InHealth MRI - Kingston Hospital

Updated 29 November 2018

InHealth Limited became responsible for the MRI service at Kingston Hospitals NHS Foundation Trust in October 2009 following a trust led procurement exercise.

The MRI service is provided from two units within the main hospital. A static MRI unit within the main hospital building utilising a one MRI scanner providing services to both in-patients and outpatients and a modular unit located near to the hospital car park provides bespoke outpatient capacity using another MRI scanner for adults.

The unit is registered with the CQC to undertake regulated activities of diagnostic and screening services. The service has been registered with the CQC in 2009. The unit is operational from Monday to Sunday 7.30am to 7.30pm. Patients with suspected malignant cord compression are scanned within 24 hours, in accordance with National Institute for Health and Care Excellence (NICE) guidelines.

Emergencies requiring possible MRI scans out of hours are managed by the on-call radiologist, whereby the patient will be referred for appropriate alternative imaging, or offered the first MRI in-patient appointment slot the following day. Patients requiring specialist neurological care are transferred to an appropriate centre.

The reporting of NHS MRI scans remains the responsibility of the Kingston Hospital NHS Foundation Trust and is managed by the radiology leads. InHealth provides support when requested by the radiology manager by outsourcing scan reporting to an external provider.

These reports are managed by the imaging services manager and the MRI superintendent radiographer from outsource to downloading of reports onto the trust picture archiving and communication system (PACS). PACS is a computerised means of replacing the roles of conventional radiological film.

The unit is managed by the registered manager who is supported by a superintendent radiographer, and a team of Health and Care Professions Council registered MRI radiographers, and supporting administrative staff. The service provides MRI scanning to both inpatients and outpatient referrals from Kingston Hospitals NHS Foundation Trust, GPs and private referrers.

Updated 29 November 2018

Kingston MRI Unit is operated by InHealth Limited. The MRI Unit at Kingston Hospital NHS Foundation Trust is a joint venture between Kingston Hospital NHS Trust and InHealth Limited. The unit was registered with CQC in March 2011. The unit provides a wide range of magnetic resonance imaging (MRI) scans examinations to the NHS, Clinical Commissioning Groups, GPs and private patients. It provided approximately 10,000 MRI examinations per year to patients.

We inspected diagnostic imaging services using our comprehensive inspection methodology. We carried out the inspection unannounced on 8 October 2018.

The service has two MRI scanners providing diagnostic imaging services in two different areas of the hospital. The static unit is situated between the cardiac unit and the hospital main outpatient reception area, behind the Sir William Rous Unit. Internal access is achieved on level 3 of the hospital main building, and the modular unit is located adjacent to the car park opposite the Royal Eye Unit of the hospital.

The unit provides diagnostic imaging services for adults, children and young people.

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.

The main service provided by this unit was MRI scanning.

Services we rate

We rated this service as good overall because:

• There were adequate systems to keep people safe and to learn from critical incidents.
• The unit was visibly clean and well maintained and there were measures to prevent the spread of infection.
• There were adequate numbers of suitably qualified, skilled and experienced radiology and administrative staff to meet patients’ needs.
• There were arrangements to ensure staff had and maintained the skills required to do their jobs.
• There were arrangements to ensure people received adequate hydration that met their needs and preferences.
• Care was delivered in line with national guidance and the outcomes for patients were good when benchmarked with other InHealth locations.
• Robust arrangements for obtaining consent ensured legal requirements and national guidance were met.
• The individual needs of patients were met, including those in vulnerable circumstances, such as those living with learning disability or dementia.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals (London)

Updated 29 November 2018

Staff had a good understanding of how to report incidents, and learning from incidents was shared locally and across the organisation.

There was a clear management structure and clear lines of accountability. Service and organisational leaders were described as visible and approachable. The culture of the service drove improvement and delivery of high quality care.

All patients gave consent prior to their procedure and staff were aware of their responsibilities under the Mental Capacity Act 2005.

The service followed InHealth complaints procedure. Complaints were discussed at governance meetings and learning from complaints were shared with staff during team meetings.

Equipment was well maintained and tested annually or in accordance with manufacturers’ guidelines.

Radiology staff were qualified, registered with their professional bodies and had the appropriate skills to carry out their roles effectively and in line with best practice.

Services were planned and delivered in a way which met the needs of the local population. Waiting times and cancellations were minimal and managed appropriately.