Summary
The plans to establish a hub, based at Sheppey Community Hospital (SCH) and a spoke, based at Rochester Healthy Living Centre (RHLC) are proceeding. The provision of imaging, physiological measurement and pathology tests and scans at these sites, over the next three years will deliver significant additional diagnostic capacity in the system, which will help to support COVID-19 recovery plans as well as future growth. Increased diagnostic provision in the community will utilise existing NHS estate and improve access particularly for communities facing the highest level of health inequalities.
Background
The Medway and Swale Community Diagnostic Centre (CDC) business case was agreed by the NHS England national team in September 2022.
The plan proposed establishing a hub and spoke model for the Medway and Swale area, with a Hub located in Sheppey Community Hospital and a Spoke planned for Rochester Healthy Living Centre. By redesigning the clinical pathways, CDCs will be expected to increase and optimise diagnostic capacity, improve efficiency and improve patient outcomes.
By supporting the Kent and Medway Imaging Network’s (KMIN) vision of a collaborative system led approach to diagnostic pathway development across Kent and Medway, CDCs will support local communities experiencing disparity and deprivation, by enabling care closer to home. The CDC will embed best practice with shared system wide learning, enabling accessible and sustainable care for the local population.
The development of CDCs will further support the recovery of elective and diagnostic services that were impacted during the pandemic, which will in turn reduce waiting times and diagnostic backlogs. There will no reduction in activity at the acute hospital site, the CDC will provide additional activity to support both recovery of services and unmet demand. Current diagnostic provision in Medway and Swale is largely provided by Medway NHS Foundation Trust (MFT) on the acute hospital site. Due to the impact of COVID-19, however, there has been a shortfall in diagnostic provision across the Medway and Swale health system which is still significant. Over the last couple of years compliance with national standards and diagnostic waiting times at MFT have fluctuated considerably due to the COVID-19 pandemic.
The Challenge
The following information taken from the Medway and Swale H&CP profile and Swale’s Dominant strategy, demonstrates wider determinants of health inequalities and poor health outcomes.
- The rate of adults (aged 18+) classified as overweight or obese in Medway and Swale is worse (70%) than England (63%).
- The percentage of physically inactive adults in Medway and Swale is worse (25%) than England (23%).
- Deaths from all cancers in Medway and Swale under 75 years is worse than England. Although rates for screening in Medway and Swale appear to be in line with England, there are still areas with low take up for cancer screening i.e., Medway Central.
- For every mile travelled between Sittingbourne (Woodstock Ward) and Sheppey (Sheppey West Ward), the life expectancy reduces by 255 days. This results in 8.3 years difference in life expectancy between the two areas.
- In some schools, 90% of students are leaving without sufficient Level 3 skills (grade 5 or above in English and Maths GCSEs).
- By 2038, 25.3% of homes in Swale will require an adaption to deal with health and care demand.
The Solution
The proposal to establish a two-site hub and spoke model will provide more equitable access to diagnostic services across a wider area and will reduce travel time for patients.
The two-site hub and spoke model will offer a central hub providing a full range of co-ordinated services for patients that require multiple diagnostic testing, with the spoke offering additional capacity, similar to the hub to meet the needs and requirements of the local population.
Project plan
- Building works to reconfigure internal space identified for a static MRI scanner (167sqft incorporating the café area, records room and part of the courtyard).
- Additional build costs for the CT mobile unit for Rochester site will be required. This will be an externally located CT scanner.
- Power upgrade to accommodate the modular CT scanner.
- Provision of physiological measurement services within existing clinical rooms (currently identified as void space or bookable rooms to be converted to CDC use).
- Rooms will require reconfiguration to incorporate extract ventilation and cooling.
Early engagement, with Medway Estates (LIFTCo), Community Health Partnerships (CHP), as the head tenant for the site, Medway Foundation Trust as the CDC host and the ICB enabled CHP to undertake a feasibility study to deliver the CDC. The feasibility study has concluded.
The team are now in the detailed design phase and the planning application will be submitted shortly with the project likely to complete in early 2024.
It has been great to work with colleagues from Community Health Partnerships (CHP) throughout the early stages of the CDC development at Rochester Healthy Living Centre. The team have been responsive and have worked collaboratively with us and partners through the initial design phases. We look forward to continuing the excellent working relationship developed with CHP colleagues, through to completion of the CDC development. We would welcome the opportunity to work with CHP in the future.
Find out more about delivering a Community Diagnostic Centre in an existing core asset.
Contact the CHP CDC team.
