InHealth Diagnostics - Nottingham Specialist Imaging Centre

Updated 24 December 2018

InHealth was established over 25 years ago with the aim of reducing waiting times, speeding up diagnoses, saving money and improving patient pathways. The Nottingham centre opened in 2006 following a local trust led procurement exercise. The NHS trust hold the contract with NHS England for the service and InHealth are the nominated sub-contractor for the PET-CT service. The building was designed specifically for the scanning of PET-CT patients and is leased from the trust. Both private and NHS referrals are received from consultants at local NHS hospitals. Although the service is independently run by InHealth, support services are provided from the trust including Administration of Radioactive Substances Advisory Committee (ARSAC) licence holders, medical physics staff for equipment testing, radiation protection services and medical physics expert (MPE) services for PET-CT. Additionally image reporting is performed by trust employed radiologists.

A registered manager had been in post since March 2011. We inspected this service on 22 October 2018. This was the first inspection since registration.

Updated 24 December 2018

The Nottingham InHealth Specialist Imaging Centre (NISIC) is operated by InHealth. The service provides PET-CT (positron emission tomography–computed tomography) and diagnostic facilities for adults and children.

We inspected PET-CT diagnostic facilities for adults and children.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced inspection on 22 October 2018.

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 PET-CT.

Services we rate

We rated this service as good.

We found good practice in relation to diagnostic imaging:

• There were effective systems in place to keep people protected from avoidable harm.

• There were sufficient numbers of staff with the necessary skills, experience and qualifications to meet patients’ needs.

• There was a programme of mandatory training in key safety areas, which all staff completed, and systems for checking staff competencies.

• Equipment was maintained and serviced appropriately and the environment was visibly clean.

• Staff were trained and understood what to do if a safeguarding issue was identified.

• Records were up to date and complete and kept protected from unauthorised access.

• Incidents were reported, investigated and learning was implemented.

• The service used evidence based processes and best practice, this followed recognised protocols. Scans were timely, effective and reported on in timely way.

• Staff were competent in their field and kept up to date with their professional practice.

• The service worked well with internal and external colleagues and partnership working was strong.

• Staff demonstrated a kind and caring approach to their patients, supported their emotional needs and provided reassurance.

• Appointments were available at short notice if required.

• The referral to scan times and scan to reporting times were appropriate and well within expected ranges.

• The service had few complaints but acted upon feedback from patients and staff.

• The service had supportive, competent managers who led by example. Staff understood and were invested in the vision and values of the organisation. The culture was positive and staff demonstrated pride in the work and the service provided.

• Risks were identified, assessed and mitigated. Performance was monitored and data used to seek improvements for both staff and patients.

• Engagement with staff, stakeholders and partners was a strong feature of the service.

However, we also found the following issues that the service provider needs to improve:

• Medicines were not always managed in line with best practice. For example, medicine fridge temperatures were not monitored.

• Personal protective equipment was not always used as per InHealth policy and best practice. As a result, we were not assured that patients were protected from risk of cross infection.

• InHealth uniform policy was not always followed as staff were wearing unauthorised jewellery. As a result, we were not assured that patients were protected from a risk of cross infection.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve.

Amanda Stanford

Deputy Chief Inspector of Hospitals (Central)

Updated 24 December 2018

Diagnostics was the only activity the service provided .

We rated this service as good because it was safe,  caring, responsive and well-led. We do not rate the key question of effective.