Innovate Diagnostics

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that patients and communities had the best possible outcomes because their needs were assessed. We checked that patient’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring patients were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant patient’s outcomes were consistently good, and patient’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

The service usually made sure patients’ care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The service generally assessed and responded well to patients' needs. Staff demonstrated an effective process for identifying and acting on clinical concerns. For example, they identified a patient who required emergency cardiac surgery following diagnostic testing. Staff promptly escalated concerns and liaised with an NHS provider on the same day, enabling the patient to receive emergency treatment later that afternoon. This demonstrated staff's ability to recognise deteriorating health needs and ensure patients received timely access to appropriate care. However, during our site visit, the service did not have arrangements in place to access interpreter or translation services for patients whose first language was not English. This presented a risk that some patients may not fully understand information about their care and treatment. Following feedback, the provider acted quickly and, by the end of the inspection week, provided evidence that a translation service had been implemented to support patients with communication needs. Overall, the service was responsive to patients' individual needs and demonstrated a willingness to address identified gaps in practice.

Staff assessed patients' health needs before carrying out diagnostic procedures and told us they routinely asked about allergies, relevant medical conditions and any other factors that may affect care on arrival. Staff described how they considered patients' individual needs during exercise stress assessments, including monitoring heart rate, breathing and general wellbeing throughout the procedure to ensure it remained safe and appropriate. During our inspection, we observed staff taking time to explain procedures to patients, check their understanding and answer questions before commencing investigations. We saw a patient being supported through the process, with staff providing clear explanations and reassurance, helping to ensure they were informed and able to participate in decisions about their care. Overall, staff demonstrated a person-centred approach to assessing and responding to patients' health, wellbeing, and communication needs.

The service usually planned and delivered patients’ care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

The service planned and delivered care and assessment in line with recognised evidence-based practice and current professional standards. Staff told us that echocardiography protocols were based on current British Society of Echocardiography (BSE) standards and that clinical pathways reflected relevant national guidance and recommendations. Arrangements for monitoring professional registration, competency assessment, continuing professional development and training compliance were undertaken through the clinicians' substantive NHS employers. Staff were able to demonstrate that they worked within these established standards when delivering diagnostic investigations. 

The service had processes in place to support the quality and accuracy of diagnostic reporting. Following completion of diagnostic imaging, sonographers submitted scans for review by consultant cardiologists. We were told that cardiologists independently reviewed and authorised reports without knowledge of previous reviews, providing an additional layer of clinical oversight. As a result, reports were subject to multiple reviews before being finalised and sent to referring healthcare providers. Reporting templates followed recognised standards, echocardiograms were undertaken using established examination protocols, and there were clear escalation processes for critical or unexpected findings requiring urgent action. 

We reviewed 10 patient records and found they contained relevant clinical history, symptoms, and risk factors. Documentation was accurate, complete, and contemporaneous, enabling care staff at the patients’ chosen service to make informed decisions about patient care and assessment. Staff demonstrated an understanding of individual patient risks and there were systems to ensure clinically significant findings were escalated appropriately.

The service monitored the quality of care through clinical audit and oversight arrangements. Staff told us image quality was regularly reviewed by cardiologists and that audits considered the quality and completeness of reporting. Leaders monitored operational performance, including referral-to-report turnaround times. Staff were proud of their ability to provide reports within 3 days and told us they had consistently achieved this target during routine operations. 

Leaders demonstrated a commitment to service development and quality improvement. Staff described plans to expand the range of services available to meet identified community needs. Staff recognised that some newly introduced services had not initially been utilised to the extent anticipated and were monitoring demand to inform future service planning. They also told us that learning, updates to guidance and changes to practice were shared through governance meetings and the introduction of new protocols to reflect changes to professional guidance and standards.

This evidence supports a finding that the service generally delivered care and treatment in line with current evidence-based practice and had effective clinical oversight arrangements to promote the quality and safety of diagnostic reporting.

Staff followed up-to-date policies to plan and deliver high-quality reports according to best practice and national guidance. All policies we looked at contained a creation and review date, and clear references to current national guidelines. There were systems to communicate changes in guidance through quarterly meetings and staff informed us of social media channels where information was shared. 

