It has been more than 18 months since the first Coronavirus case was identified in the UK, and we are still coming to terms with the devasting impact it has had on many aspects of our lives, including access to healthcare.
This level of crisis management cannot be sustained, so we now need to look ahead to how services can be re-engineered, and digitisation accelerated, to combat the backlog and reduce forward pressure
Only now are we able to see a course through the hardship with the advancement of the vaccination programme, but the pandemic has left a lasting impression on the NHS, and we continue to see a bottleneck in diagnostic testing.
And the facts are pretty staggering.
There are currently more than five million people waiting for routine operations and procedures in England.
More than 10% of patients have waited a year or more for treatment, and, in March, around five million patients were waiting for surgery – the highest volume since records began.
All of this has been further evidenced by research from the British Medical Journal (BMJ), which estimates that between April 2020 and May 2021, there were 23.67 million fewer outpatient attendances, and 3.6 million fewer elective procedures.
These statistics are a stark reminder that we are facing a growing crisis with postponed or cancelled treatments; one that will only get worse the longer we are unable to address it.
The tenacity and commitment of healthcare workers has been inspirational during the pandemic. However, this level of crisis management cannot be sustained, so we now need to look ahead to how services can be re-engineered, and digitisation accelerated, to combat the backlog and reduce forward pressure.
While some trusts are taking localised steps to curb the curve, like Royal Devon and Exeter NHS Foundation Trust which bought its local Nightingale hospital to reduce surgery waiting times in the county; we need to consider whole-system and workflow changes if we want to enable longer-term improvements.
Creating unity in pathology and radiology
Pathology and radiology sit at the intersection of nearly all hospital episodes.
Most patients will have one or more laboratory or radiological test and most, if not all, clinical decisions about treatment rely on these diagnostic tests being carried out and reported quickly and efficiently.
We have the opportunity to create optimised, integrated networks in pathology and radiology that erode organisational boundaries, remove limitations in resource and create a single, integrated view of diagnostic tests, images, reports, and results to help streamline processes
This is why we feel there is a case for integrating diagnostic services to reduce the NHS backlog, specifically to quickly diagnose and enable rapid commencement of cancer treatment.
Despite sharing a common goal in medical diagnostics, these two departments, and even sub-departments, frequently operate in silos without the ability to easily connect or share data.
Often it is the prevalence of legacy clinical systems and processes that limits data capture and sharing, which negates the obvious benefits integrated care could offer across different departments, care providers, and disciplinary teams (MDT).
However, the increased adoption of digital solutions, especially during the pandemic, means we have the opportunity to create optimised, integrated networks in pathology and radiology that erode organisational boundaries, remove limitations in resource and create a single, integrated view of diagnostic tests, images, reports, and results to help streamline processes.
Added benefits include the enablement of home working and more-convenient, quicker access to specialists or secondary opinions.
By integrating data and systems across diagnostic services, we can reduce the time and expense spent on processes and provide clinicians with faster access to complete result sets, therefore speeding up clinical decisions and the commencement of treatment.
This also carries operational benefits such as easing the burden of administrative tasks including manual input or duplication to support the easy flow of information between team members.
Introducing new ways of working in the NHS can be daunting and complex, with the potential distraction of ‘downtime’ which may make organisations and their already stretched resources reticent to adopt change
Introducing new ways of working in the NHS can be daunting and complex, with the potential distraction of ‘downtime’ which may make organisations and their already stretched resources reticent to adopt change.
However, with an unprecedented backlog to address, digitisation and cross-organisational collaboration must be a priority.
The introduction of next-generation, enterprise-wide diagnostic information systems is the potential game changer.
It could offer immediate incremental benefits on the journey to fully-integrated services for the optimal use of resources and ultimately, the betterment of patient outcomes, and equality of treatment.