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24.11.16

CQC orders trust to clear radiology backlog over patient harm fears

Worcestershire Acute Hospitals NHS Trust has been told to make urgent improvements to its radiology services after CQC inspectors found a significant backlog.

Inspectors made an unannounced visit to the trust, which operates five hospitals, in July, after a member of the public raised concerns about radiology services.

The regulator found a significant backlog of unreported plain film X-rays, which the trust later confirmed had reached 25,622 images since 2013. The number of images dating from between January and July this year was 10,442.

The CQC instructed the trust to clear the backlog, assess the impact on patients and apply Duty of Candour to any patient adversely affected, and ensure it has robust processes to report and risk assess images.

In his report, Professor Sir Mike Richards, chief inspector of hospitals, said: “Based on the findings of this inspection I authorised conditions to be imposed on the trust’s registration as a service provider as I believed that patients may have been exposed to the risk of harm if I did not impose these conditions urgently.”

The trust has submitted weekly reports to the CQC since the inspection, and a spokesperson said the backlog had been cleared. They added that they apologised for any distress caused and the backlog mainly involved secondary reviews.

Las December, the CQC rated Worcestershire Acute Hospitals as inadequate and placed it in special measures after a general inspection. Inspectors are carrying out an inspection this week, including reviewing radiology services.

Sir Mike said: “The trust has submitted information to the CQC to demonstrate the progress made in clearing the backlog and improvements to governance and this will be monitored when we inspect this month.”

In the July inspection, the CQC found that Worcestershire Hospitals could not confirm that its board had oversight or knowledge of the radiology problem. An audit of a month’s worth of films was conducted in 2013, but there was no record of the definitive outcome or conclusion of any harm review.

The length of time for the reporting of diagnostic imaging tests had been on the trust risk register since 2003, but there was no evidence of a review of the situation and actions to reduce the backlog.

In addition, reports for patients referred for urgent services were not prioritised and could take up to 21 days.

The CQC said the problems were partly due to staff shortages, with 11 whole-time equivalent radiographer vacancies within the department, which made it impossible to release radiographers from clinical sessions to undertake reporting duties.

The report also criticised the “fragmented” culture in the department, with radiographers and radiologists not working together.

A trust spokesperson added: “Our processes have been reviewed and strengthened, radiographer staffing levels are improved and we are now working to a standard of reporting all urgent X-rays within two days and all other ‘routine’ X-rays within two weeks.”

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