Leeds Screening Centre

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

This means we looked for evidence that patient’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At the previous inspection, this key question was rated good. At this assessment, it remained good.

Patients needs were assessed and reviewed, and care and treatment were mainly delivered in line with current evidence-based guidance and professional standards.

Staff worked with patient’s to support informed decision making, obtain consent and provide care and treatment that reflected individual needs and preferences.

The service had systems in place to support the delivery of evidence based care, including clinical audit, peer review activity, consultant radiologist oversight and governance processes. However, weaknesses in peer review participation, policy review arrangements and governance oversight reduced assurance that evidence based practice was consistently embedded and monitored across the service.

Despite these concerns, patients received effective care and treatment, and outcomes were generally positive.

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.

Staff assessed patient’s individual needs and described how they adapted their approach to support communication, including with patients who were non-verbal or experiencing anxiety. 

Sonography staff described how they monitored patient’s for signs of pain, discomfort or distress during examinations and responded accordingly.

Staff took account of patients physical, emotional, wellbeing and communication needs when planning and delivering care and treatment. Patients were provided with explanations about procedures and opportunities to ask questions throughout their appointments, demonstrating that staff considered individual needs when assessing, planning and delivering care.

The service had developed guidance relating to mental health support and management of patient’s experiencing acute anxiety or emotional distress.

The service generally delivered care and treatment in line with current legislation, guidance and evidence-based practice. 

Peer review arrangements, governance oversight and implementation of some professional guidance were not consistently effective, reducing assurance that evidence-based practice was fully embedded and monitored across the service.

The registered manager held quarterly face-to-face audit meetings where complex and interesting scans were reviewed in an open learning environment, with the consultant radiologist in attendance. Governance records demonstrated that audit findings, reporting practice, learning from interesting cases and updates to professional guidance were reviewed during these meetings. 

However, attendance records showed limited or no attendance by some sonographers at these meetings. As a result, the service could not provide assurance that all sonographers consistently participated in peer review activity or that learning arising from audit and peer review processes was routinely shared across the workforce. This reduced assurance that peer review arrangements were fully embedded across the service in line with British Medical Ultrasound Society (BMUS) recommendations for regular peer review and shared learning.

Policies were not always tailored to the service or fully aligned with current national guidance. For example, the Infection Prevention and Control (IPC) policy included references to clinical procedures not undertaken by the service and referenced Scottish Health Technical Note (SHTN) guidance, which was not applicable to services operating in England. This indicated that policies had not always been subject to sufficiently robust review processes to ensure they reflected current practice and the activities undertaken by the service.

Despite these concerns, sonographers demonstrated awareness of relevant professional standards and described regularly reviewing guidance updates and safety alerts issued by professional bodies. Sonographers followed Society and College of Radiographers (SCoR) and BMUS guidance, including using alternative scanning techniques where clinically indicated to support image quality and reduce the risk of suboptimal examinations. They described following SCoR Pause and Check principles to support patient identification and reduce the risk of errors before scanning procedures.

Ultrasound examinations were completed in line with national guidance. Abdominal scans included assessment of the kidneys, liver and bladder, including pre and post-micturition imaging. Obstetric scans were completed in line with national guidance, with appropriate measurements obtained and images recorded. Non-invasive prenatal testing (NIPT) was undertaken in line with national guidance, with aseptic non-touch technique (ANTT) followed and clear explanations provided regarding the procedure and next steps.

A consultant radiologist was available to provide second opinions on complex non-obstetric diagnostic scans, providing additional clinical oversight and supporting decision-making.

Phlebotomists followed evidence-based practice to minimise bruising and swelling, including applying appropriate pressure, monitoring for blood pooling and providing aftercare advice. Staff sought support from colleagues where required and used techniques to improve vein visibility before further attempts at venepuncture.

The service worked effectively across teams to support patients and ensure care and appointments were coordinated appropriately.

Staff communicated effectively and worked collaboratively to support patients, demonstrating a proactive and cohesive approach that helped ensure appointments and service delivery ran smoothly. Interactions between staff were professional, calm and respectful, and we observed effective communication and coordination between staff across different roles.

Staff spoke positively about the strong culture of teamwork and told us communication within the team was effective. New starters described the environment as supportive.

The registered manager held monthly team meetings for patient coordinators, and staff from satellite sites attended when clinics were not running. Although not all staff attended every meeting, minutes were distributed by email and important updates were shared to support communication across the service.

The service supported patients to manage their health and wellbeing by providing information, advice and onward guidance to support informed decision-making and encourage engagement with wider healthcare services.

The service informed women of the importance of continuing to attend their NHS maternity appointments and promoted regular health checks to monitor the health and wellbeing of both mother and baby.

Staff supported patients to understand scan findings, discussed any required follow-up and encouraged appropriate engagement with healthcare professionals where further assessment or treatment was required.

However, opportunities remained to further enhance health promotion information and signposting resources. We did not see information relating to conditions identified through diagnostic scans or maternity related topics such as breastfeeding, tongue-tie, bereavement or miscarriage. Information promoting healthy lifestyles, or signposting patients to local and national support services, charities and wellbeing resources, was also limited.

The service had systems in place to monitor clinical practice and patient outcomes. 

This included peer review of ultrasound examinations, review of scan images and reports, consultant radiologist oversight, patient feedback monitoring, and regular governance and audit meetings. 

Staff described peer review discussions and case-based learning activities, which supported professional reflection and the sharing of learning.

Patient feedback was collected following examinations and reviewed by sonographers and the consultant radiologist to monitor themes, identify learning opportunities and support improvements in patient outcomes.

Approximately 10% of examinations undertaken by each sonographer were reviewed using the British Medical Ultrasound Society (BMUS) audit tool. Audit findings were discussed by the practice manager, registered manager, sonographers and consultant radiologist and included image quality, reporting accuracy, professional practice, learning from interesting cases and clinical protocols. No clinical discrepancies were identified during the audit period, and six cases were discussed as part of continuing professional development to support evidence-based practice.

Staff supported patients to make informed decisions about their care and treatment and followed national guidance to gain consent. 

The service sought consent at different stages of the patient journey. Consent was initially obtained during the booking process, and we observed a three-point identification check before scans were undertaken. This helped ensure patients remained informed and had opportunities to ask questions before receiving care and treatment.

We observed sonographers explain procedures to patients in language they could easily understand.

Staff ensured consent was obtained before NIPT results or scan information was shared with intended parents in surrogacy arrangements and confirmed that surrogate parents agreed to the release of scan images and NIPT information.

A Mental Capacity Act (MCA) policy was in place and clearly outlined best-interest decision-making. Sonographers completed MCA training through their NHS employer, and all staff records reviewed during the onsite inspection evidenced completion of this training.

Staff obtained verbal consent before transvaginal (TV) scans and recorded written consent for NIPT. Staff demonstrated a good understanding of consent processes, and patients were given opportunities to ask questions before care and treatment was provided.

The service had a consent policy for ultrasound scans and blood tests. 

Patients were supported to make informed decisions about their care and treatment. They reported staff explained scans and NIPT, discussed available options and costs, sought permission before examinations and provided opportunities to ask questions throughout appointments. They described receiving clear information about testing processes, results and next steps.