and Competence Committee...2016/12/15 · Nursing Limited until October 2013; 7. On 17 October 2014: a. provided your daughter’s contact details as one of your referees

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Conduct and Competence Committee Substantive Hearing 12-15 December 2016

Nursing and Midwifery Council, 2 Stratford Place, Montfichet Road, London, E20 1EJ

Name of Registrant Nurse: Violet Tatenda Nzvimbo-Dengwani NMC PIN: 05E1119E

Part(s) of the register: RNA, Registered Nurse (sub part 1) – Adult (12

February 2006)

Area of Registered Address: England

Type of Case: Misconduct

Panel Members: Nicholas Cook (Chair Lay member)

Terry Shipperley (Registrant member)

Janet Blundell (Lay member)

Legal Assessor: Nigel Mitchell

Panel Secretary: Nour Shaheen Registrant: Not present and not represented.

Nursing and Midwifery Council: Represented by Mr Terence Wong, counsel,

NMC Regulatory Legal Team.

Facts proved: 2.a.i, 2.c, 7.a, 7.b, 8, 9.b, 9.c, 9.d, 10.a and

10.b.

Facts proved by admission: 1.a.i, 1.a.ii, 1.b.i, 1.b.ii, 1.b.iii, 1.b.iv, 1.b.v, 1.c,

2.a.ii, 2.b.i, 2.b.ii, 2.b.iii, 2.b.iv, 2.b.v, 2.d, 3.a.i,

3.a.ii, 3.a.iii, 3.a.iv, 3.a.v, 3.b, 3.c, 4.a, 4.b, 5,

6.a, 6.b and 6.c.

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Facts not proved: 9.a.i, 9.a.ii, 9.a.iii, 9.a.iv and 9.a.v.

Fitness to practise: Impaired.

Sanction: Striking-off Order. Interim Order: Interim suspension order – 18 months. Details of charge:

That you a registered nurse:

1. On or around 19 October 2013 provided incorrect information on application for

registration at VIP Nursing, in that you:

a. Stated that you worked at Frimley Park Hospital from 2000 until 2011,

when in fact:

i. you started working at Frimley Park Hospital on 8 July 2002;

ii. you had not worked continuously at Frimley Park Hospital between

2000 and 2011;

b. Described the title of your post at Frimley Park Hospital as ‘Staff nurse to

sister’ when in fact:

i. you were employed as a care assistant between 8 July 2002 and

10 February 2003;

ii. you worked shifts on the bank at Frimley Park Hospital in the

capacity of a care assistant between 2003 and 2006;

iii. you did not complete your nursing qualification or register with the

Nursing and Midwifery Council until February 2006;

iv. you were employed in a Band 5 staff nurse role between 13

February 2006 and 30 April 2011;

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c. Stated that you worked as a Band 6 Ward Sister at Southampton General

Hospital from 1 March 2011 when in fact you did not commence

employment at Southampton General Hospital until 5 March 2012;

2. On or around 20 January 2014 provided incorrect information on application for

registration at Pulse Agency, in that you:

a. Stated that she had worked as a Band 6 Ward Sister at Royal Surrey

County Hospital from February 2004 to January 2011, when in fact:

i. you did not complete your nursing qualification or register with the


ii. you did not commence a permanent Band 6 Junior Sister position

until 5 June 2011;

b. Stated that you worked at Frimley Park Hospital as a Band 5 nurse from

February 2000 to May 2010, when in fact:


ii. you were employed as a care assistant between 8 July 2002 and

10 February 2003;

iii. you worked shifts on the bank at Frimley Park Hospital in the


iv. you did not complete your nursing qualification or register with the


v. you commenced employment at Frimley Park Hospital as a band 5

staff nurse on 13 February 2006;

c. Stated that you worked as a Band 5 staff nurse at Phyllis Tuckwell

Hospice between February 2004 and August 2007, when in fact you did

not complete your nursing qualification or register with the Nursing and

Midwifery Council until February 2006;

d. Stated that you worked as a Band 6 Ward Sister at Southampton General

Hospital from February 2011 when in fact you did not commence

employment at Southampton General Hospital until 5 March 2012;

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registration at Cromwell Medical Staffing, in that you:

a. Stated that you had worked as a Staff Nurse at Frimley Park Hospital from

February 2000 to March 2010, when in fact:



10 February 2003;





v. you commenced employment at Frimley Park Hospital as a band 5

staff nurse on 13 February 2006;

b. Stated that you had worked as a Ward Sister at the Royal Surrey County

Hospital from 2006 to 2011, when in fact you did not commence a

permanent Band 6 Junior Sister position at the Royal Surrey County

Hospital until 5 June 2011;

c. Stated that you worked as a Ward Sister at Southampton General Hospital

from 2011 when in fact you did not commence employment at

Southampton General Hospital until 5 March 2012;

4. Between March 2014 and May 2014 undertook nursing work on one or more of

the shifts listed in Schedule 1:

a. having submitted to University Hospitals Southampton NHS Trust that you

were unfit for work;

b. whilst you were in receipt of sick pay from your substantive employer, the

University Hospitals Southampton NHS Trust;

5. Your conduct at charge 4 was dishonest in that you intentionally misrepresented

to University Hospitals Southampton NHS Trust that you were unfit for work and

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entitled to sick pay, when you knew that you were fit for work and not entitled to

sick pay;

6. On or around 17 October 2014, provided incorrect information on application for

a Band 5 staff nurse position at the Royal Surrey County Hospital NHS

Foundation Trust, in that you:

a. Stated that you had worked as a Staff Nurse at Frimley Park Hospital until

2012, when in fact your employment at Frimley Park Hospital ended on 30

April 2011.

