Going Digital with Diagnostics: Transforming back-Office Operations for Better Patient Care

19th March 2024

by Richard Higginbotham

In a recent webinar titled “Going Digital with Diagnostics,” we sat down with three NHS Chief Information Officers (CIOs) to illuminate the challenges, opportunities and the ground-breaking solution they developed in partnership with Netcall.

Alongside John Clarke (who, prior to joining Netcall, held several roles across the NHS, most recently CIO of University Hospitals, Leicester), we were joined by James Rawlinson (Director of Health Informatics at Rotherham NHS Foundation Trust) and Ian Hazel (Associate Director of ICT and Patient Records at Chesterfield Royal Hospital).

The diagnostic dilemma: A state of urgency 

90% of outpatient appointments require some form of diagnostic test, so any delay in these tests can lead to postponed treatments. This impacts patient outcomes. Against the backdrop of waiting lists of 7.6 million, diagnostic performance emerges as a critical concern.

The current reality paints a grim picture – demand is significantly outstripping supply. The national target for testing performance has not been met since February 2017 — in January 2023, only 69% of patients received tests within the recommended six-week timeframe, falling significantly short of the 99% target.

Beyond numbers: Understanding the imperative 

John Clarke emphasised that an appointment for radiology or a diagnostic test often serves as a patient’s first point of contact with a trust, setting the tone for their treatment journey. Despite the technological strides in clinical domains, the back-office operations, particularly in booking, have lagged behind. During the webinar, a poll revealed stark realities—staffing shortages plague 95% of NHS trusts, exacerbating both staff morale and patient experiences.

Poll results:

• We have sufficient capacity in the booking team and morale is great: 3%
• Our staffing levels are lower than needed: 25%
• Our staffing levels are lower than needed and it’s creating staffing retention issues: 21%
• Our staffing levels are lower than needed and it affects staff morale and patient experience: 50%

Pioneering change: The birth of the diagnostic booking application 

In response to these pressing challenges, Rotherham and Chesterfield started to look at their operations and challenged Netcall to assist them. This has culminated in the development of the Diagnostic Booking Application. James Rawlinson and Ian Hazel stressed the importance of building on the work they have already done in leveraging modern contact centre technology and their patient engagement portal – Patient Hub – to streamline processes and enable patients to take control of their appointment.

When viewed in this context, the state of the patient experience waiting for their radiology appointment was starkly different.

“Here in Rotherham, it could feel a bit like you went to the GP and they decided you needed a radiology appointment, they’d give you a slip of paper with a telephone number on it and say give them a call. Good luck getting through and good luck finding an appointment which is convenient for you.“

James Rawlinson

Director of Health Informatics, The Rotherham NHS Foundation Trust

“So, we’re trying to get through a massive volume of bookings in just normal business hours, which is always a problem. Most of us are at work during the day and that creates difficulty. I suppose that made it clear that a service that was as close to 24/7 as possible just made sense – with a digital solution you always have a way of booking or managing your appointment. That was a key driver for us.”

Ian Hazel

Associate Director of ICT and Patient Records, Chesterfield Royal Hospital

Navigating implementation: Challenges and triumphs  

The journey towards implementing the Diagnostic Booking Application started with taking up the challenge of hooking into the referrals sent directly from GPs.

John Clarke explained the process of engaging with the respective trusts’ Radiology Information System (RIS) providers, AGFA and Magentis. Both embraced the process, and this has laid the groundwork for a standardised, digital solution.

All agreed that doing the right thing at the right time, every time is critical for any digital roll-out. Testing is vital. It’s also been a staged roll-out, targeting the simplest modalities first – those that require the patient to prepare will still be handled by expert staff.

A digital solution has now been built and rolled out. The Diagnostic Booking Application:

• Automates the booking of radiology appointments, taking data directly from the RIS when a patient is referred
• Makes it easy for patients to choose the most appropriate appointment time – with less effort for the booking team
• Captures safety information from the patient and can provide reassuring information about the procedure in the run-up to their appointment.

Impact and promise

Since its rollout, the Diagnostic Booking Application has showcased promising outcomes. It is still early days, but there are fewer repeat calls and the team are responding to more calls, faster. Everything is clear and simple – meaning a better patient experience, fewer wasted appointments and less pressure on already stretched resources.

Looking ahead

A standardised connection to both AGFA and Magentis makes digitised and automated appointment booking for Radiology a reality.

Both Rotherham and Chesterfield have plans to roll out Diagnostic Booking across more modalities.  Chesterfield in particular sees an enormous opportunity in managing their Community Diagnostic Centres (CDCs).