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DIAGNOSTICS


testing – supporting earlier diagnosis, greater convenience to patients and helping to drive reductions in health inequalities. The Richards’ report takes into account the devastating impact of COVID-19 on an already strained NHS, but frames it as an opportunity to put in place the significant investment and radical reform that the NHS has so desperately needed for a number of years. Sir Mike Richards writes, as his number one recommendation, that there is an opportunity to introduce transformative Community Diagnostic Hubs (CHDs), to revolutionise diagnostic services in the UK while protecting against COVID-19. At the outset of the COVID-19 pandemic, the NHS put in place temporary and mobile hubs to support the initial response to the outbreak. Throughout the whole pandemic, we have relied upon our drive-through testing facilities, the incredible temporary hospital at Nightingale in London,12


and our


vaccination centres, which have all been located away from acute care settings to support the NHS response to COVID-19. The fast rollout of these facilities enabled the NHS to prioritise urgent COVID-19 treatments in main hospital facilities and prevent the spread of the virus by keeping patients separated, saving hundreds of thousands of lives in the process. The Richards’ Reports argues that we should not go back to the previous system of using main hospital settings for both acute and elective care: instead, we should keep them separate in order to continue reaping these benefits. However, the case for separating acute and elective diagnostic services is not only compelling in light of the pandemic. In fact, separating these services yields many long- term benefits beyond COVID-19, including the speed up of elective diagnostic testing (supporting prevention and early detection), faster treatment times, access to dedicated health settings with highly specialised staff, and more localised services.


The deployment of CDHs across England has the potential to greatly enhance public health, by empowering individuals to take control of their own healthcare and have better access to the tools needed to detect and treat ill-health faster; of course, that is not to mention the vital role of CDHs in


tackling the elective care backlog. The rollout of CDHs is also in line with the NHS Long Term Plan, which sets out ambitions to move to a new service model that includes investment in primary community health services to support central health services.13 One area of urgent focus in the delivery of CDHs and more localised healthcare is on endoscopy and other diagnostic testing services, which have been significantly affected during the pandemic. The impact of the pandemic on diagnostics and early detection and/or prevention of illnesses is yet to be truly felt, but Macmillan estimates that across the UK, there are currently around 50,000 ‘missing diagnoses’ for Cancer patients alone.14


These are patients


who have been unable to access diagnostic testing over the last year – and that is not including the missing patients for other preventable and/or treatable illnesses. At Vanguard, we are experts in diagnostic solutions including cancer screening, women’s health, endoscopy, non-imaging diagnostics, operating theatres, and imaging. We understand that shielding clinically vulnerable patients during the pandemic


Sir Mike Richards argues that we should utilise high street, retail and other similar local sites to deliver mobile healthcare that will provide quicker and easier access to diagnostic testing – supporting earlier diagnosis, greater convenience to patients and helping to drive reductions in health inequalities.


84 l WWW.CLINICALSERVICESJOURNAL.COM


has been fundamental to saving lives and preventing the spread of COVID-19 to those at high-risk of contracting and negatively reacting to the virus. However, the detriment to other aspects of the nation’s health, such as the rate we can identify and treat cancers, will be felt by the delay in vital diagnostic testing. Investing in CDHs and separating acute and elective care would allow us to continue carrying out vitally important diagnostic testing, supporting early detection and treatment of illnesses and improving our overall approach to improving public health.


Community Diagnostic Hubs – dubbed ‘one stop shops’ by NHS England15


in an


announcement toward the end of 2020 – are in the early stages of preparation, and there is huge potential for how we achieve this ambitious goal. Indeed, the Department for Health and Social Care (DHSC) consolidated the Government’s commitment to investing in community health services in its legislative proposals for Integrating Health and Social Care published in February 2021. The proposals, titled ‘Integration and Innovation: working together to improve health and social care for all’ outline the important role that community health services have to play in the joining up of health and social care in the UK16


and the


contribution that community health systems can make on improving public health. Achieving truly integrated care has been an ambition of the DHSC and NHS for a long time, with the deadline for becoming an established Integrated Care System (ICS) passing just weeks ago at the end of April,17 meaning we are one step closer to achieving the ICS goals of improving population health


AUGUST 2021


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