An independent report into the Community Diagnostic Centre programme has revealed that the scheme has been hampered by staff shortages, digital infrastucture, and choice of locations.
The All-Party Parliamentary Group (APPG) for Diagnostics’ report, “CDC’s Unveiled: Challenges and Triumphs”, released on Wednesday (24 January), has found only five million scans have been completed under the scheme since 2021, against a target of 17 million by next year.
According to the report, the relatively low number of scans was often attributed to the lack of workforce and issues around basic infrastructure and data sharing. The report added that locations are rarely “community-based,” and are often located on hospital estates.
Community Diagnostic Centres
CDCs are multi-diagnostic facilities created to improve local diagnostic capacity, enhance patient access, experience and outcomes, alleviate hospital burdens, and address regional disparities in healthcare by providing imaging services away from hospital sites.
As part of its inquiry into CDCs, the APPG for Diagnostics held two roundtables in June and July 2023 to investigate the current state and future of the programme.
The report found 174 CDC sites have been opened across the country. However, concerns about unequal geographic distribution and funding constraints for future expansion persisted.
It added while collaboration with the private sector has expanded services, high demand and limited capacity pose ongoing challenges, while a lack of data and research limits the assessment of the programme’s effectiveness in being “one-stop shops” for patients.
Most importantly, ongoing staff shortages, demonstrated by shortfall figures and reports of unmanageable workloads, compounded by insufficient workforce planning and funding, have limited CDC effectiveness.
The SoR perspective
The SoR is an active supporter of the All Party Parliamentary Group (APPG) for Diagnostics and welcomes the findings of this timely, independent report. The Society has supported the CDC concept since its proposal in Professor Sir Mike Richards’ report, “Diagnostics: Recovery and Renewal” in 2020.
Dean Rogers, SoR director of industrial strategy and member relations, said: “We have sought to engage positively with the programme at every available opportunity and continue to do so. Our experience in doing so informs our concerns about the programme roll out, which are echoed and amplified in the APPG report.
“We continue to believe that the community-centred model presents the right answers to increasing accessibility to early diagnosis in the community, away from acute settings. Sir Mike Richards’ Report presented a compelling argument why this was the right thing to do. It also set out clearly the additional investment needed for its successful strategic implementation.”
Expanding services
The model as proposed in the Richards’ report requires expansion for effective delivery, the SoR said. This includes delivery:
- In the right places, accessible to the community and away from acute settings
- Using the right modern equipment
- Supported by the right systems and digital connectivity to maximise the efficiencies presented by modern reporting systems
- Most critically, the right numbers of staff, with the right skills mix
The Richards' report recommended the successful implementation of its recomendations would also be reliant upon:
- 2,000 additional radiologists
- 4,000 additional radiographers
- A 50 per cent increase in the number of advanced practice radiographers who could undertake reporting
- An expansion of the assistant practitioner role
- Additional support staff and other “navigational” roles
Mr. Rogers said: “The SoR has been raising exactly these concerns throughout the roll out of the project. There is now a significant danger that this good idea will be sunk by political incompetence. The APPG should prompt an intervention to save the programme from itself.”
The project has been rolled out without any specific allocation of additional funds for increased staffing and/or training, with the exception of some funding to recruit 400 radiographers from abroad – one tenth of the number identified as being needed.
Mr. Rogers added: “It is as if the government has forgotten about the staff.”
‘Trying to press on without addressing the staff crisis is not safe’
SoR CEO Richard Evans, said: “Unless the staffing aspect of the Richards’ Report strategy is recognised, the CDC programme roll out will not meet its ambitions. Trying to press on without addressing the staff crisis is not safe. Sir Mike’s report contained a clear, costed strategic plan and a pathway for implementation that would and still could work if it is followed. Instead, it has been hijacked to make political capital.”
“In some ways, what is happening with the CDC roll out shines a light onto the wider problems in the NHS our members encounter every day. Great ideas and innovation are being undermined by a seeming determination to do things cheaply, in a hurry and without the necessary strategic oversight and accountability. As with the NHS as a whole, it’s not too late to save the CDC project but it requires policy makers to start listening to front line staff.
“Alongside unions and professional associations that champion NHS staff, there are many leaders across the NHS who have great skills, experience, knowledge and credibility. It is time for them to step up and speak up with us and challenge how programmes like the CDC roll out are allowed to be politicised. Ultimately it is patients that lose out and we need to protect services for all.”
The SoR warned in October 2023 that the government’s announcement that CDC programme is “ahead of schedule” failed to recognise the depth of the radiography workforce crisis.
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