b. Stated that you had worked as a Staff Nurse via Cromwell Nursing Agency

from March 2013 when in fact you did not register with Cromwell Medical

Staffing until 5 February 2014;

c. Stated that you had worked as a Staff Nurse via Mayday VIP Nursing

Agency from March 2013 when in fact you did not register with VIP

Nursing Limited until October 2013;

7. On 17 October 2014:

a. provided your daughter’s contact details as one of your referees on your

application to the Royal Surrey County Hospital NHS Foundation Trust for

a Band 5 nursing position;

b. subsequently relied on a reference written by your daughter, in order to

obtain employment with the Royal Surrey County Hospital NHS

Foundation Trust;

8. Your conduct at charge 7 was dishonest in that you intended to mislead Royal

Surrey County Hospital NHS Foundation Trust by stating that your daughter was

your manager, when she was not;

9. In or around February 2015, provided incorrect information on application for a

Band 6 post at the Royal Surrey County Hospital NHS Foundation Trust, in that

you:

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2000 until 2012, when in fact:



10 February 2003;





v. you were employed in a band 5 staff nurse role from 13 February

2006 until 30 April 2011;

b. Stated that you had worked as a Staff Nurse via Cromwell Medical

Staffing from May 2013 when in fact you did not register with Cromwell

Medical Staffing until 5 February 2014;

c. Stated that you had worked as a Band 6 Ward Sister/Practice

Development Sister at Royal Surrey County Hospital from February 2006

to February 2011, when in fact you did not commence a permanent Band

6 Junior Sister position at the Royal Surrey County Hospital until 5 June

2011;

d. Stated that you worked as a Ward Sister at Southampton General Hospital

from March 2011 when in fact you did not commence employment at


10. Your conduct at charges 1, and/or 2, and/or 3, and/or 6, and/or 9 was dishonest

in that you:

a. knew that one or more of the statements you made were incorrect;

b. intended to mislead your potential employers by providing incorrect

information about your previous nursing experience;

And, in light of the above, your fitness to practise is impaired by reason of your

misconduct.

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Schedule 1:

Date and time of shift Location worked Agency

12 March 2014;

07:00 – 19:30

Royal Surrey County

Hospital

Cromwell Medical Staffing

13 March 2014;

07:30 – 13:30

Lymington New Forest

Hospital

Pulse

14 March 2014;

07:30 – 15:30


Hospital

Pulse

15 March 2014;

07:30 – 17:30

Royal Surrey County

Hospital


18 March 2014;

07:00 – 18:00

Spire Portsmouth Hospital Pulse

19 – 20 March 2014;

20:30 – 08:00


Hospital

Pulse

31 March 2014 – 1 April

2014;

21:00 – 08:00

Queen Alexandra Hospital Pulse

7 April 2014;

07:30 – 13:00


Hospital

Medical Professional

Personnel Ltd

7 – 8 April 2014;

19:30 – 08:00


13 – 14 April 2014;

20:45 – 07:45

Romsey Community

Hospital

Pulse

14 April 2014;

07:30 – 13:30


Hospital


Personnel Ltd

14 April 2014;

15:00 – 21:00


Hospital


Personnel Ltd

15 April 2014; Spire Portsmouth Hospital Pulse

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07:00 – 14:30

16 April 2014;

07:30 – 15:30


Hospital


Personnel Ltd

5 – 6 May 2014;

19:30 – 08:00


6 – 7 May 2014;

20:30 – 08:00


Hospital


Personnel Ltd

7 – 8 May 2014;

20:30 – 08:00


Hospital


Personnel Ltd

9 May 2014;

07:30 – 20:00

Royal Surrey County

Hospital


11 – 12 May 2014;

20:30 – 08:00


Hospital


Personnel Ltd

Decision on Service of Notice of Hearing: The panel was informed at the start of this hearing that Mrs Nzvimbo-Dengwani was not

in attendance and that written notice of this hearing had been sent to her registered

address by recorded delivery and by first class post on 21 September 2016. Royal Mail

“Track and Trace” documentation confirmed that the notice of hearing was sent to Mrs

Nzvimbo-Dengwani’s registered address by recorded delivery on that date.

The panel took into account that the notice letter provided details of the allegation, the

time, dates and venue of the hearing and, amongst other things, information about Mrs

Nzvimbo-Dengwani’s right to attend, be represented and call evidence, as well as the

panel’s power to proceed in her absence.

The panel accepted the advice of the legal assessor.

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In the light of all of the information available, the panel was satisfied that Mrs Nzvimbo-

Dengwani has been served with notice of this hearing in accordance with the

requirements of Rules 11 and 34. It noted that the rules do not require delivery and that

it is the responsibility of any registrant to maintain an effective and up-to-date registered

address.

Decision on proceeding in the absence of the Registrant: The panel had regard to Rule 21 (2) (b) which states:

“Where the registrant fails to attend and is not represented at the hearing, the

Committee...may, where the Committee is satisfied that the notice of hearing has

been duly served, direct that the allegation should be heard and determined

notwithstanding the absence of the registrant...”

Mr Wong invited the panel to continue in the absence of Mrs Nzvimbo-Dengwani on the

basis that she had voluntarily absented herself. Mr Wong submitted that there was no

reason to believe that an adjournment would secure her attendance on some future

occasion.

The panel accepted the advice of the legal assessor. The panel noted that its

discretionary power to proceed in the absence of a registrant under the provisions of

Rule 21 is one that should be exercised “with the utmost care and caution” as referred

to in the case of R. v Jones (Anthony William), (No.2) [2002] UKHL 5.

The panel considered Mrs Nzvimbo-Dengwani’s reply to the notice of hearing dated 1

December 2016 in which she states her reason for not attending the hearing as follows:

“I am not coming to the hearing because I am not challenging the allegations but feel

that attending the hearing will have a drastic impact on my [PRIVATE].”

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Further, in a telephone call from Mrs Nzvimbo-Dengwani to the NMC on 6 December

2016, she confirmed that she would not be attending the hearing and would be happy

for the panel to proceed in her absence.

