Rivers Hospital

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 people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people 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 did not rate this key question. At this assessment we rated this key questions good. 

This meant people’s outcomes were consistently good, and people’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.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff told us there was a Language Line service for patients whose first language is not English.  

We saw posters advising staff they can request a chaperone. Staff told us they allowed relatives into imaging areas where appropriate in order to support patients who had mobility issues or were nervous.  

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. 

An audit plan for the year was kept by the service. This plan identified which audits were required and the frequency at which they should be carried out. For example, collimation audits were scheduled to be conducted every three months. Collimation, as an aspect of optimising radiographic imaging technique, is used to prevent unnecessary exposure of anatomy outside the area of interest and to improve image quality by reducing scatter radiation. 

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Multidisciplinary working was carried out by radiographers with other professionals in the service and mutual support was provided to deliver good care. Staff told us information was shared appropriately across departments with physiotherapists and doctors to ensure continuity of care and clear communication. 

Patient outcome measures were discussed, and joint working between radiographers and consultants and other departments such as physiotherapy.  

Referrals for diagnostic imaging were received from a team in place to screen referrals. When people receive care from a range of different staff, teams or services, it is co-ordinated effectively. Leaders told us relevant staff, teams and services are involved in assessing, planning and delivering people's care and treatment and staff work collaboratively to understand and meet people's needs. 

The service had monthly team meetings and staff were given access to meeting minutes if they could not attend. The service also had a daily briefing which leaders attended and fed back any updates to staff. The lead radiographer was able to provide minutes and discuss recent meetings. Staff told us they were encouraged to work across different scanners and gain expertise across the areas for their own learning and development.  

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Practical support and advice was provided by staff to help patients lead healthier lives. Relevant information promoting healthy lifestyles was available. Professional knowledge was used by staff to provide self-help tools and resource materials.  

Hot drinks were offered on arrival in the main reception, and a water machine was also available. The service had a range of information leaflets available in the reception area.    We saw evidence staff supported patients in living healthy lives. A patient told us they had been supported to understand the impact of stress on physical health. 

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service was operational 6 day per week for general radiography and MRI and occasionally 7 days per week, dependant on demand.  The service offered a 24/7 on call service for emergency imaging to support inpatient care.

The amount of radiation to which patients were exposed was logged and audited. This ensured that diagnostic reference levels were adopted and used to support safe and appropriate X-ray exposures. These audits were undertaken every 6 months.   

The most recent radiation exposure audit undertaken in April 2019 was reviewed and showed that the exposure index was at optimal levels. We observed recent audits we completed by the service to ensure patients were not over-exposed.  

We saw records for X-rays taken were maintained. This included the type of X ray, the exposure level, and patient details such as weight and measurements of the area imaged.   

 Patient-reported outcome measure surveys were conducted by the service through the use of questionnaires, which consistently produced positive results. Leaders told us they audited the quality of images and scans to ensure positive outcomes and there was regular communication with the external physicist. On the day of the inspection, we saw an email had been drafted to send to the physicist regarding reviews of images. 

Policies we saw were all up to date.  

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Patients were supported to make informed decisions about their care and treatment and the service had a consent policy. During our inspection we reviewed 4 patient records and consent documentation was present. Consent was gained verbally in line with the consent policy which outlines seeking consent. Staff explained the reasons for the scan or x-ray, and female patients confirmed they were not pregnant and that risks in pregnancy had been explained.  

Staff assessed patients’ capacity to consent to treatment and they were trained in mental capacity assessment. Patients were ensured to have consented to treatment based on full information. Staff told us they ensured they checked information gathered by the booking team before the patient arrived for their appointment. Staff told us they spoke to the booking team and checked information given to them. This demonstrated good practice.