NHS England has set up 22 imaging networks across England with the view to addressing the challenges of rising demand, shortages in the imaging workforce, ageing imaging equipment and the need to deliver timely services and high-quality patient care, writes RCR/CoR quality improvement partner Sally Walker. 

QSI is proud to be a part of this initiative, with our Quality Standard for Imaging Networks (QSIN) being implemented by all the networks.  

If you are working in an NHS imaging service in England, then your service will be part of a network and if you don’t know anything about the network it might be worth finding out which one you are in, who in your service is linking to the networks and what they are doing.  

Establishing the networks and then realising the benefits will take time and require a lot of people working together to make them successful. In order to help them grow, and to give guidance about the areas they should be concentrating on, a maturity matrix has been put in place. By using this tool, networks can accurately gauge where they are, how they are growing and to which point they need to progress.

The networks are not meant to be carbon copies of each other but instead are allowed to grow and develop to fit the needs of the population in the area they cover. A network in central London will naturally need to be very different to one based in the rural east of the country. 

Clinical governance is one area of network maturity. In this section they are required to engage with both QSI on a local level and QSIN for the network. As the network matures, they must have a plan to implement QSI accreditation within the network and at network level. Finally, when the network is thriving, Network QSI will be accredited. QSIN is designed to help the networks not only achieve this part of the maturity matrix but to help them move forward in all areas. 

NHS England has highlighted that imaging networks aim to make the services within the network more efficient for three main areas. 

1 Patient care

The first is for patients. The aim is to create sustained local services with faster turnaround times, to reduce the risk of missed diagnosis, to make images available throughout the network and allow other test results available at the point of treatment. Finally, to have more patient access to ‘state of the art’ equipment.  

Linking these aims with QSIN, there is a QSIN standard IN-101 where patients and carers are required to be involved in the work of the imaging network. This standard expects that the network is engaged in speaking and listening to patients and carers within their network and receiving regular feedback from them. The network should be consulting not only on where the network is at the start of the project but also throughout to make sure that the initiatives being implemented are having the outcome that is expected and desired.

2 Aligning IT

To enable images to be available throughout the network, there needs to be an aligning of IT equipment and programmes. We have created a new standard IN-301 Equipment and Procurement which states ‘there should be streamlining of IT systems to ensure effective collaboration’. This quality standard also helps with one of the other areas for improvement, that is Service Operations. 

In this area the aspiration is to create greater service resilience, to improve IT interoperability, purchase equipment at economies of scale and to implement AI. Again, these are covered in IN-301 where the network must streamline ‘IT systems to ensure effective collaboration’ and ‘AI should be developed and managed using aligned policies and procedures across the whole network’. This standard also ensures that ‘equipment management records are kept’, which should cover procurement, installation, calibration and infection control.

3 Staff development

The final area is staff. The NHS England networks aspire to provide more flexible working opportunities, give access to better training and CPD and more opportunities to increase skill mix. There are three QSIN standards for the workforce and these cover Network Leadership, Education and Development and Workforce Strategy. 

These standards give guidance around the governance that should be in place for staffing across the network, such as the leadership roles in the network, an education and development programme and an action plan for your workforce strategy. There is an aspiration from NHS England and within QSIN to see staff being enabled to move more easily around a network area to help with peaks and troughs and as a solution to temporary staffing problems in any one area. 

Further standards such as IN-602 Network Capacity and Demand Evaluation will help you to ensure you have an agreed plan across the network and everyone in the network has been consulted and agrees with the evaluation. 

Finally, there are standards for research within the Network (IN-703), audit of the action plans (IN-702) and a Network-wide Service Development and Improvement Plan (IN-603). A Development and Support for QSIN resource has just been created on our websites, QSIN RCR and QSIN CoR, which will help networks carry out a full gap analysis and devise a plan to complete the work for QSIN. 

Following implementation of QSIN, all networks, whether in England or elsewhere in the UK, will have in place all the plans, strategies and documentation for a fully functional and successful network which will be raising standards of care across its services. The implementation of imaging networks has the potential to transform imaging services in England but there is plenty of hard work, collaboration and vision needed to see them fully functioning, and then making the impact we all hope they will attain.