The panel has decided to proceed in the absence of Mrs Nzvimbo-Dengwani. In

reaching this decision, the panel has considered the submissions of the case presenter,

Mrs Nzvimbo-Dengwani’s email correspondence, along with her reply to the notice of

hearing, and the advice of the legal assessor. It has had particular regard to the factors

set out in the decision of Jones. It has had regard to the overall interests of justice and

fairness to all parties. It noted that:

• no application for an adjournment has been made by Mrs Nzvimbo-Dengwani;

• there is no reason to suppose that adjourning would secure her attendance at

some future date;

• the charges relate to events that occurred in 2013;

• there is a strong public interest in the expeditious disposal of the case.

There is some disadvantage to Mrs Nzvimbo-Dengwani in proceeding in her absence.

She will not be able to challenge the evidence relied upon by the NMC and will not be

able to give evidence on her own behalf. However, the panel noted from her telephone

call of 6 December 2016 that Mrs Nzvimbo-Dengwani was happy for the witness

evidence to be read into the record. The limited disadvantage is the consequence of

Mrs Nzvimbo-Dengwani’s decisions to absent herself from the hearing, waive her rights

to attend and/or be represented and to not provide evidence or make submissions on

her own behalf.

In these circumstances, the panel has decided that it is fair, appropriate and

proportionate to proceed in the absence of Mrs Nzvimbo-Dengwani.

Background

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The charges arose whilst Mrs Nzvimbo-Dengwani was employed as a Registered Nurse

by University Hospitals Southampton NHS Trust (“UHSNT”).

An investigation was opened following an allegation that Mrs Nzvimbo-Dengwani had

been undertaking nursing work via agency organisations (Medical Professional

Personnel Limited, Pulse Agency and Cromwell Medical Staffing), whilst in receipt of

sick pay from UHSNT.

The Hampshire and Isle of Wight Counter Fraud Service (the “Counter Fraud Service”)

conducted an investigation into the allegation that Mrs Nzvimbo-Dengwani had been

undertaking nursing work via agency organisations whilst in receipt of sick pay from

UHSNT. This investigation concluded that Mrs Nzvimbo-Dengwani began a period of

sickness from 10 March 2014, [PRIVATE]. During the absence period it was noted that

Mrs Nzvimbo-Dengwani was registered with temporary staffing agencies and worked as

a nurse via these agencies on 15 dates. Mrs Nzvimbo-Dengwani also received sickness

payments from UHSNT for the dates she was working elsewhere.

Throughout the course of the NMC’s investigation, it was noted that there were a

number of discrepancies in the information Mrs Nzvimbo-Dengwani provided on the

application/ registration forms she had submitted to the various employer and agency

organisations. The NMC’s investigation also concluded that Mrs Nzvimbo-Dengwani

provided a close family member referee on her application to the Royal Surrey County

Hospital NHS Foundation Trust (the “RSCHNFT”) for a Band 5 nursing position, and

subsequently relied on this reference in order to obtain employment.

Decision on the findings on facts and reasons In reaching its decisions on the facts, the panel considered all the evidence in this case

together with the submissions made by Mr Wong, on behalf of the NMC and those

made by Mrs Nzvimbo-Dengwani in her written statements.

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The panel accepted the advice of the legal assessor which included reference to the

case of R v Ghosh [1982] Q.B. 1053, as subsequently refined. He outlined the two part

test in relation to dishonesty. Firstly, the objective test: whether, according to the

ordinary standards of reasonable and honest people, what was done by the registrant

was dishonest. If it is not dishonest by those standards then that is the end of the

matter. If it is dishonest by those standards then, secondly, the subjective test: the panel

have to consider whether the registrant must have known that what she was doing was,

by those standards, dishonest.

The panel was aware that the burden of proof rests on the NMC, and that the standard

of proof is the civil standard, namely the balance of probabilities. This means that the

facts will be proved if the panel was satisfied that it was more likely than not that the

incidents occurred as alleged.

The panel has drawn no adverse inference from the non-attendance of Mrs Nzvimbo-

Dengwani.

The written statements of:

Ms 1, Human Resource Business Partner, at Frimley Health NHS Trust;

Ms 2, Clinical Nurse Manager, at Mayday Healthcare Plc;

Ms 3, previously Business Manager, at Pulse;

Ms 4, Head of Nursing, ICG Medical Ltd;

Ms 5, Nurse Consultant Interviewer and Trainer and Complaints Manager, at Medical

Professional Personnel Limited;

Ms 6, Head of HR Services, at Royal Surrey County Hospital NHS Foundation Trust;

Ms 7, Associate Human Resources Business Partner, at NHS Blood and Transplant;

Mr 8, Senior Clinical Manager/Matron, at Royal Surrey County Hospital NHS

Foundation Trust; and

Ms 9 Senior Workforce Systems and Medical HR Specialist, at University hospitals

Southampton NHS Foundation Trust,

http://login.westlaw.co.uk/maf/wluk/app/document?src=doc&linktype=ref&&context=79&crumb-action=replace&docguid=I472988A0E42811DA8FC2A0F0355337E9

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were read into the record by Mr Wong.

The panel found the witness statements of all nine witnesses to be reliable and noted

the contents were not disputed by Mrs Nzvimbo-Dengwani.

In her response to charges form, dated 1 December 2016, Mrs Nzvimbo-Dengwani

admitted the following charges:

Charges 1.a.i, 1.a.ii, 1.b.i, 1.b.ii, 1.b.iii, 1.b.iv, 1.b.v, 1.c, 2.a.ii, 2.b.i, 2.b.ii, 2.b.iii, 2.b.iv,

2.b.v, 2.d, 3.a.i, 3.a.ii, 3.a.iii, 3.a.iv, 3.a.v, 3.b, 3.c, 4.a, 4.b, 5, 6.a, 6.b and 6.c.

