Nuffield Health Manchester Diagnostic Suite

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

We looked for evidence that service leadership, management and governance ensured 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 changed to outstanding. This meant service leadership was exceptional and distinctive. Leaders and the service culture they created drove and improved high-quality, person-centred care.

Leaders had worked hard to be visible and approachable across the service and in doing so had helped foster a culture that strived to embody the provider’s values, as well as responding quickly to emerging risks or concerns. The service was well-integrated with both NHS and independent health providers who were positive about their relationship, and leaders of the service regularly engaged with partners and staff. They developed action plans from these in order to continuously improve and innovate.

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.

We scored the service as 4. The evidence showed an exceptional standard. The service had a very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The provider had developed a values framework, produced in consultation with staff, called “We CARE”, which comprised “Connected, Aspirational, Responsive and Ethical”. Each attribute had been expanded upon for understanding and examples were provided for staff to follow, which included specific expectations for leaders.

It was clear that these values were incorporated into the routine delivery of the service and embedded into staff culture. The service had made the “We CARE” framework visible to patients on notice boards and booklets, incorporated the values into staff appraisals, and encouraged staff to nominate their colleagues when they had particularly embodied one of the values, as part of a staff recognition scheme. Staff we spoke with were aware of the service’s values and could outline how the values informed and drove their practice. Staff were consistently positive about the open and ethical culture across the service.

The provider had also set out a quality strategy, which was “to provide the best care and support you can get, anywhere” and served as the primary component of the provider’s broader five ambitions, which covered other strategic goals. The quality framework was based on the Care Quality Commission’s own assessment framework.

This service had used the provider’s national strategic ambitions to inform its own local strategy, in partnership with its sister location under the same directorship. These included supporting local NHS services and the community, delivering world leading care services and becoming a centre of innovation and research. Staff we spoke with could all explain what the goals and ambitions of the local service were, and leaders had a thorough knowledge of the provider’s national strategic direction and how this guided their own work.

Progress towards strategic objectives was discussed routinely at all levels of the service. The registered manager had frequent and regular meetings with the provider’s executive committee and met with the regional director of hospitals on a weekly basis. The senior leadership team held regular site board meetings and a quarterly business review, and all staff took part in 3 to 4 business review meetings per year, which covered the service’s strategy and performance.

Talking to staff, it was clear that they felt involved in the service’s strategy. Staff were aware of the impact of their own work on the service and were invested in its success. Many staff also told us that they particularly resonated with the business strategy of the overall provider, which they described as having a charitable purpose that reinvested profits into services.

We scored the service as 4. The evidence showed an exceptional standard. The service had exceptionally 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 always did so with integrity, openness and honesty.

The registered manager and nominated individual for the service was the hospital director, who jointly managed the two sister locations including this one, and worked cross-site. The hospital director was supported by a wider senior leadership team and was able to effectively deputise responsibilities to these staff across both sites as needed. A radiology manager and patient services team lead also provided continuous clinical and operational oversight at the service on-site.

Leaders demonstrated that they had excellent understanding of their service, and had the skills, knowledge and experience to perform their roles. The provider offered a development curriculum for leadership roles which included staff performance and wellbeing reviews, as well as building team culture and navigating change. The service showed us the talent and leadership reviews as well as personal objectives that were developed annually for each leader in the service, which included a diverse range of leadership qualities. These reviews also included effective succession planning arrangements.

The provider and senior leadership team were highly invested in developing their skills and supported them to pursue additional qualifications relevant to their role as part of their continuing professional development commitments, which included qualifications up to graduate and postgraduate levels.

The radiology manager routinely undertook both clinical and leadership duties and was well-supported and engaged by the senior leadership team to manage this workload. The provider also offered regular radiology manager days and virtual meetings where equivalent managers from other locations could come together to discuss and compare their services as well as receive relevant professional and corporate updates.

Staff at all levels were very positive about the visibility and approachability of leaders, despite the service being the smaller of the two locations they oversaw. It was clear that leadership at all levels highly valued their staffing resource and were keen to invest in their development to help future-proof the service. ‘Goal setting’ and ‘management support’ were amongst the highest rated areas of the service in the most recent staff survey, rated 9.3 and 9.4 out of 10 respectively.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The provider’s Freedom to Speak Up (FTSU) policy provided guidance around raising concerns anonymously, with particular emphasis on reducing inequalities and eliminating discrimination. Staff could raise concerns internally through their line manager/senior leadership team or to an FTSU Guardian, whose contact details were available and visible throughout the service. Confidential concerns could also be reported on the provider’s incident reporting tool.

The provider had comprehensive FTSU governance processes in place, with a regional and national lead. The service demonstrated an excellent commitment to the FTSU process through a log of relevant engagement activity throughout the year, which showed that drop-in sessions were scheduled regularly and that appropriate opportunities were given for concerns to be discussed and escalated as appropriate.

The location had recorded 1 FTSU concern in January to October 2025, and the concern was responded to in line with the service’s policy, and no further concerns or escalations occurred.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff told us the service had an inclusive working culture, and they were treated with respect and equity. Staff told us managers engaged with them regularly and they felt confident any concerns they raised would be listened to. We spoke with a variety of staff, who told us they had not experienced any instances of unfair treatment, discrimination or harassment.

Staff received training in equality, diversity and human rights and the provider had equality, diversity and inclusion policies in place to provide support and guidance. This was incorporated into the service’s recruitment policies and processes. Managers told us equality, diversity and inclusion were all embedded in the culture of the service.

