Agenda item

To provide the Community and Wellbeing Scrutiny Committee with an update on the development of new NHS Community Diagnostic Centres in Brent and North West London.

Pippa Nightingale (CEO, LNWUHT) introduced the report, which provided information on the new Community Diagnostics Centres (CDCs) in NWL. She felt CDCs were an exciting initiative which had received a significant amount of investment (£44m) to decrease waiting times for residents to have diagnostics tests. The report detailed the plan for CDCs and where each centre would go, which was based around deprivation and population need. The methodology for determining the location of CDCs had focused on ensuring patients would not have to travel for more than 45 minutes to a CDC. One important thing to note was that CDCs were an additional service and did not replace the diagnostics already done in hospitals. Instead, the CDCs allowed for an extra 300,000 members of the NWL population to have diagnostics tests in a much quicker way than they were having now. The majority of patients referred for a diagnostics test did not have an illness, so they could be relieved quicker, and those who did have an illness and needed treatment could get faster access to treatment. As a result, the patient pathway was improved as well as survival rates and there was better access to care.

The Chair then invited comments and questions from the Committee, with the following issues raised:

The Committee agreed that CDCs were an exciting initiative. They knew NWL was one of many areas across the country identified as an area of deprivation and who would be opening CDCs, so asked what learning had been taken from other areas that had already launched their CDCs. Pippa Nightingale advised the Committee that the detailed work that had been done regarding deprivation had also helped other pathways, such as the Elective Orthopaedic Centre, because that data had been collected in a granular way, not just by borough but locality as well. Learning had also been taken from other parts of the country ahead of NWL in the rollout of CDCs, particularly around how those areas decided where the sites would be placed, as well as their implementation and rollout. NWL were working in a detailed and connected way with the CDC NHSE team.

The Committee asked how this related to GP direct access. Pippa Nightingale felt that CDCs were a ‘game changer’ for GP direct access, as for many years GPs had been frustrated that they had not been able to access basic diagnostics. This gave NWL an opportunity to look at direct access models on a wider scope as well, which was being done by place-based partnerships. Tom Shakespeare (Integrated Care Partnership Director) added that the Integrated Care Partnership (ICP) would be working closely with the GP community as well as acute and NWL colleagues on the development and rollout of CDCs over the coming months.

Members of the Committee advised presenting officers they had heard from residents that they had waited a long time to have tests done and once tests had been done, they had waited a long time to hear the results of those tests. They asked how they could reassure residents that these CDCs would result in better and quicker outcomes. The Committee heard that they could advise residents there would be quicker access to diagnostics with more patients able to be seen within a year, meaning there would be less patients waiting. The IT systems had been upgraded to enable a single system to share test data and a very important part of the initiative was to ensure communication did not fall down when patients were waiting for results.

There were many different staff groups involved in diagnostics, from phlebotomists to radiologists, some of which were hard to recruit to posts and so this had been identified as a risk. However, there was a good track record in NWL through the training academy which was already training staff ready for the CDCs. NWL had learned from the national programme that these were the sort of centres staff wanted to work.

The Committee asked whether there was joined up working to prioritise critical matters such as cancer diagnostics. They were advised that CDCs would help cancer patients because they would get quicker access into the first part of the pathway that all cancer patients started with. GPs and secondary care were able to refer to CDCs directly. Many services who provided care to cancer patients were challenged due to the backlog from Covid, and so CDCs would address that need too.

In response to whether this would free up hospital capacity, Pippa Nightingale confirmed that CDCs did help the acute trust deal with capacity because, currently, most referrals from primary care were because they did not have access to diagnostics so could only refer to an acute trust. Patients who were not ill would be taken out of the pathway so there were more appointments for people that did need the further care, and people were seen at the right time by the right people. Damien Bruty (CDC Senior Programme Manager) agreed that they could provide the overall volume of the activity NWL would envisage to the Committee. A lot of what they had learned from other places that had already gone live with CDCs was their experience of releasing hospitals from some of the high-volume low complexity caseloads. Patients were choosing to go to CDCs instead to have their diagnostics sooner for non-complex diagnostics, which then allowed hospitals to focus on those complex pathways.

The Chair thanked those present for their contributions and brought the discussion to an end. He invited the Committee to make recommendations, with the following RESOLVED:

i)              To recommend that groups who are more likely to be impacted by health inequalities are engaged with and will have more opportunities to access these services.