East Anglia Ultrasound Services

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Quality Statement Score: 3

Description: We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

We scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff ensured patient care was tailored to individual needs and preferences. Patients told us that staff had done their utmost to accommodate their individual needs. This included arranging appointments around work schedules, offering appointments at very short notice to support time-sensitive fertility treatment, and liaising with external providers to ensure blood tests could be processed quickly. These efforts demonstrated a flexible and patient-centred approach to care.

Staff supported patients to make their own choices about their care and treatment. Patients told us that the service provided reassurance when they had concerns about their health or wellbeing and helped them decide whether further medical intervention was necessary. One patient told us the service had been “an absolute lifesaver”, as staff had taken their concerns seriously and identified a health issue which required urgent treatment. The patient’s concerns had previously been dismissed by another healthcare provider. Patients were given access to copies of the reports and images following the scan, to enable them to make well-informed decisions about the next steps in their care.

Quality Statement Score: 3

Description: We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People could access services and appointments in a way and at a time that suited them.The service offered some evening and weekend clinics to fit with the needs of the patients it served. Patients could book an appointment to suit them either through the website or calling the clinic directly.

Managers planned and organised services so they met the changing needs of the local population. The registered manager used patient feedback and data on service demand to inform ongoing service development. As the service was not commissioned to provide NHS care, its delivery was shaped by patient demand and dependent on staff availability.

The premises were situated on a business estate with ample free parking and were accessible by both car and public transport. The premises were also suitable for patients with mobility difficulties. Waiting areas were equipped with sufficient seating and toilet facilities, and included toys for children.

There was continuity in people’s care and treatment because services were joined-up. The service had built relationships with GPs and early pregnancy units in the area. Staff liaised with other healthcare providers to share reports and imaging results.

Quality Statement Score: 2

Description: We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

We scored the service as 2. The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information was not always provided in a form accessible to all patients. For example, the service did not have information leaflets in easy-read format, in languages other than English, or in a child-friendly format. Leaders stated that they had minimised the production of information leaflets since the Covid 19 pandemic. They stated that patients were able to use technology, such as their phones, to access relevant information.

The service did not gather information about patient’s preferred communication needs before they attended their appointment. This impacted on staff’s ability to prepare in advance or make necessary adjustments for patient’s communication needs.

Staff ensured that patients could access information about treatments and local services.

Information governance systems included confidentiality of patient records. Computers were password protected to ensure service user information was securely stored. During our site visit, we observed that staff maintained the confidentiality of patient records.

Quality Statement Score: 2

Description: We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

We scored the service as 2. The evidence showed some shortfalls. There was not always documented evidence to show what actions had been taken in response to concerns raised through patient feedback. Learning from feedback was not always shared.

Leaders did not always document evidence of actions taken in response to patient feedback. For example, while some patients had raised concerns about their interactions with specific members of staff, and leaders reported addressing these by speaking to the staff involved, there was no documented evidence to confirm these conversations had taken place.

While there was evidence that learning from complaints had been shared with staff members directly involved, there was no documented evidence that learning had been shared more widely across the team. Staff did not meet to discuss learning from feedback or complaints, and they could not recall receiving such information through other channels, such as email. As a result, opportunities to improve practice and prevent similar issues from occurring may have been missed. However, staff did have access to a folder with information on incidents and complaints

Where improvements were made as a result of feedback or complaints, patients were not involved in shaping the solutions or measuring the impact. This limited the service’s ability to ensure that improvements were meaningful and enhanced patient experience.

The service did not have arrangements in place for independent external review of complaints, such as through the Independent Services Complaint Advisory Services.

The provider had not introduced accessible ways for people to raise concerns or provide feedback. For example, the service did not have feedback forms in child-friendly or easy-read formats. This may have excluded some patients from sharing their views, thereby reducing the service’s ability to respond to the needs of all patient groups.

