PET CT at the Harley Street Clinic is a private medical imaging service that comes under the general management of The Harley Street Clinic but has a separate registration.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 08 January 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.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

The main service provided was positron emission tomography–computed tomography (PET CT) and diagnostic computerised tomography (CT).

Services we rate

This was the first time we rated this service. We rated it as good overall.

We found the following areas of good practice:

• The service managed staffing effectively and services always had enough staff with the appropriate skills, experience and training to keep patients safe and to meet their care needs.
• There were systems, processes and practices essential to keep patients safe identified, put in place and communicated to staff.
• There was an effective system in place for reporting incidents. Staff understood their responsibilities to raise concerns, to record safety incidents, concerns and near misses.
• Relevant and current evidence-based guidance, standards, best practice and legislation was used to identify and develop how services, care and treatment were delivered.
• Staff had the right qualifications, skills, knowledge and experience to do their job.
• Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005 and the Children Acts 1989 and 2004.
• Staff communicated with patients to ensure that they understood their care, treatment and condition.
• People could access the service when they needed it.
• Leaders had the skills, knowledge, experience and integrity to manage the service.
• There were governance frameworks to support the delivery of good quality care.

However, we also found the following area in which the service needed to improve:

• On the day of inspection, staff were initially unable to locate the Ionising Radiation Regulations 2017 (IRR17) and the Ionising Radiation (Medical Exposure) Regulations 2017 Employers Procedures to show to inspectors. These regulations set out a list of procedures required as a minimum in any radiological installation. They ensure staff understand their individual roles and responsibilities in procedures.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South)

People received written information about what their scan would involve and they could discuss this with staff. People we spoke with described staff as "very nice" and "charming". The service was accessible by wheelchair and there were measures in place for helping people who did not speak English to understand their care and treatment.

Before people had scans medical histories were taken. Appropriate aftercare information was also provided. Staff had been trained in how to handle medical emergencies and there was emergency equipment and drugs available at the service.

Staff had been trained in safeguarding and this was refreshed on an annual basis. There was a policy and procedure for how to report concerns (including to the local authority) which staff were aware of. People using the service said they felt "safe" around staff.

Staff members received an induction to the service and received appropriate mandatory training. They had annual appraisals where their performance was discussed and targets were set for the coming year.

The service monitored the quality of the service that they provided and reported this to a clinical governance committee every two months. There were regular checks on the safety of the building and equipment. There was a comments and complaints procedure in place which people could use to raise any concerns. The people we spoke with said that they would be happy to raise any concerns that they had with staff.