The Quality Standard for Imaging

Supporting and enabling quality improvement in imaging services

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QSI Update | 19 July 2023

The College of Radiographers and the Royal College of Radiologists have agreed with UKAS that our agreement with them will come to an end in June 2024. It is important to note that this termination does not affect the UKAS accreditation of existing or applicant imaging providers. 

 

As Colleges, we are committed to delivering the best service we can to diagnostic radiology services and are taking this opportunity to develop new arrangements for services to be endorsed against the Quality Standard for Imaging. We will work closely with services to co-produce our new scheme to ensure that it reflects their needs, helps us to better understand the issues they are facing on the ground, and enables us as Colleges to continue to provide support where services need it most. We’re excited to share our plans over the coming months. We will work closely with all services to develop the new arrangements and acknowledge the significant work that colleagues have already put into quality improvement. 

 

We thank UKAS for working with the Colleges and look forward to a continued constructive working relationship with them as we develop the new arrangements.  

For further information, please contact [email protected].  

Introduction to the Standard 

The College of Radiographers (CoR) and the Royal College of Radiologists (RCR) developed the Quality Standard for Imaging (QSI) to support diagnostic imaging services to make continuous improvements ensuring patients consistently receive high quality services delivered by competent staff working in safe environments.

Services meet the Standard through accreditation via an independent third party.

The Standard reflects wide consultation with professional colleagues, as well as relevant UK government agencies and regulatory bodies. It has been assessed for use in all four countries of the UK.

Quality Standard for Imaging Networks (QSIN)

With the national direction of developing imaging networks across the UK, The Royal College of Radiologists (RCR) and The College of Radiographers (CoR) have been working to develop the Quality Standard for Imaging Networks (QSIN). The QSIN is written to stand alone; and emerging or nascent networks can use it to help develop their governance and quality improvement processes.

All processes developed for quality improvement should be embedded and in routine use to achieve a culture of quality. While led from the top of the service, a culture of quality is everyone’s responsibility. These standards are designed to encourage all services to become part of an imaging network, with the benefits of mutual support and learning this brings.

Although these imaging network quality standards have been published independently from the Quality Standard for Imaging 2021 (QSI 2021), it is envisaged that, as imaging networks develop, the QSIN will be an integral part of the QSI.

The standards were officially launched at The UK Imaging and Oncology Congress (UKIO) in July 2022.

Download the QSIN (PDF)

We welcome any feedback on these standards – please email [email protected]..


QSI and radiotherapy 

When radiotherapy equipment (CT, MRI, Ultrasound) is used for diagnostic imaging purposes then there must be policies, procedures and protocols in line with statutory requirements in place. It is recommended that these are in accordance with or duplicated from the local Diagnostic Imaging department to ensure consistency of high quality scanning. Appropriately trained Operators (diagnostic imaging staff) must be used to perform diagnostic imaging and there should be assurance that all relevant equipment QA for imaging purposes has been performed and is up to date. Staff should participate in Image Optimisation groups.

The use of radiotherapy scanning for planning purposes is not covered by the QSI as it is not, at that point, a diagnostic imaging tool.


QSI 2021 support

The RCR and the CoR acknowledge that many imaging services are operating in an environment where time, money and resources are very limited. The QSI 2021 has reframed the standards with a focus on outcome measures with the aim of reducing the burden of evidence input requirements for services.

Please find a list of resources below that can help you navigate the QSI:

  • When using the 2021 Standard remember to review the contextual guidance document
  • Use the development and support tool to assess your service against the QSI 2021. The tool will RAG rate your current standing and provide examples of evidence for reference. Should your service want to proceed to accreditation you can use the gap analysis to gauge your readiness.
  • Request an introductory presentation to the Standard and the support available by contacting our Quality Improvement (QI) Partners.
  • Attend a gap analysis workshop (commencing in November 2021) which covers all aspects of the Standard.
  • Join the online network created on Future NHS, that helps all QSI leads to keep in touch with each other; to share information, good practice, documentation, and ask questions of other services, by contacting our QI Partners.


Templates and downloads


Frequently Asked Questions

The College of Radiographers and the Royal College of Radiologists have agreed with UKAS that our agreement with them will come to an end in June 2024. It is important to note that this termination does not affect the UKAS accreditation of existing or applicant imaging providers.

We are aware that this will pose a number of questions for services and have compiled the following frequently asked questions to address these.

For any further questions please contact [email protected].

  • Why have the Colleges decided that now is the right time to explore alternatives to the UKAS QSI accreditation scheme?

    The Colleges have been considering for some years whether UKAS accreditation best serves our members and Fellows and the services in which they work. Developing an in-house scheme will enable us to further enhance the support we give our members and Fellows, and will give us richer insights into the challenges they face as they strive to provide excellent patient care. Our workforce is under significant pressure, and as Colleges we agree that the time is right to develop an improved service that is more responsive to, and inclusive of, service developments now and in the future. The Colleges' approach will be proportionate, risk-based, transparent and supportive.

