Paul Strickland Scanner Centre

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good . At this assessment the rating has remained good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

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 service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The provider’s vision to lead innovation and excellence in diagnostic imaging and cancer care was consistently reflected in strategy documents, governance minutes and staff discussions. Core values of compassion, integrity, respect and accountability were clearly articulated through organisational materials and reinforced during team meetings, supervision and appraisal processes. Staff told us that these values shaped their approach to care and decision-making.

Senior leaders communicated the vision and strategy effectively. Updates were shared through newsletters, team briefings and quarterly “town hall” sessions, where staff could ask questions and contribute ideas. We reviewed minutes from the Strategy and Quality Group (August 2025), which showed open discussion about workforce resilience, digital optimisation and equity in service access. Actions were tracked and shared transparently with teams, ensuring that communication flowed effectively between operational and senior leadership levels.

Staff described how they were encouraged to contribute to shaping the service’s direction. Feedback was gathered through engagement surveys, clinical governance forums and daily huddles. For example, staff contributed to the design of a new staff wellbeing framework and inputted into the rollout of upgraded imaging systems. These forums supported two-way dialogue, allowing staff to influence decisions about workflow, training priorities and patient experience initiatives.

Leaders modelled openness and accountability. Staff told us they felt confident to raise concerns, share learning and celebrate success. One staff member said that “leadership is visible, responsive and genuinely interested in improvement.” This aligned with evidence from governance records showing that staff feedback had led to adjustments in shift structures, training content and patient communication templates.

The service’s strategic aims were well understood by frontline teams. Staff could clearly describe how their work contributed to improving access, reducing turnaround times and enhancing diagnostic quality. Performance indicators were reviewed monthly and linked to the strategic plan, ensuring alignment between operational delivery and the organisation’s broader objectives.

Posters and onboarding materials displayed the provider’s vision and values prominently. Staff induction incorporated modules on culture, equality, diversity and human rights, embedding expectations from the outset. Managers described using these values to guide recruitment, development and recognition processes, fostering a sense of shared identity and purpose.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders were visible and approachable. Staff told us that managers were accessible, listened to concerns and acted on feedback. Regular visits to clinical areas and attendance at team meetings helped strengthen communication and maintain alignment between strategic aims and day-to-day operations.

Leadership development was structured and well supported. Training records confirmed attendance in management and quality improvement programmes, alongside courses in ethics, communication and governance. Leaders were encouraged to develop professionally and supported to access external learning opportunities relevant to their roles.

Appraisals were used to review performance and identify training needs. Compliance was high, and documentation showed that leaders used these discussions to review development goals, support wellbeing and encourage progression. Clinicians maintained current professional registration and revalidation.

Leaders had a clear understanding of governance structures and quality assurance processes. They participated in risk reviews, incident discussions and performance monitoring. Governance minutes evidenced regular review of quality metrics and escalation of key issues through appropriate channels.

The leadership approach was collaborative and focused on improvement. Staff described open communication and said that leaders encouraged feedback and learning. Policies emphasised fairness, inclusion and accountability, with staff supported to raise concerns confidently. This helped maintain a culture of openness, accountability and learning, supporting safe and effective care delivery.

The service fostered a positive culture where people felt they could speak up and their voice would be heard

Staff told us they were aware of the Freedom to Speak Up policy and knew how to raise concerns. They described clear routes to report issues confidentially, including through local freedom to speak up champions and an external reporting helpline. Staff said they felt supported to use these routes and were confident their concerns would be taken seriously.

Leaders had oversight of concerns and reported themes at governance meetings. Action logs recorded what had been raised, how it was reviewed, and what changes had been made as a result. For example, following feedback about communication in clinical handovers, a new escalation guide and documentation template were introduced to improve consistency across teams.

Freedom to speak up activity was monitored through quarterly reports to the quality and risk committee. These reports summarised the number and nature of concerns raised, timeframes for response, and any emerging risks. The reports we reviewed showed that concerns most often related to communication, workload pressures and procedural clarity, and that these were addressed through training and supervision rather than formal escalation.