The panel found no evidence that contradicted Mrs Nzvimbo-Dengwani’s admissions.

These charges were therefore announced as proved by admission.

The panel then went on to consider the remaining charges.

The panel considered each charge separately and made the following findings:

Charge 2:


registration at Pulse Agency, in that you:

a. Stated that she had worked as a Band 6 Ward Sister at Royal Surrey County

Hospital from February 2004 to January 2011, when in fact:

i. you did not complete your nursing qualification or register with the


ii. …

b. …

c. Stated that you worked as a Band 5 staff nurse at Phyllis Tuckwell Hospice

between February 2004 and August 2007, when in fact you did not complete

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your nursing qualification or register with the Nursing and Midwifery Council until

February 2006;

Charge 2.a.i

This charge is found proved.

The panel had sight of Mrs Nzvimbo-Dengwani’s application for registration at Pulse

Agency dated 20 January 2014 in which she stated that she had worked at the

RSCHNFT as a Band 6 Ward Sister from February 2004 to January 2011.

The panel also noted a print out of Mrs Nzvimbo-Dengwani’s NMC record (Wiser file) in

which it stated that Mrs Nzvimbo-Dengwani was registered as a nurse on 12 February

2006.

On this basis, the panel concluded that Mrs Nzvimbo-Dengwani did provide incorrect

information on application for registration at Pulse Agency by stating that she had

worked as a Band 6 Ward Sister at Royal Surrey County Hospital from February 2004

to January 2011, when in fact she did not complete her nursing qualification or register

with the NMC until February 2006. It therefore found this charge proved.

Charge 2.c

This charge is found proved The panel had sight of Mrs Nzvimbo-Dengwani’s application for registration at Pulse

Agency dated 20 January 2014 in which she stated that she had worked at Phyllis

Tuckwell Hospice between February 2004 and August 2007as a Band 5 Staff Nurse.

The panel also noted a print out of Mrs Nzvimbo-Dengwani’s Wiser file in which it stated

that Mrs Nzvimbo-Dengwani was registered as a nurse on 12 February 2006.

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On this basis, the panel concluded that Mrs Nzvimbo-Dengwani did provide incorrect

information on application for registration at Pulse Agency by stating that she had

worked as a Band 5 Staff Nurse at Phyllis Tuckwell Hospice between February 2004

and August 2007, when in fact she did not complete her nursing qualification or register

with the NMC until February 2006. It therefore found this charge proved.

Charge 7:

7. On 17 October 2014:

a. provided your daughter’s contact details as one of your referees on your

application to the Royal Surrey County Hospital NHS Foundation Trust for a

Band 5 nursing position;

b. subsequently relied on a reference written by your daughter, in order to obtain

employment with the Royal Surrey County Hospital NHS Foundation Trust;

Charge 7.a

This charge is found proved

The panel was provided with a copy of Mrs Nzvimbo-Dengwani’s application to the

RSCHNFT for a Band 5 nursing position dated 17 October 2014. The panel noted the

section entitled “Referee 1” in which Mrs Nzvimbo-Dengwani provided the contact

details of her daughter, whose surname is different from hers. She described this

person as the manager, when in fact she was her daughter.

The panel also noted that Mrs Nzvimbo-Dengwani had provided the exact same person

and contact details in the next of kin section on two other application forms.

There is no record that Mrs Nzvimbo-Dengwani has ever been employed by NHS Blood

and Transplant.

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The panel was therefore satisfied that the person named as a reference on Mrs

Nzvimbo-Dengwani’s application to the RSCHNFT for a Band 5 nursing position was in

fact her daughter. It therefore found this charge proved.

Charge 7.b


The panel had sight of the reference received by RSCHNFT provided, and signed, by

Mrs Nzvimbo-Dengwani’s daughter on 6 November 2014 in which she states “Ms

Dengwani was a valuable member of the team liked and respected by all. She provided

excellent team leadership and exhibited very good nursing qualities for all our patients

undergoing complex treatment. She is reliable and very dependable, a very good

negotiator and quite flexible to meet the demands of the job. I have no doubt over the

good quality nursing skills she will provide and that she will do the job well.”

Ms 6, in her witness statement, pointed out page 15 of Mrs Nzvimbo-Dengwani’s

application which states “personal references such as friends and relatives are not

acceptable unless previously stated”. She also said that had it been known that the

referee may have been related to Mrs Nzvimbo-Dengwani, the RSCHNFT would have

required a further reference from Mrs Nzvimbo-Dengwani.

The panel was satisfied that Mrs Nzvimbo-Dengwani used a reference written by her

daughter in order to obtain employment at RSCHNFT and therefore found this charge

proved.

Charge 8:

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8. Your conduct at charge 7 was dishonest in that you intended to mislead Royal Surrey

County Hospital NHS Foundation Trust by stating that your daughter was your

manager, when she was not;

This charge is found proved There is no record that Mrs Nzvimbo-Dengwani has ever been employed by NHS Blood

and Transplant.

The panel was satisfied that Mrs Nzvimbo-Dengwani would have known that providing

her daughter as a reference whilst representing that she was her previous manager at

NHS Blood and Transplant was both untrue and misleading. Mrs Nzvimbo-Dengwani

was fully aware that she had never been employed by NHS Blood and Transplant. The

panel was satisfied that Mrs Nzvimbo-Dengwani’s actions in providing her daughter as a

reference was dishonest by the ordinary standards of reasonable and honest nurses,

and that Mrs Nzvimbo-Dengwani must have realised that by those standards what she

did was dishonest. It therefore found this charge proved.