  • UKAS is a well-established national body. Why have the Colleges decided to end the current relationship?

    The Royal College of Radiologists (RCR) is the professional organisation for clinical radiologists and clinical oncologists, incorporated by Royal Charter. The College of Radiographers (CoR) is the professional organisation for diagnostic and therapeutic radiographers. Together, through the development and application of the Quality Standard for Imaging as well as through their other work programmes, the Colleges promote and develop medical imaging for the benefit of the public in the UK and globally.

    The Colleges are charitable organisations whose sole focus is on working for the benefits of our members and Fellows, the services in which they work, and the quality of care they provide to their patients. As Colleges, we believe we are better placed to meet the needs of services and patients, through effective engagement with our members and Fellows through a College-led endorsement scheme and QSI Quality Network.

  • How does the Colleges' scheme differ from UKAS accreditation?

    UKAS offers accreditation services to its customers, based upon the Colleges' Quality Standard for Imaging. The Colleges, as the owners of the Quality Standard for Imaging and the QSI logo, will aim to provide a more holistic service in the form of a QSI Quality Network, that will support services in evaluating and improving the quality of the care they provide, as well as providing a supportive network of peers through which to share good practice and learn from each other, and professional development opportunities. Our formal evaluation of services' achievement of the QSI is just one element of the overall scheme that the Colleges are developing, and within that we will work with services to manage the demands of the evaluation process.

    The Colleges are committed to co-designing the endorsement scheme with services to ensure it meets their needs, both at service and network level. However, our plans are to adopt a periodic evaluation cycle that will comprise an on-site visit every three years, with remote evaluation activity in the interim to ensure continuing compliance focused on particular areas of risk rather than on the standard in its entirety. The Colleges will also reduce the burden of assessment without losing rigour, through a proportionate approach to our work. The Colleges' scheme recognises that services differ in their nature and therefore will demonstrate their attainment of the Quality Standard for Imaging through applicable indicative inputs; we anticipate that a focus on outcomes and a flexible dialogue make our scheme an attractive prospect.

  • What is the difference between accreditation and endorsement?

    The Colleges are considering terminology, and may choose a different word to endorsement as we engage further with stakeholders.

    Accreditation involves the assessment of the competence and impartiality of an organisation and the compliance of their work to nationally and internationally recognised standards. In the UK, UKAS is the national accreditation body.

    Endorsement refers to the holistic evaluation of diagnostic imaging departments and the quality of the service they provide by a team of individuals with experience in delivering similar services, and with a specific intention to facilitate the improvement of quality over time. Endorsement will nonetheless involve the application of the QSI with a level of objectivity and rigour that is commensurate with the esteem in which the Colleges' Quality Standard for Imaging is held.

    Practice in the sector has tended towards moving away from use of the term 'accreditation' by bodies other than UKAS to avoid any confusion of association with UKAS as the national accreditation body.

  • Will the Colleges continue to give their support to UKAS accreditation?

    Once the Colleges' agreement with UKAS comes to an end at the end of June 2024, we will no longer support UKAS accreditation - we will only support our own scheme.

  • Can the Colleges' offer independent assessment, given their role in supporting services to achieve the standard?

    The Colleges have worked hard with our members and Fellows over many years to ensure that the standards statements set out in the QSI reflect what is required to deliver an effective imaging service that provides excellent patient care. It is not in the Colleges’ interests to seek to apply those standards with anything other than objectivity and rigour. As part of our scheme, we will continue to identify areas where our reviewers agree that services are not achieving our standards and outline the action that needs to be taken if endorsement is to be awarded.

  • How do the Colleges intend to resource their scheme?

    The Colleges are committed to fully resourcing this scheme, and will be appointing a dedicated staff team to join our existing Quality Improvement Partners in developing and delivering it. We already benefit from the significant and long-standing expertise of our existing staff in delivering quality assurance and enhancement schemes of this kind, and from many years of experience of working collaboratively with our members. Our team, together with the wider team of expert reviewers we will build, will ensure our approach reflects best practice. We are committed to ensuring that our staff have the range of skills required to work productively and sensitively with services and review teams to reach appropriate, evidence-based consensus in their application of the Quality Standard for Imaging.

  • What are the Colleges' plans for recruiting technical assessors?

    We will be recruiting colleagues with skills across the full range of diagnostic imaging modalities to work with us as reviewers over the coming months. We are considering a number of different ways in which we can incentivise services to release staff to work with us, and will be mindful of workload demands when inviting colleagues to participate in review activity. Further details regarding the anticipated commitment and the benefits to both the individual and the service of getting involved will be available in the coming months.

  • How will the cost of the Colleges' scheme compare to the cost of UKAS accreditation?

