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Inspection Summary


Overall summary & rating

Good

Updated 19 February 2019

Wigan PET Centre is operated by Alliance Medical Ltd. The centre opened in September 2016 and has diagnostic imaging facilities for positron emission tomography and computed tomography scans for adults under a commissioned contract from a specialist NHS trust. Patients are booked by the referring trust, then scans are reported by the consultant radiologists at the trust.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced inspection on 11 December 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

We rated it as Good overall.

We found good practice about diagnostic imaging:

  • The service provided mandatory training, including safeguarding, as well as service-specific competency training to all staff and made sure everyone completed it.
  • The service controlled infection risk well. Staff kept themselves, equipment and the premises clean. Premises and equipment were suitable and well maintained.
  • The service had enough radiography staff with the right qualifications, skills, training and experience to keep people safe to provide the right care.
  • Staff kept records of patients’ care. Records completed by staff were clear and completed appropriately. Radiopharmaceutical medicines were stored and administered in line with best practice.
  • The service managed incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned across the organisation.
  • The service provided care and treatment based on national guidance. Managers checked to make sure staff followed guidance.
  • Staff worked together as a team to benefit patients. Radiographers were supported by the NHS trusts to provide good care.
  • Staff understood their roles and responsibilities under the Mental Capacity Act 2005.
  • Staff cared for patients with compassion. Patients’ feedback showed that staff treated them well with respect and kindness. Staff put patients at ease and explained procedures in a way that patients and those close to them understood.

  • The service took account of patients’ individual needs.
  • The service treated concerns and complaints seriously. Lessons learned were shared across the organisation.
  • Managers had the right skills and abilities to run a service providing high-quality care. They promoted a positive culture that supported and valued staff.
  • The service and organisation had governance systems in place, including identify and managing risks.
  • The service involved patients and staff well.

We found areas of practice that require improvement:

  • Referrals into the service were not always clear and the service needed to confirm the details.
  • Appointments were made by the referring NHS trust by letter only. Patients did not always attend for appointments as there was no system to confirm attendance.
  • Difficulties with insufficient supplies of the radiopharmaceutical doses, affecting all contracted services, had resulted in cancellations of patients on the day of the appointment.
  • There was no information or leaflets available in formats such as easy read or in languages other than English.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve.

Ellen Armistead

Deputy Chief Inspector of Hospitals

Inspection areas

Safe

Good

Updated 19 February 2019

Are services safe?

We rated it as Good because:

  • The organisation provided mandatory training in key skills to all staff and made sure everyone completed it.
  • Staff had safeguarding training on how to recognise and report abuse and they knew how to apply it. Staff at the service worked with the neighbouring trust to protect vulnerable patients.
  • The service controlled infection risk well. Staff kept themselves, equipment and the premises clean.
  • The service had suitable premises and equipment and looked after them well.
  • The service had enough staff with the right qualifications, skills, training and experience to provide the right care.
  • Staff kept records of patients’ care. Records at the centre were clear and completed well.
  • The service followed best practice when storing and administering medicines. Patients received a radiopharmaceutical before scanning. (Aradiopharmaceuticalis a drug that can be used either for diagnostic or therapeutic purposes and is radioactive).
  • The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Incidents across the organisation were shared, by managers at the centre.

However:

  • Records from the referring NHS trust were provided daily, but information was not always clear. This meant the service needed to confirm the details with the referring trust.

Effective

Updated 19 February 2019

Are services effective?

We do not rate the effective domain in diagnostic services.

  • The service provided care and treatment based on national guidance. Managers checked to make sure staff followed guidance.
  • Staff monitored patients regularly to check if they were in any pain.
  • The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held meetings with them to provide support.
  • Staff worked together as a team to benefit patients. Radiographers and clinical assistants were supported by the neighbouring and referring trust to provide good care.
  • Staff understood their roles and responsibilities under Mental Capacity Act 2005. They knew how to support patients who lacked the capacity to make decisions about their care.

Caring

Good

Updated 19 February 2019

Are services caring?

We rated it as Good because:

  • Staff cared for patients with compassion. Feedback from patients, verbally and in the organisations patient satisfaction survey was overwhelmingly positive and confirmed that staff treated them well and with kindness.
  • Staff provided emotional support to patients to minimise their distress. We observed interactions between staff and patients. Staff put patients at their ease whilst delivering care.
  • Staff involved patients and those close to them in decisions about their care and treatment. Staff explained procedures to patients in a clear way. Patients could attend with friends or relatives if preferred and were involved.

Responsive

Good

Updated 19 February 2019

Are services responsive?

We rated it as Good because:

  • The service delivered care as planned by the referring NHS trust
  • The service took account of patients’ individual needs. The centre was accessible for patients with reduced mobility and a hearing loop was present.
  • Interpreters could be accessed for patients whose first language was not English.
  • The service had not received any complaints although information was available for patients if needed. The organisation shared any lessons learned from any other complaints received with the staff at the centre.

However:

  • Appointments were made by the referring NHS trust by letter only which meant patients may not always attend. Patients attended from a wide area of the Northwest.
  • Issues, in the three months before inspection, with receiving sufficient supplies of radiopharmaceutical doses has resulted in cancellations of patient scans.
  • There was no information or leaflets available in formats such as easy read or in languages other than English.

Well-led

Good

Updated 19 February 2019

We rated it as Good because:

  • Managers at the centre had the right skills and abilities to run a service providing high-quality care.
  • Managers promoted a positive and open culture that supported and valued staff.
  • Governance processes were in place for the organisation that were shared with staff as needed.
  • The service had good systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected.
  • The service managed and used information to support its activities. It used secure electronic systems for the organisation and communication with the referring NHS trust, with security safeguards.
  • The service involved patients and staff and worked with partner organisations effectively.
  • The service was committed to improving services by learning from when things went well or wrong.

However:

  • The organisation had embedded values, but there was no current vision and strategy. There were plans for these to be launched in January 2019.
  • The contract with the referring trust did not include out of hours support arrangements.
Checks on specific services

Diagnostic imaging

Good

Updated 19 February 2019

Wigan PET Centre provides both

positron emission tomography and computed tomography

scans for NHS adult patients. The service provides scans for patients from across the north west. It is commissioned by a specialist NHS trust. In the twelve months before inspection, 2988 scans were carried out. We found that there was sufficient staff that were trained, skilled and competent to provide the service. The centre was visibly clean and equipment was well-maintained. Staff delivered care in line with best practice together with the neighbouring NHS trust and the referring specialist NHS trust. Patients were positive about care received and we observed patients put at their ease. Patients were treated as individuals and staff supported those with additional needs. Written information was available, however; not in a format other than English. Managers supported staff in an open culture. Organisational governance and risk processes were in place with information shared with staff. Appointments were made by the referring hospital and results of scans were shared, by them, with patients

.