July 15: The UK National Health Service (NHS) should unquestionably boost outsourcing to counter the acute shortage of diagnostic centres in the country, according to a panel at HBI 2022 focused on “Building Capacity and Care Pathways through Partnerships”.
The discussion took place against a backdrop of (then) UK Chancellor Rishi Sunak having promised that the government would pump £2.3 billion (€2.7bn) into the development of 100 community diagnostic centres. The NHS aim is to build the hubs by 2025.
So far, the NHS has announced about 70, according to Dr Steve Powell, CEO and principal consultant at SKP Advisory Services. Only a few, however, meet the standards or match the large centres envisaged in the Richards Report, he said. In his November 2020 report, Diagnostics: Recovery and Renewal, Professor Sir Mike Richards, chairman of the UK national screening committee, warned that the “UK lags far behind the OECD averages for scanners (CT, MRI and PET-CT) per million population, ranking lowest among 23 countries for CTs”.
The Richards Report advised that the UK needs at least another 100 imaging hubs. ‘Acute’ and ‘elective’ diagnostics should be streamed separately via the establishment of community diagnostic hubs (CDHs) across the country. Over time, these could take on almost all the GP diagnostic and many outpatient tests.
UK Health Secretary Sajid Javid claimed in February this year that an extra 69 diagnostic centres were already “up and running”. “While this is a good start, much more capacity is needed,” Powell said.
Powell, who was part of the team who developed the circa £25 million (€29m) Somerset Foundation Trust’s new diagnostic centre in Taunton, added that other diagnostic centres were also in development in Oxford, Sheffield and South Shields.
Panellists agreed that it was disappointing that only a few developments were on stream some 20 months after the recommendations of the Richards report. Powell echoed the Richards report’s concerns. He estimated that there is a serious UK shortage of some 1,000 MRI and 1,000 CT scanners and also large numbers of X-ray and ultrasound equipment. Moreover, radiologists and radiographers are in short supply partly because there are insufficient imaging facilities in which to train them.
The answer appears obvious. With pressures facing the NHS, there is an opportunity for independent sector providers, equipment manufacturers and medical construction companies to form partnerships with NHS organisations. They then could swiftly develop new diagnostic centres away from fully utilised hospital sites and in communities.
An NHS framework has been put in place to facilitate this activity and NHS organisations are working on business cases, Powell said. It appears that the NHS is not contesting the additional resources that are needed for imaging and other diagnostic specialities.
If people are diagnosed earlier, patient outcomes would improve and there would be less need for more complex, expensive treatment and procedures, Powell added.
The NHS needs “forward looking procurement”, added Simon McGuire, regional general manager at GE Healthcare. Looking at the positives, at least the UK is taking action to raise the numbers of diagnostic centres, said David Cahill, Chief Commercial Strategy Officer, diagnostic and molecular imaging services provider Alliance Medical.
Long term partnerships were required to establish community diagnostic hubs, added Petri Bono, chief medical officer of private Finnish healthcare company Terveystalo. He said that trucks with imaging facilities were being despatched to 100 Finnish communities and some 200,000 mamograms were taking place each year.
Our Analysis: The £2.3 billion (€2.7 billion) UK diagnostic finance promise should be judged in context. The National Office of Statistics calculates that total UK health spending was £276 billion (€322bn) in 2021 including £47 billion (€55bn) in “non-government healthcare expenditure”.
In an article in Hospital Times last year, Prof. Sir Mike Richards wrote: “We must expand capacity – more equipment, new facilities and a larger diagnostic workforce…. Unlike many other countries, (the UK’s) diagnostic services are largely concentrated in acute hospitals. Patients in emergencies often compete with routine patients for the use of diagnostic testing capacity – to the detriment of both.”
Bottom line, if the Richard recommendations are carried out, lives would be saved.
Prof Sir Mike added that “the Covid-19 pandemic has further amplified the need for radical change in the provision of diagnostic services. Beneficial diagnostic pathway changes such as virtual consultations and community services have been made and should be embedded”.
© Copyright Neil Behrmann
First published in Healthcare Business International