Agenda item

To consider an update on developments within the Tees Valley in relation to Community Diagnostic Centres.

The Committee received an update on the continuing developments in relation to Community Diagnostic Centres (CDCs) across the Tees Valley footprint.  Introduced by the Tees Valley Community Diagnostics Programme Director and supported by senior clinical and operational leads / directors from County Durham and Darlington NHS Foundation Trust (CDDFT), NTHFT and STHFT, a presentation (circulated in advance) was given which focused on the following:

         Background

         What are they (CDCs)?

         Diagnostic centre locations

         Key facts and figures

         Engagement and involvement

A key driver behind the development of CDCs was the independent review of NHS diagnostics capacity undertaken by Professor Sir Mike Richards CBE.  The final report included 24 recommendations which included a focus on capacity (equipment, staff) and the splitting of acute and diagnostic services (which can assist with improving the patient experience).

Whilst not solely about radiology, diagnostics enabled increased identification of cancers and other serious health conditions at an earlier stage.  Pressure on most diagnostic services was already growing prior to the COVID-19 pandemic (e.g. demand for CT scanning was currently growing at around 7% per annum) – waiting times had therefore inevitably risen.

The Tees Valley CDC sites were outlined, with the intended CDC ‘hub’ within Stockton-on-Tees currently being developed on the former Castlegate shopping centre (a temporary mini-hub was operating from Lawson Street in Stockton).  South Tees ‘spoke’ sites existed (and were continuing to be developed) in Redcar and at the Friarage Hospital, Northallerton, with the North Tees ‘spoke’ offer nearing full capacity within Hartlepool.  In terms of the CDDFT footprint, the ongoing service at Bishop Auckland had operated well (made easier due to the adaptation of an existing building) and was working alongside other Tees Valley sites in what was a real step-change to partnership-working across the region – a five-year plan was in place which differentiated between acute and diagnostic activity, with the Trust working to ensure an educational programme around access and utilisation of these services.

Officers spoke of the opportunity to put diagnostics on the footing it should have been on years ago, with ongoing developments seeking to deliver an additional 150,000 diagnostic tests annually across the Tees Valley from 2024-2025 (with further growth planned based on demand).  However, it was emphasised that CDCs would operate on a ‘referral only’ basis (from primary and secondary care services), and that the public would need to be clear what the new Stockton ‘hub’ was and how it worked – it was not a drop-in centre, nor a hospital, but should instead be viewed as an additional imaging facility.  In that regard, referral processes would continue into each service as they did now, therefore the service would manage where these referrals were seen based on capacity at the time of booking patients in.

Further detail around the construction and resourcing of the Tees Valley CDC sites was provided, and it was stated that the aim was for the new ‘hub’ in Stockton to be open by mid-2024 (earlier than the original estimate of April 2025).  CDDFT had replaced all of its diagnostic equipment as a result of the funding for the CDC programme and COVID-related financing.

In terms of public engagement around the CDCs, officers welcomed the input of the Committee as to the best way to communicate the Tees Valley offer.  Some engagement had already taken place with GPs (though it was acknowledged that this needed to go further as GPs had a critical role in educating patients on available options), and the ICB would also be an important partner in raising awareness of diagnostic capacity.  Crucially, there was a need to ensure services were accessible, with considerations around transport routes / options and parking capabilities central to this.  It was also hoped that the enhanced facilities would help attract new professionals to the area.

Reflecting on the content of the presentation, the Committee welcomed the significant developments around diagnostics across the Tees Valley (particularly the focus on health in the community), and commended NHS Trusts for working collaboratively to ensure the best possible offer.  Clarity was then sought around the exact services which would be available within the Stockton ‘hub’ site – Members were informed that there would be a small number of consulting rooms in addition to the diagnostic capacity, but that the exact disciplines were yet to be determined (clinical colleagues would be approached for a view on how best to use these spaces).

Regarding diagnostic equipment, the Committee asked whether maintenance was outsourced or conducted in-house.  Members heard that this was mainly done by the companies who supplied the equipment, though, outside this, medical departments also had a role to ensure these operated effectively.  CDDFT had a contract with Philips which automatically replaced equipment every 7-9 years, and had access to an external technician.

Discussion ensued around the key issue of accessibility, including the importance of Local Authorities working with NHS Trusts to facilitate adequate parking options, and the challenges associated with reduced bus provision.  Members were assured that liaison with Councils over parking capacity had already been undertaken in order to maximise opportunities for patients to attend sites, and that the expansion of Patient Transport Services (PTS) was also being considered.

Continuing this theme, the Committee noted that there were some communities in Redcar and Cleveland which were not covered by PTS.  Officers emphasised that it was pointless spending money on buildings / diagnostic equipment and then not enabling people to access them, and stated that any Member support in terms of linking-in with transport providers (e.g. Arriva) would be welcome.

Returning to the key issue of communications, the Committee asked if there was any specific funding earmarked for this critical element and heard that, whilst there was no formal budget, the collaborative nature of the CDC project meant that organisations were looking to pool their resources anyway.  There was a big national agenda around diagnostics (and health inequalities) at present, and work had already been undertaken with regional media partners to make it clear what CDCs were and dispel any myths.  Members cautioned against the use of the word ‘hub’ which, to some, may imply a drop-in feature – officers responded that this would be considered as part of future public engagement around the CDC offer (it was noted that the term ‘hub’ was used in order to allocate funding) and that a further update on CDC developments could be provided to the Committee at a future meeting if desired.

AGREED that the Tees Valley Community Diagnostic Centres update be noted.