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Our proposals
Access to rapid and expert diagnosis and needs assessment
Why it matters
Chronic conditions shouldn’t mean a chronic
wait for a diagnosis.Delays in receiving a diagnosis
can cause tremendous stress and anxiety for individuals
and can also mean delays in accessing services.
Tackling delays and ensuring that people’s
wider needs are assessed may improve clinical outcomes,
produce cost savings and provide a better quality
of life for people living with long-term conditions
as a day-to-day reality.
People with long-term conditions have changing needs
as their conditions and lives change. Reassessment
of an individual’s health and social care
needs is vital to make sure that people receive
the right care, medication is not wasted and interventions
are timely to prevent crises.
However, a diagnosis shouldn’t be the only
passport to services.We need to ensure that individuals
have their needs met even if their condition is
yet to be diagnosed.
Where next
We need greater investment in GP services, nurses
and other healthcare professionals with special
interests to develop assessment and diagnostic capacity
in GP surgeries, pharmacies and elsewhere. In addition,
individuals with long-term conditions should be
given direct access and the option of self-referral
to specialists, including GPs and nurses, where
this is agreed as part of the Care Plan.
While a medical diagnosis is important, this must
be one part of a more holistic assessment of an
individual’s needs.This means greater investment
and more incentives to develop multi-disciplinary
assessment and diagnostic teams,working in appropriate
local settings, with expertise in particular groups
of conditions.
We need to learn from existing good practice in
the NHS, particularly services that have established
a continuing relationship between the individual
and the healthcare professional, a right to reassessment,
and more flexible access routes to diagnosis and
reassessment.Working within national standards,
NHS organisations should have the freedom to establish
local agreements about how particular conditions
will be assessed and diagnosed, and how health professionals
can work in new ways to assess people’s needs
in the round.
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North Staffordshire Musculoskeletal Clinic
In North Staffordshire, a gap was identified
in services for people with musculoskeletal
problems. Concerns arose that there was inadequate
access to rapid diagnosis and appropriate
treatment for patients with conditions such
as spinal pain, osteoarthritis and chronic
widespread pain, who were often inappropriately
referred.
In response, the local trust redesigned its
services to really meet the needs of the local
community. A musculoskeletal department was
established involving a broad multi-disciplinary
team bringing together rheumatologists, orthopaedic
surgeons, GPs with special interests, specialist
nurses and physiotherapists.
A system of assessing patients for referrals
means that patients are now able to see the
most appropriate specialist for their condition
as a first point of contact. This system has
reduced waiting times and reduced the number
of patients being incorrectly referred to
surgeons when they have non-operative conditions.
Future plans in North Staffordshire include
extending the service into more accessible
settings within the local community.
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Tracey Fox
Tracey Fox remembers well the day she was
told she had multiple sclerosis.“The
diagnosis was a shock to the system, a frightening
thing”, says the 32-year-old mother
of two.
But, there are positive memories too. Alongside
Tracey’s neurologist was an MS-specialist
nurse, part of the multi-disciplinary MS team
at the Royal Hallamshire Hospital in Sheffield.
By the
time she left, Tracey knew she was not fighting
her MS alone but had the support of the complete
team of health professionals, providing nursing
care, physiotherapy, pain control and other
skills,working together.“It’s
wonderful to feel you’re not out there
on your own and to be dealing with real people,
real voices, real faces.”
Tracey also took part in a course to help
people recently diagnosed to understand more
about MS and living with the condition.“We
heard about the new MS drugs, about health
and fitness and many other things. It wasn’t
just getting information. It was meeting other
people in a similar situation to me.“
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