George Eliot NHS Hospital

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 reviewed assessing needs, delivering evidence-based care and treatment, monitoring and improving outcomes and consent to care and treatment. Assessing needs: Staff worked as part of a multidisciplinary team to ensure patients receive the treatment they needed. Delivering evidence-based care and treatment: Staff followed policies to plan and deliver high quality care according to best practice and national guidance. Monitoring and improving outcomes: The service monitored treatment times and worked to improve outcomes. Consent to care and treatment: Staff followed policy to gain patients consent to treatment.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients could choose which hospital they attended for imaging appointments. This meant patients could sometimes get their treatment sooner in a hospital other than the 1 most local to them. Some of the patients we spoke to told us they had attended George Elliot Hospital because they could get seen there sooner.

Staff ensured radiation doses were kept as low as reasonably practicable. Staff attended 12 regular and effective multidisciplinary team (MDT) meetings to discuss patients and improve their care, including 6 oncology MDTs. There was a rota which included cover arrangements to ensure each of the meetings was attended by a consultant radiologist. Radiologists held a monthly radiology events and learning meeting to review discrepancies in reporting or clinical incidents. These meetings were held in line with the Royal College of Radiologists standards to develop a positive learning culture and enhance reporting competencies.

We saw evidence provided by the trust that showed NHS England reporting times for scans were not being met. This showed there were 5.1 week delays from scan to report for MRI images and a 6.1 week delay from scan to report for CT images. However, we saw evidence that the trust had recruited 5 fellows. It was anticipated but this would enable them to introduce processes to reduce turnaround times for reporting across the department. We also saw evidence that the trust did not have an acknowledgement system in place. This meant there was no acknowledgment process or function to confirm when a radiology report had been viewed or by whom. This risk was recorded as a high risk on the risk register however it had been on the register since August 2020 with no action taken to reduce the risk that we could see. The department had processes to audit and re audit imaging to ensure but it met best practice and national guidelines. For example, the quality of chest X-rays was re-audited in July 2023, and 3 ultrasound audits had taken place in 2024 to measure the efficacy of the intervention in disease detection.

We looked at the scanning protocols for each modality and saw they gave staff clear guidelines which contained up to date information. Staff followed policies to plan and deliver high quality care according to best practice and national guidance such as Ionising Radiation (Medical Exposure) Regulations 2017, the Royal College of Radiologists and the National Institute of Health and Care Excellence (NICE). The service had an image quality assurance process that staff understood and were using in line with protocols. Staff used Local Safety Standards for Invasive Procedures and National Safety Standards for Invasive Procedures and a modified World Health Organization safer surgery checklist to help keep patients safe. Patients were provided with specific instructions relating to eating and drinking prior to their scan with their appointment letter. A text service was also used to remind patients of what they needed to do in preparation for their scan.

The service had guidance on consent, this included the process to follow if patients lacked capacity to consent. We saw consent forms that contained sections that required completing for patients that lacked capacity to ensure evidence of a best interest decision was documented correctly. The service had a did not attend policy so staff knew what processes to follow to ensure patients were offered further appointments when necessary.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

Staff told us they worked to improve patient access to treatment as well to improve the quality of imaging and reporting through a culture of continued learning and development. Staff participated in relevant national and local clinical audits to review the effectiveness of care and treatment. Managers and staff used results to produce action plans and improve patient outcomes. Radiologists and radiographers vetted referrals to assess the urgency for scanning. Patients at greatest clinical risk were offered appointments soonest. To reduce waiting times the provider sent a text reminder of the appointment time and date and information about any preparation that was required for the scan. Patients could respond to the text, free of charge, to say if they were attending their appointment or needed to cancel or rearrange. This meant fewer people did not turn up to their appointment and the booking team had the opportunity to offer unwanted appointments to other patients.

The service monitored time to treatment and turnaround times for reporting on scans and had introduced initiatives to improve both metrics. There had been a significant improvement in waiting times for ultrasound from 18 weeks to 5 days this was because staff worked together to look at how use of clinic times could be improved. The department had employed 5 internationally recruited fellows to reduce turnaround times for reporting. The service undertook regular Radiology Events and Learning Meetings in line with Royal College of Radiologists guidance and monitored these meetings with evidence of historic case discussion and learning.

Patients told us they had given written consent, or verbal consent in the case of plain film imaging, before their imaging and that they had been given both verbal and written information about the procedure they were having to explain the risks associated with their imaging, as well as information about their pathway up to how and when they would receive their results. The service had patient information leaflets and information on the website about each type of imaging so that patients understood what was going to happen at their appointment and also about side effects of radiation so they could make an informed choice about their treatment.

Staff could explain the consent procedure to us, and all the staff we spoke to were able to tell us what steps they took if they felt a patient lack capacity to consent. This involved referring the patient back to the referring doctor to ensure a best interest decision was made involving 2 doctors and next of kin/power of attorney. The consent form we reviewed had been completed in line with best practice. Staff explained they ensured that patients were aware of potential side effects of radiation before gaining consent. Staff were aware that they needed to give additional information to people that could be pregnant, they understood that this included checking with all patients that may have been born female.

The service had consent forms for all imaging (apart from x-ray where patients gave verbal consent and declared pregnancy). The forms contained sections for patients as well as sections for staff. There were sections for doctors to record information about patients who lacked capacity. The consent form for CT also included a section so staff could demonstrate the level of radiation for the procedure was justified.