Agenda item

The Director of Strategy and Partnerships (DSP) and the Diagnostics Programme Director (DPD) at Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) delivered a presentation on the proposed diagnostic centre at Barking Community Hospital (BCH), which was part of a national NHS England-funded programme of diagnostic centre building, that would help to improve access to diagnostics to support the early diagnosis of disease. The presentation detailed that:

• The Community Diagnostic Centre (CDC) preparations were already underway, with a Computed Tomography (CT) scanner and Magnetic Resonance Imaging (MRI) scanner currently being built there.
• The construction of the larger building containing the majority of the diagnostic capacity had been subject to two recent public consultations, which had both reported very positive findings. The CDC was proposed to cost £15 million to build and would contain the full suite of diagnostic services (such as CTs, MRIs, X-rays, ultrasounds, physiological measurements and blood tests);
• The aim of the CDC was to enable residents to go to a ‘one stop shop’ for diagnostics before they were fully referred into secondary care, so that any issues could be determined.
• Over the next couple of years, it was planned to build one CDC in Barking, one in Mile End and a third in another location.
• The Barking CDC was proposed to open between October-December 2023.

The Cabinet Member (CM) for Adult Social Care and Health Integration stated that, whilst herself and other Council colleagues had lobbied hard for this very positive development, she wished to put on record her thanks that the system had listened to all concerns and taken action to address these.

In response to questions from Members, the DSP and DPD stated that:

• BHRUT had submitted a provisional business case to NHS England (NHSE). Whilst this did not specify every exact detail, it would provide BHRUT with the

£14.9 million for the construction of the building. NHSE had confirmed that it was satisfied with the provisional business case and had given BHRUT a formal letter of agreement to confirm that BHRUT could access this funding.

• NHSE had also committed to three years of revenue funding to pay for the staff to run the scans within the centre. Whilst this was the maximum length of funding that NHSE would currently provide, this was not to say that there would not be funding after this three-year period.
• The funding was entirely new money that was being given to the system from the NHSE pot of programme funding, that would not need to be repaid.
• Whilst BHRUT could not guarantee exact waiting times as part of this new CDC as it did not know how much demand would change and grow, the CDC would help to reduce the current backlog. The majority of access to the CDC would be through direct GP referrals, rather than through lengthier referral processes through GPs and then hospital consultants as previously.
• As the CDC would not be based in a hospital, the diagnostic services would be more sustainable and could be used for more elective appointments. Current hospital diagnostic services always had to prioritise emergencies, whereas the CDC would operate outside of the emergency hospital pathway.
• Workforce, and information and digital were the two challenges that BHRUT had with any of its investments into buildings across its services. Most recently, it had recruited a number of radiographers; however, it was also investing in a training academy for radiography and other diagnostic services. It was also working closely with other North East London (NEL) acute trusts such as Barts and the Homerton, to start to build workforce plans, so that it could have a more resilient workforce. This could include joint appointments and rotational posts across NEL, ensuring a sustainable and growing workforce, and that Barking and Dagenham and other areas of NEL could be as attractive to these professionals as inner London teaching hospitals.
• BHRUT had also secured an additional £250,000 from Health Education England in 2022, to support and improve its training academies.
• This was the start of further investment at BCH and other locations in the Borough. Discussions were being had around maximising BCH to better serve the local population, as well as how to best meet the needs of the population as it grew and changed, using data and local insights.
• The CDC was additional capacity and would not replace current capacity and services. In the long-term, the system would need to work collectively to consider where to best place its services, understanding the need to ensure that these were conveniently located for residents.
• Whilst mental health diagnostics were not part of the first stage of the CDC, BHRUT understood the importance of mental and physical health parity and wanted to work with partners within the place-based partnership to consider how to best treat patients holistically. One further benefit of the CDC was that it could be designed in such a way that was more pleasant for people with mental health problems, or conditions such as ASD (autism spectrum disorder), in a greater way than was possible in acute settings with blue light pathways, which could prove more traumatic for patients.
• Being representative of the local community was very important to BHRUT. It had a strong apprenticeship model, and strong outreach models into colleges and schools to build relationships with young people from an early age and demonstrate the range of NHS roles that were available. A new Chief of People officer would also be starting in November 2022, to ensure that BHRUT was creating an inclusive environment to attract a diverse workforce.
• The BCH would create around 100 extra permanent jobs across different grades and responsibilities. BHRUT was keen that people could build their career within the CDC, from an apprenticeship stage to senior-level careers.

The Integrated Care Director at NELFT also stated that there was no intention to move any of the mental health services out of BCH. As part of current transformation activity, NELFT was working more closely with its primary care networks (PCNs) and investing in equipment such as portable electrocardiogram (ECG) machines that enabled some diagnostic activity to take place in the community, such as in people’s homes and in GP practices, as NELFT was aware that issues, such as cardiac problems and obesity, were higher in patients with mental health issues.

In response to a question, the CM stated that there had been considerable patient and resident engagement to ascertain how residents wanted to experience services and how they wanted these to improve, with suggestions arising around garden areas and patients with multiple conditions being able to have one appointment to address all of their conditions. The DSP stated that there had also been visits to shopping centres and focus groups. Discussions were also being had with residents with additional needs, to ensure that all patients could be comfortable to visit the CDC, as well as have conveniently located and well-timed appointments.