NHS South East London Integrated Care Board: Lambeth Borough of London

Community cardiology diagnostic services case study

Overview

The Borough of Lambeth undertook a review of its cardiology diagnostic services which highlighted a variation in patient access to local ECG and blood pressure monitoring (ABPM) services. This presented an opportunity to improve the consistency of testing across the borough. The report also found that while many GPs possess considerable skills in 12-lead ECG interpretation, unless accompanied by a report that describes clinically important findings, patient information presented in graphical form may be of limited value.

Approach

Xyla, part of Acacium Group, set up a network of community hubs to deliver a consultant-led GP direct-access
ECG and blood pressure service. This service was designed to provide GPs and referring clinicians with a primary
care network (PCN) led service, giving patients fast access to diagnostics and specialists in their local community.
Xyla supplied all equipment, infrastructure, staff, and expertise during service mobilisation to get the community hubs up and running across the borough.

Impact

We provided the operational, governance and quality management expertise, ensuring the day-to-day clinical service ran smoothly and capacity increased and decreased as the community hubs and referring clinicians required.

In a year, the service saw 6404 patients in the community from six community clinic bases. Month on month, the activity continued to grow alongside a huge reduction in did not attend (DNA) rates, from over 30% at the start of service to 7% last month. Lambeth patients now benefit from quick, direct access to critical
diagnostic tests in their local community, which has reduced waiting times for GPs, patients and the ICB. This has also reduced hospital visits to the main two secondary care centres in the Lambeth borough.

In addition, the team worked to very short KPIs, with 12 leads ECGs able to be offered within 48 hours for most referrals and within 20 days from test to report for all ambulatory tests. In some cases, we offered same-day
appointments, which meant same-day direct access from GP clinic to test, which benefits the patient, and the clinical pathway and reduces the requirement for multiple visits.

The following year saw a 45% activity increase which led the team to work with the ICB to enable testing for housebound patients, ensuring access is equitable for all patients within the Lambeth borough.