Cleveland Clinic London Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

The service planned care to meet the needs of people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment. The complementary range of clinical specialties available made many care pathways available on a seamless basis.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider developed and expanded services to meet patient demand and changing health trends. For example, the cardiac echocardiogram service was equipped to provide patients with exercise and stress tests, which often formed part of comprehensive health and wellbeing checks.

While most scans were provided as a result of a clinical referral, some patients could self-refer to specific modalities. For example, women over the age of 40 could book mammograms without the need for a referral.

In the previous 12 months, 97% of patients rated their individual care as ‘excellent’ or ‘good’. A patient said staff had gone “above and beyond” to deliver an MRI scan despite their anxiety. For example, radiographers had been able to carry out the scan whilst keeping the patient’s head outside of the MRI machine, which meant they could go through with the scan. The % figure quoted here is overall for diagnostic imaging services across the provider’s 3 London sites. The patient feedback is specific to this location.

Staff understood how to provide good standards of care for patients who needed additional support. For example, they were trained to provide care to patients living with dementia, with a neuro-diverse condition, or a learning disability. Staff adapted their communication to meet the needs of people with hearing or sight conditions and worked with those experiencing anxiety or a mental health issue to access their scan safely. Specialists were available on-demand through the provider’s London locations to provide 1-to-1 support for staff and patients.

Staff delivered care primarily based on referrals from medical professionals. Radiologists protocolled patients and radiographers carried out scans and an appropriate specialist reported on the results to the referring clinician and patient. This ensured continuity of care through the department and rapid access to results and subsequent treatment decisions.

The service had a 90% 3-day referral-to-scan target. In the previous 12 months they achieved 71%. Performance in reporting times for critical urgent referrals was better where reports were needed within 48 hours. In this measure, the service met or exceeded the 90% target. However, performance for 6-hour turnaround scans was below the 98% target, at 65% between January 2024 and October 2024. The figures reflect all 3 locations. The team had implemented a quality improvement plan that included better coordination with booking staff and improved communication with radiologists. Staff planned to assess impact in early 2025.

Imaging services were integrated with medical specialties and several radiologists were subject matter experts. For example, a radiologist delivered ultrasound services for musculoskeletal (MSK) conditions with ultrasonographer support.

Exploratory, research-driven care underpinned the service, and staff were inquisitive when looking to develop effective treatment options. For example, they carried out case studies to measure the differences between CT and MRI scans to shape treatment for patients who had experienced a bleed on the brain.

The MRI service monitored delays to planned scans. During an audit in May 2024 and June 2024, 37% of patients across all 3 sites experienced a delay, of which 31% related to an issue in the department.

Clinical staff and managers carried a digital pager that provided rapid communication with colleagues across the clinic and the provider’s 3 locations. This enabled staff to work efficiently by coordinating care, urgent queries, or emergency responses.

Staff worked within a series of policies and standard operating procedures (SOPs) to ensure image reporting was in line with national IR(ME)R guidance, such as the reporting of radiological images and using previous scan images.

Staff provided printed information, or links to electronic information, that explained scans and contrast to each patient. They encouraged patients to ask questions before and after procedures and where it was safe to do so, explained what they were doing and why during scans. Patient feedback was consistently good, and staff encouraged patients to discuss how the service could be improved. Recently, this included a need for more information on fasting requirements ahead of an X-ray. Staff addressed this during quality monitoring meetings.

The service acted on feedback to improve patients’ experiences. For example, a patient noted arriving 1 hour before a fluoroscopy scan was inconvenient. Staff reviewed the guidance given to patients and found it was inaccurate. They subsequently updated this so that patients had less time in the department.

Patients could access their scan images, radiographer annotations, and their results remotely as soon as they were available using a digital smart phone app.

Patients rated access to information highly in feedback and noted the availability of staff for digital communications as well as the information given during scans was consistently good.

The provider encouraged feedback from patients throughout their care and empowered every member of staff to record this and act on it. Patient feedback record systems were digital and centralised and enabled appropriate senior staff to maintain a continuous understanding of patient experience. The service had introduced advanced communication protocols as a result of patient feedback. This reflected some experiences in which patients felt their scans were not explained, radiographers did not introduce themselves, and staff did not update them on delays to appointments. The new protocols included improved communication training for staff, particularly around managing unexpected delays to the service. While this contradicted the broadly very good feedback received, it reflected the approach of the service to act on all suggestions, even if these were not widely represented by patients. Complaints in imaging services were rare and the team received just 1 complaint in the previous 12 months. The patient experience team investigated this and worked with the patient to understand their concerns and address them. They shared learning widely across the provider to help colleagues benefit from the outcomes. s diagnostic imaging staff worked across the provider’s 3 London sites, and were not permanently attached to any single location, learning was shared across the whole team. The imaging team involved patients in governance and quality activities to ensure they had a voice in the service. A patient recently invited to a monthly quality monitoring meeting shared their journey through the department, which led to changes in patient literature and pre-scan information for those with preexisting conditions.

The service had introduced new scheduling guidance for administration staff. This provided a buffer between each scheduled scan, based on known potential delays or complications.

In the previous 12 months, 97% of patients said they found it easy to access care in the service. The service had a range of communication options for patients, including online booking and app-based messaging, which made it easy to reschedule appointments. This was reflected in a low ‘did not attend’ rate of less than 1% per month. The provider reported these figures at departmental level, which meant they reflected all 3 London locations.

Patients rated the service highly in feedback collected during patient experience ward rounds, in which 92% rated this aspect of the service as excellent or good. This was an average figure across all 3 London sites.

Staff worked within exclusion criteria for each modality and discussed alternatives with referrers and patients where a preexisting condition, previous scan results, or implant would present a high level of risk.

The imaging team had a consistent focus on operational efficiency and a key annual target was to increase slot utilisation by 10%, which the service achieved in the previous 12 months.

The global patient services (GPS) team worked with embassies, private companies, and individual patients to coordinate complex care plans involving multiple providers in different countries. The GPS team worked with the case management team to ensure patients had continuous care when they left the clinic and where other organisations, and health systems were involved. Patients receiving care under this agreement had access to the same standards of evidence-based care and support as patients treated solely by the provider. The GPS team managed data sharing protocols and other aspects of confidentiality directly with embassies and other providers, ensuring patients maintained equitable outcomes.

Staff used an equality impact assessment tool for each policy or standard operating procedure. The tool helped to identify if any group of people, based on protected characteristics, would be disproportionately and negatively impacted by the policy or its update.

All staff undertook training in learning disability and autism awareness and demonstrated high levels of awareness and knowledge. They recognised the barriers to care people could face in relation to communication and understanding procedures and worked collaboratively to overcome these.

The service had a tried and tested resiliency plan that enabled staff to switch to alternative operating procedures in the event of an equipment failure. We observed this in use during our assessment when an MRI machine at the provider’s Moorgate site failed. Staff redirected patients to this hospital on the same day, which resulted in no cancellations. This reflected resilience in the provider’s capacity.

Contingency plans for emergencies were in place and staff had rehearsed their response to certain events, such as a radiation accident. This reflected good practice and formed part of the provider’s learning culture and risk management system.

Demand on diagnostic imaging services had grown rapidly since the hospital opened. The senior team had an expansion plan to increase capacity, staffing levels, and resiliency to ensure increased numbers of patients did not negatively impact quality and safety. The service was impacted by a national shortage of radiographers and was working with international services within the provider’s network to build future staffing resilience.