Point of Care Testing within the Community Project

1. Point of Care Testing withinthe Community Project Acknowledgement to the following recipients for their collaboration & input: • Author/Project Lead – Finlay Love (Thames Valley Health Knowledge Team) • Pathology Clinical Reference Group • Oxford University Hospital NHS Trust • Heatherwood & Wexham Park Hospitals NHS Foundation Trust • Plymouth Hospitals Trust • Buckingham Healthcare NHS Trust • St Mary’s Hospital, Isle of Wight • University Hospital Southampton NHS Foundation Trust

2. Point of Care Testing withinthe community • Proliferation of POCT technology over the last 10 years • The global point-of-care (POC) diagnostics market reached $13.8 billion in 2011. It will further grow to $16.5 billion in 2016. • Large increase in tests available • Devices are becoming smaller, more portable and easier to use • Costs are reducing as competition in the market expands • Existing markets such as the USA and Australia are driving demand with new emerging markets in Asia and China

3. POCT within Secondary Care • Increased demand on laboratory services within the acute setting • GPs referring Patients to Hospitals for tests resulting in them having to travel • Follow up appointments at GP practice (weeks?) to find out results, despite pathology 24hr turn around • Little or no partnership with social services • Ever increasing admissions for elderly patients often from complications resulting from LTCs

4. POCT within Primary Care • Fragmented service delivered around POCT • Increased appointments for results follow up • Insufficient staff training in device usage • Little or no partnership with social services • Limited IM&T available to capture results • Little or no external accreditation within Quality Assurance & Governance

5. Secondary Care Business Model Index • Strong Executive Support • Clinically lead Point of Care Testing Team • Strong partnership with Trust IM&T • Pharmacy to advise & procure consumables • Large potential gains in joint procurement • Although voluntary, recommend CPA/ISO 22870-2006 accreditation within POCT • Staff training linked to CPA • POCT Board to oversee Governance within both Primary & Secondary care • Service Level Agreement to cover (A to H) C. IM&T A. Strong Executive Support D. Pharmacy I. SLA E. Procurement B. Trust POCT Team F. CPA ISO 22870-2006 Trust Quality Assurance H. Trust Governance within Primary & Secondary Care G. Staff & Training

6. Primary Care Business Model Index • POCT Board to oversee Governance within both Primary & Secondary care • CCG POCT lead to link with Trust POCT Board • Community Hospital(s) to follow POCT guidance & quality assurance • Multiple GP surgeries to share Community POCT centre via commissioning from CCG • Community Nursing to link in with community POCT centre • CCG POCT Community centre serving the patients within the community • Essential to link in with social services • Service Level agreement to Cover (B to G) A. Trust Governance for both primary & secondary care B. Pathology/POCT CCG Lead C. Community Hospital(s) D. GP Surgery D. GP Surgery D. GP Surgery H. SLA E. Community Nursing G. Local Authority/Social Services F. CCG POCT Community centre

7. Patient Benefits “Unity is strength... when there is teamwork and collaboration, wonderful things can be achieved”. Mattie Stepanek • Access to patient medical history • Linking to third party providers such as social services • Reducing hospital admissions • Treating patients within their homes • One stop care • Continuity of care with dedicated health team • Faster diagnosis & follow up • Reduced financial costs in travel & parking

8. Cost benefits within Primary & Secondary care • Joint procurement • Shared service across GP practices (reduced staff & equipment) • IM&T savings • Reduction in Hospital admissions • Reduced logistics costs • Savings in patient transport • Reduction in GP workload • Better prevention of complications arising with patients with LTCs

9. Abingdon Emergency Multidisciplinary Unit • Direct referral from GP Practices • One stop Health Centre • Heavily reliant on POCT • Integrated with Social Services • Provides Community Nursing • Provides Specialist Community Nursing • Provides short term admission • Has own patient transport • Average patient age 88