The North Central London Integrated Care System’s (NCL ICS) Digital Diagnostics programme is revolutionising NHS healthcare services in Barnet, Camden, Enfield, Haringey and Islington, by looking at ways to improve the speed, accuracy and quality of diagnostics services (tests) that patients have.
These diagnostic services include imaging (like scans and x-rays), and pathology (how diseases are studied, such blood tests), carried out at both hospitals and our community diagnostic centres (knowns as CDCs at Finchley Memorial Hospital and Wood Green Shopping Centre that have opened since the COVID pandemic).
The Digital Diagnostics programme is a key part of the NHS Long Term Plan – a way of making the NHS fit for the future so that it can better cope with the increased demand and needs of a growing, ageing population.
The main aims of the national Digital Diagnostic programme
- Introduce digital technology to improve healthcare services, diagnoses, patient outcomes and file sharing across different parts of the NHS
- Make sure that the right people are involved in the programme, that patient voices are heard and that everyone is working in a joined-up way
- Ensure that NHS allocates enough resources to pay for new digital technology as it emerges
- Improve access to healthcare and improve outcomes, especially amongst people who face additional health needs because of who they are or where they live (e.g. people with disabilities, and/or living within deprived communities)
- Make it easier for everyone to access healthcare diagnostic services and including out of hours services
- Get the best value for money for the NHS and the taxpayer.
The benefits of the Digital Diagnostic programme
- Reduced waiting time to diagnostic tests
- Faster diagnosis time (due to above and better deployment of network resources as have interoperability)
- Better health outcomes (e.g earlier diagnosis of cancer and start of treatment leads to better health outcome)
- Reduction in stress related to waiting times
- Enhanced data accessibility to patients
The benefits of the Digital Diagnostic programme for NHS staff:
- Less administrative burden – such processes can be automated
- Enables more flexibility in the workforce (home reporting, sharing images, ability for shared reporting)
- Enhanced access to timely expertise and advice
- Live feeds into demand and capacity models to improve local planning
- Further advances in the availability and automation of diagnostics data to support population health management
The benefits of the Digital Diagnostic programme for wider healthcare services:
- Efficiencies – reduction in rejected referrals, utilise capacity across the system better
- Support in reducing population health inequalities
- Procurement savings through standing up a Network insourced image reporting model
- Data feeds from the system compatible and comparable with other ICSs
- Consistent ordering and reporting pathways
Imaging (like x-rays and other scans)
Like all other ICBs in England, north central London’s ICB is now introducing new technology that all the different healthcare providers and organisations within its Integrated Care System can use to share patient scans quickly and easily, which in turn will help speed up how quickly patients can get test results (and treatment, if needed).
GPs currently use many different systems and forms to refer patients for a scan at the different hospitals and test centres, often making the process longer and more complicated than it needs to be.
NHS services in north central London are working towards a single system for GPs to order patients scans from all four test centres. Other changes include using modern digital technology to make it quicker and easier for GPs to decide on and order the right scan for their patient, leading to more accurate and timely results.
Benefits for patients
- Faster access to imaging tests, results and reports
- Clearer information about and choice of provider for diagnostic examinations
- Improved access to specialist opinions
- Better patient experience of the diagnostic testing process
- Improved patient care, particularly cancer patients, by making appropriate integrated comparison.
Benefits for NHS staff
- Standardised requesting, image viewing and visibility of reports
- Ability to enhance the skills and workforce development of those working within NCL through facilitating accessible learning.
- Ability to deliver care in the most appropriate community or acute setting based on patient need.
- Flexible working with links to the NCL imaging academies for virtual learning.
Benefits for wider health services
- Quality standards imaging shared seamlessly
- Reduction in delays, cost and duplication created by incorrect referrals
- Easier and expedited access to timely specialist advice.
- Increased resilience when operating under crisis conditions
- Improving diagnostic access to geographic areas in NCL where health inequalities are greatest
Patients often had to deal with lots of paper forms and made several trips to GP surgeries and test centres before getting their results. Using old technology also meant it was more difficult to book, change or cancel a test appointment.
North Central London ICS is now introducing new systems to make it much easier for doctors and other health professionals to order tests, simpler for patients to choose, amend or cancel a test appointment, and much quicker for healthcare professionals to carry out the tests and send results back to the person who ordered them, usually a GP.
GPs and other health professionals who need to order a blood test for a patient in Barnet, Camden, Enfield, Haringey and Islington can now do this quickly and easily online, rather than completing paper forms that patients need to physically come and pick up to take to the test clinic.
Patients can use a new online system to choose from a range of different appointment times and locations, and can also easily change or cancel appointments, if needed, without needing to ring a busy helpline.
The new system also makes it much easier for phlebotomists to carry out the blood tests. When a patient arrives at the phlebotomy clinic they can often check in using a specially designed kiosk, saving time waiting at reception. The labels with patient details on that phlebotomists fix to the test tubes are now automatically printed off when a patient checks in to the clinic, saving them from manually completing sticky labels.
Once the tests have been carried out and the blood sample is sent off for analysis, new digital software systems that can easily interact with each other make the process of getting results back to the healthcare professional who ordered the test, and therefore back to the patient, much simpler and quicker.
These new systems will also make it much easier for doctors to share a patient’s results with their peers to get second opinions, obtain specialist advice from other healthcare professionals or share work between teams in busy periods. In the future this will also help the NHS make use of ground-breaking new technology like AI and machine learning.
Benefits for patients
- Testing available closer to home
- Improved turnaround times for results
- Easier access to second opinions and remote diagnosis
- Patient-centred governance, including patient safety and patient experience
- Reducing service risks (such as slides getting lost)
- Monitoring the safety of medicines.
Benefits for NHS staff
- Improved workflow and multi-disciplinary team decision making
- Remote diagnosis to support diagnostics
- Increased efficiency and capacity to cope with expansion of clinical services.
- Enabling automated tissue diagnosis to be incorporated into digital health risk prediction models
- Improved sharing of information for training and research.
Benefits for wider health services
- Improvements in consistency of reporting.
- Anticipated cost savings from reduction in retrieval and storage of glass slides.
- Research opportunities to better understand, diagnose and prognosticate disease.
- Supports the aims of OneLondon and the SoS technology vision Facilitating care across traditional borders e.g. ICS’.