Quality Standard for Imaging (QSI)
QSI Quality Improvement Scheme
Launched in July 2024 in collaboration with the College of Radiographers, this scheme focuses on quality improvement for imaging services for the benefit of both patients and our members. It is an investment by both Colleges in supporting services in delivering changes for the benefit of both patients and staff by engaging imaging services in continuous quality improvement through formal peer review.
This new scheme brings services together to facilitate an easier way of sharing good practice and peer learning. It introduces a new and enhanced level of support for those services working towards QSI through the QSI Hub, which builds on the existing support provided by both Colleges.
QSI Quality Mark
The Colleges are pleased to announce the services which have achieved the QSI Quality Mark, and those who are Working Towards QSI.
Quality Standard for Imaging
QSI is a developmental standard and underpins the colleges’ vision that all providers of imaging services be invested in a continuous quality improvement journey. QSI allows services to evaluate their performance and develop where needed to continually improve patient experience and outcomes.
QSI represents the judgements of panels of lay representatives, radiographers, radiologists, medical physicists, and sonographers who have overseen its creation and revision. It reflects wide consultation and valuable comments and suggestions received from professional colleagues, relevant UK government agencies and professional and regulatory bodies.
QSI sets out best practice to improve patient care and outcomes. Assessment against the standard has been and will continue to be the hallmark of a quality imaging service. Clinical practice is a continually evolving field, and the QSI will be independently reviewed every four years.
Introduction to QSI
This presentation is to provide information and support to services and leads who want to know more about what QSI is or are just starting their QSI journey. It will be presented by the QIPs on Teams and is designed to help you identify how you may begin with QSI.
Our sessions in 2025 will be on July 8th 11am-12.30pm; September 10th 2pm-3.30pm; November 20th 10am-11.30am. If you would like more information or to join any of these sessions, please email [email protected].
Find out more
Watch our joint video with the College of Radiographers - Radiology Excellence: Navigating the Quality Standard for Imaging.
Some of the benefits that engaging with our QSI standard can bring to your service:
Recognised quality indicator for imaging services
Compliance with regulation and guidance
Networking opportunities and sharing good practice with other imaging services
Framework for delivering high quality and patient focused care
Supports building teamwork and collaboration across the whole department
High level of service user satisfaction and confidence
Improves and assures efficiency and validity of services
Independent recognition ‘badge of quality’
Enables continuous quality improvement
Offers assurance of the service – both internally and externally
Improved staff retention and recruitment
Potential market advantage
Recognised quality indicator for imaging services
Compliance with regulation and guidance
Networking opportunities and sharing good practice with other imaging services
Framework for delivering high quality and patient focused care
Supports building teamwork and collaboration across the whole department
High level of service user satisfaction and confidence
Improves and assures efficiency and validity of services
Independent recognition ‘badge of quality’
Enables continuous quality improvement
Offers assurance of the service – both internally and externally
Improved staff retention and recruitment
Potential market advantage
FAQs
The Quality Standard for Imaging (QSI)©, sets out the criteria for defining what makes a quality imaging service. The standards were developed as a collaboration between the Royal College of Radiologists and the College of Radiographers and continue to be owned and updated by the Colleges.
*© QSI is copyright to IQI Limited (a collaboration between RCR and CoR)
The QSI Quality Mark offers imaging services an opportunity to be formally recognised for meeting the Quality Standard for Imaging. It is available to all UK imaging services working towards meeting the Quality Standard for Imaging (QSI).
Services that are currently accredited or going through the accreditation process with UKAS will be eligible to join the Colleges’ scheme. The Colleges value and recognise the work that accredited services will have put into attaining their accreditation and will therefore offer a 'fast-track' admission process for services.
Services that have achieved and maintained UKAS accreditation against the QSI standard will automatically be eligible for the award of the QSI Quality Mark. We will honour this fast-track entry arrangement until 30 June 2028 .
Each service will have an individual conversation with the QSI team to determine where you sit within the Colleges’ cycle and discuss options for future review dates.
