Archived: Radiology Reporting Online LLP - London Head Office

Updated 13 November 2019

Radiology Reporting Online LLP – London Head Office is operated by Everlight Radiology. The service began carrying out regulated activities from this location in July 2018. The location is the provider’s UK head office and includes operations, scheduling and administration teams in addition to reporting facilities for radiologists. The service has no direct contact with patients and does not provide direct patient care.

The location is registered to provide the following regulated activity:

• Diagnostic and screening procedures

The London office primarily provides routine daytime reporting and the dedicated operations team provide live monitoring and resource control based on demands on the service, including for urgent out of hours reporting. The team works with colleagues in other UK and international locations to coordinate reporting capacity.

Radiology Reporting Online LLP, London Head Office, was previously located at another address. A registered manager has been in post since the service began operating.

We have not previously inspected this service.

Updated 13 November 2019

Radiology Reporting Online LLP – London Head Office is operated by Everlight Radiology. The service provides teleradiology reporting services to NHS hospitals across the United Kingdom, including plain film, computerised tomography (CT) and MRI, as well as quality assurance monitoring for ultrasound screening. The services operates 24-hours, seven days a week and 365 days a year. Reporting is available for urgent daytime and out of hours cases, in addition to routine and backlog reporting. The service provides audit and second opinion reporting. The service began reporting from this location in July 2018.

The provider has other offices in the UK that are registered with CQC and international offices that do not fall under our regulatory powers. While this inspection did not include the provider’s other UK locations, and international offices are outside of our scope, we reference them in some contexts as a number of teams and services are shared with the head office location.

This service employs 17 radiologists who are registered with the General Medical Council as specialists or with the Royal College of Radiologists. A further 181 reporting radiologists worked for the service nationally. Radiologists can work from home using equipment approved and maintained by the provider or from the nine fully-equipped reporting rooms on site.

The service provides diagnostic imaging services on a remote basis, which means patients do not attend the location and staff have no contact with patients. All patient care and contact is made by the NHS trust responsible for their treatment. The service does not store or prescribe medicines and does not monitor patient symptoms such as pain or clinical presentations.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 8 March 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. However, we did not inspect the service using the caring domain of our inspection framework because the service has no direct contact or interaction with patients.

As the service does not have direct contact with patients the provider has no areas of required compliance with the Mental Capacity Act 2005.

Reporting radiologists typically process tens of thousands of reports per month from the provider’s UK locations or UK-based homeworking.

We rated the service as Outstanding overall:

• 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.
• There were effective systems to act on urgent and emergency referrals. There were escalation processes for reporting radiologists to contact referring clinicians in the event of significant finding. Failsafe processes meant radiologists always had a named point of contact within each hospital in the event the referring clinician was unavailable.
• Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients and had access to good information. All services were available seven days a week.
• The service sought accreditation by appropriate awarding bodies and had developed benchmarking and audit processes to establish consistent standards of work.
• Services were provided flexibly, provided choice and ensured continuity of care. The organisation involved NHS clients in all aspects of service provision and provided highly tailored solutions based on their needs. There were innovative approaches to providing integrated pathways of care that involved other service providers, particularly for emergency scan results. All aspects of the service were available 24-hours, seven days a week with senior clinical oversight available at all times. The senior team actively reviewed complaints within an established framework that ensured improvements were made as a result.
• Leaders 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. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

We found areas of outstanding practice:

• All staff had a demonstrable, driven approach to improving standards for patients and clients. This included multiple, responsive processes that senior staff continually sought to develop. Although the service did not provide direct care to patients, staff clearly had patient outcomes at the centre of their dedicated work ethos.
• The provider had effective, well-established systems to ensure reporting radiologists who provided services for UK-based hospitals had appropriate equipment installed. This included a visual check of their reporting area by the IT team and installation of equipment carried out by approved UK-qualified technicians.
• The service was highly responsive to client and patient needs and had tested and implemented solutions to issues in a timely manner.
• There was a continual, well-defined focus on improvement and innovation. Dedicated staff continually reviewed work processes and systems to identify opportunities for improvement.
• In the absence of national standards for teleradiology reporting, the provider had established an internal peer review system aimed at benchmarking reporting quality.
• The provider had developed innovative solutions to challenges relating to 24-hour working. This included scheduling work hours based on the report’s location to avoid the fatigue associated with night shift.
• The senior team placed value on effective, advanced communication between staff and provided opportunities for advanced development. For example, the provider had secured training from a neuroscience specialist to help staff build strong working relationships by recognising how they perceived each person’s style of communication

Nigel Acheson

Deputy Chief Inspector of Hospitals

Nigel Acheson

Deputy Chief Inspector of Hospitals

Updated 13 November 2019

We rated this service as outstanding because it was safe, effective, responsive and well-led.