The Community Diagnostic Centre (CDC) programme was introduced in 2021, and since then, it has enabled 7 million appointments to be delivered.
The programme intends to release diagnostic capacity in hospitals, reduce the appointment backlog and most importantly, speed up the diagnosis of health conditions.
However, NHS England has set a target to deliver 17 million appointments by March 2025. Meeting these targets is not impossible, but we will need to work collaboratively and innovatively to do it.
The need to unlock diagnostic capacity
At Gateshead Health NHS Foundation Trust, working with Newcastle Hospitals to deliver our CDC is a top priority.
Before we started the project, our capacity pressures were increasing, with a growing number of referrals in services such as imaging, spirometry, and point of care testing.
We knew that unlocking diagnostic capacity was incredibly important for our patients, but a lack of joined up working across the region meant it was difficult to achieve.
We worked as separate trusts, assigning ‘Newcastle days’ and ‘Gateshead days’ for community diagnostic appointments.
As a result, patients were waiting a long time for an appointment, and the backlog was not being effectively tackled.
More joined up ways of working was needed.
We knew that we needed to bring the two trusts together to deliver an effective CDC.
By combining – and effectively democratising – the diagnostic capacity of both organisations, more patients will be able to be seen more quickly, speeding up the diagnosis of conditions like cancer, COPD, and heart disease, as well as enabling monitoring and observations throughout treatment.
Taking the right approach for our patients
The challenge was how to do it. Should we continue as we were, working independently?
Should we procure a new diagnostic imaging solution? Or should we try to make the most of the existing technology we have in place?
It is easy to become distracted by the latest solutions available and think that bringing in something new is the only way to tackle the capacity problems we face.
At Gateshead and Newcastle, it was about looking at our existing systems in a new way.
That’s not to say that procuring a new solution isn’t a valid option, but for us, we knew we already had highly capable systems in place and that the best course of action would be to innovate with the technology we had already deployed to release diagnostic capacity quickly.
There wasn’t time nor the need to wait for another system to be implemented in order to achieve the objectives of the programme.
Within the north east, Newcastle and Gateshead have some of the highest levels of social deprivation and poorest health indicators, so redesigning our services to improve these outcomes couldn’t wait.
The King’s Fund’s latest report on the impact of poverty on the backlog also does well to highlight just how important it is to address these social factors, and quickly.
Designing the best system
It was really important that what we did was collaborative between our two trusts, and clinically led.
We listened to what our clinicians wanted, understanding the best way to design the diagnostic pathways to suit them.
The pathways for services like radiology and imaging are really complex, so making sure the design was clinically led was crucial.
Working with Answer Digital as our delivery partner, we developed a sophisticated data architecture to join up all of our existing systems (RIS, PACS, EPR) at our two trusts.
This will provide us with better visibility of our diagnostic capacity and most importantly, enable us to deliver care to people more quickly.
Taking this approach and innovating with what we already have will enable us to maximise diagnostic capacity from day one, deliver timely care to the people who need it and put us in good stead to meet NHS England’s appointments target.
Improving access to care
When patients had to come to our hospitals for appointments, we had a high DNA rate, with many people being unable to afford to travel into the city or being unable to make their appointment time.
Our CDC, located in the Metrocentre, is highly accessible, with over 550,000 people being able to reach it by public transport in under 30 minutes.
This will greatly improve access to care.
Given the potential impact that the CDC could have on public health as a result is great, it’s been so important to us to get the design right.
Taking the approach we did means the vast amounts of data that we have already collected in our existing systems are being joined up and put to use.
This will provide us with the best view of our population, as well as the necessary infrastructure to deliver high-quality care in the community.
Stay true to your organisation’s strategy
There are currently 155 CDC’s open in England, and government has stated that a further 5 (160) must be open by March 2025, in addition to the target of delivering 17 million appointments.
Alongside this very modest increase in the number of CDC’s, this target seems challenging. So, our priority should be making it possible to create capacity through the existing CDC’s as quickly as possible, in whatever way is best for each region.
As with most NHS programmes, there is not a cookie cutter approach.
The concept that we have developed with Answer Digital is now being blueprinted for use at other organisations, and I hope what we have done at Gateshead and Newcastle will help others embarking on similar journeys.
However, the most important thing to make sure of – on whatever path you decide to take – is that it aligns with your overall organisational strategy, that you ensure your planning is clinically led, and that you always keep what is best for your patients front of mind.
We have fostered a culture of continuous improvement, which will enable us to update our architecture over time as needs change and make sure the solution is futureproofed.
We have a system in place that works, and that will deliver value from day one.
Doing so is going to have a transformative impact on our population, reducing health inequalities and greatly improving access to care.