Charge 9:

9. In or around February 2015, provided incorrect information on application for a Band

6 post at the Royal Surrey County Hospital NHS Foundation Trust, in that you:


2000 until 2012, when in fact:


ii. you were employed as a care assistant between 8 July 2002 and 10

February 2003;

iii. you worked shifts on the bank at Frimley Park Hospital in the capacity

of a care assistant between 2003 and 2006;



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v. you were employed in a band 5 staff nurse role from 13 February 2006

until 30 April 2011;

b. Stated that you had worked as a Staff Nurse via Cromwell Medical Staffing

from May 2013 when in fact you did not register with Cromwell Medical Staffing

until 5 February 2014;

c. Stated that you had worked as a Band 6 Ward Sister/Practice Development

Sister at Royal Surrey County Hospital from February 2006 to February 2011,

when in fact you did not commence a permanent Band 6 Junior Sister position at

the Royal Surrey County Hospital until 5 June 2011;

d. Stated that you worked as a Ward Sister at Southampton General Hospital

from March 2011 when in fact you did not commence employment at


Charge 9.a

This charge is found not proved in its entirety Ms 1, in her witness statement, said that Mrs Nzvimbo-Dengwani was first employed by

RSCHNFT as a care assistant, in a permanent capacity, between 8 July 2002 and 10

February 2003. She said that Mrs Nzvimbo-Dengwani then left her permanent position

to complete her nursing studies, but continued to work on the bank at Frimley Park

Hospital as a care assistant. Ms 1 further said that on 13 February 2006, Mrs Nzvimbo-

Dengwani commenced a permanent Band 5 Staff Nurse role with RSCHNFT and

worked in that position until 30 April 2011.

The panel noted that on Mrs Nzvimbo-Dengwani’s application form for a Band 6 post at

RSCHNFT she states that she worked as a “healthcare assistant/staff nurse” between

February 2000 and February 2009.

The allegation against Mrs Nzvimbo-Dengwani is that she provided incorrect dates on

an application for a Band 6 post at RSCHNFT, stating that worked as a Staff Nurse at

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Frimley Park Hospital from 2000 until 2012. The panel considered that, whilst Mrs

Nzvimbo-Dengwani had never worked at Frimley Park Hospital in 2000, she did start

working there from 2002. She did not, as alleged in the charge, state that she had

worked as a Staff Nurse from 2000 until 2012. Therefore this charge is not proved.

Charge 9.b

This charge is found proved Ms 4, in her witness statement, said that Mrs Nzvimbo-Dengwani applied to register

with Cromwell Medical Staffing on 30 January 2014. She said that Mrs Nzvimbo-

Dengwani completed the Cromwell Medical Staffing compliance programme and was

considered available to commence shifts on 5 February 2014.

In her application for a Band 6 post at RSCHNFT Mrs Nzvimbo-Dengwani states that

she worked as a Staff Nurse at Cromwell Medical Staffing from May 2013.

The panel was satisfied, having been provided with a copy of Mrs Nzvimbo-Dengwani’s

application for registration at Cromwell Medical Staffing, dated 30 January 2014, and a

copy of a print out of all shifts booked for Mrs Nzvimbo-Dengwani, in which it is

confirmed that her first shift was on 21 February 2014, that Mrs Nzvimbo-Dengwani did

not register with Cromwell Medical Staffing until 5 February 2014. It therefore found this

charge proved.

Charge 9.c

This charge is found proved Ms 6, in her witness statement, said that Mrs Nzvimbo-Dengwani was employed by

RSCHNFT from 5 June 2011 to 5 March 2012 as a Band 6 Junior Sister. She said that

Mrs Nzvimbo-Dengwani first registered with the Bank Register on 3 July 2006.

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In her application for a Band 6 post at RSCHNFT Mrs Nzvimbo-Dengwani states that

she worked as a Ward Sister/ Practice Development Sister at RSCHNFT from February

2006 to February 2011.

The panel considered that given the fact that Mrs Nzvimbo-Dengwani qualified as a

Registered Nurse in 2006, it would be highly unlikely that she would have commenced

as a Band 6 Ward Sister/Practice Development Sister straight after qualification. In

addition, the panel have evidence to show that Mrs Nzvimbo-Dengwani worked as a

Band 5 Staff Nurse at Frimley Park Hospital from 2006 up until 2009. The panel was

satisfied that Mrs Nzvimbo-Dengwani did not commence a permanent Band 6 Junior

Sister position at the RSCHNFT until 5 June 2011. It therefore found this charge proved.

Charge 9.d

This charge is found proved The panel noted that Mrs Nzvimbo-Dengwani in charges 1.c, 2.d and 3.c has admitted

that she did not commence employment with Southampton General Hospital until 5

March 2012. The panel was satisfied that, in her application for a Band 6 post at

RSCHNFT, Mrs Nzvimbo-Dengwani stated that she worked as a Ward Sister at

Southampton General Hospital from March 2011 when in fact she did not commence

employment at Southampton General Hospital until 5 March 2012. It therefore found

this charge proved.

Charge 10: 10. Your conduct at charges 1, and/or 2, and/or 3, and/or 6, and/or 9 was dishonest in

that you:

a. knew that one or more of the statements you made were incorrect;

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b. intended to mislead your potential employers by providing incorrect information

about your previous nursing experience;

Mrs Nzvimbo-Dengwani, in her written statement, said “I do not challenge any of the

investigations but want to stress that there was never an element/intention to mislead

and I made judgemental errors in the accuracy of some of the information I provided. I

admit that I should have made efforts to check the accuracy of information on my

application forms in relation to the dates and job description. I did not and still do not

have the exact dates of when I started or left my jobs and could therefore not provide

actual dates of employment and this is one of the issues of concern in this case. My

application for the job in the Royal Surrey was rushed to meet the deadline.” Mrs

