Abstract

Introduction
Quicker access to a respiratory diagnostic hub (RDH) was needed within a London PCN; 8 practices serving approximately 48,000 patients. There was a delay in setting up a local diagnostic hub due to Covid, which meant that patients had to be referred outside the geographical area, resulting in increased waiting times, inconvenience for patients and delays in diagnosis and treatment.

Methods
A local RDH was set up and funding obtained to update current ARTP clinicians to deliver the service. Equipment was checked, guidelines reviewed, and SOPs written.
The service was piloted in July 2023, led by a clinical pharmacist and supported by another for referrals, screening and booking.
Two survey tools were designed to evaluate the pharmacist-led RDH: patient and clinician perceptions. Ethics was obtained via Kingston University Ethics Committee. The surveys were distributed digitally and as paper copies to patients, and via email to clinicians over a month (February 2024).

Results
25 patient responses and 16 clinician responses were received. 92% (n=23) of patients strongly agreed or agreed that the overall test appointment was positive, they felt listened to, and the staff conducting the test were knowledgeable and professional. One patient suggested clearer pre-appointment instructions.
Ten clinicians had referred patients into the RDH. All who had referred and received results strongly agreed/agreed they were satisfied with the interpretation, reporting, establishing diagnosis and initiation of treatment. 90% (n=9) strongly agreed/agreed they were satisfied with the service overall.
Qualitative comments/suggestions for improvement from clinicians include to expand capacity, to train additional staff, and questioned the need of CXR as a pre-requisite.

Conclusion
The majority of patients and clinicians were satisfied with the pharmacist-led RDH. Feedback from surveys has resulted in further staff being trained, with audits carried out by a respiratory consultant, and the learning being shared with other PCNs.