Here we go again
NHS England is to overhaul the way MRI, CT and other diagnostic services are delivered
‘They announce One stop shops to be set up away from hospitals,
“so that patients can receive life-saving checks close to their homes”.
NHE envisage Centres set up in “free space on the high street or retail parks”.
One-stop shops they ain’t
Before NHS England turns Starbucks or the local chippie into a Diagnostic Hub, perhaps they might think of the actual cost of installing an MRI machine. Because, as this video explains, there is more to it than you think:
One vital ingredient seems to have been overlooked – the patient. Has anyone asked them if they want to put an MRI Scan on their shopping list, or if they might prefer to have the procedure done in hospital where they are assured the process is carried out safely, cleanly and efficiently?
Professor Sir Mike Richards was commissioned by NHS chief executive Sir Simon Stevens to review diagnostic services as part of the NHS Long Term Plan. Apparently proposals will “help save lives and improve people’s quality of life including…. cancer, stroke, heart disease and respiratory conditions”.
Now, where have we heard that before?
This mantra has been spouted by politicians for decades, to show their ‘caring side’. Their report gets an airing in the press, the political party to which “he/she belongs trumpets what a boon this will be – and then all gets forgotten. Until the next time someone has a bright idea…….
Of course, the relevant press office has to make sure buzz words are covered, so this time we are assured these one-stop-shops are ‘covid free’. How does he know? Apparently with diagnostic checks in A&E separated from tests taken ahead of routine procedures” Er – what? .
Mike brushes this aside with “such an approach would be quicker and safe for patients, so anyone who is in hospital should be able to get a scan on the day”. Hang on a minute – I thought these ‘shops’ were going to be on the high street so we could pop in, rather than go to hospital?
More to come
“Access to blood tests in the community should also be expanded so that people can give samples close to their homes, at least six days a week, without having to go to hospital”. Yes – but who is going to get hold of all the extra nurses needed for this? I thought there was a shortage? Trying to get a blood test for a very OAP in our village shows up there aren’t enough District Nurses to carry out even this basic task.
The report adds that any new services will need to be implemented over time, requiring significant investment in facilities, equipment and workforce alongside replacing outdated testing machines. So where is the money coming from?
Recommendations include (wait for it) :
- Tests for emergency and elective diagnostics should be separate, to reduce hold-ups for patients
- CT scanning capacity should be doubled over the next five years to meet increasing demand and to match other developed countries But ‘they’ tell us the NH’S is the envy of the world.
- Tests for heart and lung diseases need to be enhanced given the link to coronavirus
- More staff need to be trained to undertake screening colonoscopies Well, they got that right but where are they going to find them, and how long before they are trained? Surely it’s several years.
- The imaging workforce needs to be expanded as soon as possible with 2,000 additional radiologists and 4,000 radiographers as well as other support staff Ditto
But fear not – “Not only will these changes make services more accessible and convenient for patients but they will help improve outcomes for patients with cancer and other serious conditions.”
Alongside improvements in outcomes and convenience for patients, Sir Mike said that there were major efficiency gains to be had, including:
- Reductions in costs of CT and MRI scanners through bulk buying We’ve seen how much money NHS contractors wasted buying dud PPE equipment
- Increased use of same-day emergency care through improved access to diagnostics in A&E departments
- Shorter hospital stays through tests undertaken on day of request
Taking a pragmatic appoach, Rachel Power, Chief Executive of The Patients-Association comments “Any investment that enables patients to access diagnostic tests quickly and in a way that suits them is to be welcomed. Many of our diagnostic and treatment pathways are now long-established, and work well for the system but not necessarily patients – provided changes are made in true partnership with patients, fresh thinking on how the NHS does things is positive.”
Now, the NHS hierarchy might be thinking this way, and have done a deal to get the machinery, build the centres etc at a low cost, found a ready source for trained staff, etc. but ………
Isn’t it time the NHS took stock of what it has at the moment and realised there probably isn’t funding available for ‘pie in the sky’. Every major hospital (and some minor ones) already have scanners installed, so wouldn’t it be more cost-effective to improve access to those available?