In summer 2021 we started a conversation about how we could improve diagnostic services across Staffordshire and Stoke-on-Trent.
Currently, most diagnostic services (tests to work out what is causing a person’s illness or symptoms) are provided in hospitals, but it is now recommended that NHS organisations across England move to providing these in Community Diagnostic Hubs.
We believe this will give patients across the county access to diagnostic services such as blood tests, scans, x-rays and imaging more quickly and nearer to home. The services provided at these hubs would be elective (planned), so would not change how people access diagnostic services if urgent or emergency care is needed. Elective or planned services could include referrals from your GP for blood tests, x-rays or scans to investigate health complaints and concerns.
- It is recommended that NHS organisations across England move to providing diagnostic services in Community Diagnostic Hubs(CDHs). All health systems are expected to include a network of CDHs as part of their health services offer. The creation of Community Diagnostic Hubs was recommended following the Sir Mike Richards’ Review of Diagnostics Capacity
- The Hubs will allow you to access planned diagnostic care nearer to home without the need to attend acute hospital sites. These services would also be separate to urgent diagnostic scans. This means shorter waiting times and a reduced risk of cancellation which can happen when more urgent cases take priority. Therefore this would lead to improved patient experience and outcomes.
- The CDHs will help achieve the following ambitions:
- To improve population health outcomes by diagnosing health conditions earlier, faster and more accurately.
- To increase capacity in the diagnostic service by investing in new facilities, equipment and training new staff, contributing to recovery from COVID-19 and reducing pressure on acute hospital sites.
- To improve productivity and efficiency by streamlining the way we provide acute and elective (planned) diagnostic services where it makes sense to do so; redesigning clinical pathways to reduce unnecessary steps, tests or duplication.
- To contribute to reducing health inequalities by ensuring everyone has the same access to care and the same health outcomes.
- To deliver a better diagnostic service and more personalised experience by providing a single point of access to a range of services in the community.
- To support more joined-up care across primary, community and secondary care.
- The Integrated Care System (ICS) for Staffordshire and Stoke-on-Trent, Together We’re Better, is looking at ways to invest in the current services. All the ICS partners want to improve the way diagnostic services are currently provided, where they are provided and how they are accessed.
- Community Diagnostic Hubs would build on the diagnostic services currently available.
- The investment in these sites would improve the way services are currently provided for people with a range of conditions. In the first instance, this would include those with Long Covid, Breathlessness and Valve Disease symptoms.
- We would aim to have three or four CDHs across Staffordshire and Stoke-on-Trent. We need to develop a five-to ten-year plan for what services would be included in each Hub.
- The minimum test list includes:
- Imaging:CT, MRI, Ultrasound, Plain X-Ray
- Physiological measurement:Echocardiography (ECHO), Electrocardiogram (ECG), including 24-hour and longer tape recordings of heart rhythm monitoring, ambulatory blood pressure monitoring, oximetry spirometry including reversibility testing for inhaled bronchodilators, Fractional exhaled nitric oxide (FeNO), full lung function tests, blood gas analysis via Point of Care Testing (POCT) and simple field tests (e.g. six-minute walk test)
- Pathology:Phlebotomy, Point of Care Testing, simple biopsies, NT-Pro BNP, urine testing and D-dimer testing
- For larger CDHs only:Endoscopy services including gastroscopy, colonoscopy and flexi sigmoidoscopy.
Our involvement work last year included a survey and online discussions. Comments received during this work have been analysed and considered. Thank you to everyone who took part in this conversation; the reports of findings can be read in full here
No decisions have been made about the hubs, and we will keep you informed.
Why do we need Community Diagnostic Hubs?
Community Diagnostic Hubs are part of a national plan to improve diagnostic capacity within the NHS. The Hubs would form a network of such facilities, creating a number of ‘one-stop-shops’ to allow patients to receive life-saving checks sooner, with more appointments made available, and prioritised pathways to health services and treatment.
How many would be created across Staffordshire and Stoke-on-Trent?
National guidance is that we provide three Hubs per million population. Based on this, we would aim to have three or four Community Diagnostic Hubs across the county.
Is this a money-saving exercise?
No. The creation of the Community Diagnostic Hubs would be an investment into health services across Staffordshire and Stoke-on-Trent. They would allow patients to access services quicker, with less waiting time, and receive the treatment they need sooner. The services provided at the Hubs would build on the diagnostic services currently being provided.
How would they be funded?
We are already funding diagnostic services across Staffordshire and Stoke-on-Trent, and have available funds within our budgets to support this investment. We are also looking at national funding opportunities which are available from NHS England and NHS Improvement, and which allows Integrated Care Systems such as ours to bid for capital and revenue funding to support our investment plans to improve diagnostic services across the county.
Where would the Community Diagnostic Hubs (CDHs) be located?
The national recommendations are that Community Diagnostic Hubs are located away from acute hospital sites, but recognises that community hospital sites may provide suitable locations.
Each CDH must:
- be a freestanding, digitally connected, multi-diagnostic facility that can be, as an option where appropriate, combined with mobile / temporary units. The Hubs should be located separately from the main acute hospital facilities and closer to patients’ homes.
- contribute to six primary aims – improve population health outcomes, increase diagnostic capacity; improve productivity and efficiency; reduce health inequalities; improve patient experience; and support the integration of primary, community and secondary care
- deliver a minimum set of diagnostic tests
- receive referrals from a range of healthcare professionals across the system, book and prepare patients; deliver coordinated testing; and provide timely reporting.
What services could be provided at these Hubs?
We are at a very early stage of the project, but have started to ask people about how they access diagnostic services in Staffordshire and Stoke-on-Trent, what they like about diagnostic services Staffordshire and Stoke on Trent, what could be better and how we could make the most of the proposed Hubs.
We already have a clear picture of what people can expect to see in the Hubs in terms of diagnostic services. They fall into three areas:
- Imaging: CT, MRI, Ultrasound, Plain X-Ray
- Physiological measurement: Echocardiography (ECHO), Electrocardiogram (ECG), including 24-hour and longer tape recordings of heart rhythm monitoring, ambulatory blood pressure monitoring, oximetry spirometry including reversibility testing for inhaled bronchodilators, Fractional exhaled nitric oxide (FeNO), full lung function tests, blood gas analysis via Point of Care Testing (POCT) and simple field tests (e.g. six-minute walk test)
- Pathology: Phlebotomy, Point of Care Testing, simple biopsies, NT-Pro BNP, urine testing and D-dimer testing
- For larger CDHs only: Endoscopy services including gastroscopy, colonoscopy and flexi sigmoidoscopy.
Where else could they be located and would they offer different services?
The plan is for the Hubs to be genuine ‘one-stop-shops’ for patients to access a range of services in locations that have high demand for diagnostic services or where services could be more easily accessed (either because of location or public transport services). We want to hear from people and understand their views about where Community Diagnostic Hubs could be located and what services they could offer. We have identified three priority areas – Long Covid, Breathlessness and Valve Disease – but we are open to suggestions about other services which could also be provided.
When would the Hubs open?
We are at a very early stage in this project, and the details are still being worked out. We will be looking at how we can implement the CDHs over the next five years.
How do I have my say on these ideas?
We want to hear from as many people as possible. Complete the Community Diagnostics Hub survey online.
If you need help completing the survey, call 0333 150 2155 between 8am and 4pm, Monday to Friday.