Across Shropshire, Telford & Wrekin (STW), we are proposing to transform the way we deliver diagnostic services, through the introduction of Community Diagnostic Hubs (CDHs). CDHs are a national recommendation that have come out of the Richards’ Review of Diagnostics Capacity and will see services provided away from hospitals, so that patients can receive life-saving checks close to their homes.
This briefing sets out the STW approach to the delivery of CDHs, along with details of a successful bid for more than £6 million of national funding to deliver an initial pilot project. It highlights our plans to introduce CDHs across STW, starting with a pilot site which is likely to either be in Hadley Park or Hortonwood. This will benefit all residents across Shropshire, Telford and Wrekin by giving more timely access to elective diagnostic scans.
It also highlights early engagement work that has already taken place and ongoing work that is under way – this work includes a comprehensive survey being delivered by a research company, Influential, to help us understand what our populations think about the plans for dedicated elective diagnostic centres and what else they would want to see provided in community health and care hubs. This engagement work will be key for shaping the initial pilot and the way it is then developed over the next two to five years.
- In STW, we are looking to open a network of Community Diagnostic Hubs (CDHs). We are one of the first parts of the country to introduce this new model.
- The hubs will mean that elective (planned) diagnostic services will be delivered away from acute hospital sites and separately from urgent diagnostic scans.
- This separation will reduce waits and the risk of cancellation at short notice, so improving patient experience and outcomes – including for cancer and other serious conditions.
- STW has been successful in being allocated £4 million of capital funding to develop and open a pilot CDH in either Hadley Park or neighbouring Hortonwood, in Telford. This could open by the end of the financial year 21/22. The capital funding is backed up by recurrent revenue funding of more than £2.1 million per annum to recruit the required staff.
- The Hadley / Hortonwood area has been identified for the pilot as an area where there is some of the greatest health inequality in STW. Hadley is a borough which falls within the 10% of most deprived areas in England and Wales.
- The Hadley/Hortonwood site will also benefit Shropshire residents, who will also be able to access it to get more timely diagnostic tests. The work is part of our broader health and transformation work as an integrated care system.
- Subject to public engagement, it is proposed to site three further CDHs in STW, with one in Shrewsbury, one in North Shropshire and one in South Shropshire.
- A pod will also be opened on the site of the Royal Shrewsbury Hospital, separating elective from urgent scans. Funding is in place already for this pod, which is on schedule to open in August.
- The pod will likely eventually be replaced by a more permanent hub as set out above.
- What’s the rationale for opening Community Diagnostic Hubs?
The principle behind this national initiative is to create ‘one stop shops’ across the country, away from hospitals, so that patients can receive life-saving checks close to their homes.
By separating elective diagnostics from urgent work, we can reduce waits and cancellations, ensuring patients get better quality services.
- Who is ‘we’? Who is behind this project?
This is a real partnership effort, involving pretty much every organisation linked to the STW Integrated Care System.
It includes public health colleagues from Shropshire Council and Telford & Wrekin Council, as well as diagnostics providers including Shropshire Community Health, The Shrewsbury and Telford Hospital NHS Trust (SaTH) and The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust (RJAH). It also involves colleagues from STW Clinical Commissioning Group (CCG).
- So is this about saving money?
Indeed, there will need to be significant investment to deliver the programme of CDHs that we envisage. We are delighted to say that we have already secured funding of more than £6 million to begin a pilot project in Hadley Park or Hortonwood, in Telford.
- That’s a lot of money. Where is it coming from?
We have been successful in a bid to NHS England and NHS Improvement. We have been awarded £4 million for capital costs associated with the pilot, and more than £2.1 million for revenue costs.
- Why Hadley Park/Hortonwood for the pilot?
Hadley and its surrounds have been identified as an area where demand for diagnostic services are amongst the greatest in STW, and where health inequalities are amongst the most severe.
Indeed, the borough of Hadley is amongst the 10% of the most deprived areas in all of England and Wales. Basing our pilot site in or close to this area should have the greatest immediate impact and provide proof of concept for further rollout of the CDH model.
It should be noted that the Hadley/Hortonwood site will serve our population across Shropshire, Telford & Wrekin, giving all the opportunity to benefit from more timely elective diagnostic treatment.
- So where else could we see CDHs in Shropshire, Telford & Wrekin?
We want to talk to people about this and understand what they would like to see. Our ambition is to see services provided in all corners of STW. This could mean a new CDH in the south of Shropshire (maybe in Ludlow), one in the north (in Whitchurch or Oswestry) and one in the county town of Shrewsbury.
- How soon will these open?
The Community Diagnostic Hub programme covers a period of up to five years. The Hadley Park/Hortonwood pilot is ear-marked for Year 1, with funding already secured and other sites would follow from Year 2 onwards.
- What will be in these hubs?
We want these hubs to be real ‘one-stop shops’ for health services, providing not just diagnostic scans but other vital services as well. We want our communities to help us shape this vision. We have already begun a programme of engagement to ask people what they like about diagnostic services in STW, what could be better and how we could make the most of the proposed hubs.
We already have a clear picture of what people can expect to see in the Hadley/Hortonwood hub in terms of diagnostic services. This falls into three areas:
- Imaging: CT, MRI, Ultrasound and Plain X-ray / DEXA (an imaging test to measure bone density).
- Physiological measurement: Electrocardiogram (ECG), including 24 hour and longer tape recordings of heart rhythm, monitoring, ambulatory blood pressure monitoring, echocardiography (ECHO), oximetry, spirometry including reversibility testing for inhaled bronchodilators, Fractional exhaled nitric oxide ( FeNO), exhaled carbon monoxide, full lung function tests, blood gas analysis via Point of Care Testing (POCT).
- Pathology: phlebotomy, Point of Care Testing, simple biopsies, NT Pro BNP (a blood test used to detect heart failure), urine testing and D dimer testing (a blood test to rule out a serious blood clot).
- Endoscopy: used to investigate unusual symptoms, to perform certain types of surgery or to carry out biopsies (removing a small sample of tissue for analysis).
Our proposal is that the pilot hub is developed alongside the planned community renal dialysis unit, identified as one of the ‘Big ticket Items’ by our ICS.
- What is the imaging pod at the RSH that I’ve heard about?
As part of our pilot project proposal, we have committed to an ‘early adopter’ imaging pod on the Royal Shrewsbury Hospital. This will be a standalone unit close to the Copthorne Building, which will provide elective diagnostics only, while urgent scanning continues inside the hospital. This pod will provide CT and MRI scans.
It will run for 12 hours a day and allow for the RSH to increase its capacity by up to 336 patients a week. The pod is already under construction and will open in August 2021. As further hubs are developed in due course, it could then be re-located away from the acute hospital site.
- How do I have my say on these proposals?
A programme of engagement is already under way to understand what our communities want to see from their diagnostic services. You can find the survey here:
We want to reach as wide an audience as possible, so encourage you to share this link with your own networks and on your own channels
You can also share our poster to help spread the word image Community Diagnostics Hub Survey Poster :
Thank you for your support.
If you still have questions about the Community Diagnostic Hubs programme, please speak to our system communications team in the first instance. They will be able to help you with your query or direct you to a member of the project team as relevant. Key contacts are: