New centres should bring diagnosis to the people

NHS Community Diagnostic Centres must stay true to their mission if the public is to benefit, according to a study by Imperial researchers.

The Community Diagnostic Centres (CDCs) currently being set up across England by the National Health Service (NHS) should be located close to people’s homes, and in areas with the most significant health inequalities, if they are to have the greatest impact. This is the conclusion of a study carried out by Imperial researchers, working independently via Imperial Consultants with healthcare company Philips UK and Ireland.

CDCs must be established in communities, not in overburdened hospitals. Dr Jonathan Clarke Department of Mathermatics

The study also underlines the scale of the challenge that the CDCs have to face, with more than 1.4 million people currently waiting for diagnostic tests. “CDCs can play an important role in getting the NHS back to pre-pandemic levels of care and beyond, but their rollout must be consistent with their design,” said Dr Jonathan Clarke, co-author of the study together with Dr Leigh Warren. “CDCs must be established in communities, not in overburdened hospitals, and critically they must be staffed by a highly trained workforce and have the appropriate equipment.”

The goal of the CDCs is to give patients better access to diagnostic care, without the need for them to attend acute hospital sites. Their services are intended to be separate from urgent diagnostic facilities, which should mean shorter waiting times and a reduced risk of cancellation, which can happen when more urgent cases take priority. The result should be a better patient experience and improved health outcomes.

This initial wave of 40 CDCs is set to expand to 160 centres by 2025, with the ambition to provide an additional 17 million diagnostic tests during that period. This represents a 25% increase in testing capacity compared to before the pandemic, while also improving local access to diagnostics.

“More evidence is required to guide the rollout of CDCs in areas where there is high demand for diagnostic services, and where certain communities would benefit from dedicated hubs,” says Dr Leigh Warren. 

Evidence for industry

This was also of great interest to Philips, which is active in diagnostic imaging, image-guided therapy, patient monitoring and health informatics, amongst other areas. It commissioned the study to provide an evidence base for discussions on the provision of diagnostics through the NHS in England, and to strengthen its position as a healthcare thought leader and advocate for improved access to diagnostics.

“The introduction of community diagnostics offers a once-in-a-generation opportunity to rethink how we can work with the NHS to build a resilient healthcare system fit for the future, including how and where the NHS delivers timely care to patients,” said Mark Leftwich, managing director of Philips UK&I.

The introduction of community diagnostics offers a once-in-a-generation opportunity to rethink how we work with the NHS. Mark Leftwich Philips UK & Ireland

Part of the study involved assessing the locations of the first 40 CDCs, as far as the information available allowed. While there was some variation between sites, the study found evidence that the CDCs are generally located in proximity to relatively more socioeconomically deprived areas. “While this is encouraging, proximity to a CDC alone is not enough to address wider issues of access to healthcare,” says Dr Jonathan Clarke.

However, most of these initial CDCs are located on existing NHS sites, rather than in locations not currently used for healthcare provision. “This may partly reflect caution on the part of commissioners to develop new models of care alongside creating new clinical locations," says Dr Clarke. “But ideally, priority should go to placing CDCs in locations outside of existing NHS sites, to bring diagnostic services closer to underserved communities.”

The study concludes with recommendations to the government, NHS England, and the Integrated Care Systems, for taking the CDC programme forward.

“CDCs hold the potential to relieve persistent pressure on acute hospitals and empower GPs and primary care providers to ensure patients can get a swift diagnosis and begin their treatment journeys sooner,” said Mr Leftwich. “The research demonstrates the importance of locating CDCs in community-based settings, bringing services closer to people’s homes and in those areas where diagnostic services can’t meet patient demand.”

Pictures: Getty Images/Monty Rakusen & Bryn Lennon