Archived: HeartScan Ltd

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 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 people were at the centre of their care. We also looked for evidence that managers instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

However, we found there were missed opportunities to proactively support people to live healthier lives and to identify service improvement opportunities through effective audits.

At our last assessment we inspected but did not rate this key question. At this assessment the rating has changed to good. This meant the effectiveness of people’s care, treatment and support achieved good outcomes and was consistent.

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 evidence showed a good standard. The service made sure people’s care and treatment was effective because staff checked and discussed people’s health, care, wellbeing and communication needs with them.

People contacted the service through the service’s website and directly by telephone.

Patients were pre-assessed prior to arrival for their procedure. People’s individual needs were discussed with them, with consideration for any protected characteristics, and the assessment was recorded using documented prompts on a pre-appointment checklist. This meant assessments of need were completed consistently, prior to arrival at the service. When patients had used the service previously, records associated with each attendance were added to their digital record and held securely.

We observed the receptionist helped people to complete their agreement if required.

Patients we spoke with who had recently used the service, confirmed the registered manager asked about their reason for self-referral, discussed their health history, current health concerns, any communication and mobility needs, and whether they wished to bring a companion.

Staff met patient’s needs for food and hydration. For example, drinking water and simple snacks were available in the kitchen, if requested.

The evidence showed a good standard. The service followed current evidence-based good practice and standards when delivering diagnostic and screening procedures. They always planned and delivered people’s care and treatment, in accordance with national best practice guidance.

Staff worked in accordance with evidence-based protocols for each type of diagnostic procedure undertaken.

Staff we spoke with knew how to access online guidance relating to their speciality. They told us they maintained continuing professional development through online learning and accessed regular webinars on all aspects of current practise. They demonstrated they knew about any relevant, current national guidance to inform their practice.

The evidence showed a good standard. Staff worked with NHS services when required to support patients.

There was an up-to-date policy for sharing data with the NHS and GPs and a policy for management of reporting results.

The service contacted the patient’s GP/referrer and made onward referrals to the local NHS services, with people’s consent, where there was an identified need. For example, if diagnostic tests showed serious concerns regarding cardiac function. Staff kept a record of all onward referrals in patient’s individual electronic records.

In addition, staff contacted the NHS reporting cardiologist directly if they had concerns or needed clinical advice about a patient.

The evidence showed some shortfalls. The service did not fully support people to manage their health and wellbeing. There were missed opportunities to support people to live healthier lives, or where possible, reduce their future needs for care and support.

Staff asked patients about their social history, at pre-assessment This included, for example, exercise frequency and tolerance levels.

However, there was no health promotion information, such as smoking cessation, alcohol intake reduction and healthy eating, or signposting to support services, in the waiting area or on the service’s website. We also identified this at our previous inspection.

Following our assessment, the registered manager shared plans to revise the service’s website, to include appropriate health promotion material relevant to cardiac screening.

The evidence showed some shortfalls. The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Although the service had a quality assurance policy and audit schedule for the year, it was not comprehensive and did not include all audit requirements identified in the service’s policies. For example, staff audited clinic waiting times, echocardiogram process data, reporting turnaround times and patient satisfaction surveys. However, audits required in policy including, but not limited to, IPC, consent forms, accessible information standard and equipment safety checks were not on the schedule and not audited.

The audit outcomes we saw for the 4 activities on the schedule were positive.

The cardiac physiologist and consultant cardiologist double-reported diagnostic tests to provide quality assurance of test results. The physiologist provided a technical report, and the cardiologist reviewed this and associated images and provided a medical report for the patient and referring doctor.

The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering care and treatment.

The service had a consent policy and staff we spoke with understood the Mental Capacity Act (MCA) 2005, consent and the implications for their patients.

The provider shared training records following our assessment to demonstrate that some staff who had not been up to date with MCA training had now completed it. Training records we received following our assessment showed staff that were overdue MCA training, had now completed it.

The service’s mandatory training and consent policies did not include consent training, however, training records showed 1 staff member had completed it.

Staff followed the service’s policy and procedures to gain lawful and appropriate consent from people who used the service. Staff understood the principles of child consent and the policy included guidance on Gillick competence.

Staff we spoke with told us they ensured asymptomatic patients understood what tests they were having and why, and that they were clear about the implications of any abnormal results. They were mindful that an abnormal result could have significant consequences for the patient’s employment or social or personal life. This reflected best practice General Medical Council GMC) consent guidance.

Patients we spoke with confirmed staff had discussed benefits and risks of cardiac screening with them and they received appropriate written information prior to their appointment explaining their procedure and limitations of screening. They told us staff asked their permission before sharing information with their GP.

Staff scanned completed consent documentation into to the electronic patient record.

Symptomatic patients were not required to complete a written consent form, but staff gave them an explanation of why any tests were necessary or recommended and staff asked for verbal permission before proceeding.