25 Harley Street

On this page

• 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 patients had the best possible outcomes because their needs were assessed. We checked that patient’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring patients were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment we did not rate this key question in line with the methodology. At this assessment the rating has change to good. This meant patient’s outcomes were consistently good, and patient’s feedback confirmed this.

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.

The service usually made sure patient’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

DEXA scans and X-rays were planned and delivered in line with evidence-based, guidance, standards and best practice. For example, we observed a referral being returned as the correct information had not been completed in order to comply with IR(ME)R. This meant staff did not want to expose patients to unnecessary levels of radiation.

Referral information and safety questionnaires were reviewed before imaging procedures took place to confirm the requested scan was appropriate and to identify any risks or individual patient needs.

During the assessment we observed staff checking patients’ mobility and support needs prior to imaging. Patients were assisted with positioning and made comfortable before scans began. Staff liaised with referrers in order to ensure the imaging was correct. For example, the team liaised with an orthopaedic surgeon, so they understood the angle the image needed to be taken at.

The service had a clear exclusion criterion for which patients they were unable to accommodate. For example, there were weight limits for the Xray and DEXA Scan and patients with impacted mobility that required a hoist or sliding sheet could not be seen at this location. If they were unable to meet the needs of a patient, the referral would be returned to the referrer signposting to other services.

Staff told us they could access interpreters if required to support communication with patients.

The service usually planned and delivered patient’s care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

Staff followed up-to-date policies to plan and deliver high quality care that were in line with best practice and national guidance. All policies we we reviewed included a creation and review date, and clear references to current national guidelines. Changes to the policy was clearly listed at the front of the document detailing what had been updated. The provider had a document control policy which detailed the process staff should follow to create or adapt an existing policy and the stages through to ratification. This included details on adopting nationally recognised documents such as those produced by the Royal Colleges or National Institute for Health and Care and Excellence (NICE). All policies we reviewed included an equality impact assessment that was required to be completed before any changes were made.

We reviewed 3 sets of patient records for evidence of completion of risk assessments and consent obtained and found all 3 had been completed.

Patients told us they received clear explanations regarding the purpose of their scan or Xray they were having and that care was informed by assessments and consideration of personal circumstances.

The service usually worked well across teams and services to support patients. Staff made sure patients only needed to tell their story once by sharing their assessment of needs when patient moved between different services.

Staff worked together as a team to benefit patients. Staff reported having positive working relationships across the outpatient centre with staff in different departments.

Staff across the provider worked together. Radiographers could assist another location if they needed additional staff. For example, the diagnostic centre offering MRI and ultrasounds could ask for support from the service if an appropriately qualified radiographer was available, meaning patients were able to have a scan on the day rather than have an appointment made for another day.

Staff attended daily huddles to discuss the patient list and any support needed or concerns with operational pressures.

Radiology staff worked closely with the referrers to enable patients to have a prompt diagnosis and treatment pathway. Referrers were encouraged to liaise with the radiographers when they were trying to obtain specific imaging. For example, an orthopaedic surgeon required X-rays to be taken in a certain way and worked with the team to achieve the best imaging results for the patient.

The service used a teleradiology service to report on scans. The service worked closely with them to ensure scans were reported on and results could be sent to the referrers in a timely manner.

We did not look at Supporting people to live healthier lives during this assessment. There is no previous rating for the Effective key question so we cannot yet publish a score for this area.

The service monitored patient’s care and treatment to continuously improve it. Staff ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of the patient themselves.

Staff monitored the effectiveness of care and treatment through clinical audits. The service used the findings to make improvements for patients. The service participated in relevant provider led clinical audits, including the Xray reject analysis audit. This audit was carried out to review the number of images that were rejected as they were not of sufficient quality for diagnostic purposes. The audit looked at why the images were not good enough, the actions to take and mentorship and training that was required. The most common reason was anatomy cut off and positioning. Actions taken as a result of these audits included hands-on training and quality refresher courses. The audit in April 2026 showed the rejection rate was 10.89% which was within the national average range of 2.3% - 12%. May 2026 identified the number of images rejected fell outside the national average range at 13.92% and that urgent action needed to be taken. An action plan was developed and implemented to improve this and included immediate objectives and actions to take to improve the standard but also long-term objectives to continually score under 5%. Actions included training for all staff on positioning, creation of a shared resource folder with examples of images and guidance, completion of the reassessment of competency of staff and to discuss the action plan at staff meetings. At the time of the assessment the action plan had recently been developed, and we had not seen the impact of any improvements.

The service audited the turnaround times (TAT) of imaging examinations and the report being made available to the clinician. This was outsourced to a teleradiology service and took place off site remotely. The service level agreement (SLA) was for the image to be reported on in 24 hours for Xray and 48 hours for DEXA. Data was reviewed monthly for DEXA and Xray’s. This data showed compliance was over 90% for the last 5 months. The action plan considered that some delays were public holidays and weekends as the 24-hour SLA covered Monday – Friday. The delays were discussed at the Integrated governance meeting and Radiation protection committee. Reminders were sent to radiologists to remind them of the SLA in place.

The service told the patient about their rights around consent and respected these when delivering person-centred care and treatment.

Staff told us they understood how to obtain informed verbal and formal written consent from patients before commencing imaging procedures. We reviewed patient records and found that consent was documented appropriately. During the assessment we also observed staff obtaining informed consent during patient interactions. For example, we observed radiology staff explaining an Xray to a patient and obtaining consent before proceeding with the scan. Staff also asked whether the patient would like a chaperone in line with the provider’s standard operating procedure.

Training records showed that 87% of staff had completed training on the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) which was above the target of 85%.