Princess Royal MRI Unit is operated by Alliance Medical Limited. The service provides magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA) (an X-ray scanner that uses two different X-ray energies to measure bone mineral density) scanning for Princess Royal Hospital as part of a contract with Brighton and Sussex University Hospitals NHS Trust. Princess Royal MRI Unit registered with CQC in April 2016 and has not been inspected before.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit to the service on 13 February 2019.

We rated it as Good overall.

Our key findings were as follows

• There was evidence of investigation, learning and dissemination of learning from incidents within the Alliance Medical Limited organisation.

• Equipment was well maintained and tested annually or in accordance with manufacturer’s guidelines.

• Staff demonstrated a kind and caring approach to patients, supported their emotional needs and provided reassurance. We observed staff providing care in a compassionate and respectful manner. Staff ensured patients understood the procedures, answered questions and obtained consent before providing care.

• The service provided care and treatment based on national guidance and evidence of its effectiveness.

• The service offered people appointment times to reflect their needs and preferences, for example if they had limited mobility.

• The unit manager ran an audit programme to monitor the effectiveness of care, procedures and policies. Staff used the findings to improve the service. They carried out a monthly image quality audit to evaluate images and techniques to improve image quality.

• The service made sure staff were competent for their roles. There were systems to check staff professional registration, appraise their work and provide support.

• The service leaders had a sound understanding of their risks and challenges. These were reflected on the local risk register and reported to reported to the regional director and liaised with the central quality and risk team.

• Staff described a visible and approachable local leadership team and told us they were able to raise concerns and report incidents.

However:

• Access to the MRI units were not always well restricted. In the static unit there was no lockable door separating the waiting room from the controlled area of the three tesla (3T) scanner. This created a risk to patients and/or visitors with implanted devices such as a pacemaker if they crossed the threshold without being screened.

• The DXA room had a carpeted floor, which did not meet the requirements of Health Building Notice (HBN) 00-09: Infection control in the built environment.

• Contrast media was not always recorded in ward patient records of care, in line with best practice.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals