The Patients Association has been working with Ramsay Health Care UK, and patients and carers in England, to understand how patient experience of diagnostic services can be improved.

Diagnostic services provide or carry out tests to identify a patient’s disease or condition. They include X-rays, magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, ultrasounds, and mammograms. The results of these tests can help a doctor to give an accurate diagnosis and agree a treatment plan in partnership with the patient.

Earlier this year we ran an online focus group with 10 patients and carers who have experience of using NHS and private diagnostic services. We asked about their experiences and how their journey through diagnostic services could be improved. None of the participants had used Ramsay Health Care UK’s services.

Our findings

We found that patients and carers value diagnostic services highly, and they play an important role in the patient journey. Timely access to diagnostic services can speed up diagnosis and treatment, reduce health anxieties, and are highly valued by patients.

Variation in patient experience

Patient experience varies in both the NHS and private sector. Some of the factors that can influence a good or bad experience include:

• The accessibility of the hospital/mobile unit
• The attitudes and behaviour of staff 
• The quality of the facilities
• The availability of parking
• The accessibility and convenience of booking systems
• Information resources and correspondence which is written in accessible language for patients.

Variation in patient choice

We heard that choice of where to have a diagnostic test or scan varies. Patients who used private diagnostic services with private medical insurance or paid for it themselves they had been able to choose providers and had a choice of appointments. Patients who used NHS services or who had tests at private healthcare providers as NHS patients reported not being given a choice of providers. The exception to this was if the person lived in an area with a lot of well-resourced hospitals.

“It’s extraordinary the choice I have locally when that is not replicated across the country.”

Further barriers that can impact patient choice include:

• Difficulty getting a GP appointment
• Reluctance of GP to refer
• Living in a deprived area with poor access to services
• Having disability access requirements
• Requiring access and facilities for carers and families.

Health inequalities, such as having a disability or living in a deprived area, further limits the choice available to patients.

“If you come from a very deprived area [it’s a very different experience]. Cost of living and everything doesn’t help ... not everyone can afford to pay privately.”

Patient partnership 

Having a diagnostic test or scan can be a daunting experience. A person-centred approach is, therefore, needed to ensure patients are informed and have access to the facilities and support they need when choosing and using diagnostic services.

There is not one single factor that influences patient experience or choice of diagnostic provider.  Patients’ choice and subsequent experiences depend on need and preference, and may be influenced many overlapping and interconnected factors including: 

• Booking systems that match patient needs
• Comfortable, accessible and appropriate facilities
• Disability access Facilities for carers and family members
• Patient friendly information before, during and after appointments
• Good parking
• Friendly and caring staff
• A patient-centred approach during the appointment
• Availability and transparency about waiting times
• The cost of the test or scan (if paying privately)
• Transparency about the cost of the test or scan (if paying privately).

It’s therefore essential that providers of local diagnostic services work in partnership with patients and carers to design and deliver services that best meet their needs.

“If you feel looked after as a person then you'll go home smiling.”

Joined up working

Joined up and integrated working between GPs, consultants and diagnostic services is important to ensure timely referrals and results, and the sharing of test results. This includes improving the relationship between private diagnostic providers and the NHS since patients may use both systems either as an NHS funded or self-funded patient to receive their test or scan.

What will happen next

We have provided a report of the focus group’s findings and recommendations to Ramsay Health Care UK. This will inform how Ramsay Health Care UK continues to improve its diagnostic services at sites across the country.

The findings from the focus group echo the results from our recent survey of more than 1,000 NHS patients on diagnostic testing services. Read the Patient Experience of Diagnostic report.

We will continue our work to ensure that everyone can access and benefit from the health and care services they need to live well. Our Chief Executive Rachel Power spoke to Professor Bola Owolabi, Director of the National Healthcare Inequalities Improvement Programme at NHS England about tackling health inequalities as part of our Patient Partnership week. You can watch the recording of Mobilising the system to tackle health inequalities with Bola and Rachel.