PETCT Mobile Services

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

RESPONSIVE Key question commentary We reviewed person-centred care, providing information, listening to and involving people, and equity in access. Person-centred care: The service was inclusive and took account of patient’s individual needs and preferences. The service had information leaflets available in languages spoken by the local communities. Providing Information: The service provided information so patients knew what to expect at their appointment. Listening to and involving people: The provider used patient feedback to improve the patient experience. Equity in access: People could access the service when they needed it and did not have to wait too long for their scan or scan results.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

All patients we spoke to told us they had been asked their preferred name. They had all received information about their scan and had received information about the side effects of their treatment. Patients had been offered the first available scan but had been able to choose a different date and time if that suited them better.

The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. Staff coordinated care with other services and providers to ensure patients did not have to make too many trips to the hospital. Transport was considered when booking appointments and when patients rang up to change or cancel their transport needs were discussed before rebooking. In line with the Inclusive pregnancy status guidelines (Society of Radiographers, 2021) there was a pregnancy procedure which took account of both cisgender women and transgender men. The service had information leaflets available in languages spoken by patients and local community. An interpretation service was available for patients whose first language was not English.

We saw staff working to meet the changing needs of a patient. On the morning of their appointment, a patient had consumed a cup of tea with milk and sugar. This meant they had not fasted for long enough prior to their appointment to have their radiotracer administered. The team worked quickly to contact the Administration of Radioactive Substances Advisory Committee (ARSAC) to tell them what the patient had consumed and at what time. The ARSAC then advised the earliest time the patient could be administered the radioactive tracer. The radiographer worked out if they would have enough tracer in the next timeframe to include the dose this patient would require. The patient was offered a choice of being rebooked to the following day or waiting 90 minutes before their treatment commenced.

We did not collect enough evidence from patients about this quality statement to express their views in this report.

At a recent development day for managers and technologists staff had been given training about what deprived communities look like and what barriers to treatment some patients might face, for example, transport or language needs. This training was designed to give staff a greater awareness of deprived communities so they could introduce strategies to help members of these communities access treatment. Staff told us they sometimes provided taxis to help patients can access treatment. Interpreters were regularly used for patients whose first language is not English. There was some flexibility built into each day’s list in case there was a problem with equipment. Staff endeavoured to use this flexibility for patients who arrive late rather than rearranging their scan to another day.

Partners told us they believed the provider understood the problems that arose from health inequalities especially in areas of increased deprivation. However, one partner recognised that sometimes mobile units were only on site for part of each week which meant rebooking patients who could not attend or who had a failed scan was more difficult and could result in a delay in patients’ treatment pathway.

The provider had a diversity and inequality policy and a standard operating procedures (SOP) for staff to follow for patients that did not attend appointments, and when appointments were cancelled by the patient or provider. These documents supported staff to recognise the diverse needs of patients and provide the additional support they may require to access treatment.

Patients told us they had received information about their scan at the time their appointment was booked. Additional information was emailed to them following the phone call. However, one of the patients we spoke to did not received a phone call, instead a message about his appointment had been left with a member of his family. As they did not have their own phone or an e-mail address this meant that patient did not receive all of the information they needed prior to their appointment.

There was information available on the organisation’s website about what to expect at the appointment, what preparation was required, and what happens afterwards. Staff knew how to book interpreters for patients whose first language was not English including people whose first language was British Sign Language or Makaton. Information leaflets were available in braille, and in other languages for patients whose first language was not English.

The service had processes ensure the information that patients received met their needs. During our onsite assessment we saw evidence staff implemented these processes, for example, patients requiring translation and interpretation services, and providing information to patients which met the Accessible Information Standard.

We saw a copy of the aftercare e-mail sent to patients which included details of how to provide feedback on care. However, patients told us that they did not receive information about how to provide feedback on their care.