The service promoted psychological safety through staff development and reflective practice. New starters were introduced to the speaking up process during induction, and refresher training was available for all staff. Freedom to Speak Up champions met regularly to share learning and ensure staff could raise issues informally before escalation.

People using the service and their carers also had clear ways to provide feedback. The provider’s website included an online form and contact details for PALS and the Care Quality Commission. Feedback routes were highlighted on appointment letters and information leaflets.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Leaders took active steps to create a fair, inclusive and representative working environment and to ensure policies supported equitable opportunities for all staff.

Workforce equality data was routinely collected and reviewed through governance meetings. This included analysis of protected characteristics such as ethnicity, disability, gender and age. The information was used to identify under-representation and inform recruitment and progression planning. Data from 2025 showed a broadly representative workforce profile compared to the local community and patient population.

Staff told us they were encouraged to work flexibly where possible. Flexible working arrangements were available to accommodate caring responsibilities, health conditions and personal circumstances. Managers reviewed requests on a case-by-case basis, balancing service needs with individual wellbeing. Examples included adjusted shift patterns, reduced hours during treatment or recovery periods, and home-based administrative work for non-clinical roles.

Reasonable adjustments were made to support colleagues with disabilities or long-term conditions. Occupational health assessments informed these adjustments, which included adapted equipment, ergonomic furniture and modified duties where appropriate. Staff told us that requests were handled sensitively and without stigma.

Equality, diversity and inclusion training formed part of the mandatory induction for all staff. Training covered key legislation, unconscious bias and inclusive language. Staff also completed refresher modules every three years. Equality champions were in place across the service, including representatives for LGBTQ+ and race equality, who worked with managers to promote awareness campaigns and advise on inclusive practice.

Recruitment processes were designed to be fair and transparent. All interview panels included at least one EDI-trained member, and shortlisting was anonymised to minimise bias. Appraisal discussions included reflection on inclusive practice and professional conduct.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Governance arrangements ensured that essential information, including learning from incidents, complaints and audits, was shared consistently. Standing agendas were in place for team and governance meetings, which included discussions on patient safety, risk management, feedback themes and quality improvement actions. Meeting minutes demonstrated follow-up of previous actions and escalation of unresolved risks to senior leaders.

Governance processes supported consistency and learning. Policies and protocols were reviewed regularly, with a 5% threshold for out-of-date documents monitored through governance meetings. Radiologists took responsibility for updating scanning protocols in line with national best practice and multidisciplinary feedback.

Staff told us they felt informed and involved in quality discussions. They described how learning from reviews of incidents and complaints was communicated through governance bulletins and huddles. For example, following a near-miss incident, staff implemented new double-check procedures and strengthened the escalation process for critical findings. Learning outcomes were reviewed at audit and safety meetings to ensure actions were embedded.

Risk management was proactive and well structured. The risk register was accessible to staff and reviewed monthly by managers and senior leaders. Staff concerns aligned with risks recorded on the register, demonstrating transparency and shared understanding. High-level risks such as scanner downtime and radiopharmaceutical supply issues were monitored through mitigation plans that included contingency lists, external contracts and escalation protocols.

Performance and quality were monitored through regular clinical and operational audits. These included image quality reviews, radiation safety checks, hand hygiene audits and turnaround time monitoring. Audit results were presented at governance meetings, and where gaps were identified, improvement plans were developed and re-audited to confirm progress.

Data systems supported effective oversight and were not burdensome for frontline staff. Managers had access to real-time performance dashboards covering key indicators such as activity levels, waiting times, incident trends and mandatory training compliance. Information was accurate, timely and clearly formatted to support decision-making and workforce planning.

The service maintained external accreditation with UKAS and achieved the Quality Standard for Imaging (QSI). Evidence showed compliance with national standards for governance, clinical effectiveness and patient safety. Quality documentation was version-controlled and reviewed annually to ensure alignment with regulatory and best-practice updates.

