Research by the Alliance for Heart Failure has revealed that the majority of Community Diagnostic Centres (CDCs) in England are not delivering NT-proBNP blood tests, a crucial diagnostic for heart failure. Last September, Freedom of Information requests were sent to 213 Trusts with 146 responses received. Only six NHS Trusts responded saying they provided access to NT-proBNP testing in CDCs, with the majority reporting that either they didn’t provide access or did not hold the relevant data.
A previous FOI request was sent to 42 ICBs. Of the 37 responses received, just four indicated that they were operating CDCs with access to the test.
Guidance published by NHS England last year stated that these Community Diagnostic Centres must provide NT-proBNP testing as part of their “minimum core tests for a standard CDC”. However, with the programme now in its fourth year, a majority of these centres do not appear to be following this guidance.
The research also found that CDCs offering NT-proBNP are mainly located on hospital based sites, with access to testing community-based settings limited. Cheshire and Merseyside NHS Trust provides NT-proBNP testing across 10 CDC sites, including one at Runcorn shopping centre.
A significant number of respondents from both the ICB and trust data did not have the relevant information, suggesting a lack of clarity around the accountable body for CDC operations.
Some CDCs that do not offer NT-proBNP testing cited that strategic and pathway planning - particularly for their breathlessness pathway - is ongoing, with the possibility of incorporating CDC testing into these plans.
Eight Trusts reported they were currently developing plans for their CDCs in their footprint that will go live in 2025.
According to the British Society for Heart Failure there are an estimated 400,000 people living with undiagnosed heart failure in the UK, with the cases set to nearly double by 2040.
Late diagnosis of the condition continues to be a problem across the NHS, with 80% of diagnoses made in emergency departments despite 40% of those cases having had symptoms that could have triggered an earlier assessment.
Preeti Minhas, co-chair of the Alliance for Heart Failure, said: “The growing burden of heart failure is now a health emergency, with hundreds of thousands of patients at risk of ending up in hospital and dying prematurely because they do not have timely and equitable access to important diagnostic interventions.
“Community Diagnostic Centres are intended to be a pivotal part of the government’s strategy to transform the NHS. Yet heart failure is being overlooked in these plans - with a worryingly large number of these centres not offering NT-proBNP testing to patients despite being required to do so.
“Expanding access to these essential tests in CDCs - alongside proper resourcing across the diagnostic and treatment pathway - can help relieve pressure on hospitals, reduce the financial and human cost of late diagnosis, and, most importantly, save lives.”
