A dietician who bluffed her way into a senior NHS job by exaggerating her experience has been struck off after colleagues found she did not know 'basic anatomy' and could have put patients at risk.
Ifenyinwa Chizube Ndulue-Nonso was hired as a dietician at Manchester Royal Infirmary in 2024.
Having moved from Nigeria, she claimed to have experience working with a range of different health problems and nutrition-related diseases as well as working with people with eating disorders and cancer.
However within days of beginning her role, colleagues quickly discovered worrying gaps in her knowledge and inconsistencies with her application.
They found she could barely answer questions about dietetics, struggled to calculate BMI and had only a 'basic understanding of human anatomy'- even mixing up the small and large intestine.
Mrs Ndulue-Nonso also could not identify a feeding tube, explain what coeliac disease was and believed radiology was used to treat heart failure.
Concerned by her lack of knowledge, the Trust launched an investigation and suspended her within weeks, fearing she was unsafe to practice.
At a disciplinary hearing, the Trust found her guilty of gross misconduct. She was sacked and her appeal failed.
A Health and Care Professions Tribunal Service (HCPTS) hearing found that she deliberately lied on her application form and during her interview, and was not qualified for her role.
Mrs Ndulue-Nonso 'minimised' concerns raised, admitting she had overstated her knowledge and experience 'a bit', putting it down to cultural differences.
But the panel found her dishonesty was premeditated and deliberate, putting patients at risk by misrepresenting her knowledge and experience to 'benefit her personally'.
They said she had 'much to gain personally from securing employment in the UK, including the right to reside here with her family'.
The only reason no one was harmed was because of the precautions taken by her supervisors, who did not allow her to be patient-facing, the panel said.
The panel was told that Mrs Ndulue-Nonso applied for a Band 6 Rotational Dietician role at the trust in August or September 2023. She was the only person interviewed for the role.
In her interview, she was assessed as having suitable skills and knowledge, scoring 28 out of 45 points.
The Trust received satisfactory references about her previous roles, and she began work on 19 February 2024, having moved from Nigeria to the UK.
Two weeks later on February 28, her line manager Curtis Roberts returned from annual leave and met Mrs Ndulue-Nonso.
He immediately discovered that her descriptions of her previous role were inconsistent with what she had described in her application form.
Her colleague Lorna Haywood, who was the other Band 7 dietician in the team, had already started a supervision log after becoming concerned about her lack of knowledge.
Just three days into the job, Ms Haywood has asked Mrs Ndulue-Nonso which part of the intestine comes after the stomach in the digestion process. She incorrectly replied that it was the large intestine.
That same day Ms Haywood said she could not calculate a BMI correctly and did not know what the signs or symptoms of dysphagia were.
On February 28, she was called into a probation review meeting with Ms Haywood and Amy Barker, Dietetic team lead, where they explained concerns about her lack of knowledge about anatomy, biochemistry and pharmacology, as well as a lack of ability to create treatment plans.
She was called into a further one-to-one meeting with Ms Barker the following day and said she felt overwhelmed and scared by the previous meeting.
Ms Barker identified that not only was Mrs Ndulue-Nonso unqualified for a Band 6 role, but she was also barely qualified for a Band 5 role.
Mrs Ndulue-Nonso was asked to go through a Band 5 job description and write on it what she could and could not do. However, when she was asked to explain the requirements which she said she had knowledge of, she was unable to do so.
On March 12 Jane Alderdice, Divisional Professional Lead for Adult Dietetics, met with Mrs Ndulue-Nonso.
There, she was informed that she was suspended while an investigation was launched into whether she falsified her application.
Her colleagues felt that she was 'unsafe to practice', the panel was told.
In her application, Mrs Ndulue-Nonso wrote: '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...'
She added: '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.'
Mr Roberts told the panel that Mrs Ndulue-Nonso was unable to tell him about coeliac disease, eating disorders, cancer, irritable bowel syndrome or gastrointestinal disease.
Mr Roberts recorded in the supervision log that she was not sure of the difference between Coeliac disease and IBS.
He said she had no experience of patients with burns, nor with parenteral nutrition, despite her claims made in her application.
When she was asked to complete a case study, he said she Googled dietetic terms that he expected her to know.
On February 27, Ms Haywood asked Mrs Ndulue Nonso 'what is Radiotherapy used to treat?', to which she replied 'heart failure, to help his chest'.
She added that when they entered a high-dependency unit (HDU), Mrs Ndulue-Nonso said she had experience in the unit and with enteral feeding.
However, when asked to identify the feeding route, Mrs Ndulue-Nonso could not identify the feeding tube placed in the patient's nose.
She wrote in the supervision log: 'She told me that the tube he had in his nose was his breathing tube.
'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 telling me previously she has had a 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 that they were not fixed with tape to the nose, but the tubes were the same.'
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In evidence to the panel, Mrs Ndulue Nonso said she was not aware that she did not meet the standards for the role and did not accept that she had no knowledge, having worked as a dietician in Nigeria.
She said in her role in Nigeria, doctors deal with medical matters before referring patients to dieticians.
Under cross-examination, she was asked what the gallbladder does and said it was the part of the kidney where urine is stored.
The panel also asked about the effects of cancer on the human body and Mrs Ndulue-Nonso was only able to provide general answers, which she said included hair loss and a change in skin colour.
She failed to mention any impact of chemotherapy on taste changes and swallow challenges that may accompany treatments.
The panel found she had little or no knowledge or experience in most of the areas she claimed to have in her application.
She admitted having no experience at all in several critical fields, including parenteral nutrition, artificial feeding, working with pharmacists or medical lab scientists.
She tried to play down what she had done, saying she exaggerated her experience 'a bit', putting it down to cultural differences.
Assessing whether she should still be allowed to work, the panel said she showed almost no real remorse.
She was struck off the register, meaning she can no longer work as a dietician anywhere in the UK.
A spokesperson from Manchester University NHS Foundation Trust said:'We are pleased to see the hearing has concluded after we reported Mrs Ndulue-Nonso to the relevant professional body,in this case the Health & Care Professions Council.
'Whilst Mrs Ndulue-Nonso was a registered practitioner at the point of employment,concerns were raised by staff within a few days that she may have misrepresented her qualifications.
'We ensured she was always supervised in the workplace as we conducted a rapid fact-finding exercise,following which swift action was taken and she was removed from her post.No patients were harmed or their care impacted.'
'We have since reviewed our recruitment processes and strengthened our operations.Anyone that falsifies information in the recruitment process will be reported to the Health & Care Professions Council.'
Mrs Ndulue-Nonso was contacted for comment.