The vast majority of GPs are persuaded of the benefits of moving diagnostic services from the hospital to the community, according to a new survey of 200 GPs in the UK. Just 4% of would choose the hospital as the preferred location of testing, compared to 46% for the GP surgery, 18% for a community hub, 15% for a patient’s home and 12% for the pharmacy.
As GPs get behind the latest in diagnostic technology, we can expect to see patient care continuing to shift from hospitals to community settings in the coming year. GPs and pharmacists can now get a range of lab-quality tests on one compact platform that weighs just over a kilogram. With results in minutes, the technology enables a patient to be assessed, tested, and treated in the first clinical contact. Portable point-of-care test kits can even be brought into nursing homes and patients’ own homes, to enable timely treatment of the frail and critically ill, where the risk of infection is lower.
Reducing carbon emissions
Most GPs perceive improved quality of care to be the top benefit of point of care diagnostics, while others point to the rapid results, enhancement of clinical decision making and fewer escalations to secondary care. Perhaps surprisingly, given all the immediate pressures in primary care, 84% of clinicians advocate point of testing as a means to cut carbon emissions.
Bringing diagnostics away from the hospital and into the community cuts the road travel that “Delivering a ‘Net Zero’ National Health Service” estimates accounts for 14% of NHS emissions. Of the four approaches to reducing carbon emissions named in the report, the new technology would enable the NHS to achieve three: bringing care closer to home, faster diagnosis and reduced interventions.
Reducing unnecessary journeys is essential if the NHS is to achieve its goal of becoming the world’s first net zero health service. Rapid point of care diagnostics mean that patients no longer have to make three trips: first to a clinical appointment, then to a blood test and back to the clinician once the test results are back from the lab. By facilitating a fast track to treatment, the technology ensures a more efficient health service, a better outcome for the patient and a greener future for the planet.
The economic case for point of care diagnostics
While the vast majority of GPs recognise the advantages of point of care diagnostics, it is understandable, given the financial constraints across the NHS, that many of them are reluctant to invest in it. I would encourage them to consider the significant cost of repeat appointments they could avoid by making a rapid diagnosis in the first consultation. In my own experience as a GP, I would sometimes see a patient four or five times before reaching a diagnosis that I could have arrived at within minutes using the technology that is now available.
Early adopters of point-of-care diagnostics are telling us that they are effective and efficient for their GP practices. The cost savings for the NHS, as a whole, are even greater. For example, there is estimated to be a million people in the UK who do not know that they have diabetes. Identifying at-risk individuals through an HbA1c test, will ensure that many more of these people receive the early intervention needed for them to avoid its debilitating complications. When you consider that about 10% of the NHS budget goes into caring for people with diabetes, and 80% of that goes towards dealing with its complications, the economic case for easy-to-access diagnostics becomes clear.
For point of care testing to be made available as standard in primary and community care, the NHS needs to go further, faster on its pledges to deliver holistic patient care that is geared towards prevention. By investing in early diagnosis at the point of need, the NHS can dramatically improve cost efficiencies and move towards a truly preventative, integrated and carbon neutral future.
About the author
Dr Matt Fay is medical director at LumiraDX. Since becoming a GP in 1999, Dr Fay served as clinical chair and clinical director of Affinity Care PCN, a 27-partner “super-practice” providing care for over 64,000 in Bradford. He was on the NICE AF Guideline Development Group and NICE Quality Standard Advisory Committee and is currently clinical advisor to the AF Association, the Syncope Trust, and Arrhythmia Alliance. He is on the Expert Advisory Panel for the Stroke Association and on the faculty for Heart Valve Voice and is a Trustee of the AF Association and Thrombosis UK.
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