InHealth MRI - Barnet Hospital

Barnet MRI Centre is operated by InHealth Limited. The service is situated in a unit shared between the provider and the NHS host trust. The unit sees both NHS and private patients on an outpatient basis; as well as providing a service for inpatients from the host trust. Both adults and children under 18 years old are seen at the unit.

The unit contains one MRI scanner that belongs to a third party. The unit is separately staffed by InHealth. The opening hours are Monday to Friday, 7am until 9pm, and Saturday and Sunday, 8am until 8pm.

The service is part of the host trust’s ‘one stop shop’ for prostate and breast cancer clinics.

We inspected this location under our diagnostic and imaging inspection methodology. We carried out our visit as an unannounced inspection lasting one day, on 24 January 2019, with two CQC inspectors and a specialist advisor.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

This was the first time we rated this service. We rated it as good overall.

We rated this service as good because:

• Staff completed and updated risk assessments for each patient. MRI safety questionnaires were completed by all persons entering the MRI scanning room to ensure their safety. This included patients and staff. There was a specific protocol in place for any pregnant patients requiring a scan. Staff escalated any concerns to an appropriate clinician immediately before the patient left the unit.
• Staff treated patients with kindness and understanding. They reassured patients and, where necessary, sat with them throughout their scan to support and reassure them.
• There was effective multidisciplinary working between staff working across the provider and the host trust. The superintendent radiographer attended the daily bed meeting to establish the patients requiring MRI scanning for that day. Certain appointment times were kept free to accommodate the host trust inpatient scan requests.
• The service planned and provided services in a way that met the needs of local people and people could access the service when they needed it. Patients could be seen seven days a week, from early in the morning until late at night.

However:

• There was no service level agreement (SLA) between the host trust and the provider, or with any third party for the provision of services at the location. This included cleaning of the shared unit, attending crash calls and waste management.
• There was no security in place to prevent unauthorised entry to the unit. This was a risk to patients and staff alike. A business case had been put forward to address this issue; however, at the time of our inspection, there was no security in place.
• Patients did not always have their privacy and dignity maintained. The scanning viewing room was also the team office and therefore did not afford privacy to the patient inside the scanner.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South East England)