Community Diagnostic Centres

Diagnostics landscape

The United Kingdom has experienced an increase in year-on-year diagnostics demand for Long Term Conditions. According to Cancer Research UK, cancer incidence has been growing by 2% per annum, and is expected to continue to rise to 742 cases per 100,000 by 2035¹. These factors, along with a decrease in referral thresholds has led to Imaging demand growth of 6.4%² (CT) and 4.8%² (MRI) per year.

Growing diagnostic backlogs

The affect of the coronavirus pandemic meant that non-urgent activity reduced or ceased, resulting in rises to diagnostic backlogs. Post-pandemic, backlogs and are expected to grow further, with a bow-wave of referrals forecast due to patients not previously presenting. Any ‘new normal’ capacity could be far lower than pre-pandemic levels.

Insufficient and outdated equipment and estates

The United Kingdom is behind OECD averages for medical imaging scanners per million population³, with much equipment across CT, MRI, PET-CT, X-ray and Ultrasound outdated. Additionally, there are challenges with space and capacity across existing Trust estates, some of which have become outmoded.

Imaging staffing

Pre-existing Radiographer and Radiologist staff shortages are well documented. When we combine with extreme pressures that have arisen during the pandemic, this could lead to further stretching of human resources and rising attrition rates.

Patient care

Delayed diagnostic testing and treatment could lead to increased patient health issues in the future – some untreatable. Cancer Research UK estimates around 350,000 fewer people in the UK were sent on an urgent suspected cancer referral during April-August 2020¹.

Delivering the NHS Long-term plan and boosting Out-of-hospital care

The NHS Long-Term Plan sets out an ambition to transform capacity and responsiveness of clinical services. This transformation is at the heart of new models of care and will require closer integration across patient pathways.

Traditional approaches have been to provide elective diagnostics in acute settings (i.e. hospital-based diagnostics), typically following a pathway from GP referral to hospital consultant, with periods of several weeks between referral to diagnostic tests and additionally further delays between tests and follow up appointments.

In a post pandemic landscape, there is opportunity to redesign safe patient pathways – taking into account the needs of primary care and commissioners, resource limitations of secondary care with advantages gained by improved access and improved productivity, provided in new environments.

Community-based diagnostics

Diagnostic tests could be delivered in a community-based setting, with increased and appropriate use of GP direct access – as recommended by GIRFT. Joining up primary and specialist follow up care in settings that are closer to patients’ homes is essential if we are to reduce the number of journeys to hospitals, reduce ‘Referral To Treatment’ times and drive efficiency and productivity.

‘Hot & ‘Cold’ sites

Post-pandemic patients will need to feel confident of their safety to re-access care. The separation of elective and non-elective care, with ‘hot’ and ‘cold’ clinical sites, will be part of a future landscape that needs to allow for future waves of pandemics, without compromising on care provision.

Addressing health inequalities

Community-based healthcare, particularly in areas of deprivation, is essential if we are to stand a chance of addressing the long-term health inequalities that have been amplified by the pandemic.

Diagnostics: recovery and renewal

The Diagnostics: Recovery and Renewal (‘Richards Report’) recommends significant reform and investment in critical diagnostic services, including new service delivery models, equipment and facilities, workforce, digitisation and connectivity, in order to improve capacity, efficiency and reduce diagnostic backlogs.

The Richards Report outlines that NHS England should consider plans to build an out-of-hospital diagnostic centre per 300k of the population - meaning scope for between 100-150 diagnostic hubs.

Download the report here (1.11MB)

Diagnostics: recovery and renewal (Download .pdf)

What are Community Diagnostic Centres?

Community Diagnostic Centres (CDC) are key to transforming current models of care delivery by providing access to “right first time” diagnostics and treatment services, closer to patient's homes.

In order to meet rising demand for diagnostic services, the NHS have outlined their vision to increase diagnostic capacity to drive early disease diagnosis and enable access to the latest medical technologies, efficient workflows and robust informatics tools.

The scope for CDC or Community Diagnostics Hubs (CDH) is broad. Philips vision is that these centres will specialise in providing services that meet cardiovascular, fitness, wellness and health themes across Radiology, Cardiology, Oncology, Respiratory and Sleep health spaces. With a continuing need to focus on the wider health needs of our population, we also envisage the expansion of CDC with further NHS–commissioned specialist services. The focus would be to support the elderly and patients with underlying health conditions by improving access to expert health services whilst reducing travel. This could encompass general practice, pharmacy and tele-dentistry services.

Cardiovascular

Stroke/Head
Heart
Sleep

Fitness

Heart
MSK (Musculo-skeletal)
Pulmonary

Wellness

Breast
Osteoporosis
Heart
Gynae
Bowel
Prostate
Liver

Health

Mental health
Sleep

Interim CDC/H

Modular solutions
Relocatable solutions

Delivering innovation excellence across the diagnostic pathway

Philips partners with primary, acute and private care providers in order to deliver improved patient experience and better health outcomes, throughout the diagnostic pathway.

Community Diagnostic Hub related articles

Exploring the strategic planning opportunities for the UK’s initial Community Diagnostic Centres

Stephen McMillan & Jeevan Gunaratnam of Philips, explore the factors to consider when strategically planning a CDC.

Read the article (515.0KB)

Innovating in diagnostics with new models of out of hospital care

Partnering with healthcare providers to pioneer Community Diagnostics Centres (CDC) across the UK

Read the article (828.0KB)

Healthcare inequalities report

Rapid acceleration of community diagnostics urgently required to alleviate pressures on the NHS, findings by researchers from Imperial College London and Philips UKI reveals

Read the article (28.14MB)
Virtualisation of healthcare

Charting the growth of virtual care models, new patient behaviours and the opportunity for out-of-hospital care.

Read the article (260.0KB)

Read how Philips provide a range of solutions to help build CDC/H (0.0KB)

Events

Diagnostic & Treatment Provision in England – Expanding Care Delivery

Presenters: Stephen McMillan, Head of Solutions CoE Philips UKI & Jeevan Gunaratnam, Community Diagnostic Director, Philips UKI

In order to deliver on the NHS plan and vision, Philips’ premise is that there needs to be a transformation in delivery of diagnostic and treatment services in England, expanding care delivery out of traditional hospital settings into community and specialist settings, as well as using the opportunity granted by affordable and accessible spaces on our high streets.

Watch on-demand here

^1.https://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence/

^2.https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/monthly-diagnostics-waiting-times-and-activity/

^3.http://data.oecd.org/healtheqt/magnetic-resonance-imaging-mri-units.htm

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