Physiological Measurements is an award winning provider of community non-invasive diagnostic services for the NHS.

And if you’ve found this podcast, you’ve probably been referred to PML for an appointment by your GP. 

In this episode Charlotte Foster introduces you to the staff at the Shropshire head office of PML. 

You’ll hear from co-founder Jon Pither about the origins of the company, as well as members of the team who not only sort your appointment but also make sure everything at HQ runs smoothly.

If you have any extra questions about your appointment or referral to PML you can get in touch with the team via the Physiological Measurements website physiologicalmeasurements.com

Episode 1: Behind the scenes at Physiological Measurements - Transcription

Welcome to the physiological Measurements podcast for patients who've been referred for an appointment for a scan. I'm Charlotte Foster and I've been taking a look behind the scenes at head office in Shropshire, as well as speaking to one of the sonographers who works in one of the clinics run by PML. Throughout this series, I'll be finding out about who PML are you, the work they do, and most importantly, what you can expect as a patient who's been referred to PML. To start this all off, I've come to the head office of PML in Oswestry. It's a market town on the English Welsh border. A lot goes on in here and I'll be introducing you to some of the team who are based here. First off, though, I'm going to chat with Jon Pither. He is one of the directors and co-founders of the company.

So, Jon, thank you very much for inviting me into the head office here. It's always a pleasure to come along. I just think it's really useful for people who are listening to just find out a little bit more about what Physiological Measurements Limited does here.

Physiological Measurements was set up in 2006 by myself and Andy Honeyman. We're both clinical physiologists by background, so we started doing cardiac testing in a non hospital setting.

So why did you set up PMl? What was it that you decided was the time and the place to do this?

There was an opportunity here to perhaps change the way that healthcare is delivered, to make it more accessible. We've obviously got family members, we worked in healthcare, we worked in hospitals, and we would sit there and think, why have people come to hospital to do this, when this could be done out of GP surgery? And the fact that equipment has become smaller, has become more portable means that it is easier to set up a clinic, particularly where you're doing low risk examination, so no radiation is involved, and you can literally set one up anywhere. The bulk of our business is general ultrasound, so this is what we call non obstetric ultrasound, or NOUS. And this covers all body parts apart from babies, so we don't look at babies. So this could be lumps, bumps, blood vessels, all sorts of things. So it's designed as a first look to detect gross sort of abnormalities or to monitor the condition. We also do a range of non-invasive cardiac tests, so things like resting ecgs, echocardiograms, ambulatory ecgs, ambulatory blood pressure testing. And again, that's all done in the community. And the bulk of that takes place in Bexley in south east London, where we set up an award winning service with a local GP.

You're not the NHS, but you work with the NHS as a partner. How does it all fit in? Because I think people can feel a little bit confused about a private company that partners with the NHS.

There is a lot of scepticism around private providers. As a private company operating in the public sector, we've got to deliver a very high quality service for our patients, and I think we do that. Privatisation in the NHS is not a new thing. It's always been there, to a degree. Family doctors, gps, the majority of those are privately run businesses but with an NHS badge.

I can see on your badge, you've got NHS on your staff badge there. How important is it for you to have that symbol, that logo on your badge?

Well, it's incredibly important for us because it means that the NHS recognises us as a business partner. We're not just some two bit business that can see patients and has got some grey market bits of equipment. Everything we do is it's all about quality, it's all about making sure that we are the best that we possibly can be.

You have to hit the standards and the values that the NHS has, don't you?

Yes, we do. We operate under what's known as the standard NHS contract, and that applies to all providers to the NHS.

You talk a lot about quality, you talk a lot about how important that is to you. What other values are there that you have as a company?

Our values as an organisation are obviously to strive to deliver the highest quality patient care and to make sure that the patient has the best possible experience and the best outcome for them in the time that they are with us. So aligned to that are all our staff training, our policies and procedures for literally how we do everything from walking into the clinic to walking out of the clinic. We have a policy and a procedure for pretty much everything. Also aligned to that, we are increasingly conscious that we have a substantial carbon footprint and we need to, along with everybody else, we have to reduce our carbon footprint. And that's not just by planting trees, but that's actually by reducing the amount of carbon that we produce from the activities that we undertake. So whether that's bringing equipment and supplies, are there alternatives for that? In the process of completing our carbon certification, which then we'll know our up and downstream carbon, and then we can come up with a carbon reduction plan.

What would you want people listening to this series to take away from it?

There's a lot of waste in the NHS and a lot of that waste is people not turning up for appointments. The amount of work that goes into putting a name to a slot for a clinic, there's a lot of work that goes there and that's probably about half the work, because the next half is the clinical examination and getting the results back to the GP. So there's a lot of effort that goes in to make sure that an appointment happens. And a lot of that is making sure that the GP has ticked the right box on a form. And if they've got a pain in their left side and it says knee scan, then that's wrong. So we need to go back to the GP and ask them why. We call it getting it right first time. So, you know, the patient turns up at the right clinic to see the right person with the right bit of equipment for the right test, gets their test done, we get the right result back to the GP as quickly as possible.

