Sheffield PET/CT Centre

Sheffield PET CT Centre is operated by Alliance Medical. The centre facilities include; reception and waiting area; an administrative area, which includes a reporting office, and a clinical area. The clinical area includes one scanner room, control room, dispensing laboratory, three uptake rooms and a changing room for patients, as well as male, female and accessible hot toilets (only to be used by patients who had their received radioactive injection).

The service provides diagnostic imaging using PET-CT equipment. A PET-CT scan is a combination of a PET (positive emissions tomography) scan and a CT (computerised tomography) scan. PET-CT scans are usually performed to help with the diagnosis, assessment and treatment of; cancer, heart and circulatory conditions and neurological (brain) abnormalities. The service can also provide CT scan only. The service carries out around 2800 scans per year.

The service saw adults and children as NHS patients as well as self-funded adult patients.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit on 28 May 2019 and telephone interviews with patients on 5 June 2019.

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.

This was our first rating of this service. We rated it as Good overall.

We rated safe, caring, responsive and well-led as good. We do not rate effectiveness of diagnostic imaging services; however our findings are included in this report.

We found good practice in relation to diagnostic imaging services at this location:

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. Patients told us all staff were helpful and understanding, informative, polite, reassuring and explained things well.
• Staff assessed and managed risks and kept clear records of patients’ care and treatment.
• Staff understood how to protect patients from abuse and all staff (technologists, clinical assistants, manager) had completed level 2 training in safeguarding vulnerable adults and level 3 safeguarding children.
• The service had suitable premises and equipment and looked after them well. Equipment and premises were visibly clean, and staff used control measures to prevent the spread of infection.
• Staff of different kinds worked together as a team to benefit patients. The service provided care and treatment based on national guidance and evidence of its effectiveness.
• People could access the service when they needed it. Waiting times from referral to scan were in line with good practice.
• The service planned and provided services in a way that met the needs of local people and of the individual patient.
• The service had managers with the right skills and abilities to run the service and staff described a positive culture where they were supported by their managers.
• The service improved service quality and safeguarded high standards of care through systems which identified risks, plans to eliminate or reduce risks.
• The service partnered with local organisations to plan and manage appropriate services and collaborated to deliver services effectively.

However, we also found the following issues that the service provider should improve;.

• The service provided mandatory training in key skills to all staff, however not all staff had completed formal radiation safety training appropriate to their current role.
• Managers investigated incidents and shared lessons learned with the team, although levels of harm were not clearly identified in a timely way.
• Local dose reference levels were available for PET but not CT scans.
• Local procedures did not refer to consent processes for children and young people, for example in relation to Gillick competency.
• Two-person checks were not completed where staff administer radiopharmaceuticals, in line with best practice, although this was in line with company policy.
• Staff felt leadership was not always visible at this location. Maintaining detailed management oversight of the service was sometimes a challenge.
• The service recognised there were opportunities to strengthen patient engagement.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals (North of England)