Finchley Memorial Hospital (FMH) is an important existing NHS Local Improvement Finance Trust asset, with opportunities to improve efficiencies and utilisation, and explore creatively how to rapidly scale up provision of new diagnostics.
The site was identified as a preferred location for the new Community Diagnostic Centre (CDC) following a detailed analysis of local health (both access and outcomes), demand, current service backlog and system performance by partners from across the ICS. The estate analysis we produced helped identify FMH as a preferred CDC location. A key advantage of this property was its ability to deliver significant additional capacity, at pace and at an accessible location.
LIFTCo North London Estate Partnerships, worked closely with NCL and Community Health Partnerships (CHP), as the head tenant for the site, Royal Free as the CDC host and gbpartnerships consult to deliver the CDC project.
The CDC provides additional testing capacity at a community site which does not have the COVID-19 risks incumbent in Acute Hospital sites, nor the worry for some patients that attending those settings triggers. The CDC in FMH is one of two making up a coherent population health strategic approach to CDC placements in North Central London, the second being at Wood Green Shopping City.
The NCL project team is using this pilot to learn what patients want in terms of out of hours access and experience, to encourage greater understanding of convenience and choice factors.
The service aims to not only support elective recovery but also relieve pressure on acute sites by getting patients their diagnostic test results quickly – usually on the day of request instead of waiting up to 48 hours.
Virtual Tour of Finchley Memorial Hospital Community Diagnostic Centre
Key Challenges
- Communication to the public, and public understanding and trust.
- IT; understanding the extent of complexity of working across providers all with different systems.
- Lack of clinical cover availability to support contrast scanning
- Weekend working.
- Ambitious national timelines.
- Culture; finding a governance balance for people to feel accountable to both their ‘own’ organisations and the CDC.
- Communication across providers.
Learning Points
- To meet the expectations of both NHS England and NCL the programme needed leadership qualified and willing to take risks, make decisions and challenge providers to work differently.
- The rapid pace presented challenges but also encouraged buy-in from stakeholders and effective decision-making.
- Time spent working on good relationships between organisations at the CDC board fostered a collaborative and team-focused approach.
- Problem sharing is a strength and a firm basis for future CDC roll-out.
- System-wide approach to financial modelling.
- Sector capacity & demand modelling for the CDC.
- Value for Money (VFM) /Cost: avoid focussing solely on cost and look at wider VFM.
As of 25 December 2021, the FMH CDC had conducted a total of 12,486 diagnostic tests, split across 5 modalities. The CDC aims to deliver a further 31,919 tests by the end of March 2022, split across 8 types of diagnostics available.
It is expected that the CDC will help to support sector partners in managing upcoming winter pressures by providing a flexible green site resource that can be used by partners as needed.
It is too early to identify the positive impact on diagnostic waiting times and length of stay. We do know that demand is rising for cancer and emergencies. Clinicians have suggested that the additional CDC capacity has meant that patient access has been significantly improved.