Polices and processes took account of changes to the Royal Colleges guidelines and National Institute for Health and Care and Excellence (NICE) guidelines.

The service usually worked well across teams and services to support patients. Staff made sure patients only needed to tell their story once by sharing their assessment of needs when patients moved between different services.

Sonographers, cardiorespiratory physiologists, and other healthcare professionals worked collaboratively to support positive outcomes for patients. Although the service had a small staff team, Staff demonstrated effective working relationships and confidence in each other's knowledge, skills, and judgement, enabling them to work autonomously and collaboratively when appropriate. Staff described drawing on colleagues' areas of expertise to support decision-making and the effective running of the service. Staff worked closely with referring clinicians to support timely diagnosis and access to treatment pathways. We saw evidence that staff escalated concerns identified during diagnostic assessments in line with service processes to ensure patients received appropriate follow-up care and treatment.

The service supported patients to manage their health and wellbeing to fully maximise their independence, choice and control as appropriate for the service they provided. 

The service did not have health promotion information available via the provider website. However, this is not an expectation due to the nature of the service. The provider did speak to patients regarding what to expect from their diagnostic assessment. Although opportunities to support people to live healthier lives were limited due to the nature of the diagnostic service, leaders demonstrated a commitment to improving patient outcomes through innovation. 

The service monitored patients’ care and treatment to continuously improve it. Staff ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of patients themselves.

Staff monitored the quality and effectiveness of care through audit, benchmarking, and peer review processes. Clinical reports were subject to regular quality assurance checks, including independent review, to ensure accuracy and consistency. Any issues identified were reviewed and addressed through established governance arrangements. The service used the findings from these activities to make improvements and achieve good outcomes for patients.

Improvements had been made because of patient feedback. Patients who were required to wear ambulatory heart monitors for a period of time told the service they were concerned about returning the equipment outside of normal operating hours. This enabled patients to return heart monitors at a time convenient to them, reducing potential barriers to care and improving the overall patient experience. The change demonstrated that leaders listened to patient feedback and took practical action to improve the accessibility and convenience of the service.

Staff told us that echocardiography services were delivered by sonographers who held certification through the British Society of Echocardiography (BSE). The BSE is responsible for setting professional standards within echocardiography and provides accreditation, education, and professional guidance to practitioners. This helped provide assurance that diagnostic investigations were undertaken by staff with the appropriate knowledge, skills, and expertise to deliver care in line with recognised professional standards.

The service told patient about their rights around consent and respected these when delivering person-centred care and treatment.

Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent. Staff knew how to support patients who lacked capacity to make their own decisions or were experiencing mental ill health. 

Staff told us that people that do did not speak English as a foreign language or required British sign language (BSL); the service would attempt to acquire a language or BSL translator to gain consent if required. 

Staff understood how and when to assess whether a patient had the mental capacity to make decisions about their care. Staff followed the service’s policies related to consent, mental capacity, deprivation of liberty and restrictive practice, as relevant. We observed staff seeking verbal consent before providing care or treatment. People were involved in decision making at all levels.

Where specific requests had been made by patients, for example, a same sex health care professional, this was discussed and provided whenever possible. Chaperones were provided if requested. Chaperones could also be requested for people that lacked mental capacity or had learning difficulties. 

Staff sought permission before sharing patient information with family or friends. All staff received and kept up to date with training in the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) and knew where to access the current polices as per NHS guidelines. Staff could describe how to access the policy on the Mental Capacity Act and DoLS. 

The service had an up-to-date consent policy and provided patients with written information about the consent process before attending their appointment. Staff explained procedures to patients and ensured they had the opportunity to ask questions prior to investigations being undertaken. The service did not provide care or treatment to children and young people under the age of 18 and therefore did not require specific arrangements relating to consent for minors. We saw evidence that consent was obtained appropriately and that patients were supported to make informed decisions about their care and treatment. Patients we spoke with told us they received sufficient information about their procedures and felt involved in decisions regarding their care.