Nzvimbo-Dengwani also said, in an email received by the NMC on 13 December 2016,

“When I applied for the job I was given a paper application form to fill in on the spot so

as to meet the deadline which was the same day. I had worked in the hospital before

starting as a healthcare assistant with NHSP (NHS Professionals) and had a good

relationship with the manager. There was no intention to mislead anyone but it was an

error on my part with regard to dates and not differentiating the job role. I have to

reiterate that I did make mistakes on dates and that was a genuine error on my part. I

also did not differentiate my job roles which I noticed on the evidence provided. I

qualified as a nurse in 2006 and had worked in Frimley Royal Surrey and Phyllis

Tuckwell as an HCA before then. I was never a band six in Frimley.” [sic]

Charge 10.a


The panel was satisfied that, save for charge 9.a which was found not proved, Mrs

Nzvimbo-Dengwani knew that the statements she made in her application forms were

incorrect and that her conduct was dishonest. The panel considered that it was

inconceivable that Mrs Nzvimbo-Dengwani could not recollect that she had qualified as

a Registered Nurse in 2006 and mistakenly stated that she was working as a

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Registered Nurse in 2000. The panel was satisfied that Mrs Nzvimbo-Dengwani’s

actions in providing incorrect statements was dishonest by the ordinary standards of

reasonable and honest nurses, and that Mrs Nzvimbo-Dengwani must have realised by

those standards that what she did was dishonest. It therefore found this charge proved.

Charge 10.b

This charge is found proved The panel was satisfied that Mrs Nzvimbo-Dengwani had a clear motive in trying to

mislead her employers by providing incorrect information about her previous nursing

experience and that she knew this was dishonest. The panel considered that the

statements made were not minor errors. They were numerous and significant and

related not only to dates, but also levels of seniority which would vastly impact on a

recruiters’ perception of her experience as a nurse. The panel was satisfied that Mrs

Nzvimbo-Dengwani’s intention to mislead her employers by providing incorrect

statements was dishonest by the ordinary standards of reasonable and honest nurses,

and that Mrs Nzvimbo-Dengwani must have realised that by those standards what she

did was dishonest. It therefore found this charge proved. Submission on misconduct and impairment:

Having announced its finding on all the facts, the panel then moved on to consider,

whether the facts found proved amount to misconduct and, if so, whether Mrs Nzvimbo-

Dengwani’s fitness to practise is currently impaired. The NMC has defined fitness to

practise as a registrant’s suitability to remain on the register unrestricted.

In his submissions Mr Wong invited the panel to take the view that Mrs Nzvimbo-

Dengwani’s actions amount to a breach of The Code: Standards of conduct,

performance and ethics for nurses and midwives 2008 (“the Code”). He then directed

23

the panel to specific paragraphs and identified where, in the NMC’s view, Mrs Nzvimbo-

Dengwani’s actions amounted to misconduct.

Mr Wong referred the panel to the case of Roylance v GMC (No. 2) [2000] 1 AC 311

which defines misconduct as a word of general effect, involving some act or omission

which falls short of what would be proper in the circumstances.

He then moved on to the issue of impairment, and addressed the panel on the need to

have regard to protecting the public and the wider public interest. This included the

need to declare and maintain proper standards and maintain public confidence in the

profession and in the NMC as a regulatory body. Mr Wong referred the panel to the

case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery

Council (2) Grant [2011] EWHC 927 (Admin).

The panel has accepted the advice of the legal assessor which included reference to a

number of relevant authorities, which included: Roylance and Ronald Jack Cohen v

General Medical Council [2008] EWHC 581 (Admin).

The panel adopted a two-stage process in its consideration, as advised. First, the panel

must determine whether the facts found proved amount to misconduct. Secondly, only if

the facts found proved amount to misconduct, the panel must decide whether, in all the

circumstances, Mrs Nzvimbo-Dengwani’s fitness to practise is currently impaired as a

result of that misconduct.

Decision on misconduct

When determining whether the facts found proved amount to misconduct the panel had

regard to the terms of The code: Standards of conduct, performance and ethics for

nurses and midwives 2008 (the “Code”).

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The panel, in reaching its decision, had regard to the public interest and accepted that

there was no burden or standard of proof at this stage and exercised its own

professional judgement.

The panel was of the view that Mrs Nzvimbo-Dengwani’s actions did fall significantly

short of the standards expected of a registered nurse, and that her actions amounted to

a breach of the Code. Specifically:

From the Preamble:

The people in your care must be able to trust you with their health and wellbeing To justify that trust, you must: • be open and honest, act with integrity and uphold the reputation of your profession

As a professional, you are personally accountable for actions…and must always be able

to justify your decisions.

And Specifically:

61 You must uphold the reputation of your profession at all times.

The panel appreciated that breaches of the Code do not automatically result in a finding

of misconduct. However, the panel was of the view that Mrs Nzvimbo-Dengwani’s

actions constituted a very significant departure from the standard expected of a

registered nurse. The panel considered that fellow practitioners would regard Mrs

Nzvimbo-Dengwani’s actions as deplorable. The panel concluded that her actions

constituted misconduct not only because of the dishonesty proved, but also because

Mrs Nzvimbo-Dengwani’s acts were numerous and for personal gain.

The panel found that Mrs Nzvimbo-Dengwani’s actions did fall seriously short of the

conduct and standards expected of a nurse and amounted to misconduct.

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Decision on impairment The panel next went on to decide if as a result of this misconduct Mrs Nzvimbo-

Dengwani’s fitness to practise is currently impaired.

Nurses occupy a position of privilege and trust in society and are expected at all times

to be professional. Patients and their families must be able to trust nurses with their

lives and the lives of their loved ones. To justify that trust, nurses must be honest and

open and act with integrity. They must make sure that their conduct at all times justifies

both their patients’ and the public’s trust in the profession. In this regard the panel

considered the judgement of Mrs Justice Cox in the case of Council for Healthcare

Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011] EWHC 927

(Admin) in reaching its decision, in paragraph 74 she said:

“In determining whether a practitioner’s fitness to practise is impaired by

reason of misconduct, the relevant panel should generally consider not

only whether the practitioner continues to present a risk to members of the

public in his or her current role, but also whether the need to uphold

proper professional standards and public confidence in the profession

would be undermined if a finding of impairment were not made in the

particular circumstances.”

