Updated 18 July 2019
DMC Healthcare Ltd offers a radiology reporting service to NHS hospital trusts and independent healthcare providers providing remote reading and analysis of images. Services can be provided as a bespoke package for organisations for both backlog reduction initiatives and routine and urgent scans depending on the participating trusts requirements.
The service delivered 30,250 cross sectional reports between April 2018 and March 2019, each based multiple sets of images. During the same period the service reported on 54,250 plain film images (X-rays).
The reporting centre is staffed by a team of trained administrators who assign for reporting to a team of General Medical Council (GMC) registered, sub specialist consultant radiologists who provide interpretation of diagnostic radiographs, magnetic resonance imaging (MRI) and computerised tomography (CT) scans.
Teleradiology is defined as the transmission of images and associated data between services for primary interpretation or consultation or clinical review. Teleradiology also encompasses the process of remote viewing of images via a web viewer. Such processes include the sharing of patient identifiable information within and among organisations and across international boundaries.
We inspected this service using our comprehensive inspection methodology. Due to the nature of this service, we provided a period of short notice to the registered manager to enable them to ensure the correct people were available at the inspection.
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. Although we have legal duty to rate teleradiology services, we considered there was insufficient evidence to rate the effective, caring and responsive key questions for this location. This was due to the nature of services being provided and the limited ability to assess all key lines of enquiry.
Our findings of the service were:
- Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.
- The service provided staff with appropriate equipment.
- 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 kept detailed records of patients’ care and treatment. Information was kept secure.
- The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave patients honest information and suitable support.
- The service provided care and treatment based on national guidance and evidence of its effectiveness.
- Managers monitored the effectiveness of care and treatment and used the findings to improve them.
- The service made sure staff were competent for their roles. Managers appraised non-clinical staff’s work performance and held supervision meetings with them to provide support and monitor the effectiveness of the service.
- The service planned and provided services in a way that met the needs of local people.
- The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.
- Managers at all levels in the service had the right skills and abilities to run a service providing high-quality sustainable care.
- Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
- The service used a systematic approach to continually improve the quality of its services and safeguarding high standards of care by creating an environment in which excellence in clinical care would flourish.
- The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.
- The trust collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.
- There were processes in place for safeguarding vulnerable people. Unexpected or significant findings could be escalated to relevant persons to avoid any potential delays or clinical complications.
However, we also found the following issues that the service provider needs to improve.
The provider should:
- Ensure there are processes for ensuring visual display unit (VDU) screens are calibrated in line with national standards on a regular basis.
- Ensure recruitment processes allow for the provider to demonstrate how they assess an individual to be fit and proper to provide regulated activities as defined by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Dr Nigel Acheson
Deputy Chief Inspector of Hospitals (London and South)