For more information about what this process involves please get in touch with the QSI team on [email protected].
Both Colleges are committed to continuing to support our members and Fellows, and the services of which they are a part, to engage in quality improvement for patient benefit. The QSI and QSIN standards will remain available as a resource for all stakeholders, and as professional membership bodies we will, of course, answer questions about the standards from any member or Fellow. The Future NHS QSI page is available to support for all UK service providers with QSI.
Our QSI Quality Improvement Network will exist to facilitate improvement, and to support services working towards meeting the QSI and achieving the Quality Mark. Membership will be available to all services that wish to take it up, though the support available to network members will be designed specifically with progression to the Colleges’ QSI Quality Mark in mind. We encourage you to continue to engage with our QI Partners regarding the support that you or your service would find valuable.
Across the UK the QSI standards are recognised as the hallmark for quality within imaging services. As such both the Colleges’ and UKAS schemes are recognised.
The NHS values the work that imaging teams undertake to systematically evidence their compliance with relevant standards, through engagement with assessment and quality improvement schemes.
The Colleges have developed strong relationships with NHS England, NHS Wales and NHS Scotland along with services in Northern Ireland over the years. Since the announcement of our new scheme, we have worked with organisations in all four devolved nations to ensure they have complete understanding of our scheme and our continued dedication to the Quality Standards for Imaging (QSI).
The Colleges have experience and expertise in running assessment processes and have utilised this to design the scheme and guide its implementation, along with learning from other organisations running similar schemes in the UK and internationally, both within healthcare and other industries. The final model reflects a holistic approach to objectively and rigorously evaluating the achievement of standards, and to facilitating continuous quality improvement through sharing expertise and good practice.
As with other schemes of this nature, our scheme will analyse the way in which a service demonstrates that it meets the standards through written evidence and an onsite visit undertaken by a review team that consists of competent professionals reflective of the imaging service they review. A quality assurance process will be in place to ensure that the Quality Mark is awarded appropriately to services that meet the standard. Services will need to provide evidence that they have responded appropriately to any areas where the review team identifies a need for improvement, whether as a requirement for the Quality Mark to be awarded (where standards are not met), or to enhance the robustness or sustainability of the ways in which particular elements of the standard are achieved. Any service concerns identified by the review team will be raised at the time of the visit in order the service can consider any immediate actions which is required.
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 the Quality Mark is to be awarded.
As with accreditation the QSI Quality Mark process will analyse the way in which a service demonstrates that it meets the standards through written evidence and an onsite visit undertaken by a review team that consists of competent professionals reflective of the imaging service they review. It will be a rigorous process that will ensure confidence in a services level of quality and that the QSI Quality Mark is awarded appropriately to services that meet the standard.
The QSI 2021 standards were designed to emphasise outcome measures (what quality looks like in practice) rather than the inputs required to achieve quality. This ensures that QSI remains applicable to a range of services and service delivery contexts. The Colleges scheme will reflect this ethos and allow for a more flexible and individualised approach to implementing QSI whilst ensuring consistency of standards.
The Colleges scheme will also have a focus on celebrating services’ successes and highlight areas of good practice to the wider QSI community.
Participating services will pay a single annual subscription for the level of membership that applies to them. Services that attain the Quality Mark will remain members of the QSI Hub but will only pay the relevant Quality Mark subscription.
Details on the costings for Hub membership are available here.
The Quality Mark subscription fee will be tailored to individual services taking into consideration a variety of factors including service size and the modalities covered. To receive a quote for your service please complete the quote registration form linked below.
You can join the scheme as a Quality Mark reviewer and influence the standard of QSI across the country. Our expert reviewers will engage with other imaging services to understand how they tackle the complexities of high-quality service delivery. In doing so, you will gain in-depth insights into how best to approach similar circumstances in your own service, putting you in a great position to improve upon any specific challenges you and your colleagues are dealing with.
The Royal College of Radiologists (RCR) and The College of Radiographers (CoR) have worked together to develop the Quality Standard for Imaging Networks (QSIN) ©. The standards are jointly owned and updated by the Colleges.
