Video: the challenges of implementing community diagnostic centres and connecting clinicians

Our last HTN Now Focus event of the year included a live, interactive webcast from the team at Feedback, who are also the brains behind innovations such as Bleepa, an app which connects clinicians securely, and CareLocker, a patient-centric way of storing data.

The discussion panel was comprised of: Professor Rory Shaw, a former NHS medical director and Chair of Feedback PLC; Nick Mayhew, the company’s Commercial Director; and Stephen McAteer, Chief Operating Officer.

Among the many topics covered in the chat were the challenges for NHS services when setting up community diagnostic centres (CDCs), how to connect care providers and ensure that healthcare professionals have the right patient information at the right time, and the importance of sharing feedback.

The team also shared an overview of a pilot scheme that’s currently underway with the Sussex Integrated Care System (ICS), one of the UK’s first CDC sites, where Feedback is to put in place digital infrastructure to create a connected workflow that cuts across provider settings. The aim is that the pilot will ‘act as a blueprint’ for time saving and smoother patient journeys. 

“Our CDC education and learning programme, is really a programme around collating ideas, observations, thoughts, feedback around the whole CDC initiative…what we’re trying to do is to collate as many observations as we can, so we’re creating a library of ideas and thoughts,” Nick said to kick-off the talk, and asked the audience to submit questions to the team throughout.

Professor Rory Shaw then took to the virtual stage to discuss why the UK government’s CDC initiative – which will see the creation of over 100 ‘one-stop-shop’ community diagnostic centres to help tackle the elective care backlog in the NHS – is so important, and also addressed the challenges it might pose. 

“I spent my career as a consultant physician and academic, and for 15 years I was a clinical director of three different trusts…it’s very frustrating because there are so many little problems and we are so unable to deal with them. Everybody is trying their best but we still bump into the same sorts of blockages. When I left the service, one of the things that really got to me was that everyone was always waiting for something, and so I joined this company – Bleepa – because together we could bring out a solution which helps deal with that. Then we discovered this new initiative with the community diagnostic hubs and I thought it would be worth thinking about,” Professor Shaw said.

“We’re actually quite keen to hear from you, so if you have any ideas – just ask a question – because we are looking for feedback. We think we have a technical solution to solve problems but we need a sounding board. I’m a clinician and you need people to tell you what you’re doing, you need advice from the frontline, as you can’t go off and have some plucky idea. We need feedback – it’s even in the title of the company.”

Offering a macro view of the elective care backlog situation, Professor Shaw added: “It’s so difficult to do things quickly and efficiently. How can we do that? Everyone is doing their bit. It’s something to do with how the bits of the service interlock, which often causes friction and slows things down…you want to bring in the expertise by involving specialists but, actually, the more people you bring in, the slower the process becomes because there’s always someone who is not quite available.”

On the plan for government funding and one-stop-shop CDCs, he added: “It’s a great plan…[but] you need some good, underpinning IT and data transfer systems, in order to make all this work, and systems that can monitor that and know what’s going on.

“It’s all about data management. This whole thing works if the data management is effective. If it’s not, all sorts of things will get lost. That’s why we’ve become interested in trying to help. Essentially, it started as a messaging system between clinicians and now it’s moved to the ability to actually be at the centre…and be the thing that moves the data into the right place, allows people to communicate and know what’s going on, and allows us to escape from the constraints of geography and time – both of which create inefficiency. That’s our view and we want to bounce that off you and see how you feel,” he said.

Nick jumped back into the presentation at that point to explain, “We ran a very interesting roundtable discussion with a number of people involved in the CDCs in London…we think there are about 40 functioning CDCs, predominantly being delivered out of acute settings or remote provision.

“Every CDC is going to be different…but how are we going to deliver? How are we going to communicate with each other? And what’s going to be the governance and guidance around that?”, he asked, running through some of the feedback and concerns about CDCs going forward, and highlighting the need for digital integration and changes to the current ways of working.

“Bleepa is a mobile-based communication tool that allows you to see clinical grade imaging…on a mobile phone, tablet or laptop. It allows you to annotate against the particular part of that image and share that image with a cohort of clinicians. That facilitates really quick, expedient dialogue amongst those clinicians, wherever they are,” Nick noted, mentioning the importance of clinicians being able to reply when it’s convenient for them and the ‘zero footprint’ aspect, which means images are stored on the system rather than individual phones.

“We very much see it as that glue that sits in the middle between care settings and facilitates that communication amongst all those multiple care settings…we’ve [also] just developed a new package called CareLocker, which takes all that information and makes that available. It’s stored on a patient-centric cloud and it’s downloadable by whoever wants that information and has that authority [to take it],” he added, before handing over to Stephen, who provided a use case from Sussex ICS.

Stephen stated: “The community diagnostic centres have a lot of potential in terms of really dealing with the elective care backlog and taking non-acute illness away from hospitals and applying it in a different way.

“The reality though is, unless things are done differently, how CDCs function and the success of what they bring to the system, is going to be very much dependent upon not just doing tests but organising those tests and improving pathways and communication.”

On the partnership with Sussex, Stephen explained the focus was on the breathlessness pathway and went on to detail how Bleepa would be used to support care delivery, “With this proof of concept, the plan is to roll-out to other pathways and really continue to build…the centre of this is always the patient. But critical to the patient is that there needs to be significant clinical input and guidance, in the development of the pathway and participation within it.”

“For the first time, what we’re trying to do is create an integrated care record which is patient-specific and pathway-specific, to facilitate communication between the referring clinician – in this case the GP – and a multi-disciplinary team (MDT).”

“Bleepa really sits at the heart of that,” Stephen went on to add, “as the means by which the information around the patient, to inform decision making and support the necessary communication and care planning, sits centrally.”

“It really has the potential to be a bi-directional conversation between the MDTs and the clinician…this clearly has many benefits in terms of access…it often creates a central repository or record about that care and care plan, which can also be fed back to the group and centrally, [and] onwards to a referring partner, ” he added, “it is the enabler, it is the means by which this critical information can be pulled together in a mobile, flexible app.”

The outcome of the presentation and discussion is expected to feed into ongoing learning, so Feedback welcomes viewers to share their thoughts and observations, and to direct any questions to or

Catch up on the full session, and the subsequent audience Q&A, below: