Worcestershire Imaging Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

At our previous assessment this key question was rated requires improvement. Following this inspection it has improved to good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The service had a vision for what it wanted to achieve and a strategy to turn it into action. The vision was to be a leading regional diagnostic imaging provider. This included being a centre of excellence for clinical quality, patient safety and accessibility. The values reflected the vision. Staff understood the service vision and could describe how their work contributed to achieving this.

Staff were focused on putting the patient first, kindness, quality, safety and teamwork. The service provided opportunities for learning and had an open culture where patients, their families and carers as well as staff could raise concerns. The manager worked clinically with patients and alongside staff and encouraged them to use the suggestions box.

Staff told us that they felt respected, supported and valued. We observed and were told relationships between staff of all grades were positive, with strong teamwork and collaboration.

Staff felt motivated about the future and planned changes for the service.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Staff described management as supportive and open, and said managers were approachable and listened to their views. Leaders had the necessary experience, skills, and knowledge to run the service effectively and demonstrated an understanding of the key priorities and challenges faced by the service. Staff told us they felt well supported in their professional development.

Leaders were visible within the service and maintained regular contact with staff. The registered manager was present during our inspection and provided oversight of clinical practice, staff performance, and the day-to-day running of the service. They supported staff through supervision, appraisals and ongoing professional development.

Leadership responsibilities were shared across both clinical and administrative teams, with clear lines of accountability. Staff told us they found managers to be approachable and supportive and said they were encouraged to raise concerns, access training and develop their skills. We also saw evidence that leaders promoted professional development through attendance at relevant training and study days.

Equality and inclusion were promoted through fair recruitment and access to development opportunities.

Leaders took incidents seriously and managed concerns appropriately, helping to promote a positive culture within the service. The manager also worked clinically alongside radiographers, allowing them to gain first-hand insight into how the service was operating.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff and leaders acted with openness, honesty and transparency. Staff were encouraged to raise concerns and offer ideas; the culture allowed staff to be confident and feel their voices were heard.

Staff told us they could raise concerns and would be supported without fear of detriment. When concerns were raised, leaders told us they would investigate sensitively and confidentially.

As a small independent magnetic resonance imaging (MRI) company, staff feedback was primarily gathered through regular day-to-day communication, team meetings and direct discussion between staff and senior staff.

Due to the small size of the team, formal anonymous staff surveys were not routinely undertaken. The service instead used an open and continuous approach to staff engagement, which allowed issues, concerns and suggestions to be discussed promptly and informally.

We saw recent patient survey results and out of 30 patients surveyed 91% answered with very good, 8% for good and 1% for satisfactory.

Staff and patient feedback results were acted upon. For example, following staff suggestion the service introduced 48-hour pre-scan phone calls to confirm attendance and complete safety screening. This led to a reduction in ‘did not attend’ (DNAs) and unnecessary patient journeys. Patients also reported feeling better informed and reassured before attending.

After reviewing patient feedback, the service installed a waiting area board with key information. For example, they displayed, “meet the team” information, and “you said, we did” updates. Patients fed back the information was helpful and reassuring.

Sharing feedback outcomes demonstrated that comments were listened to and acted on.

The service had a freedom to speak up and whistleblowing policy. Staff knew how to access the policies and could name the designated freedom to speak up guardian.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff told us the service had an inclusive working culture, and they were treated with respect and equity. Staff told us managers engaged with them regularly and they felt confident any concerns they raised would be listened to. Furthermore, they had not experienced any instances of unfair treatment, discrimination or harassment and had opportunities for development.

Equality, diversity and inclusion (EDI) policies were accessible to staff, and all staff had completed EDI training Staff showed a good understanding of how this related to their role. Staff felt everyone was treated fairly and that they would be able to report behaviour or attitudes which were negative in style.

The EDI policy stated staff with disabilities would be offered reasonable adjustments to support them to carry out their roles well. Any reasonable adjustments would be considered individually, proportionate and based on what would be reasonable and practicable.

