Diagnostics HCS contribution to 7 days Ruth Thomsen Scientific Director NHSE London Region

80% of all diagnostics 1 billion tests a year 55 K workforce 52 different specialisms Screening–Diagnostics–Monitoring-Therapy-Rehab Equipment Safety Cost to NHS 10% of budget (£8 billion) Healthcare Science and Services

Audiology Autonomic Neurovascular Function Cardiac Physiology Clinical Perfusion Science Critical Care Science GI Physiology Neurophysiology Opthalmic and Vision Science Respiratory Physiology Urodynamic Science Vascular Science Clinical Physiology – 11

Over 300 different types 15 Million undertaken a Year Clinical Physiology Diagnostic Testing

Contact with a HCS for Hearing Loss Hearing problem –Screener (Baby 7/7) Blood tests – Pathology (GP) (7/7) Hearing tests - Audiologist (6/7) X-Ray/Scan – Imaging (7/7) Blood tests – Pathology(Specialist) (7/7) Auditory pathway test (ABR)– Audiology/Neuro (5/7) Inheritance – Genetics (5/7) Blood Pressure- Cardiology (7/7) Rehabilitation- Audiologist/Social care/Education (5/7) Monitoring- All of the above

Already Providing 7 days Pathology (Haematology, Biochemistry, Microbiology) Medical Physics Cardiac Physiology

HCS 7 day survey NHSIQ sept 2013 Key Findings Groupings Neurophysiology Medical Physics Cardiac Physiology Pathology Overall Responses (n) % who believe we should offer 7DS 80.0% 91.1% 92.3% 92.7% 86.3% % currently implementing7DS 24.0% 26.7% 37.5% 78.1% 43.9% % implementing as 'Full' 7DS 0.0% 2.3% 5.1% 17.0% 8.3% % who think should offer Level 2+ service 57.6% 52.2% 84.6% 86.2% 69.1% % who have consulted with 'Service Users' 34.8% 46.2% 25.8% 87.9% 53.9%

Barriers Barriers to implementation % Financial Constraints 84.6%88.4%76.9%82.8%75.7% % Recruitment Shortages 73.1%69.8%87.2%44.8%55.7% % Patients won't attend out of hours 15.4%20.9%10.3%6.9%14.4% % Inflexible Contracts 11.5%9.3%17.9%25.3%19.1% % Legislation 11.5%14.0%20.5%31.0%18.2% % Lack of Trained Staff 69.2%58.1%79.5%41.4%48.7% % Staff Rota Preferences 61.5%58.1%48.7%54.0%52.8%

Drivers % Access for Primary Care 7.7%0.0%15.4%9.6%6.2% % Financial Drivers 7.7%4.3%7.7%15.7%11.1% % Patient Choice & Experience 23.1%4.3%11.5%16.9%23.5% % Waiting Times & Elective Workload 69.2%34.8%26.9%24.1%25.7% % Urgent & Emergency Care 38.5%65.2%69.2%73.5%54.4% % Clinical Demand 38.5%39.1%53.8%79.5%63.7%

HCS and support for 7day services Prevention- Education, improve access Early Intervention- Timely diagnostics Acute care - Rapid diagnostics Recovery – hospital stay min. Follow up- Self management and monitoring Rehabilitation- Self support and peer support