Staff knew what to do if a patient wanted to make a complaint. There were details on the organisation’s website for the customer care team so patients could get in touch to discuss any their concerns about their care. Senior leaders told us they had involved patients in the design of new mobile units. They had contacted patients who had previously provided feedback about their experience of care and asked them to consult on design ideas.

The service could demonstrate how they learnt from complaints. In the 12 months before our inspection 5 concerns and 8 complaints were received by the provider’s customer care service. They also received 5 compliments. The main theme was cancelled appointments due to radiotracer or equipment failure and an insensitivity to patient’s needs from staff. The number of complaints and concerns represented 0.3 concerns or complaints per 1000 scans. The supplier of the radiotracer was a third-party provider. They were responsible for making the radio tracer and delivering to each site in specified amounts at regular intervals throughout the day. Occasionally a shipment might be delayed because of traffic conditions. Because the radiotracer was short acting, delayed delivery meant it sometimes could not be used because it would not have enough radioactivity to last as long as required for a scan to be successful. Equipment failure meant the scanner was temporarily unable to function and there was a delay in getting it working again. The provider worked to reduce the likelihood of things going wrong with the scanners and provided staff with training to understand and fix common problems. If a scan could not go ahead a goodwill gesture was given to patients to cover their transport costs and show how seriously they took patients scans being delayed. The service had ‘you said, we did’ posters. The posters displayed some of the feedback they had received from patients and what changes had been made as a result.

Patients told us have they were offered their scan very quickly after their doctor requested it. Some patients said they were offered an appointment the same day they were first contacted by phone, or for the following day. If patients couldn't attend that appointment, they were offered a choice of other dates and times.

The provider had a key performance indicator (KPI) based on access. They had 7-days from the point a referral was vetted to scan a patient and for their scan results to be reported on. At some locations the provider was responsible for both the scan and reporting, at other locations trusts were responsible for reporting. The service worked in partnership with trusts to ensure reporting was completed within the agreed timeframe by providing a reporting service if the trust did not have capacity. Staff told us there was some flexibility with appointments as 1 or 2 slots were kept free each day for urgent referrals. If 1 of these slots was un-booked patients arriving late or not fully fasted might be able to be moved into them. Patients were offered the opportunity to join a short notice waiting list. This meant they could be offered an appointment sooner if there was a cancellation or an urgent slot was not taken. If the number of referrals suddenly increased the provider would attempt to increase the number of days they provided the service, in agreement with a trust. They could also extend their opening hours to increase capacity. To reduce waiting times the provider sent a text reminder of the appointment time and date and information about any preparation that was required for the scan.

The service monitored the KPI for time to treatment and turnaround times for reporting on scans. Patients were normally contacted by the booking team the same day as the referral was received and vetted by the Administration of Radioactive Substances Advisory Committee (ARSACS). Patients typically had their scan within 2 days and their scan was reported on within the following 2 days. For example, from November 2023 to May 2024 the average wait for patients from vetting to scan was 1.95 days. During the same timeframe the average time from scan to reporting was 1.23 days.

We did not collect enough evidence from patients about this quality statement to express their views in this report.

Some staff had recently undergone training to understand what health inequalities are and how they might impact on patients experience or outcomes. The training included exploring how staff could support all patients to access treatment. Staff understood how to arrange for interpreters and how to access transport for patients who may otherwise not been able to attend their appointment. Staff understood that the reasons for patients arriving late or not fully fasted could be varied and they endeavoured to ensure patients received their scan on the day of their appointment.

When requesting patient feedback, the provider also requested demographic data that enabled them to understand if people from different backgrounds experienced care and treatment differently. The demographic breakdown of feedback did not show any clear variables. The provider had a diversity and equality policy to acknowledge they recognised and celebrated difference between individuals and communities.

We did not collect enough evidence from patients about this quality statement to express their views in this report.

We did not collect enough evidence from staff and leaders about this quality statement to express their views in this report.

We did not collect enough evidence about processes regarding this quality statement to add to this report.