The QSIN is written to stand alone; and emerging or nascent networks can use it as part of an internal quality improvement programme. 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.
As many networks are still in the early stages of development, the Colleges do not plan to begin assessing networks against QSIN until 2025. We are keen to ensure the process we develop does not duplicate work for networks and is fit for purpose. As such we will be consulting with a variety of imaging networks as we develop our plans.
Are you a service manager or clinical director wanting to find out more? We have developed a series of FAQs aimed at answering your queries and would be happy to help – contact [email protected] .
Become a QSI Quality Mark Reviewer
Apply now for 2025We're recruiting for Quality Mark Reviewers to join our Quality Mark Review teams. Find out more about the role and apply below.
Helping you reach your goals – support for the QSI
The Colleges are continually developing a range of supporting resources such as guidance and best practice documents and using these documents will support services in achieving Quality Mark. Ongoing colleges support is available via the QIP’s and other college staff.
Development and Support tool
The development and support tool has been designed to help services assess themselves against the QSI and provides examples of evidence required to meet the standard.
Online network
Further resources, advice and support are available through the FutureNHS QSI platform along with information on our regular monthly meetings and dates for training/networking days.
Intention statement
The College of Radiographers (CoR) and Royal College of Radiologists (RCR)* hope to consistently provide the level of service that you have a right to expect. If you feel we have not done that then we want you to let us know so that we can put things right and improve our systems and processes for the future.
Scope
We will investigate any complaints or comments about the services provided for the Quality Standard for Imaging (QSI) and its Quality Improvement scheme, comprising the QSI Hub, Working Towards QSI, and the QSI Quality Mark.
A complaint can be about any aspect of the service that is provided to you or the organisation you represent by the RCR or CoR in relation to the QSI. This includes concerns or complaints about the behaviour and conduct of the reviewers that contribute to the QSI scheme. However, there is a separate Appeals Policy [link to be added once published] and procedures for decisions on the award of Working Towards QSI status or the QSI Quality Mark. It is not intended that this complaints process reviews the outcome of that process and nor is it a replacement for it. As such, we will not accept any appeals under the complaints process.
For members of the public seeking to raise concerns or complaints
If you wish to make a complaint regarding the conduct or behaviour of one of our reviewers whom you have encountered whilst attending an imaging service, we will investigate your complaint under this procedure.
We are unable to investigate any complaints regarding your interaction with an imaging service, or the quality of care you have received. You should raise your concerns with the imaging service directly. More information on making complaints about NHS services is available at the following link: NHS England » Feedback and complaints about NHS services
We are also unable to consider any complaints or concerns about the professional practice of a radiologist or a radiographer, or other healthcare or support staff; these should be raised and addressed internally in the first instance and then directed to:
- The General Medical Council (GMC), for radiologists
- The Health and Care Professions Council (HCPC), for radiographers
You may also wish to speak to the relevant NHS Trust/Health Board or employing organisation about your concerns. The CoR and RCR cannot investigate or comment on these matters.
* The College of Radiographers (CoR) and the Royal College of Radiologists (RCR) provide the Quality Standard for Imaging scheme via their joint venture Imaging Quality Improvement Ltd (IQIL). Where a service has been awarded Working Towards QSI status or the QSI Quality Mark, our award reflects the assessment of the services offered, and the evidence made available to and considered by the reviewers acting on our behalf, at the point at which the review was undertaken. IQIL is not liable for the acts or omissions of these services.
Process
We have a three-stage process, as set out below.
- Informal stage
- Formal stage
- Appeal
1. Informal stage
We try to resolve problems informally and, if possible, where and when it is first brought to our attention. Where there is a problem, please contact the Quality Improvement Manager to explain why you are unhappy and what outcome you would like. This can be done by telephone or in writing to [email protected].
We will aim to resolve this as swiftly as possible, and in any event meet the following deadlines:
- Acknowledge your complaint within five working days and give you an indication of when you should expect a response.
