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BIVDA and ABHI working jointly with NHS England to in using point of care tests in ARI hubs to support the delivery of a pilot which will benefit patients in the long term.

Context

NHS England is working with the ABHI and BIVDA to deliver a pilot that will use of point of care tests in acute respiratory infections (ARI) hubs to understand the extent to which they can support clinical decision making in the management of patients and:

Triage patients to the most appropriate care.
Enable antimicrobial stewardship.
Reduce hospital admissions and future attendances at ED.

This paper provides an update on the activity undertaken to deliver this pilot.

 

Recruiting ARI hubs

Hubs were invited to test patients for CRP using a point of care device. This was in addition to or separate from the inclusion of an LFD multiplex test that would, on behalf of the UKHSA, help to assess the effectiveness of these LFDs at rapidly detecting flu A and flu B in comparison to PCR tests.

NHS pressures, the high quantity of patients attending ARI hubs and the end of funding period for some hubs has led the pilot recruitment process to take longer than anticipated. However, there are now potentially 3 large hubs keen to participate and work is underway to link them with their relevant pathology networks.

 

The tests being used

The pilot committed to remain commercially neutral and to use overstock devices held by the UKHSA and NHS England.

Commercial neutrality is deemed critical to ensuring open procurement after the pilot. To this end the pilots:

Will not be able to specify which device they use.
Will not compare the devices for effectiveness and will focus on clinical decision making and patients’ outcomes blinded to which device is used.
Ensure results from the pilots are not specific to either device.

As there are no longer available overstock supplies of the iStat device, all hubs involved in the pilot will use the LumiraDx. The use of these tests from UKHSA enables nationally procured stock to achieve value for money.

 

The service evaluation

As ARI hubs have limited capacity to collect data the evaluation of the pilots will be qualitative, with ARI hubs completing a short survey for each patient during the consultation to enable results to be gathered throughout the pilot activity.

The survey will require ARI hubs to provide the following:

Key patient demographics.
The patient management they would pursue at first assessment of the patient.
The patient management they will pursue after using point of care tests.
The immediate outcomes for the patient.

The survey has been developed and is currently going through an information governance process.

 

Timescales

These will be provided once all hubs are onboarded.

Natalie Creaney