Archived: Medical Imaging Dexa Scanning: Crawley

Updated 5 July 2019

Medical Imaging Partnership (MIP) provides a DEXA scanning service which commenced in September 2016 in response to a request from the local clinical commissioning group to set up a DEXA provision for mid-Sussex following the cessation of another service. DEXA uses a very small dose of ionising radiation to produce pictures of the inside of the body to measure bone loss (medical use), or body fat (composition scans).

The service is established within the MSK Unit at Crawley Hospital. The service is provided in a room within the MSK Physiotherapy department on the ground floor of the hospital with level access. The room has a dedicated changing room immediately adjacent. The room is equipped with a Hologic W scanner and IT equipment to link to the radiology information system and the picture archiving communication system so that images and paperwork can be retrieved and sent to the reporting team securely.

The central referral centre for Medical Imaging Partnership organises appointments for patients on receipt of the referral. The patients are referred from GP surgeries in Sussex as direct access activity or via approved specialist fracture liaison nurses.

The service currently runs three or four days per week.

The service had not been inspected prior to this inspection.

The service was registered to provide the following regulated activities:

• Diagnostic and screening procedures.

Updated 5 July 2019

Services we rate

We rated it as Good overall.

We found good and outstanding practice in relation to diagnostic imaging:

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

• Staff were all trained to level two in safeguarding and demonstrated knowledge of when a safeguarding referral may be needed.

• The waiting room and clinical areas were visibly clean and tidy. The service had suitable premises and equipment and looked after them well.

• The service had a robust process for reporting any unexpected findings such as suspected cancer. They kept clear records and asked for support when necessary.

• Risk assessments were undertaken for each patient including radiation risks.

• Staff told us how the incident reporting system worked and gave examples of learning from past incidents.

• Policies and procedures used in the service followed evidence based practice and were developed in line with the health and care professions council (HCPC) standards of proficiency for radiographers.

• Staff had the required qualifications, training and specialist experience. The professional qualifications of all relevant clinical staff were checked before they started work. We saw their professional membership status was monitored quarterly.

• Consultants, radiographers and technicians had good relationships and staff said they would have no hesitation to ask for advice if they felt it was not needed.

• Patients were treated with dignity and respect. We observed staff being professional and compassionate. We heard staff speak to patients in a friendly yet professional manner both in person and in telephone conversations.

• Referrals were responded to rapidly. Patients could be offered immediate appointments if required.

• The service was compliant with the Disability Discrimination Act 1995. The premises catered to individual needs when reasonably possible.

• Timely reporting was monitored, supported with IT systems allowing results to pass quickly to referrers. Urgent or unexpected findings triggered process, which ensured results were seen promptly by consultants.

• The company had reviewed its values and refreshed them with staff involvement. Corporate functions aimed to support clinical activity at site level with policies, procedures, resources and effective communication cascaded to ensure that provision met objectives for patient care.

• We found an open and candid approach to incident and complaint management. Staff we talked with understood their role to ensure an open and transparent approach was routinely applied.

• Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

However; we also found areas of practice that require improvement;

• The service could not always guarantee impartiality throughout the interpretation process because they could not always access external translators.

• The service had not concluded their review of all policies and procedures to ensure they are up to date and in line with best practice.

Updated 5 July 2019

The service provided care that was safe, effective, caring, responsive and well led. Patients were extremely happy with the care they received and found staff to be caring and compassionate. Staff took the time to interact with patients and those close to them in a respectful and considerate manner. Staff were encouraging, sensitive and supportive to patients and those close to them.

Staff were well trained and supported and worked according to agreed national guidance to ensure patients received the most effective care. There were sufficient staff, with the skills and expertise to manage the service.

Patients were able to access the service at times that suited them. Individual needs of patients were considered.

The service had clear leadership and governance both locally and at provider level at Medical Imaging Partnership.