The Care Quality Commission
  • Hospital
  • Independent hospital

Archived: Fusion Radiology

Overall: Good read more about inspection ratings

70 Trent Road, Luton, Bedfordshire, LU3 1TA (01582) 249216

Provided and run by:
Fusion Radiology Limited

Important: This service is now registered at a different address - see new profile

All Inspections

16 June 2021

During a routine inspection

Our rating of this location improved. We rated it as good because:

  • The service had enough staff to provide a safe service. Staff had training in key skills, understood how to identify abuse, and managed safety well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
  • The provider had systems to ensure reporting radiologists who provided services had appropriate equipment installed.
  • The registered manager monitored the effectiveness of the service and made sure clinical staff were competent. There were effective systems to act on urgent and emergency referrals. There were escalation processes for reporting radiologists in the event of a significant finding. Staff worked well together for the benefit of patients and had access to good information.
  • Clients could access the service when they needed it and received the report within the agreed time frame.
  • The registered manager ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. Staff were clear about their roles and accountabilities.

However:

  • The administration staff did not have a mandatory or update training programme or schedule.
  • Policies and procedures were not always reviewed and updated, in a timely manner.
  • The service had systems for identifying risks, however, they were not always reviewed and updated, in a timely manner.

03 March 2020

During a routine inspection

Fusion Radiology is operated by Fusion Radiology Limited providing teleradiology service. Teleradiology is the transmission of patients’ radiological images between different locations to produce an imaging report, expert second opinion or clinical review.

Fusion Radiology initially began by providing a reporting service for general magnetic resonance imaging (MRI) scans. The service since inception has developed its capacity and created a consultant radiologists’ panel to provide dental cone beam computed tomography (CBCT) and MRI neurology reporting. CBCT is a special type of x-ray equipment used when regular dental or facial x-rays are not sufficient.

We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 3 March 2020.

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.

Services we rate

Our rating of this service stayed the same. We rated it as Inadequate overall.

The service was previously placed into special measures following the last inspection in April 2019. Due to the significant concerns found at this inspection we issued a warning notice under Section 29 of the Health and Social Care Act 2008 on the 13 March 2020 and told the service it must improve by 30 April 2020. On the basis of this inspection the service will remain in special measures. We will continue to monitor the service closely and may take further action, in line with our enforcement procedures if compliance is not achieved.

We rated the service as inadequate because:

  • The service did not have effective processes to ensure all contracted staff completed and provided them with their training competencies.

  • The service did not have an appropriate safeguarding policy to safeguard vulnerable service users.

  • Staff did not have safeguarding training and did not understand how to protect service users from abuse.

  • Processes were not in place to ensure that the equipment used by the service was safe for use.

  • There were no effective processes to disseminate lessons learnt.

  • Policies and procedures were not reviewed and updated, in line with national guidance, or in a timely manner.

  • The service did not have effective systems to ensure all staff were competent for their roles.

  • The service did not have a written vision and strategy for what it wanted to achieve and workable plans to turn it into action developed.

  • The systems and processes did not effectively maintain the overall governance of the service.

  • While the service had systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected, they did not have processes to manage the risks.

  • The service did not have effective processes to manage and widely share learning from adverse events, incidents, discrepancies or errors that might occur.

  • The service had systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected, they did not have processes to manage the risks.

However:

  • The service had enough teleradiology staff with the right skills and experience to meet the imaging reporting needs of patients.

  • The service had processes to respond to unexpected and urgent report outcomes.

  • Records were kept secure and were only accessible to authorised staff, to maintain confidentiality.

  • The service monitored the effectiveness of care and treatment.

  • Staff worked together and supported each other as a team to provide good care.

  • Clients could access the service when they needed it as outlined in their individual contract.

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, which were shared with all staff.

  • The service manager had some skills and abilities to run the service, to ensure they provided quality sustainable care.

  • The teleradiologist we spoke with praised the registered manager and felt supported to raise concerns.

In addition to the warning notice, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals

2 April 2019

During a routine inspection

Fusion Radiology Limited is a UK based teleradiology service. Teleradiology is the transmission of patients’ radiological images between different locations to produce an imaging report, expert second opinion or clinical review.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 02 April 2019.

Fusion Radiology initially began by providing a reporting service for general MRI scans. The service since inception has developed its capacity and created a consultant radiologists’ panel to provide dental cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) neurology reporting. CBCT is a special type of x-ray equipment used when regular dental or facial x-rays are not sufficient.

The registered manager informed us that they are currently not reporting any activity for general MRI and have focused on neurology (brain injury) and dental images. The service continues to maintain the general MRI reporting service activity should they wish to continue in the future.

The registered location is in Luton, Bedfordshire and provides general and subspecialty reporting services to support existing radiology departments within NHS, private healthcare and dental organisations.

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.

Services we rate

This service has not been previously rated. We rated it as Inadequate overall.

We found the following issues that the service provider needs to improve:

  • While the service had systems for identifying risks, they did not have effective processes to manage them.
  • While the service had processes to respond to diagnostic reports received, there were not effective processes to manage the quality of the reports.
  • The service did not have processes to manage discrepancies which included disseminating information to all staff. This was not in line with the Royal College of Radiologists (RCR) guidance.
  • The service did not have processes to ensure they complied with the European Union Health and Safety legislation regarding the working time directive.
  • While the service recorded safety incidents, but lessons were not always shared or disseminated with the whole team. There had been nine reported incidents from January to March 2019 which related to administration errors which included wrong patient data being paired up with wrong images when downloaded from the client imaging portal directly. The service did not have effective processes in place for learning from clinical incidents
  • Staff did not always work together and support each other as a team. There was no regular contact with contracted staff to ensure they provided high-quality sustainable care.

We found good practice within the service:

  • Staff understood and knew how to identify, protect and report patients from abuse.
  • The environment was suitable for the management of imaging services and there were processes in place to maintain the equipment.
  • The service had enough staff with the right skills and experience to keep manage patients’ imaging reporting needs
  • Records were kept in locked in a cupboard and were only accessible to authorised staff, to maintain confidentiality.

Following this inspection, we told the provider that it must take some action to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice. Details are at the end of the report.

I am placing the service into special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Nigel Acheson

Deputy Chief Inspector of Hospitals (Central Region)