Wigan PET Centre

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• 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

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

At our last assessment we did not rate this key question due to differences in our assessment methodology. At this assessment, effective has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

The service had systems in place to help patients achieve good outcomes. Staff worked well together and had the skills needed to provide safe and effective care. Care and treatment were provided in line with legislation, national standards, and current evidence-based guidance. Staff understood patients' needs and were able to manage these effectively.

Staff understood the importance of gaining informed consent before providing care. They also knew how to respond if there were concerns about a patient's mental capacity to make decisions about their treatment.

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.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The service received important clinical information about patients before their scan through the referral process. This included details about their current health, such as diabetes, mobility needs, and potential incontinence. Referrals also included the reason for the scan, details of any previous scans, and information about appointment arrangements, such as whether hospital transport was required.

Staff checked and confirmed this information when patients arrived for their appointment. This was recorded on the PET-CT safety consent form. Staff also considered patients' wider needs and recorded these where relevant. For example, they asked if patients were claustrophobic (had a fear of small or enclosed spaces) or experiencing symptoms related to their condition. We saw staff ask patients about their plans after the appointment and whether someone would be accompanying them home.

Staff helped patients sit or lie comfortably while they waited for their scan. Patients did not usually need pain relief as part of the procedure. However, the service recognised that some patients might take medicines, such as diazepam prescribed by another clinician, to help manage anxiety before their appointment.

Patients attended their appointment having fasted, in line with clinical requirements. Drinking water was available throughout the procedure. The service recognised that some patients might feel faint or unwell after fasting. After the scan, staff could offer drinks and snacks to support patients' recovery and wellbeing.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff followed local policies and procedures to plan and provide care in line with best practice, national guidance, and the Ionising Radiation (Medical Exposure) Regulations 2017 (IRMER). The policies we reviewed included creation and review dates and referenced relevant national guidance. The service had systems in place to communicate changes in guidance through meetings and staff updates. Staff noticeboards also displayed current guidance and recent changes.

Staff had the qualifications, skills, and experience needed for their roles. They completed specialist training relevant to the service, including ‘IV Cannulation and Administration of Radiopharmaceuticals’, ‘Whole body / half body scan practical assessment and viva completion’ and Radiation Protection Supervisor (RPS) training. The service also had access to specialist support when needed, including on-call radiologists and link services provided by the nearby NHS trust.

The provider demonstrated its commitment to evidence-based practice by maintaining imaging services accreditation through the United Kingdom Accreditation Service (UKAS). The location was included in the most recent accreditation assessment in 2023, and no significant concerns were identified. The provider also held International Organization for Standardization (ISO) certification for information security management systems. The service was included in a review of these standards in 2025. In addition, the appointed Medical Physics Expert (MPE) carried out an annual audit of compliance with IR(ME)R requirements. The most recent audit had taken place shortly before our inspection.

The only invasive procedure carried out by the service was routine cannulation to give patients the radiotracer. The service did not consider separate Local Safety Standards for Invasive Procedures (LocSSIPs) to be a proportionate requirement. However, we found that the provider-level procedure relating to cannulation was 6 months overdue for review and contained some outdated references. Although the procedure still provided appropriate guidance for staff, it referred to older documents and did not include some more recent guidance, such as publications from the National Institute for Health and Care Excellence (NICE).

We scored the service as 4. The evidence showed an exceptional standard. The service always worked well across teams and services to support people and ensure clinic timings and service continuity could be maintained wherever possible.

The service needed to manage the timing of radiotracer injections and scans carefully. This was important because the radiotracer had to contain the right level of radioactivity for the scan to produce clear images. During the inspection, we saw a clinical team of 4 staff work together effectively when unexpected issues arose, such as a patient arriving late or needing a larger dose of radiotracer than expected. Staff adapted quickly to make sure the service continued to run smoothly.

Staff who administered the radiotracer also changed roles during the day. This helped share radiation exposure fairly between team members and supported safe working practices. Radiographers and radiography assistants showed a high level of skill and worked closely together to reduce delays for patients.

The service held regular meetings to plan workloads and review performance. Monthly team meetings were also used to share updates, governance information, and learning with staff. Staff told us they had enough time and support to access the information they needed to do their jobs effectively.

We observed strong, positive and supportive working relationships within the team and between staff and service leaders. There were also effective communication systems in place with the referring NHS trust.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

The service provided information leaflets that explained what patients could expect during their visit, how to prepare for their scan, and what would happen afterwards. The service also had arrangements in place to support patients with specific needs. For example, patients with diabetes were given additional guidance, including bringing a packed lunch and any medicines they needed to take after the scan.

Staff were able to discuss health and wellbeing concerns in a sensitive way and direct patients to further support when needed. During the inspection, we observed a member of staff speaking with a patient about poorly controlled diabetes. The staff member encouraged the patient to discuss this with their care team so they could receive additional support.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service carried out a wide range of audits to make sure patients received safe and consistent care. This included monitoring local diagnostic reference levels (LDRLs) to ensure patients received an appropriate radiation dose for their needs. The appointed Medical Physics Expert (MPE) also completed an annual review to check that patients were being treated safely.

Every 4 months, the service carried out an audit of compliance with the Ionising Radiation (Medical Exposure) Regulations 2017 (IRMER). This reviewed different stages of the patient pathway to make sure they met the service's standards. The audit checked whether imaging was completed on time, whether staff had up-to-date training and the appropriate IRMER entitlements, and whether clinical information and risks had been recorded accurately. The most recent audit showed 100% compliance and identified no concerns.

The service also took part in clinical audits, including reviews of image quality and rejected images. Results from the previous 12 months showed no concerning themes or trends. The provider combined these results with information from its other locations to compare performance across services and identify any areas that needed improvement. Audit findings were reviewed regularly as part of the service's monthly quality reporting process.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service followed a provider-wide consent policy. The policy covered situations specific to PET-CT scanning and helped staff obtain consent appropriately for all procedures. During the inspection, we saw staff obtain both verbal and written consent before providing care and treatment, in line with the policy.

However, some of the national guidance referenced in the policy was out of date, despite the document having been reviewed recently. This included references to the ‘Standards for patient consent particular to radiology’ 2012 guidance from the Royal College of Radiologists which was archived in 2021, and ‘Consent: Doctors and Patients Making Decisions Together’ 2008 guidance from the General Medical Council (GMC) which was withdrawn in 2020.

To help patients make informed decisions, staff explained the benefits and risks of the procedure before obtaining consent. This included explaining the amount of radiation involved and what this meant in simple terms. Information could be provided verbally or in writing. Staff also had access to telephone interpretation services when required and an interpreter had not already been arranged.

Staff understood the requirements of the Mental Capacity Act 2005 (MCA) and knew how to assess whether a patient had the capacity to give consent. Staff described a recent example where a patient attended for a scan, but the clinician was not satisfied that the patient had capacity to consent. As a result, the scan did not go ahead until this could be resolved.

All staff were up to date with mandatory training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had also completed learning disability awareness training and a specialised face-to-face training course on safe scanning for patients living with dementia.