Jon, thank you so much for chatting to me just now. I'll catch up with you again in another episode.

Now, the offices in Oswestry are where most of the admin takes place. You'll have no doubt already been contacted by the team in the patient management centre. They're based here and Hannah Pither is the PMC manager. She explains what they do.

So the patient management centre is responsible for leading on the patient contacts to ensure the patient receive their appointment in a timely manner, but receiving that patient care that they deserve. So we receive the referral and we do the entire process from adding that referral onto our system, contacting the patient, rescheduling if required, providing courtesy calling, and then all the way to the end of the pathway, which is sending the results to their referring GP practice.

So I'll be chatting to Hannah from the PMC in a bit more detail in another episode later on in the series. I also want to introduce you to a few of the other people who work here who are making sure your appointment takes place. And it might surprise you to learn what goes on before your appointment can even take place. Well, Ellie Roberts is the operations lead, and without the work they do in her team, there'd be absolutely no scans happening, as she explained to me.

And so tell me a little bit, Ellie, about what it is that you do here at PML, please.

Yeah, so, the operations team, we are responsible for clinics, both cardiology and ultrasound. So we go through start to finish of a clinic, from booking the room to storing your images at the end of the scan. We are there for everything that's running in your clinic, from the staff being there to the equipment to. To the consumables, such as the bed roll that you're lying on, that's us down to that.

Even that level, that bit of paper.

That down to that being there, that's our responsibility to get it there.

Essentially you're building out the clinic.

Yeah.

What does that involve?

The clinic that we run in, so we rent rooms in local GP surgeries. So first of all, searching for a surgery to run in is point number one. We have a site visit. We vet the clinic. So that includes looking at the accessibility for patients. We look at sort of the areas that refer to us. There's no point having a clinic miles away from where we're getting our referrals because then that's not community service for who we're seeing.

Once we are in the surgery and making sure it's suitable for us, such as, you know, we need an adjustable bed, privacy curtains and stuff like that. Easy for a reception staff to direct our patients. A waiting room, all that sort of thing is important to run a clinic.

So that's the room, then you need to fill the room.

Obviously we need a clinician, we need someone to do the scanning to run the appointment. And then certain places have assistants as well. So we have our AIAs, which is our advanced imaging assistants. So both of them run in the clinic and it's normally just them too.

And then the kit as well. So what sort of kit are we talking about?

So for ultrasound clinics, we have our portable ultrasound machine that we take to the clinics. Now for that to get there, it could either be done via a courier from our head office here or the staff take it themselves. It all depends on, you know, whether they drive or use public train. No one wants to take an ultrasound machine on a train.

No.

So that, that's the point. If it's a courier, we have to organise that, that to be booked to get from a to b. And then with our cardiology clinics as well, we have our monitors. So this is a monitor that the patient will take home with them and bring back once their results are on there and complete.

You've got all of that. You've got, as you mentioned, the paper towels that you lie on, all of those as well. What about the results themselves? Is that something you guys look after as well? The end result or.

Yeah, so the results team in the actual patient management centre, they deal with them, but then there's a point after the results is the images. So we are responsible for retention of all images. So any image taken, we make sure it's saved, it's stored in our database and it's available if requested. So we have requests from GP surgeries or a hospital. So whatever your result may be, you might be then referred to a hospital who needs that set of images. So we are responsible for that as well. So we have those daily requests which have quite a fast turnaround. So if a hospital requests an image, if it's urgent, it's done within 24 hours.

Yeah. It's quite a fast turnaround for images as well.

A lot going on in your world. I'm very grateful you've managed to find some time to talk to us.

Yeah, it's a lot. We have a good team. There are six of us, so we'll have bits we work on and then work together for anything else.

Now, feedback from patients about PML is generally very good, but if anybody does feel as though something didn't go as well as they expected, they end up speaking to Coral Whynes. She is the patient experience lead at PML and she works into the governance team. She's been telling me about what that entails.

Okay, so a patient experience lead that encompasses all aspects of our patient journey. For patient feedback, patient complaints, patient incidents and things like that. I take on board any patient feedback that we receive. I normally try and phone the patients whenever I receive a complaint or any patient feedback to discuss it with them further. So I find communicating with the patients by phone is better for getting the information, a good history as to what's happened, you know, if they have a frustration and I can do better investigating on the back of that discussion, I'd like to also ensure that the patient feels that they've had their voice heard so we can pick up all of their feedback as an opportunity for improvement, any learnings in the organisation, anything that needs to be communicated out to different areas of our organisation. So, yeah, I do a lot, then.

It's an important role.