She went on to say in Paragraph 76:

“I would also add the following observations in this case having heard

submissions, principally from Ms McDonald, as to the helpful and

comprehensive approach to determining this issue formulated by

Dame Janet Smith in her Fifth Report from Shipman, referred to above.

At paragraph 25.67 she identified the following as an appropriate test for

panels considering impairment of a doctor’s fitness to practise, but in my

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view the test would be equally applicable to other practitioners governed

by different regulatory schemes.

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 dishonestly and/or is liable to act

dishonestly in the future.”

The panel finds that all four limbs are engaged. Mrs Nzvimbo-Dengwani has in the past

acted, and is liable in the future to act, so as to put patients at unwarranted risk of harm

by misrepresenting her length and level of nursing experience. She has in the past

brought, and is liable in the future to bring, the nursing profession into disrepute by

breaching the Code. Mrs Nzvimbo-Dengwani has in the past breached, and is liable in

the future to breach, one of the fundamental tenets of the nursing profession and her

actions have been proved to be dishonest on more than one occasion.

Regarding insight, the panel considered that although Mrs Nzvimbo-Dengwani had

been engaging with the NMC leading up to the hearing, and has shown some limited

insight by admitting a number of the charges against her, she had not submitted

anything before the panel which shows that she understands the seriousness of her

actions and the potential consequences. The panel has found no evidence of real

insight or remorse on Mrs Nzvimbo-Dengwani’s part. She has demonstrated no

27

understanding as to how serious her actions were, nor the potential impact of her

actions on public trust in the nursing profession. Notwithstanding that Mrs Nzvimbo-

Dengwani had told the panel that at the relevant time she was suffering severe personal

difficulties, the panel was of the view that this had no bearing on the misconduct found.

The panel recognises that dishonesty is difficult to remediate and in this case has been

provided with no evidence of remediation.

In the absence of any significant insight and remediation, the panel is of the view that

there is a real risk of repetition of this misconduct, specifically dishonesty.

Misrepresenting both length and level of experience could potentially result in placing

patients at risk of harm. The panel therefore decided that a finding of impairment is

necessary on the grounds of public protection.

The panel bore in mind that the overarching objectives of the NMC are to protect,

promote and maintain the health safety and well-being of the public and patients, and to

uphold/protect the wider public interest, which includes promoting and maintaining

public confidence in the nursing and midwifery professions and upholding the proper

professional standards for members of those professions.” The panel determined that,

in this case, a finding of impairment on public interest grounds was also required. This

was necessary, not only because Mrs Nzvimbo-Dengwani has acted dishonestly and

brought the nursing profession into disrepute, but also because public confidence in the

NMC as a regulator would be undermined if the wider public knew that there was a

possibility that nurses were being recruited and were practising on the basis of

dishonestly misrepresenting their level of experience and seniority.

Having regard to all of the above, the panel was satisfied that Mrs Nzvimbo-Dengwani’s

fitness to practise is currently impaired. Determination on sanction:

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The panel has considered this case very carefully and has decided to make a striking-

off order. The effect of this order is that the NMC register will show that Mrs Nzvimbo-

Dengwani has been struck-off the register.

In reaching this decision, the panel has had regard to all the evidence in this case. The

panel accepted the advice of the legal assessor which included reference to the case of

Atkinson v GMC [2009] EWHC 3636 (Admin). The panel has borne in mind that any

sanction imposed must be appropriate and proportionate and, although not intended to

be punitive in its effect, may have such consequences. The panel had careful regard to

the Indicative Sanctions Guidance (“ISG”) published by the NMC. It recognised that the

decision on sanction is a matter for the panel, exercising its own independent

judgement.

The panel considered the aggravating and mitigating factors in this case as follows:

Aggravating:

• Mrs Nzvimbo-Dengwani’s actions involved prolonged and repeated dishonesty;

• Mrs Nzvimbo-Dengwani defrauded the public purse in continuing to receive sick

pay whilst she was working as an agency nurse;

• Mrs Nzvimbo-Dengwani has previously been subject to NMC proceedings; and

• Mrs Nzvimbo-Dengwani has demonstrated a complete lack of remorse and a

lack of an understanding into the potential consequences and severity of her

actions.

Mitigating:

• Mrs Nzvimbo-Dengwani has demonstrated insight through her admissions to

some of the charges against her, albeit limited insight; and

• The panel noted the severe personal difficulties Mrs Nzvimbo-Dengwani was

facing at the time, although none of which are relevant to the dishonesty found

proved.

29

The panel first considered whether to take no action but concluded that this would be

inappropriate in view of the seriousness of the case. The panel decided that it would be

neither proportionate nor in the public interest to take no further action, nor would it

adequately protect the public.

Next, in considering whether a caution order would be appropriate in the circumstances,

the panel took into account the ISG, which states that a caution order may be

appropriate where ‘the case is at the lower end of the spectrum of impaired fitness to

practise and the panel wishes to mark that the behaviour was unacceptable and must

not happen again.’ The panel considered that Mrs Nzvimbo-Dengwani’s misconduct

was not at the lower end of the spectrum and that a caution order would be

inappropriate in view of the seriousness of the case. The panel decided that it would be

neither proportionate nor in the public interest to impose a caution order, nor would it

adequately protect the public.

The panel next considered whether placing conditions of practice on Mrs Nzvimbo-

Dengwani’s registration would be a sufficient and appropriate response. The panel is

mindful that any conditions imposed must be proportionate, measurable and workable.