Managers told us they routinely engaged with staff to maintain an inclusive, diverse, and supportive work environment. Staff felt positive about their role and the support they received from their managers and the wider organisation.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The service operated effective governance processes. There was a range of information collected, monitored and communicated at meetings, which was also shared with the local Trust.

Performance data was analysed, and when improvements were needed at the location level, action plans were developed to make this happen. We saw that during NHS contract meetings the performance and key performance indicators (KPI) were discussed, alongside operational issues and risks.

Staff at all levels were clear about their roles and accountabilities. Staff had job descriptions, and these set out expectations and responsibilities. Staff had undertaken tasks related to audit and monitoring the quality of services.

Staff could find the data they needed, in easily accessible formats, both in a folder and on the computer system. The information systems were integrated and secure. The service had an external IT contract to maintain systems and provide advice.

All policies and procedures we looked at were in date and reflected practice There was leadership oversight of the accuracy and validity of each policy. Policies referred to best practice guidelines they were following and when they needed to be reviewed.

Leaders made sure accurate information was discussed and shared with staff. For example, information was shared through a newsletter, a handover document, staff meetings and through a confidential instant messaging service.

Risks were identified and a formal log was used to keep oversight and manage mitigations. Staff contributed to decision-making to help improve sustainability and improve quality of care. Risks we identified through our inspection had already been recorded as a risk on the risk register and appropriate mitigations were in place. For example, we observed risks recorded in relation to an aged scanner and a broken keypad lock to the door. Clear and timely mitigations were in place.

Audit processes and the outcomes were used to ensure the quality of services was maximised. Where improvements were required, leaders ensured action plans and the monitoring of these led to positive changes.

The service had not reported any data breaches and systems were secure. Patient identifiable information was handled correctly.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Staff and leaders collaborated with relevant external stakeholders and agencies to improve care and treatment for patients using the service. For example, the service had contracts with a local NHS Trust, and other independent services. We saw evidence that these contracts had been renewed.

Managers and staff provided examples of collaborative and transparent relationships with other providers. For example, radiographers and radiologists had a network of colleagues from NHS trusts they had regular contact with to ensure patient scans were safe and effective.

Managers worked alongside partners to embed seamless pathways with other providers. For example, they worked with the physiotherapy team through a contract with a local trust to improve access to MRI. This reduced scan waiting times and led to improvements in patients receiving treatment.

The service met with the NHS twice a year to discuss the trust contract with lead physiotherapists. They discussed the service and any potential concerns. We saw that a separate email inbox had been set up to mitigate the risk of a report not being seen.

We saw from meeting minutes that external commissioners had no concerns about the service and managers kept them informed. They were satisfied with the service’s performance around delivering timely scans and reports.

The registered manager liaised with similar services. They worked closely to support one another and shared policies, procedures and ideas.

Leaders and staff actively and openly engaged with patients, staff and external partners, to plan and manage services.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Staff were committed to continually learning and improving services.

Following an incident in which an urgent scan report was missed, the policy was changed to ensure the patient’s GP was identified at the time of referral.

An urgent finding was identified on the MRI scan, and the report was sent promptly to the referring practitioner in line with the existing process. However, there was a delay before the patient was contacted and referred for onward medical management.

The service recognised that, where referrals were received from non-GP healthcare professionals, there was no secondary route for communicating urgent findings.

As a result, the referral process was changed. When an MRI report contained findings requiring urgent action, the report was sent to both the original referrer and the patient’s GP. This provided additional reassurance that urgent findings could be acted upon promptly.

Staff in general had a good understanding of quality improvement. Staff were provided with routine continual professional development (CPD) learning sessions. Recent sessions focused on understanding gender identity and reflective learning following an incident.

The service had carried out a quality improvement initiative to reduce waste and environmental impact following suggestions from staff. They had implemented recycling and a plan was in place to reduce paper records. Staff told us this had resulted in a reduction in general waste, supporting a more sustainable way of working with a lower negative environmental impact

Staff and leaders were committed to excellence that centred on the patient experience. Where they saw a need, they worked together to find a solution. For example, the service had started the process to purchase a new scanner due to the age of the current scanner. We saw from team meeting minutes that staff were positive about future changes to the service.