The service did not display information about how to make a complaint in patient areas. This could have limited the opportunities for the service to learn from concerns and improve patient experience. However, the service’s terms and conditions, which were available on the service’s website, included information about how to make a complaint. Despite these gaps, patients expressed confidence that their complaint would be taken seriously and handled with compassion. They reported feeling comfortable approaching staff with concerns, and staff demonstrated and understanding of how to manage complaints appropriately.

Complaints were thoroughly investigated, and actions had been taken in response to identified learning. The service had received 1 complaint in the 12 months prior to our assessment, which related to a potentially inaccurate diagnosis and concerns about the quality of care.

All patients received an email following their appointment inviting them to complete an anonymous survey. Staff could provide examples of how they used patient feedback to improve daily practice. For instance, staff had created a video for the website to visually guide patients on how to locate the clinic.

Quality Statement Score: 3

Description: We make sure that everyone can access the care, support and treatment they need when they need it.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff made reasonable adjustments for patients on a case-by-case basis to ensure services were accessible. Staff liaised with patients and their relatives or carers to understand what adjustments were required. For example, staff told us how they had worked with the parents of a child with autism to ensure the scanning room lighting was dimmed and that there was a quiet atmosphere during the scan.

The premises were accessible for patients with mobility issues. Staff had access to a translation and interpretation service. Patients told us that staff had made every effort to accommodate their individual needs.

The service did not have a waiting list. An online booking system enabled patients to view appointment availability and choose an appointment date and time that suited them. At the time of our assessment, patients were typically able to secure an appointment within the same week that they were requesting one.

Managers monitored data on cancellation rates and did-not-attend rates. Cancellation rates were approximately 8%. However, when asked during our assessment, leaders were unable to provide information about any actions taken to address this. Did-not-attend rates were low, at approximately 0.6%. At the time of our assessment, waiting times for blood tests were not being formally monitored.

Leaders did not formally monitor waiting times once patients arrived for their appointment. However, the service’s patient feedback survey included the question ‘How satisfied are you with the length of time you had to wait for your appointment?’. The registered manager told us the responses to this question helped them to identify any concerns regarding waiting times. None of the patients completing the patient feedback survey in the 12 months prior to our assessment had indicated a dissatisfaction with waiting times. Staff reported that waiting times once patients arrived for their appointment were minimal.

The service’s medical questionnaire did not include questions about accessibility and communication needs. Staff told us that as a result, there had been occasions where they had not been aware of a patient’s additional needs until they arrived for their appointment. This impacted on staff’s ability to prepare or make necessary adjustments ahead of time. In addition, most staff had not completed training on how to support patients with learning disabilities and autism.

Quality Statement Score: 2

Description: We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

We scored the service as 2. The evidence showed some shortfalls. Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

The service did not actively gather, listen to, or act on information about people most at risk of experiencing inequalities in experience or outcomes. For example, the post appointment patient survey sent did not include questions about ethnicity, gender or other protected characteristics. As a result, the provider did not have a clear understanding of how different groups experienced the service, making it more difficult to identify inequalities, tailor care, or make the service more inclusive.

The provider had not undertaken equality impact assessments of their policies and procedures to ensure they did not unintentionally disadvantage vulnerable people or those with protected characteristics.

Staff fostered a culture in which people using the service felt encouraged to share their views. Patients believed the provider would listen to and act on any concerns to improve care. Additionally, staff received training in equality, diversity, inclusion and human rights.

Quality Statement Score: 3

Description: We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

The service did not routinely care for people who were nearing the end of their life. However, staff supported patients to understand the results of any scans and tests, and communicated these in a sensitive and dignified way. Staff discussed the next steps in their care and treatment, and referred patients to other healthcare providers when appropriate. Staff shared images and reports with other healthcare providers to support continuity of care. Staff were also able to signpost patients to external organisations for further advice, emotional support, or specialist services, helping to ensure patients felt informed and supported throughout their care journey.