The panel took into account the ISG, in particular:

64.8 It is possible to formulate conditions and to make provision as to how

conditions will be monitored

The panel is of the view that there are no practical or workable conditions that could be

formulated, given the nature of the charges in this case. The misconduct identified in

this case involved numerous findings of dishonesty which was not something that can

be addressed through retraining.

30

Furthermore the panel concluded that the placing of conditions on Mrs Nzvimbo-

Dengwani’s registration would not adequately address the seriousness of this case and

would not protect the public.

The panel then went on to consider whether a suspension order would be an

appropriate sanction.

66.1 Does the seriousness of the case require temporary removal from the

register?

66.2 Will a period of suspension be sufficient to protect patients and the public

interest?

The panel took note of the following paragraphs of the ISG:

68 This sanction may be appropriate where the misconduct is not fundamentally

incompatible with continuing to be a registered nurse or midwife in that the public

interest can be satisfied by a less severe outcome than permanent removal from the

register. This is more likely to be the case when some or all of the following factors are

apparent (this list is not exhaustive):

68.1 A single instance of misconduct but where a lesser sanction is not sufficient.

68.2 No evidence of harmful deep-seated personality or attitudinal problems.

68.4 The panel is satisfied that the nurse or midwife has insight and does not

pose a significant risk of repeating behaviour.

This was not a single instance of misconduct. There is evidence of attitudinal problems.

Mrs Nzvimbo-Dengwani has not demonstrated sufficient insight and the panel is

satisfied that there is a significant risk of repetition of this behaviour.

The seriousness of the misconduct, in particular the dishonesty, aligned to a complete

absence of any evidence of real insight into the seriousness of her actions and potential

31

risk to patients, remorse or of remediation, led the panel to conclude that there remains

a significant risk of repetition of this behaviour.

The conduct, as highlighted by the facts found proved, was a significant departure from

the standards expected of a registered nurse. The panel noted that the serious breach

of the fundamental tenets of the profession evidenced by Mrs Nzvimbo-Dengwani’s

actions is fundamentally incompatible with her remaining on the register.

The panel felt that the nature of the dishonesty was such that a suspension order would

not be a sufficient, appropriate or proportionate sanction to protect the public and satisfy

the wider public interest.

Balancing all of these factors, the panel has determined that a suspension order would

not be an appropriate or proportionate sanction.

Finally, in looking at a striking-off order, the panel took note of the following paragraphs

of the ISG:

71.1 Is striking-off the only sanction which will be sufficient to protect the public

interest?

71.2 Is the seriousness of the case incompatible with ongoing registration (see

paragraph 66 above for the factors to take into account when considering

seriousness)?

71.3 Can public confidence in the professions and the NMC be sustained if the

nurse or midwife is not removed from the register?

72 This sanction is likely to be appropriate when the behaviour

is fundamentally incompatible with being a registered professional, which may involve

any of the following (this list is not exhaustive):

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72.1 Serious departure from the relevant professional standards as set out in key

standards, guidance and advice including (but not limited to):

72.1.1 The code: Standards of conduct, performance and ethics for nurses

and midwives

72.6 Dishonesty, especially where persistent or covered up

72.7 Persistent lack of insight into seriousness of actions or consequences

Mrs Nzvimbo-Dengwani’s actions were very significant departures from the standards

expected of a registered nurse, and are fundamentally incompatible with her remaining

on the register. The panel was of the view that the findings in this particular case

demonstrate that Mrs Nzvimbo-Dengwani’s actions were serious and to allow her to

continue practising would undermine public confidence in the profession and in the

NMC as a regulatory body.

The panel also considered paragraphs 36-38 of the ISG which had particular regard to

dishonesty. The panel recognised that there was no evidence of actual harm to patients

but Mrs Nzvimbo-Dengwani’s actions had the potential to put patients at harm.

Moreover, dishonesty of any kind has the potential to undermine the public trust in the

profession and honesty, integrity and trustworthiness must always be the bedrock of

any nurse’s practice.

The panel considered Parkinson v NMC [2010] EWHC 1898 (Admin). There is in Mrs

Nzvimbo-Dengwani’s case, no evidence of remorse, no realisation that the conduct was

dishonest, and no undertaking that there would be no repetition. Furthermore, there was

no demonstration of any real insight into the seriousness or potential risk to patients

arising from her actions.

Balancing all of these factors and after taking into account all the evidence before it

during this case, the panel determined that the appropriate and proportionate sanction

is that of a striking-off order. Having regard to the matters it identified, in particular the

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effect of Mrs Nzvimbo-Dengwani’s actions in bringing the profession into disrepute by

adversely affecting the public’s view of how a registered nurse should conduct herself,

the panel has concluded that nothing short of this would be sufficient in this case.

The panel considered that this order was necessary, notwithstanding any potential

adverse impact this order may have on Mrs Nzvimbo-Dengwani, to mark the importance

of maintaining public confidence in the profession, and to send to the public and the

profession a clear message about the standard of behaviour required of a registered

nurse.

Determination on Interim Order The panel has considered the submissions made by Mr Wong that an interim

suspension order for a period of 18 months should be made on the grounds that it is

necessary for the protection of the public and is otherwise in the public interest.

The panel accepted the advice of the legal assessor.

The panel was satisfied that an interim suspension order is necessary for the protection

of the public and is otherwise in the public interest. The panel had regard to the

seriousness of the facts found proved and the reasons set out in its decision for the

substantive order in reaching the decision to impose an interim order. To do otherwise

would be incompatible with its earlier findings.

The period of this order is for 18 months to allow for the possibility of an appeal to be

made and determined.

If no appeal is made, then the interim order will be replaced by the striking-off order 28

days after Mrs Nzvimbo-Dengwani is sent the decision of this hearing in writing.

That concludes this determination.

Documents

Conduct and Competence Committee...2016/12/15 · Nursing Limited until October 2013; 7. On 17 October 2014: a. provided your daughter’s contact details as one of your referees