Is activity on the increase over the last 5 years?

The NHS tracks the time in which patients have to wait for a diagnostic scan. This should be no more than 6 weeks from an initial consultant request. The NHS has a tolerance of 1% to achieve a 99% target, and this has, for the last 8 years, not been met! However, in April 2018 it was the worst it has been since May 2011, so what is happening?

Overall there was 1.8m diagnostic test performed in April 2018, which is 133k more than in April 2017. However, more surprisingly this is 344k more than 5 years ago, which shows what an increase in diagnostic imaging is having on the system. At nearly £1bn cost to the system and a 5-year activity increase of over 23%, surely this will have an impact on an already struggling pathway?

The top 5 diagnostics in terms of activity

The top 5 diagnostic imaging modalities across the NHS by activity, show an interesting mix. Below is a comparison between April 2018 and April 2013:

* Data sorted by April 2018 activity

Non-obstetric ultrasound has increased by of 15% and at present shows, the most substantial throughput, so does this now translate to the waiting list, is non-obstetric ultrasound, the highest?

The table above shows that with a waiting list increasing by over 51%, this is now a growing problem! With the same diagnostics being used in both lists, the questions to ask is; Can your technology either speed up the throughput or help reduce the need for so much diagnostic scanning?

It could be that in some cases the diagnostic is inconclusive, so more tests are needed before deciding on surgical intervention. Is diagnostic a way of slowing down surgery and keeping patients on a waiting list, under the ‘watchful wait’ approach?

If the throughput continues at this rate, will we find equipment needing replacement sooner? Does the NHS have a budget for new capital expenditure on this scale?

To summarise, we have an ever-increasing waiting list for diagnostics, and we are pushing more scans through the system than ever before. We have approached many new models of care within the NHS, like treatment centres, specialist centres and moving services from one NHS trust to another. Is it now time for us to look at specialist diagnostic centres and allow those facilities to be run with diagnostic solely in mind?

In my view, the time has come to relook at the diagnostic estate and better understand why such an increase has taken place. Health Analytical Solutions has the knowledge and scientific expertise to analyse complex real-world data; To show those pathways which have a high diagnostic to surgery ratio and plot which are contributing most.

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