Medica Operational HQ - Havelock

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service had a proactive and positive culture of safety based on openness and honesty, in which concerns about safety were listened to, safety events were investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.

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.

The service provided guidance to staff on reflective practices and any reporting discrepancies or errors were sent to the reporter for a reflective review. This included identification of learning and modifications to practice. If there was disagreement or it was felt that there was further opportunity to reflect, the case would be reviewed by an arbitrator and sent back to the reporter for further review. As part of the data request, we saw evidence of learning opportunities being offered to reporters following a case discrepancy review. In addition to the discrepancy process, the service provided regular learning opportunities through Educational Case Reviews (ECRs). We reviewed three ECRs which included case studies with learning points. The service also held webinars where case studies were discussed for further learning. Radiologists were expected to attend a minimum of three Radiology Events and Learning (REAL) meetings per year. Attendance was mandatory and this was verified during the appraisal. These meetings provided radiologists an opportunity for focussed shared learning from actual cases with closer questioning and panel discussions. Learning from complaints and incidents were disseminated to staff via emails and medical director communications. We saw evidence of new guidance released to staff as a result of a case which was subjected to a coroner’s inquest. All complaints and incidents were investigated to identify learning and to follow through and monitor progress on actions. A full Root Cause Analysis (RCA) was triggered in the event of an incident where there was actual or potential harm and where there were multiple factors. RCAs were reported to the Clinical Governance Committee and actions were identified and tracked. We reviewed an RCA which included lessons learned and an action plan.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

New reporters received an induction and undertook an entry audit in each of their competency areas following their training session. The aim of the audit was to provide reassurance to the service that the new radiologist reached an acceptable standard of reporting of routine work within their scope of practice. Successful audited induction led to Acute emergency reporting after a month and elective, same day reporting after three months. The clinical governance committee reviewed the entry audit outcome and provided formal approval for reporting. The service had two recruitment selection policies for reporters and radiologists. We reviewed both policies which included the recruitment process and the selection criteria for standard and overseas staff. All reporters received an annual appraisal. Most of the doctors employed were connected to the NHS where they received their main appraisal. Medica provided information for their NHS appraisal in line with the scope of practice requirements. This was in the form of an “Information for Whole Practice Appraisal” (IWPA) and was designed to cover the practicing privileges requirements and to provide a short statement for their NHS appraisal. Reporting radiographers were granted practicing privileges which were formally renewed on an annual basis. The Clinical Appraisal committee provided oversight of the appraisal process and the Medical Advisory Board; MAB provided oversight of the Revalidation process. The service reported Appraisal and Revalidation process outputs to NHS England. The Medical Director was the Responsible Officer (RO) and made revalidation recommendations to the General Medical Council (GMC). They also had regular planned meetings with the GMC Employment Liaison Advisor (GMC ELA) and had good access to the GMC ELA for advice and decision calibration. Staff received inhouse training on the radiology reporting system and completed a New Reporter Training Checklist and Radiology Reporting Process Guide.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.