Business continuity and emergency planning were embedded into operational delivery. Plans covered potential disruptions such as equipment failure, power outages and severe weather. These were tested through annual exercises, and learning was documented. Cost improvement plans were reviewed through governance structures to ensure they did not compromise patient care or staff wellbeing.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service worked collaboratively with commissioners and NHS trust partners to monitor performance and contractual compliance. Senior operational leaders maintained regular contact with commissioners and NHS Trust partners, and monthly governance meetings reviewed key performance indicators, patient outcomes and incident data. Leaders told us that suggestions from these meetings informed ongoing service development, with actions such as pathway redesign and improved referral management recorded in their governance minutes.

Partnership arrangements supported seamless care transitions. The service worked closely with referring NHS Trusts to coordinate imaging for people on cancer and diagnostic pathways. Communication between radiology and oncology teams enabled timely reporting and review of results, ensuring that people received consistent and coordinated care. Staff attended joint coordination meetings with the trust to review imaging capacity and reporting timelines, which supported continuity of care and timely escalation of urgent cases.

Issues identified with outsourced reporting were escalated to the external provider’s governance lead, and learning was shared to improve quality. Collaborative working extended beyond service delivery to workforce development, with external training opportunities and shared learning sessions promoting consistency in standards, safety and quality improvement.

People using services were actively involved in shaping service development. A patient experience group, which included staff and patient representatives, met quarterly to discuss feedback and improvement plans. Evidence from these meetings showed that patient input influenced tangible changes, such as improved waiting area layouts, clearer signage, and the development of accessible patient information materials.

Engagement also extended to staff. Clinical and administrative representatives participated in joint planning sessions and governance forums. Leaders communicated updates through newsletters, briefings and open forums, ensuring transparency and shared ownership of improvement initiatives. Staff told us that partnership working had strengthened understanding across disciplines and enhanced coordination with external providers.

The service also engaged with local Healthwatch representatives, who provided independent perspectives on patient experience. This feedback was discussed at governance level and informed the patient involvement strategy for the following year.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

The service had a structured and well-governed audit programme, which covered clinical quality, safety and information governance. Staff told us they participated in audit cycles that informed practice development and service improvement as part of their appraisal, The findings and actions were discussed at quarterly governance meetings, with learning shared through staff briefings and quality improvement sessions. These audits included reviews of image quality, referral accuracy and contrast safety, which showed consistent performance against national benchmarks.

Staff were given time and support to develop service improvement initiatives. Service improvement groups were established within each imaging modality, enabling staff to lead small scale projects and contribute to wider service redesign. For example, pathway optimisation for CT pulmonary angiograms, improved image reconstruction processes, and enhanced pre-scan communication for people with additional needs. The CT pulmonary angiogram (CTPA) protocol was optimised to reduce scan delay from 8 to 4 seconds, improving image quality. This was re-audited and presented at a national conference. These changes resulted in measurable improvements in workflow efficiency and patient satisfaction.

Research was well supported and actively encouraged. Staff actively participated in both internal and national research projects, contributing to studies that informed best practice in diagnostic imaging. Governance oversight was maintained through a dedicated research committee, and all research staff completed Good Clinical Practice (GCP) training. Staff told us that involvement in research improved their clinical understanding and inspired innovation in their daily roles.

The service held external accreditation through the Quality Standard for Imaging (QSI), demonstrating compliance with recognised standards for governance, safety and quality. Accreditation reviews provided an additional mechanism for assurance and improvement.

Staff used recognised quality improvement methods, including Plan-Do-Study-Act (PDSA) cycles and root cause analysis, to test and embed changes. Improvements were tracked through audit outcomes and patient feedback, ensuring that learning translated into sustainable improvement.

Education and professional development were prioritised. Staff attended external courses, study days and conferences, with protected time allocated for continuing professional development. Joint learning sessions with NHS partners supported cross-organisational collaboration and shared learning.