European Scanning Centre (Harley Street) Ltd is operated by European Scanning Centre Ltd. European scanning centre (ESC) operates diagnostic imaging services across two other locations.
The service at Harley street consists of an Aquilion ONE 640 slice CT (computed tomography) scanner, a MRI Open upright and open MRI (magnetic resonance imaging) scanner, EOS dual source linear upright CT scanner (EOS imaging) and an Aplio 500 ultrasound scanner.
The service is split over three floors (basement, ground and first floor) within a building that has a shared entrance for residents residing on the third floor.
Patients are greeted by the receptionist and wait in a dedicated waiting room before being called through for their scan.
The service provides specialist diagnostic imaging services for adults, and children and young people.
We inspected this service using our comprehensive inspection methodology. We carried out the inspection on 15th January 2019, along with an unannounced visit to the service on 28th January 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.
The main service provided by this provider was diagnostic imaging.
Services we rate
We rated this service as Requires improvement overall.
- Although staff had training on how to report and recognise abuse, staff were not trained to an appropriate level in safeguarding.
- Labels on sharps bins were not correctly completed.
- Hazardous items were not always secured, and some areas were cluttered.
- Patient specific directions (PSDs) and patient group directions (PGDs) were not used for administration of contrast media or medication.
- The service had no robust systems for reporting incidents and it was not clear how learning from these, was shared or how practice was reviewed.
- There was no medicines management policy in place.
- The provider could not be assured staff understood their roles and responsibilities under the Mental Capacity Act 2005.
- Arrangements for identifying, recording and managing risks were not robust.
- There was no systematic programme of clinical audit to monitor quality or systems to identify where action should be taken.
- There was a lack of effective governance processes to assess, monitor and review risks.
- There were no meetings or formal measures of performance, except for financial performance.
- Monthly staff meetings were not minuted and action logs were not recorded.
However, we also found the following areas of good practice:
- MRI local safety rules were up to date and reflected best practice.
- There were systems to demonstrate staff were competent to do their jobs and develop their skills.
- There was good collaborative working to meet patients’ needs.
- Patients were treated with dignity, respect and compassion.
- Patients were given the opportunity to ask staff questions, and patients felt comfortable doing so.
- Staff provided patients with emotional support; staff were sympathetic to anxious or distressed patients.
- Same day appointments could be provided for patients.
- Patients could access services easily. There were no waiting lists.
- The service was planned and designed to meet the needs of the patients as it gave them access to timely scans.
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. Details are at the end of the report.
Dr Nigel Acheson
Deputy Chief Inspector of Hospitals (London and South)