- Provide a response within three working weeks, or if we are unable to do so let you know why and when you should expect a response.
- If you are unhappy with the response you receive, you can make a formal complaint.
2. Formal stage
Formal complaints will be considered by one of the directors of Imaging Quality Improvement Ltd (IQI). We ask that formal complaints about our service be made in writing, either by letter or e-mail. It would be helpful if you could let us know:
- The nature of the complaint
- Who has been involved so far
- What has/has not been done
- Why you are not satisfied with the outcome
- How you would like to see the matter resolved
- You can e-mail your complaint to [email protected] (please click on the link) or post to:
QSI
The Royal College of Radiologists
63 Lincoln's Inn Fields
Holborn
London
WC2A 3JW
If you are unable to put your complaint in writing, please contact us to discuss alternative ways to let us know your concerns.
We will acknowledge all formal complaints within five working days.
We aim to let you have a full response within 30 working days of receipt. We will let you know if we are unable to meet this deadline and provide you with an estimate of when you should expect a response. While we would always like to provide a complete reply within this timeframe, please be aware that some complex issues may take longer.
In most instances we hope that the matter can be satisfactorily resolved at this stage. However, should you feel that the response to your formal complaint has not taken all relevant matters into consideration or that the resolution offered does not address the problem then you may wish to request an appeal.
3. Appeal
Appeals will be considered by the Chair of the QSI Quality Mark committee.
If you wish to appeal the process or proposed resolution of your formal complaint, we ask that you put in writing the grounds for your appeal. This should set out why you believe relevant matters were not taken fully into consideration, or how the proposed outcome does not resolve the matter. It would be helpful if you can indicate the outcome you would like to see.
If you are unable to put your appeal in writing, please contact us to discuss alternative ways to let us know your concerns.
We will acknowledge all requests for an appeal within five working days, and let you know how we intend to proceed with the appeal request within 30 working days. We may wish to invite you to submit further written evidence or invite you to speak with us.
Please note that the appeal is the final stage in our complaints process. The outcome of the appeal will be our final decision. You may ask for your complaint to be withdrawn at any time in the process.
The QSI team welcomes feedback from its stakeholders, and we aim to learn and improve from the process. We will review complaints on a regular basis and report to the QSI Quality Mark Committee on themes and issues.
Other common questions
The Colleges are continually developing a range of supporting resources such as guidance and best practice documents and using these documents will support services in achieving accreditation.
The Quality Improvement Partners (QIP’s) are available by email, phone or to visit your department where appropriate. Online resources, including the standard and development and support tool, can be found here or at CoR QSI
Further resources and support are available on the FutureNHS QSI platform along with information on our regular monthly meetings and dates for training/networking days
If you would like to become a member of the FutureNHS QSI group or join our monthly meetings, contact the QIP’s at [email protected]
Yes – and to NHS, commercial and not for profit imaging services in any of the four UK countries. The notes for each standard contain the appropriate relevant information for all four countries.
Yes. The QSI enables services to develop quality improvement building on their existing evidence base. By working through the standard, you can be assured that the entire evidence healthcare regulators require will be easily available within your quality management system and a quality culture is embedded across your service.
The CQC and devolved nation equivalents (RQIA, HIW, HIS) provide regulation for services via rules and guidance which must be followed as a legal requirement. The QSI considers quality with specific reference to imaging services. Imaging services are obliged to meet their legal obligations via the CQC and other healthcare regulators. In meeting the QSI you will have approval from a professional body that you have met an external standard that exceeds the baseline requirements of regulators and embeds the culture of quality improvement within your team.
The full list of accredited services can be found on the UKAS website.
The QSI Quality Mark committee
The Quality Mark Committee ensures the quality of the Colleges’ QSI scheme.
Membership of the QSI Quality Mark Committee includes six appointed members, a lay representative, a representative of the College of Radiographers and a representative of the Royal College of Radiologists.
*QSI is copyright to IQI Limited (a collaboration between RCR and CoR)