Agenda item

The Chief Operating Officer (COE), BHRUT, the Clinical Cancer Lead (CLL) and the Programme and Service Development Lead – Community Diagnostics (PSDL), presented a report on the progress of the new Community Diagnostics Centre (CDC) at Barking Community Hospital (BCH). 

As part of a national programme since the beginning of the pandemic, CDCs were to be introduced as a means to increase the capacity for patient investigations. By working with community providers for staff and facilities, alongside gaining funding to carry out the project, the development of this innovative service would work to reduce delays for patient services. Especially as a Borough which does not have an acute hospital to support its growing population would contribute to a 21% increase in demand for services, this would reduce deprivation levels overall, by contributing to the reduction of health inequalities in the Borough.

The PSDL highlighted the importance of engagement with the local population who supported the development of the CDC. Their suggestions were considered throughout the development and reflected the needs of service users in the Borough.

As a result of service user feedback, the BCH CDC would include:

·  Free parking for patients;

·  Calm pastel and pale colours throughout to make it more relaxing for all patients;

·  Floor to ceiling windows;

·  Ramps, lifts and accessible changing rooms run throughout, and all patient services available on ground floor;

·  Landscaped outdoor space;

·  Increasing ways to book appointments;

·  Staff to be trained on how to communicate with all patients; and

·  Continuous improvement of care and experience gathered through patient and staff survey before and after the CDC opens

With various facilities at the CDC, the PSDL explained that an extra 72,000 scans would be possible every year. Scanning equipment such as MRI, CT and ultrasound would be housed at the CDC alongside consultation rooms for a range of other tests. Early diagnoses for some cancer types would also be available as well as innovative tests such as cystosponge, colon capsules, transnasal endoscopy and a rapid asynchronous triage clinic for oral lesions. Included with this were public facilities for waiting and changing and hearing induction loops for patients with hearing impairments. Such advancements would also provide job opportunities amongst the local population, for example, where nursing staff would benefit from an expanded scope of practise when the CDC opened.

The progress of the CDC for 2024 was then outlined. Whilst the BCH CDC would open in Spring 2024, there would be ongoing engagement with stakeholders, patients and staff including site visits and a patient trial run in order to understand their first-hand experience at the centre. Furthermore, there would be collaboration with Healthwatch on accessible information standards training for staff to further improve patient care. The opening of a new CDC in St George’s (Hornchurch) embedded in the St George’s Health and Wellbeing Hub was proposed.

On a question regarding staff communication with patients of differing abilities, the PSDL explained that all staff would be trained to communicate effectively with patients to give them the best experience during their visits. The use of accessible information with posters, portable hearing booths for deaf patients and interpreting services would be available for patients who faced a language barrier due to not speaking English. A question following up on communication services was brought forward, regarding whether frontline staff were trained in interpreting skills or British Sign Language (BSL), for example. It was highlighted that external providers would provide services, for both BSL and telephone interpreting for referral patients with language barriers due to the short appointment times that the CDC would enable. A member suggested that staff demographic based on diversity and equality would be beneficial, not only for the staff but also as a cost-effective means for interpreting services for patients facing a language barrier.

In consideration of patients with learning disabilities, it was noted that one-and-a-half years ago, a system was put in place to identify such patients to ensure they received proper care in collaboration with the learning disabilities team as a means to reduce health inequalities.

In response to questions regarding the appointment booking system, specifically for groups such as the elderly who may be technologically excluded, the PSDL explained that various methods of communication were available for patient use; these included already existing e-referrals, a patient call service, email system and an online booking system which would be introduced in the future. It was recognised that in order to create connections and maximise engagement with patients, Do Not Attends (DNAs) were monitored frequently and a need to push for telephone communications to discuss appointments instead of automatic text messages was desirable.

The CLL was asked about the range of cancer diagnoses that were tested at the CDC, and whether these were inclusive of factors such as age, cancer type or gender.. The CLL outlined that breast, prostate and lung cancers were increasingly identified at Stage 1 and Stage 2 from patient screening services. Contributory to this was the targeted lung health checks within the Borough which promoted screening for a quicker diagnosis. The CDC enabled a secondary preventive measure which focused on the top five cancers in the Borough. The importance of world-class technology was indeed costly, however effective where the CDC could provide a cancer diagnosis within 7-10 days in comparison to the standard 28-day time frame. In relation to this, a Member asked why only some cancer types were detectable at the CDC. The CLL explained that some cancer types were commonly detectable at a later stage, such as pancreatic cancer, so the CDC as a means of early diagnosis was not applicable. On the other hand, blood cancer was diagnosed with blood tests, so patients would be diverted to haematology clinics at acute hospital sites. Other cancers would require sedation or other interventions which may not be facilitated at the CDC.

Further, the CDC’s proposed for an extra 72,000 scans per year was raised. In consideration of the pressure on staff, the COE suggested that selective staff would be recruited to deliver services, where a phased roll out of additional staff would improve efficiency for the CDC. Throughout the CDC, the COE and PDSL stressed the value of recruiting local staff to further develop the Borough. However, a question was then raised on the available staff training to meet the expectations of the increased capacity for services across old and new CDCs. The CLL highlighted that a radiology academy would be in place to improve training for junior staff; by encouraging staff to rotate between sites and use different facilities, these experiences helped to create better patient services as staff are well-developed on programmes which provide a breadth of insight into various departments. This would also help to generate a new workforce amongst the local population.

The Committee noted the report.

(Standing Order 7.1 (Chapter 3, Part 2 of the Council Constitution) was suspended at this juncture to enable the meeting to continue beyond the two-hour threshold).