Pathways and diagnostics: Community Diagnostic Centres
In our recent webinar, Community Diagnostics on Your High Street, Ashleigh Boreham, Dorset CCG, and Jaime Bishop, co-founder of Fleet Architects and co-chair of Architects for Health, explored the new Community Diagnostic Centre in the shopping centre in Poole. A question which arose from many CDC leads focussed on two key aspects: how anchor specialities were chosen by the CDC and what changes were made to diagnostics and patient pathways. As Ashleigh took us through the setting up of the CDC, it became clear that whole pathways were moved, not just diagnostics.
The CDC at Poole has focussed on shifting whole pathways rather than just diagnostics. How did you choose which to shift?
Ashleigh explains: “The reason why we chose specialities was because they were what we called ‘the early adopters’. We already had learns from other systems – for example, we shared and learned from Moorfields – so we knew the eye lane and the consultant on board knew how to work that, and was really enthused.
“So that was how we brought people on – so that ROC (Rehearsal of Concept) drill identified the people who wanted to play early and that’s how we then brought those ones on first to get the thing going. It’s about great momentum.
“When I first started out in community diagnostics, it was diagnostics. But anybody else in the audience who has been involved in the CDC programme will understand that it has moved from simple diagnostics to pathways.
“…You want a one stop shop. You want one conversation, you don’t want your patient having five conversations. But certainly when you are dealing with inequality and deprivation, people cannot afford to go five times to these places, and if you’re working, and you’re working in an industry that doesn’t give you the leave that some other industries have, and that you’re maybe self-employed, four times out of your time is four times you’re not earning money, and also it means that four times you may not decide to turn up, so your DNA rates increase.”
“So reducing the amount of engagements is why we’ve linked diagnostics and outpatients and pulled it altogether into a pathway approach. And all of our pathways are designed with a front end of diagnostics and then face to face as required, and then into action with the third sector.”
Understanding and designing the Community Diagnostic Centre at Poole was based around ensuring effective interaction could be achieved to ensure for the best patient experience and to rapidly reduce patient waiting times. The Health on the High Street model at Poole allows for a patient to be engaged with the community; the right help can be easily signposted – whether that’s coming from social prescribers, public health services, local stakeholders or patient navigators at the CDC.
“100 patients go through, of those 100 patients going through we are finding that 54 do not need a surgical intervention – they need another type of intervention”. Ashleigh explains that this could be a type of lifestyle intervention or social prescribing.
“…That is 54 people that are not going to an acute that are then being treated elsewhere but also are then bringing other parts of the third sector and community together.”
To watch Ashleigh’s full explanation of how diagnostics and patient pathways were structured in the diagnostic hub in Poole, watch the webinar clip here.
If you have any questions about the structure of community diagnostics and pathways, please contact us and we will be happy to provide further guidance.