Quality Standard for Imaging (QSI)

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)

On 30 June 2023 the Colleges gave UKAS 12 months’ notice to terminate their exclusive licence to use the QSI standards to accredit imaging services. In line with this, as of July 2024 UKAS will no longer be able to use the QSI logo or the QSI standards themselves.

It is important to note that this termination does not affect the UKAS accreditation of existing or applicant imaging providers.

The Colleges will be offering a new model of engagement for services, delivered through a QSI Quality Improvement Network, and an assessment of achievement of the standards set out in the QSI, resulting in the award of the QSI Quality Mark.

We want to work collaboratively with UKAS to ensure that there is a transition plan that does not disadvantage services that have been accredited or are engaging in the certification process.

Further details of how the QSI Quality Network and Quality Mark will run are outlined in Quality Standard for Imaging: Quality Improvement Scheme.

Services that are currently accredited or going through the accreditation process with UKAS will be able to transition to 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 (one full current UKAS cycle from launch of the Colleges’ scheme).

Any services that want to apply for the fast-track admission can contact the QSI team to discuss in more detail on a one-to-one basis.

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

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 platform will remain open to those already registered until July 2025

Our QSI Quality Improvement Network will exist to facilitate improvement, and to support services working towards meeting the QSI and achieving endorsement under the Colleges’ scheme. 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.

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.

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 endorsement 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 meet the 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 celebrate 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 Quality Improvement Network but will only pay the relevant Quality Mark subscription.

The Quality Mark subscription fee will be tailored to individual services taking into consideration a variety of factors. The principles underpinning our pricing are set out in Quality Standard for Imaging Quality Improvement Scheme, along with some indicative costings.

We are committed to ensuring that the scheme we run is accessible, supportive, and affordable. If you would like to receive a quote for your service please complete the request form and email it to [email protected].

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 specialist 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. These new roles will be advertised in early 2024 to be in post ready for launch in July 2024. Keep an eye out for details and get in touch with us if you would welcome an informal conversation.

Recruitment for specialist review team members, as well as lay reviewers, will also commence in early 2024. If you would be interested in joining us, please contact the team. You do not need to be in a currently accredited service to apply. We also welcome anyone with previous experience in assessment or reviews to contact us for a conversation. We will be providing training in our approach which all reviewers will need to complete in order to be able to undertake a review on our behalf.

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.

Services that would like to join the new Quality Improvement Network can register by completing this form. We will launch the network in April 2024, but you can register with us at any point.

Services seeking the award of the QSI Quality Mark can request a quote from the team by completing a request form. 

Services will need to consider whether UKAS accreditation or the Colleges new scheme 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.

Services that have achieved UKAS accreditation against the QSI will be automatically eligible for the award of the QSI Quality Mark. Each service would have an individual conversation with the QSI team to determine where you sit within the Colleges cycle and discuss options for the next review dates.

We have now closed our stakeholder engagement process and published Quality Standard for Imaging: Quality Improvement Scheme summarising the feedback received.

We continue to welcome feedback as we develop and launch the new scheme over the coming months. Please get in touch via [email protected].

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.

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.