We scored the service as 4. The evidence showed an exceptional standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

The service had a corporate information governance lead. There had been no Information Commissioner's Office (ICO) reportable data breaches relating to the service in the 12 months prior to our inspection.

Local policies and procedures were aligned with provider policies and followed similarly strong governance processes of document control and review. The provider had a central register of policies and procedures applicable to all locations that was easily accessible to staff through an intranet. A range of standard operating procedures (SOPs) had been developed to be applicable to the local service only, and a live tracker was used to monitor review dates for these documents. The provider was shortly planning to release an app for all staff that contained a complete directory of documents and local SOPs, which would automatically flag review dates as well as analyse readership to ensure continuous improvement. We noted that the service had an effective and comprehensive crisis and business continuity policy that had recently been reviewed.

We saw the service held various routine meetings with clear agendas, attendance lists, and minutes. Where full attendance had not been obtained, staff communications emails were used to disseminate essential information across the service and the service maintained good assurance that all staff were appropriately informed of new or emerging developments at daily huddle meetings. Where appropriate, we saw evidence that actions plans were produced and discussed at these meetings, and that they had acted on these within the agreed timeframes.

The service had a local audit schedule which appropriately showed areas of improvement and dates of review as well as staff responsibility. The findings of certain audits were submitted to central teams to enable service comparisons in key areas, whereas other audits were reviewed locally. We saw evidence of action plans being developed in response to audits and these were documented with clear timeframes and staff responsibilities. Staff told us that audits and data collection were not excessively burdensome on their workload, and that they did not feel like any cost improvement measures had compromised patient care. No audits were overdue for completion at the time of inspection.

The service’s local approach to incidents and risk was particularly effective. All staff at all levels had a clear understanding of this approach. Risks were discussed and updated weekly, with a risk register that aligned closely with the concerns and priorities of staff we spoke with across the service. The service had developed its own data dashboards that very clearly displayed live operational information across the service, which leaders said had improved their understanding at short notice and allowed concerns to be actioned quickly. We saw evidence that actions raised at each weekly incident review meeting were tracked through each subsequent meeting until closure, with clear ownership.

We scored the service as 3. The evidence showed a good standard. The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They share information and learning with partners and collaborate for improvement.

The location maintained close working relationships with various independent health providers who routinely referred people to the service for scans. This included routine cross-sectional scanning, plain film x-ray and non-obstetric ultrasound. People were also referred for specialist cardiac scanning by private cardiologists, and for chest x-rays as part of visa medical tests. The service also engaged closely with the neighbouring NHS trust, undertaking cross-sectional scans to NHS patients in support of reducing the trust’s waiting lists.

The service had integrated its provision for both NHS patients and privately funded patients into its overall delivery. We saw staff and leaders prioritised making the transition between providers as seamless as possible for patients, for example by holding monthly minuted meetings with the neighbouring NHS trust to discuss clinic arrangements and patient experience, and we saw appropriate action plans were produced as a result of these meetings, that were acted on in a timely way.

We spoke to key stakeholders from both the NHS and independent health sectors who engaged regularly with the service. They were complimentary of the service and described the leadership team as responsive and reliable. We noted that the visa medical stakeholder had been happy to work with the service for many years despite what they described as the competitive field of scan provision and noted that the service would provide scans to the higher standards required for the visa medical process. The NHS contract contained requirements on work volumes, key performance indicators (KPIs) and expected quality standards, and the service had consistently met these requirements.

The service did not routinely engage with local communities due to the nature of the diagnostic scan services they provided, but there was routine public engagement through its partnership to its sister location, as well as social media that focused on raising awareness of conditions relevant to the service in addition to routine marketing.

The service also had a robust understanding of the need to notify regulators about certain incidents. We saw examples where appropriate notifications were made to the relevant bodies.

We scored the service as 4. The evidence showed an exceptional standard. 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 demonstrated a continuous and consistent approach to improvement in both clinical and operational areas. Leaders were invested in the service, and they had fostered a culture amongst staff at all levels that was focused on improving outcomes and creating better experiences for patients. Staff demonstrated a good understanding of quality improvement and lead radiographers took responsibility for this on a local level.

Staff told us they felt able to suggest improvements and that leaders had listened to and implemented these in the past. For example, staff were conscious of the limitations of their current MRI and CT equipment due to their age and so leaders of the service responded by making a business case with the provider and had started to develop plans to replace this equipment. Staff also told us they had enough time and opportunities to develop themselves and reinvest their learning back into the service.

The service demonstrated innovative clinical activity, through the recent development of Radiology Events and Learning Meetings (REALMs), adapting the Royal College of Radiologists standards for use within an independent healthcare setting. In doing so, the service aimed to make imaging quality assurance processes more consistent to improve clinical outcomes.

The service had been used by the provider as an early adopter to pilot different operational strategies. For example, the implementation of a new model staffing tool for imaging departments prior to it being rolled out across the wider organisation. The service had also recently taken part in a radiographer staffing restructure that introduced radiographer leads to improve quality and governance, and a new laboratory information management system (LIMS) to improve the pathology specimen pathway.

The service also participated in external or provider-level audits and inspections for quality improvement in areas such as aseptic non-touch technique (ANTT) and radiation protection. For example, a provider-level medicines audit had recently taken place at the service, and we saw many examples of completed improvement actions.