InHealth MRI - Northumbria Specialist Emergency Care Hospital

On this page

• 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

Well-led – 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.

Leaders and staff understood the vision and mission statement of the service, and how they contributed to this. There was an open culture, based on listening, learning and trust. Staff knew how to speak up and were confident that they would be listened to. Leaders were visible, knowledgeable and supportive and staff were supported to develop in their roles. Leaders had oversight of the service through effective governance and risk management systems.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

The provider 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 patient and their communities.

The purpose, vision and mission statement of the provider were displayed on the noticeboard in clear language and staff were aware of their role in helping to achieve these goals. Staff were focussed on the needs of patients receiving care.

The service had an open culture where as well as staff, patients, their families and carers could raise concerns without fear. Staff told us that they felt respected, supported and valued. Staff said that the leadership culture was inclusive, and relationships between staff of all grades were positive with good teamwork and collaboration. All of the staff we spoke with were happy in their roles and said that the service was a good place to work.

Team and individual staff achievement and success was celebrated through schemes like the employee of the month, which all staff were allowed to nominate colleagues for. The chosen employee was rewarded with some time off in lieu and a small gift. There were also team away days, where cover was arranged from neighbouring departments to enable the whole team to have a day together each year.

The provider had inclusive leaders at all leaders 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.

The service worked very closely with the InHealth MRI units located at 3 other sites at the same NHS trust. Each site had a superintendent radiographer, with a regional superintendent radiographer overseeing all 4 sites. The regional superintendent radiographer had a training and clinical mentorship role across each of the 4 sites. A regional operations support manager had a similar role overseeing patient administration staff across all 4 sites. An operations manager offered managerial support to the team across all 4 sites of the trust and a head of operations north provided managerial support at a wider regional level.

Leaders had a range of experience, skills and abilities to run the service and they were visible and approachable in the service for patients and staff. Leaders had taken incidents seriously and knew how to deal with concerns when raised which promoted a positive culture in the service.

Staff and patient survey results were acted upon. We saw an action plan following the staff survey and saw that issues that staff had raised were addressed. For example, the employee of the month scheme was put in place to respond to a need for staff recognition on a more local basis. A lease car service was made available through staff requests. We also saw examples of team briefings where patient feedback had been provided to staff with actions where the feedback involved a complaint.

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

Staff and leaders acted with openness, honesty and transparency. Staff were encouraged to raise concerns and offer ideas. The culture allowed staff to be confident their voices would be heard.

The staff we spoke with had no concerns, but they told us that if they did have concerns they would be confident in raising them and felt that they would be supported and listened to. The service had an up-to-date Freedom to Speak Up policy, and staff knew how to find it.

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

Leaders promoted equality of opportunity and experience for the workforce within their place of work, and throughout their employment. The provider used the Workforce Race Equality Standard Report (WRES) to measure workplace fairness and career access. The Workforce Race Equality Standard was used to highlight areas of inequality so that appropriate actions could be taken to improve. The provider had policies and processes to encourage a diverse workforce and to promote equal opportunities. The local manager had signed the NHS Confederation inclusive leadership pledge which committed to always challenging exclusion, showing respect at all times and remaining judgement free.

The service had a diverse workforce, with several members of staff from overseas, and the provider supported these staff members through a relocation specialist, who worked very closely with local managers to help overseas staff adapt to life in the UK. Measures included a tailored induction programme, help with finding accommodation and support to adapt to British culture. Professional mentorship was also provided through the regional superintendent radiographer.

The service supported staff to take time off for religious holidays. The provider offered virtual cultural appreciation and storytelling sessions where staff from around the world could tell stories about their culture and how they celebrated their religious festivals. Staff welcomed these sessions.

Managers told us that reasonable adjustments were supported wherever possible and staff could arrange to work flexibly when circumstances required it. Staff could access support from mental health first aiders available either locally or nationally through the provider if they felt overwhelmed, stressed, or anxious.

We saw the latest staff survey results, which showed that 97% of staff responded positively when asked about the service’s approach to Equality, Diversity and Inclusion.

The provider 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 acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Governance was well embedded within the service, supported by effective governance processes, clear accountability, and robust oversight of performance and risk that drove continuous quality improvement. For example, we reviewed the reports from 2 clinical quality sub committees where learning was shared across local sites from incidents, complaints, audits and patient feedback. We also saw presentations and minutes from national governance meetings where information from MRI services across the country was compared and any learning cascaded.

Staff at all levels were clear about their roles and accountabilities. Staff had job descriptions, and these set out expectations and responsibilities. Staff could find the data they needed to understand performance, make decisions and improvements.

The information systems were secure. Information technicians sent regular updates about cyber security to staff via email, and staff only used equipment supplied by the trust to maximise data security. The service engaged with the host trust's no-snooping campaign, to make sure that staff only saw patient files that were directly relevant to their work. The service had not reported any data breaches and patient identifiable information was handled correctly.

Leaders made sure that accurate information was discussed and shared with key staff.

For example, they used a regular learning outcomes bulletin to share positive feedback and learning from incidents and complaints.

Risks were clearly identified and a formal log of these was used to keep oversight and manage mitigations. Audit processes and the outcomes were used to ensure the continued quality of services. We saw several examples of completed audits, including but not limited to: drug administration record audit; hand hygiene audit; MRI image quality audit; and documentation audits. Results were shared with staff via email, which contained examples of good practice, as well as a list of actions where improvements were needed.

The service had plans in place to cope with unexpected events and we saw a copy of the business continuity plan. This included plans to deal with major incidents such as fire and floods, as well as unexpected disruptions to local services such as down time of the scanners.

The provider had an ambitious sustainability agenda, with a range of learning, development and support for staff around sustainability and had achieved and maintained national certification for environmental and energy management.

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

Staff and leaders at the service collaborated with relevant external stakeholders and agencies to improve care and treatment for patients using the service. For example, staff told us that they had very good relationships with the host NHS trust and local Integrated Care Board. Leaders attended shared quality assurance meetings with the trust to share learning across different services, which managers told us was very useful.

The service reported incidents onto the NHS incident reporting system as well as the InHealth national reporting system, to maximise learning across organisations.

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

Staff were committed to continually learning and improving services. There were processes in place for learning when things went wrong or from good practice either nationally or locally, as well as opportunities to attend external learning sessions and events as part of continuing professional development. We saw examples of learning outcomes bulletins, where learning from incidents was shared with staff. We also heard about learning through after action reviews of incidents. For example, referral processes were reviewed and improved as the result of one incident.

The managers we spoke with had a good understanding of quality improvement methods, and we were told about some of the areas of work which they had focused on. For example, we saw a copy of a presentation for staff about the safety factors to consider when scanning patients with implanted devices such as pacemakers, and we heard about the work that has happened in this area to improve patient safety.

The provider worked collaboratively with the host trust to expand paediatric services and introduce scanning under general anaesthetic. This resulted in reduced waiting times and more local provision of services for patients.