The Clinical Imaging team provides services across the county, managed and delivered from its central hub at Royal Cornwall Hospital in Truro, with satellite services at West Cornwall Hospital in Penzance and St Michael’s Hospital in Hayle. The team also supports eight community hospitals based minor injury units, GP and outpatients services. Together they provide full range of imaging services including x-ray, CT, MRI, ultrasound, nuclear medicine, mammography, bone densitometry, fluoroscopy and interventional radiology (IR) including cardiology. The team also delivers the breast screening programme for Cornwall and RCH hosts the specialist commissioned PET-CT mobile service. Imaging services across the county are comprehensively supported by an in-house medical physics service.
Recognising that NHS Trusts with Imaging Service Accreditation Standards (ISAS) were viewed positively by the Care Quality Commission (CQC) during inspections and, along with Q-pulse capability and actions arising from a serious incident, work towards ISAS accreditation began in earnest about 2.5 years ago. However, the clinical imaging teams had been steadily building a quality management system (QMS) for more than a decade, so already had some very robust systems and protocols in place.
“Whilst supporting and ‘feeding’ two teams with slightly different agendas, there is little doubt that the ISAS preparations enabled us to deliver what was required to assure the CQC of the quality of our service,” says Emma Spouse, RCHT’s Imaging Lead.
“The most challenging aspects of driving the ISAS accreditation project were releasing staff time and capacity to work on the application at a time when NHS resources and services are so stretched. This was one of the reasons why we identified strong admin support early on in the process. Staff could identify the information or evidence but did not always have time to collate it into a user-friendly format or file it appropriately,” says Emma.
“We also learnt that there needed to be a systematic approach to uploading evidence and documents onto the ISAS template and this was easier to achieve if access was restricted to a couple of super-users. The positive aspects were the high level of consultant radiologist engagement with, and their enthusiastic commitment to, the project. The business admin role provided invaluable support to busy clinicians by sitting with them and going through each domain and line of enquiry. This significantly assisted in the identifying and refining of the evidence and assurance of compliance with each standard.”
The ISAS application process also had the unanticipated impact of unifying services regardless of location, with radiographers and support staff working at community hospitals becoming involved and working across the collective imaging team.
“Going forwards the challenge is to embed ISAS assurance into everyone’s job, particularly the frontline radiographers, and to make sure that evidence is updated and relevant to services as they evolve over time. We have also had a change of leadership roles and so there is a learning curve for staff new to the ISAS process. However, this does mean that the depth of understanding of ISAS is being spread widely across the service,” says Emma.