The Government has announced the launch of 13 new community diagnostic centres (CDCs) in England, eight of which will be led by the private sector.
The announcement comes one day after NHS England announced CDCs and local hospital hubs would make more areas of diagnostics directly accessible to GPs without requiring a specialist referral.
Health secretary Steve Barclay said that by ‘making use of the available capacity in the independent sector’, paid for by the NHS, patients will gain ‘a wider choice of venues to receive treatment and in doing so diagnose major illnesses quicker and start treatments sooner’.
There are currently 114 CDCs around England, offering ‘one stop shop’ tests including for cancer but yesterday NHS England said they would also start doing tests for asthma, COPD, cardiovascular disease and heart failure ordered directly by the patient’s GP.
It said this would help reduce winter pressure on hospitals although GP leaders warned it would pile pressure on overworked GPs who already face barriers to referring patients to specialist care.
The 13 new CDCs will provide capacity for more than 742,000 extra tests a year once all are fully operational, which they will become between this winter and next year.
According to the Department of Health and Social Care, which intends to open up to 160 centres in total, CDCs ‘drive efficiency’ in the NHS by ‘shielding’ diagnostic services from ‘wider hospital pressures’.
Explaining the use of the private sector to run the centres, Mr Barclay said: ‘We must use every available resource to deliver life-saving checks to ease pressure on the NHS.’
While health minister and elective recovery taskforce chair Will Quince added that he had ‘turbocharged’ the NHS effort to bring down waiting lists.
‘These actions will bolster capacity across the country and give patients more choice over where and when they are treated,’ he said.
The DHSC has also published its response to a consultation on a new procurement system that give NHS commissioners more freedom to purchase services without what it called ‘unnecessary levels of competitive tendering and barriers to integrating care’, following the abolition of section 75 regulations from Health and Social Care Act.
National director for elective care Stella Vig said NHS England has increased its use of the independent sector ‘by more than a third since April 2021’, ‘carrying out 90,000 appointments and procedures and more than 10,000 diagnostic tests every week’.
She added: ‘Independent providers will continue to play a key role as we work towards the next milestone in our recovery plan, as well as the additional one stop shops announced today as part of NHS England’s rollout of community diagnostic centres.’
NHS England is tracking use of private sector services paid for by NHS and will evaluate how impactful it is, the DHSC added.
Where the 13 new CDCs will be based
Private sector-led:
- Thurrock CDC (Southend), Southend
- Northampton CDC, Northampton
- South Birmingham CDC, Highter’s Heath, Birmingham
- Camborne and Redruth CDC, Redruth
- Devon and Torbay CDC, Torbay
- East Somerset CDC, Yeovil
- North Bristol CDC, Bristol
- Weston CDC, Weston-Super-Mare
NHS-led:
- Barking CDC (St George’s), Hornchurch
- Grantham CDC (Skegness), Skegness
- Lincoln CDC, Lincoln
- Nottingham City CDC, Nottingham City
- Stoke-on-Trent CDC, Hanley, Stoke-on-Trent
翻译：
More defunding of the Public sector and the poaching of public sector trained staff at over inflated rates.F=== the Tories.
Almost all GP practices are private companies undertaking NHS contracts.
Almost all GP locums are either self employed or Ltd companies undertaking work for GP surgeries.
If the CIVIL SERVICE is able to organise decent contracts – highly unlikely given their history over many years with a notable example being the initial QoF negotiations – then this would provide desperately needed diagnostics and ensure the equipment is maximally utilised.
COP is diagnosed by spirometry, used to be done by our nurses, no additional funding, just qof points. They changed the training during covid, none of the nurses were retrained to the new training so now can’t do it at surgeries. Paying diagnostics centres does not seem a good use of tax payers money when we did it already no extra cost. Maybe retrain the nurses.
Asthma; FeNO testing? Sledgehammer to crack nut. Been doing respiratory medicine for 20 years including London Chest clinic. Asthma is a clinical diagnosis; history, examination, family history-most important, response to treatment.
FeNO; may be useful if there is some clinical uncertainty; very infrequently. Asthma has been managed for decades without this test. Doubt it’s pivotal. Bet its costly. Costly and pointless and run by the private sector. Hits the government’s hat trick of
favourite things.
Lastly Richard Collman. Yes we are private contractors. One’s run by people who are doctors, understand both medicine and how the system works and are not taking a large profit while skimming off the public purse and doing the minimal of useful input.
Off site imaging centres for secondary care to refer into if there is not enough capacity in the hospital.
Fine. no one complains.
Patients having surgery done in private hospitals. All for it. End to end care, takes off the workload.
Random diagnostics we don’t need, specialist care dumped on us, while being told no more funding into general practice.
Funding from the CDCs we could really do with to provide better care.
Then we are not happy.
Cardiology; no I don’t want any more cardiology diagnostics. I can order a BNP to guide me, as well as history and examination.
Beyond that I want cardiologist input. Am already fed up of echos done by private diagnostics services that make no sense to me BECAUSE I AM NOT A CARDIOLOGIST and I don’t know how to action them.
And sick of cardiology referring back to me after seeing the patient once with ‘start a b blocker of your choice, or ace or diuretic and up titrate as appropriate’.
Trying not to state the obvious but specialists had 10 years additional training at least for a reason. So we are kind of hoping you will manage them. It’s no phone a friend. Personally I refer them straight back and advice I need them to do that management.
We manage COPD and asthma in primary care anyway. When it is beyond our limitations due to diagnostic uncertainty or management trialled so far not working, we don’t need diagnostics, we need a specialist review. (A doctor not a test).
This is EVEN MORE SECONDARY CARE DUMP.
BUT IT’S WORSE. It’s work we are not trained to do and making us request tests and manage patients needing specialist input gives the patients substandard care.
We have neither the time nor training to manage care that should be referred in to secondary care.
Ditto all the musculoskeletal imaging; spine MRIs, knee MRIs etc I get left to file and action.
Generally I don’t know how to action them. Because I am not an orthopaedic surgeon.
(Generally with Spine MRIs, if there are no red flag symptoms I don’t even know why we are doing them because if they are just causing pain physical therapies and medication are more effective and less risky than a spinal operation so that would be my last resort and would be a referral not a scan. As I keep having to explain to patients after their scan, that someone else requested, ‘it doesn’t change management, yes sorry a scan doesn’t actually treat you’ but doesn’t help when the government and its media barrage keep mixing up diagnosis and treatment and alluding to tests being the answer to everything.
A lot of the time the MSK MRIs get declined by DRSS and we are told they are inappropriate and to refer in to orthopaedic services if we want review.
Correct.
Wonder if DRSS will vet these CDC referrals and decline them. Doubt it.
They’ll get sent through and results to us to action so that will be great dealing with that can of worms.
Medicolegal responsibility will of course rest with us. Of course.
It’s just ridiculous. We need more doctor time. Specialist and GP. Funding primary care properly, getting funding into core contract, ending the BS of PCNs and ARRS is a start.
Sorting out the strikes and engaging doctors would help.
How does anyone think diagnostic centres not run by the correct diagnosticians IE CONSULTANTS will help.
Tests do not equal diagnosis; correct tests and interpretation needed, specialist input needed. And then treatment is another jump away.
Remember medical training; 85% from history, 10% from examination, 5% from investigations; anyone want to break this to the government.
Sorry for long rant. Frustrated in the extreme. Very glad the new chair is an arse kicking woman. Much arse kicking needed.
@ Finola ONeill
Great rant, righteous and comprehensive.
Alternative plan for managing the frustration
RLE
(and hopefully you’ll have some colleagues
You communed with when you were younger)?