Yeah. And one I love, actually. I really love discussing with the patients any of their feedback, because all of it is important, all of it helps our business grow, helps our business change and evolve, because the patients have that first experience and it's them we are trying to serve and deliver a great service for them, I think. Yeah. By speaking to the patients, I can gather all of that information, that understanding straight away.

And you said about hearing that it's important to hear the patient's voice so that they know that they've been heard as well. That's really key, I think, isn't it? Getting that communication there.

Totally, because I think on so many occasions you can leave a doctor's appointment, anything, any appointments whatsoever, and think, oh, that was awful. I really hope I don't have to go back there again. And that's really not the service that we try and deliver by the patients taking time, they've taken time to provide their feedback to us. It's imperative that we listen to that feedback because we do see it as continual improvement. We do see it as opportunities to make our business better and provide a better service for the patients and for our staff as well. It's learning all around, really, not just for the service we deliver to patients, but also how our staff can deliver that service, how our staff can learn. It might be gaps in their learning, perhaps, that we've identified. So just by one piece of feedback from a patient can open up to all sorts of avenues of continual improvement in our organisation.

And because getting it right is important. You can hear more from Coral in a later episode in the series. And of course, there's some extra stuff that goes on here as well, stuff that most businesses have, in fact, but are actually really important for PML. Sean Lawcock is the HR advisor. He's been telling me about how they're not just bringing in the best staff to the business, but also now having an impact on decisions that support the growth of the business, too.

We link in with so many departments, in fact, all of the departments, there's learning and development, there's policies, and making sure that we're running safe, working alongside the actual compliance department to make sure that we are running safely and within legal compliance .

And sort of longer term as well. I think people will be surprised to hear how much you're involved in the

Business development side of things, as well.

As any other business. Everything is moving forwards, and that includes HR. So for us, we, at the back end of last year, we looked into automating more of our HR systems to make sure that we were on hand for hands-on support, but also supporting with business development. One thing for us is our social values, making sure that we are working within the communities, making sure that we're using everything that we can and the resources that we've got to work in those communities. That includes not only like things like the charitable side, so we, you know, give to charity within the local communities, but also, and actually foremostly, employment, making sure that we're giving opportunities within those communities. Just wanted to mention as well that we, part of Srag, a collection of organisations that really have social values at the forefront, and that's what we push. That has also opened on the business side of things so many doors regarding working with people that may have hurdles in the way of being recruited, things like veterans, people with disabilities. It's an endless list, really.

And last, but by no means least, there is the IT team. They have the really important job of making sure all the systems are up to date, running well, and of course, that your data is safe. Now, I'm going to speak to Niall Wales, the IT lead, in more detail about all of this in a later episode, but I wanted to just let him tell you a bit about what he does right now.

We have a service desk where people can post queries, we have a number for them to call for any IT issues. So on a day to day task, really, it's making sure that any issues with the physical equipment or the software itself, any issues, are basically monitored with the correct SLA's making sure that they're responded to if it's a critical, know in a time that we see fit, which is basically ASAP if it's critical. So, yeah, so just, just overseeing any equipment, software with the company and making sure that there's no interruptions for clinics or patients that may be seen.

Fabulous stuff. And I know that some people listening will be thinking about, hang on a minute, you're not quite the NHS. How is my data going to be looked after? You're external to the NHS. What does that mean for my privacy and my data? You're just out to make money from me.

I guess the word external is quite a scary word as well. There's many things that we do at PML to help negate any concerns that people might have. So if we have any external companies inside of the NHS which are also partners, we have items such as NHS Expressroute, which is a private VPN with NHS that you can only get if you are a partner with NHS, basically. And to access our expressroute, you need to have an expressroute. So it's just another layer of security to let us know that the external people are also taking precautionary measures, that they need to access our data. So that's what we do have for external companies, but those companies would only be NHS anyway. So you don't have any non NHS contact, basically.

And I know for lots of people, any kind of thing to do with your health, your medical history, it's very sensitive. So how seriously do you take things like data privacy and security?

We do have our own governance team that handles bits such as guidelines and what we should be doing to keep data safe, which is hand in hand with the DSPT and cyber essentials, which again is guidelines that we have to follow that the DSPT is strictly from NHS, so it can be items such as how policies are handled, how people's permissions are handled on software, and it's also a review of our own company policies, so it can be how our complaints handled, stuff like security. So one of the commonest ones, or one of the newest ones that we updated recently, is the password policy. Obviously, I won't give details on what it is, unfortunately, but it lets us revamp and make sure that we're keeping up with current technologies, current requirements and standards for technology as it moves forward.

And this is obviously an issue that I think we could talk for ages and ages about. So we'll go into more detail about what happens in IT, security, data protection and all that in episode six. So we'll have a longer conversation with Niall very shortly.

So that's the glimpse behind the scenes at what goes on at head office, at Physiological Measurements. In the next episode, I'll be exploring how your GP refers you to PML and the reasons why PML are chosen to do the scans.