    The Colleges are considering a range of potential financial models for the QSI Quality Network and endorsement scheme, and whilst we aren't in a position to confirm specifics at the moment, we can confirm our commitment to developing a fee schedule that is straightforward, transparent and demonstrates cost-effectiveness. We appreciate the substantial investment that services make when seeking recognition of their achievement of the Quality Standard for Imaging, and will do all we can to reduce the assessment burden whilst retaining rigour and evidence-based decision making. We will price our services in a way that recognises that reduced burden. The Colleges are charitable organisations that work solely for the benefit of their members and fellows, the services in which they work, and the patients they serve. If it happens that there is a surplus generated through QSI, it will be reinvested towards meeting those charitable objectives.

  • Will my service still be able to use the QSI logo to promote our accreditation status?

    Only participants in the Colleges' scheme will be entitled to use the QSI logo.

  • Will patients and service users understand the difference between endorsement and accreditation?

    The Colleges will develop resources to help services communicate the meaning of their award to patients and service users. Patients understand the expertise brought to bear by Royal Colleges and professional associations, and will recognise the Colleges' approval of services under the QSI scheme as a reliable quality mark.

  • Will services that are currently accredited by UKAS be expected to transition to the Colleges' endorsement scheme?

    UKAS have indicated their intention to continue to offer accreditation against the Quality Standard for Imaging as a publicly available and nationally recognised standard. On this basis, the UKAS scheme will operate as a competitor to the Colleges' scheme: it should be noted, however, that once our current agreement has come to an end in June 2024, the Colleges will not support UKAS in this endeavour and will not permit UKAS to use the QSI logo. Services will need to determine which scheme best meets their needs.

    As such, there will be no expectation or requirement that currently-accredited services should transition to the Colleges' scheme; however, the Colleges value and recognise the work that services will have put into attaining accreditation and will therefore offer a 'fast-track' admission process for those services who do wish to participate in the Colleges' scheme and QSI Quality Network. We will write to services soon to confirm further details, and will work with services to ensure the availability of that fast-track process aligns with their established assessment schedule - whether that falls before June 2024 or after.

  • Will services be expected to be accredited by UKAS and endorsed by the Colleges?

    Services will need to determine which scheme best meets their needs. We do not recommend that services seek both accreditation and endorsement, as this will create more work for departments: our expectation is that departments will join will one scheme.

  • When can services express an interest in the Colleges' QSI Quality Network and endorsement scheme?

    The Colleges will invite services to express their interest in joining the new scheme in the coming weeks, however, feel free to email [email protected] to express your interest at any time. Colleagues who express an interest on behalf of their service will receive priority invitations to participate in the series of workshops we have planned in the Autumn of 2023 to co-design our scheme.

  • My service has been thinking of applying to UKAS for accreditation. Should we wait for the Colleges' scheme to be up and running?

    Services will need to consider whether UKAS accreditation or the QSI Quality Network and endorsement scheme offered by the Colleges best meets their needs. The Colleges' scheme represents a long-term investment in quality improvement, and will facilitate this over time through the provision of peer support and learning, professional development and feedback on both the areas that services need to address in order to meet the requirements set out in the QSI, and on areas of innovative or otherwise excellent practice. As Colleges, we would welcome you expressing an interest in joining our scheme, and would be happy to talk to you further about any questions you have.

  • My service has applied to UKAS for accreditation. Should we continue with planned assessments or wait until the Colleges' scheme is available?

    Services will need to consider whether UKAS accreditation or the QSI Quality Network and endorsement scheme offered by the Colleges best meets their needs. The Colleges' scheme represents a long-term investment in quality improvement, and will facilitate this over time through the provision of peer support and learning, professional development and feedback on both the areas that services need to address in order to meet the requirements set out in the QSI, and on areas of innovative or otherwise excellent practice. As Colleges, we would welcome you expressing an interest in joining our scheme, and would be happy to talk to you further about any questions you have.

  • My service has only just had a UKAS assessment visit. How soon will we need to undergo a site visit from the Colleges?

    The Colleges are committed to making the process of signing up to the new QSI Quality Network and endorsement scheme as straightforward as possible. We value and recognise the work that services will have put into attaining accreditation and will therefore offer a 'fast-track' admission process for those services who do wish to participate in the Colleges' scheme and QSI Quality Network. We will write to services as soon as applications are open to confirm further details, and will work with services to ensure the availability of that fast-track process aligns with their established assessment schedule - whether that falls before June 2024 or after.

    We are looking forward to co-designing the details of our new scheme with services, but at this stage anticipate a three year cycle of on-site visits and remote review activity, and will work with individual services to agree an appropriate review schedule.

  • Will the Colleges continue to provide support to services that retain UKAS accreditation?

    Over the coming year nothing will change: support will continue to be available from our QI Partners. After June 2024, we will not support those on the UKAS scheme as we will no longer be part of it. We will support those on the Colleges’ scheme and will be co-designing that with you over the coming months to ensure it meets your needs.

If you have any further questions or need help using the Standard, please contact our Quality Improvement Partners