Quality sits at the very heart of everything we do at 4ways.
Our clinical governance framework is founded upon seven principles that provide a structured approach to ensure the clinical effectiveness, safety and patient (customer) experience of our services.
All of our services are supported by robust clinical and IT governance principles. These have been at the heart of our operational approach since the business began in 2005.
Culturally, 4ways is a clinically led organisation and has always focused on quality reporting with every team member embracing the ideals and processes of quality improvement.
We’re very proud of this commitment to quality and can demonstrate our continuous improvement over time, driven by strong clinical leadership and recognised by our numerous accreditations.
2. Radiologist competence
All 4ways reporting is undertaken by FRCR UK Consultant Radiologists who are qualified doctors with at least 2 years postgraduate experience followed by 5 years accredited training within the NHS. All have been listed on the GMC/equivalent specialist register in Radiology for a minimum of 2 years.
Our radiologists have held NHS substantive posts, with a minimum of 2 years employment including the provision of acute services. This means all our radiologists are experienced in the processes and nuances of NHS reporting.
Our Radiologists are engaged through a rigorous process, led by our Medical Director and Clinical Leads and we use NHS revalidation evidence & offer CPD via regular Discrepancies meetings.
3. Radiologist output
4ways team led by the Medical Director and CEO meet on a weekly basis to review the quality of the reporting output of the radiologists.
In line with our radiologist’s output monitoring policy, we typically audit 10% (minimum of 5%) of cross sectional reports , and 2% of plain film reports each month from both an individual contracted Radiologist and an individual Client’s work. In practice, we audit the majority of client reports and therefore all radiologists, at a rate closer to 10%.
Our internal audit policy supports our management of discrepancies. Where error rates are identified we implement remedial action, including further training if required, according to the significance of the error rate.
We value and record all compliments and complaints. We have a complaints policy which identifies different types of complaint as well as the process for responding to a complaint and the timeframes for each response.
We acknowledge all complaints/discrepancies within one working day, we investigate each issue thoroughly and provide detailed feedback, including the actions we have taken to improve systems, typically within 10 working days.
4ways maintains a register of complaints, recording all actions, outcomes and timescales. Regular reports are presented to our Board detailing complaints received, action taken and improvements to systems and processes as a consequence.
5. Incidents and learning
4ways has a dedicated Quality and Risk Officer who is responsible for recording and managing incidents, complaints or discrepancies which may be identified by our internal audit process or by clients.
Our quality assurance department logs and tracks all discrepancies on our bespoke Client Issues Register and Risk Register. This ensures an accurate record and accessible reference point for all discrepancies. We have an Urgent Findings Escalation Policy which follows RCR guidance and contains clear processes for managing incidents and discrepancies.
4ways holds 3 Quality Assurance Conference meetings annually. These meetings are attended by our Consultant Radiologists, Medical Director and Clinical Leads. Discrepancies are presented by the Clinical Leads, with in depth discussion taking place, contributing to the learning and professional development of our radiologists.
6. Information governance
Information Security and Governance are core pillars of our overall business processes, and are fully embedded within all areas of the organisation.
4ways has an IG Forum group, comprising of Caldicott Guardian, DPO, IG Lead/SIRO, IAA, and ISMS 27001 representatives. The IG forum is responsible for setting policy & procedures within 4ways, and managing staff awareness and training. All staff irrespective of role within the organisation receive Information Governance and Security training during HR induction whilst onboarding, and also receive annual IG training and assessments in line with NHS DSPT (formerly IGT/IGSoC).
4ways also utilise the services of external Cyber Security Specialists for consultancy on Cyber awareness, system protection, annual penetration testing, and updates to real-world threats and vulnerabilities.
Assuring the quality of our reporting output is actioned by way of 4ways’ established and extensive audit programme. Clinical audit underpins our statutory duties, compliance with sector standards (ISAS), our quality assurance for our clients and our market reputation. It also maximises the learning potential for our Radiologists and improves reporting precision.
We have an outstanding track record of measuring and reporting our clinical performance through independent audit and are able to provide the most in-depth review and analysis of radiological reporting in the UK.
It is our current practice to audit 10% (minimum of 5%) of all cross sectional reports and 2% of all plain film reports for all work undertaken, per radiologist and per client across all routine elective, specialist and out of hours reporting.
4ways has been providing flexible support to NHS Trusts and private clients since 2005 and currently supports over 70 NHS Trusts and numerous private companies across c.160 sites.