Community Diagnostic Hubs - a patient centred pathway through the diagnostic journey

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Summary of report content

Community Diagnostic Hubs are intended to improve diagnostics across England. This study on what patients want from a local Community Diagnostic Hub (CDH) was carried out by Healthwatch Brighton and Hove from start to finish in just two weeks (1st -14th April 2021) in order to meet NHS England and NHS Improvement (NHSEI) deadlines. NHSEI are currently developing a model of how CDH’s should operate at a national level. They spoke to 21 people from communities whose voices are often less heard: people with Black, Asian and minority ethnic backgrounds, people from the gay, lesbian, bisexual and trans community, younger people (under 25), and those with complex clinical conditions.

Top of the list is good communications. This includes good interpersonal skills, clear information as regards the process and about their condition. Good communication needs to be an ongoing proactive process that keeps patients fully informed about what is happening to them, with whom, where, and in what timescale – and that meets their language preferences and needs.

People’s recent experience of diagnosis reveals less than satisfactory experiences, with people’s lives being on hold and “in limbo”. Whilst people did have some specifics related to their communities, their needs mostly related to been listened to, treated with dignity and their whole person being addressed. However, some people with language and cultural needs will need some additional sensitivities when arranging services, such as translators and awareness of religious needs, awareness of gender issues and the availability of sign language services.

The concept of a CDH was welcomed by people who took part in the research as a place where all tests could be carried out concurrently, but questions remain about where they would be, what services they would contain, and whether and how specialist advice could be on hand - and how they fitted in with ‘other’ services. People also mentioned wanting the option to go elsewhere if a CDH was, for instance, not an easy journey. Good public communications which define CDHs will be needed as they cannot be seen as the panacea for all diagnostics.

A number of people spoke about the role of the GP both at the beginning of the diagnostic process and afterwards - to support and explain the implications of a diagnosis and this crucial relationship must be addressed in any CDH model.

Lastly, people had some very good practical ideas as to how diagnostics could be improved from IT solutions to incorporating preventive services into CDH’s. Co-designing with users from their experiences will provide a better inclusive model for everyone.

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General details

Report title 
Community Diagnostic Hubs - a patient centred pathway through the diagnostic journey
Local Healthwatch 
Healthwatch Brighton And Hove
Date of publication 
Tuesday, 29 June, 2021
Date evidence capture began 
Thursday, 1 April, 2021
Date evidence capture finished 
Wednesday, 14 April, 2021
Key themes 
Communication between staff and patients
Engagement
Information providing
Integration of services
Interpreters
Quality of care
Service delivery organisation and staffing

Methodology and approach

Was the work undertaken at the request of another organisation? 
Yes
What type of organisation requested the work 
Other local body
Primary research method used 
Structured interview
Unstructured Interview
If an Enter and View methodology was applied, was the visit announced or unannounced? 
N/A

Details of health and care services included in the report

Primary care services 
Diagnostic and/or screening service - single handed sessional providers

Details of people who shared their views

Number of people who shared their views 
21
Age group 
1-15 years
16-17 years
18-24 years
Gender 
Transgender
Ethnicity 
Asian / Asian British
Black/ African / Caribbean / Black British
Specific ethnicity if known 
Gypsy or Irish Traveller
Sexual orientation 
Bisexual
Homosexual
Other population characteristics 
Refugees or asylum seekers
Does the information include public's views? 
Yes
Does the information include carer's, friend's or relative's views? 
Not known
Does the information include staff's views? 
No
What was the main sentiment of the people who shared their views? 
Neutral

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Yes
Does the information contain a response from a provider? 
Yes action has been taken or promised
Is there evidence of impact in the report? 
Yes
Is there evidence of impact external to the report? 
Not known
What type of impact was determined? 
Network related impact

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
 
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
 
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.