Following the government commissioned Report, Diagnostics: Recovery and Renewal by Professor Sir Mike Richards in October 2020, it is evident that the NHS has been subject to continuously growing pressure prior to the COVID 19 pandemic. Many referrals were being outsourced to private providers at a significant cost. In 2017, the median time to report an MRI test result was 3 days (as reported by the Care Quality Commission) whilst the waiting period was significantly longer.
Following the pandemic, the NHS backlog has no doubt been exasperated due to the virus itself but also complications arising as a result resulting in urgent referrals for imaging such as cancer referrals.
Key actions within the Report include:
- Community diagnostic hubs should be established away from acute hospital sites and kept as clear of Covid-19 as possible.
- Diagnostic services should be organised so that as far as possible patients only have to attend once and, where appropriate, they should be tested for Covid-19 before diagnostic tests are undertaken.
- Community phlebotomy services should be improved, so that all patients can have blood samples taken close to their homes, at least six days a week, without needing to come to acute hospitals.
The Report focuses on adapting “patient-centred pathways for diagnostics”. Major changes need to be considered over the next five years to meet the recommendations of Professor Sir Mike Richards. Of these changes, mobile units should be used to deal with the hospital backlog and the COVID 19 vaccination effort. This also includes the Test and Trace process by providing an adequate testing facility. Mobile units are required to:
- Minimise risk of COVID 19 transmission between patients, staff and visitors therefore creating a safe environment
- Increase diagnostic capacity for the NHS by allowing for a variety of tests in one location
- Be located close to good transport links
- Placed in consideration of physical, cultural and social needs of communities
- Reduce the number of patients attending hospitals.
The MDU is able to provide diagnostic and screening services either as a stand alone unit or booster to existing facilities. Its purpose is multi-functional however and depending on the intended usage, can be used for a variety of diagnostic purposes.
The MDU within communities will target specific groups or areas which require diagnostic services. In respect of COVID 19, the MDU will be able to target hotspots or areas where there has been an outbreak. During the pandemic, hospitals saw a decrease of patients attending for pathology services such as blood tests out of fear. The MDU would allow for flexibility by providing the patient to complete similar type tests close to their area in an alternative facility.
The MDU is designed to aid the vaccination efforts to ensure the usability of the Test and Trace system. After vaccinating, the Test and Trace is the most important method in monitoring and controlling the Coronavirus.
The implementation of MDUs within care services is designed to assist the NHS Long Term Plan to narrowing health inequalities. Also, by dealing with initial diagnostics, hospitals are given breathing room to ensure a faster turn around in regards to acute services to patients.
The UK’s vaccination rollout was the world’s first mass immunisation programme for COVID 19. By February 2021 the British Government had placed orders for a combined total of 457 million doses across 8 different vaccines and as of 23 August 2021 this had increased to more than 540 million doses. At the time of publication, 63.6% of the UK had been vaccinated but there is a large percentage yet outstanding.
The COVID 19 pandemic has shown us that changes which have been considered too difficult or strenuous logistically have been done within weeks such as remote consultations with GPs. These consultations are even happening with those who need secondary care.
Having seen the ability of health care services to adapt, it is clear that MDUs are workable and adaptable into the current health care system on both a GP and hospital level. With regards to Professor Sir Mike Richard’s report, the MDUs provide a real solution to an ever growing problem.
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