InHealth Milton Keynes MRI Centre is operated by InHealth Limited.

The MRI Centre at Milton Keynes University Hospital is a joint venture between a local acute NHS trust and InHealth Limited. The site was opened in 1998. The site provides a wide range of magnetic resonance imaging (MRI) scans to NHS and private patients.

The unit is the only MRI service within the acute NHS trust hospital. The unit is registered with the CQC to undertake the regulated activity of diagnostic and screening procedures. The site provides a service for both adults and paediatric patients. The site opening hours are 7am to 9pm seven days a week, also providing an out of hours on call service for emergency cases up to 11pm. site also provides an on-call service for urgent scans required out of normal working hours.

The service has one magnetic resonance imaging (MRI) scanner. The MRI Centre is a single-story building attached to the main hospital through a link corridor. The unit has its own external entrance and also offers seven parking spaces for staff and patients. The unit comprised a waiting area and reception, two offices for use of InHealth staff and a store cupboard and kitchen area. There are two patient toilet facilities, one for mixed sex and one with disabled access. The unit also houses seven offices which are used by the trust radiologists. The clinical area provides two changing rooms, one of which contains a secure storage cupboard. The controlled access area contains two bed bays and has access to the control room, plant room and scan room. The control area is accessible through a secure access door.

The service provides contracted imaging to NHS and a number of private patients.. There were 15,570 MRI scans performed at the service between August 2017 to August 2018; 15,500 of these were commissioned by a local acute trust 70 were completed as part of a NHS contract for a clinical commissioning group. 796 of the 15,570 patients scanned were under the age of 18. 61 were under one year, 107 were between the ages on one and five and 728 were between six and 18.

The service had not been the subject of an external investigation between August 2017 and August 2018.r

InHealth is not responsible for the reporting of the images for this service. The Reporting for all NHS commissioned work is completed by the NHS trust radiologists. Private work undertaken at this service is reported on by radiologists working for InHealth under practising privileges. We inspected diagnostic imaging services at this location.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 1 October 2018.

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 service provided the regulated activity of diagnostic and screening procedures.

Services we rate

We rated it as good overall following this inspection.

We found the following areas of good practice because:

• There were systems, processes and practices essential to prevent people from harm identified, put in place and communicated to staff.
• The design, maintenance and use of facilities and premises were appropriate and standards of cleanliness and hygiene were maintained.
• There were sufficient numbers of staff with the necessary skills, experience and qualifications to meet patients’ needs.
• Patients’ individual care records were written and managed in a way that protected patients from avoidable harm.
• Patients’ needs were assessed, and their care and treatment was planned and delivered in line with evidence-based guidance, standards and best practice.
• Information about the outcomes of people’s care and treatment routinely collected and monitored.
• Staff had the right qualifications, skills, knowledge and experience to do their job when they started their employment, took on new responsibilities and on a continual basis.
• Patients had timely access to scanning.
• 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 treated patients with dignity, kindness, compassion, courtesy and respect. Staff were caring, kind and engaged appropriately with patients.
• Information about the needs of the local population was used to inform how services were planned and delivered.
• Services were planned to take account of the needs of different people, referrals were prioritised by clinical urgency.
• Leaders had the skills, knowledge, experience and integrity needed both, when they were appointed and on an ongoing basis.
• The provider had a clear vision and a set of values, with quality and safety the top priority.

However, we found areas of practice that the service needed to improve:

• Two issues noted did not meet infection prevention and control guidance. There was a sign in a changing room which had been fixed to the wall with tape. A wedge being used to position patient’s legs in the MRI room was not covered with a protective cover between patients. The wedge had been covered with a pillow case: the pillowcase was changed daily and not changed between patients.
• While the service had recognised radiographers’ scanning performance should be monitored through peer review to enable any issues to be discussed in a supportive environment, at the time of inspection, this had not commenced.
• Not all issues impacting on the service were on the risk register. For example, the ageing MRI scanner.
• Two protocols passed their time for review. The abdomen and pelvis protocol was due for review in July 2018 and the orthopaedic protocol was due for review in August 2018.

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.

Amanda Stanford

Deputy Chief Inspector of Hospitals (Central)

We spoke with two people following their scan at Milton Keynes MRI Centre. They told us that staff had been very caring and had looked after them very well. We also spoke with relatives who were accompanying young people for their scan. People’s only concern was the length of time it took for them to receive their results from their doctor. We noted that this delay was outside the control of Milton Keynes MRI Centre.

We saw that people had been provided with information about their scan and that any questions had been answered before they consented to the procedure. We heard staff treat people with dignity and respect.

We found that regular checks which had ensured the safety of the equipment and the environment had been completed, and that people’s records were maintained and stored appropriately.

We spoke with two people who had used the service and they told us that staff were very reassuring and that they had been treated in a calm and kind way which made them feel relaxed. We saw that staff spoke with people in a reassuring and dignified way. One person told us that they were given the right amount of information to help them understand the procedure and that they were seen promptly. The provider sought feedback after each person had received their scan and we saw that any suggestions and compliments had been fed back to staff.