To consider a document detailing Community Diagnostic Centres and access to diagnostic services.
The Board received a presentation on Community Diagnostic Centres (CDC’s), explaining what they were and how they worked, as well as how the programme would be developed moving forwards.
The Board then heard from ICB colleagues Nicola da Costa, Jackie Kerby and Alison Cartright on the Integrated Health and Care Delivery Plan and the Community Diagnostics Centres research. Also in attendance was Steve Snead, System Lead for Diagnostics and Dr Riya Patel, Researcher.
The presentation advised that each ICB had been asked to deliver three CDC’s starting in October 2021 and ending in March 25. Each area would be hosting a CDC from Autumn 2023. The initial focus was on increasing diagnostic capacity and developing the programme onsidered the patient journey from the point of referral for a diagnostic test. This comprised three active workstreams: Data review, Available Tools and Research.
Officers gave a thorough explanation of each of the workstreams, the aim of each process, how this would be achieved and future steps. The officers concluded by advising that the work would give an increased understanding of inequalities in diagnostics and would highlight opportunities for improvement. It was hoped that these improvements could be shared across the system as well as seeking to learn from others working in this area.
The Chair thanked the officers for attending, delivering the presentation and answering questions. Councillor Bell then opened up the floor to questions from those present which covered the two agenda items preceding this one.
Councillor Marian Humphreys referred to the GP Services Task & Finish Review and queried if empty or part shared buildings were being looked at for GP’s to use in communities for those who struggled to get to the main surgery. In response, Ali Cartright advised that some of this work was already being undertaken within the Estates Strategy but highlighted that there was still a work force issue and staffing the sites may be difficult.
Councillor Jerry Roodhouse queried if there was an opportunity to work with the District & Boroughs to look at properties and land within their ownership and asked for a joint property strategy to maximise those opportunities. He referred to Warwickshire having the second largest population growth and the demographic suffering with anxiety and depression. He also felt that social prescribing would be playing a greater role in the future.
Councillor Roodhouse also provided a direct example of a resident within his division who had been experiencing problems accessing their GP, was subsequently sent to UHCW, then Warwick Hospital and then back to UHCW. He also highlighted the issues being encountered at Rugby St Cross Hospital and felt that the Rugby Place Partnership needed to understand the spokes model.
Dame Manzie responded to Councillor Roodhouse’s comments and assured him of the work being undertaken by the Rugby Strategy Board to look at the development of Rugby St Cross. She advised that there were plans for considerable investment and reassured him that Rugby was on the front page of UHCW’s work with more services being planned, not less. She did highlight that not all of the funds were available at the present time but the strategy would be in place for when the money became available.
On the issue of CDC’s, Dame Manzie added her support to her colleagues and felt that the work had the potential to be a game changer with regard to tackling health and inequality. In relation to the delivery plan for the ICB, she reminded those present that all services were facing massive health and care issues and were working hard to find better health outcomes whilst providing system wide value for money.
The Chair asked for clarification on the CDC process, and officers advised that the programme was looking at giving clinicians direct access to avoid them having to through a secondary care setting but this would not be a self-referral system.
Alison Cartright expanded on the point explaining the reasons that direct referrals may not be appropriate but advised that work was ongoing to explore those services that patients may be able to self-refer to, such as physiotherapy and audiology.
Councillor Penny-Anne O’Donnell raised a query relating to the increase of population as a result of new housing. She was concerned that the infrastructure was not in place to cope with demand and asked how confident officers could be of the numbers. Officers advised that figures were obtained from the developer outlining the estimated build out rate and this was refreshed on a quarterly basis. These figures could fluctuate depending on the economic climate.
Diane Whitfield complemented the community engagement work being reported and gave assurance that the challenges were not being underestimated. She advised that all providers were focusing on the healthcare workforce and the Board would be kept updated on progress.
Chris Bain of Healthwatch recognised that access was a complex issue with varying requirements from different areas such as GP’s, primary care and dentistry. He queried if there was capacity to deal with this if access to services was improved. He reiterated the importance of communication and strong administration being essential for the outcomes of patients.
The Chair asked a number of questions relating to GP’s understanding the national action plan, how better Members could understand the framework, how this would be measured and an accurate picture of the current situation. She queried the influence that the Board or others could have on GP surgeries and recognised that individuals wanted different types of appointments.
In response, Ali Cartright explained the work that was being undertaken with individual GP practices and were developing plans to address all of the actions. With regard to Coventry and Warwickshire, she explained that teams were working hard to employ and attract people into jobs and noted the gaps evidenced in North Warwickshire. The percentage of patients seen by their GP face to face was the highest in the Midlands but it was recognised that some practices needed greater support.
The Chair raised an issue relating to the ability of patients to access advice through other services such as pharmacies. She noted that a number of pharmacies were closing and yet NHS advice was still directing people to them for advice. She requested that a report be brought back to the Committee on the changing picture and the contrast between supply and demand.
Councillor Bell went on to request an easy to read document which would link to the Board’s priorities and encouraged Board Members to consider the three priorities and make comment by 2 June 2023 if necessary. She also noted the request for a property strategy for primary and secondary care services and how this could link to future property development.
She echoed the comments made regarding the fundamental need for good administration and communication to ensure that time and resource were not wasted and so that individuals did not get lost in the system.
She referred Members back to the overarching recommendations detailed in Agenda Item 3 and these were agreed.