Overview

Delivering Quality and Value

World Class Commissioning demands that service provision in the modern NHS delivers both Quality and Value. The required efficiency savings for the Department of Health in 2010/11 will necessitate the commissioning of higher quality services at lower cost, calling for an innovative approach to service development and delivery.

Quality and Value are inextricably linked, since:

'Good quality care costs less than sub-optimal care as length of stay, admission rates and readmission rates are reduced.’
Institute for Innovation and Improvement. Focus on Heart Failure Jan 2009 

The Echotech service model combines the security of full governance found in an accredited clinical department with the financial gains of delivering leaner services within the community setting. This model has been continually refined since the company’s establishment in 2001.

Echotech depolys single Echo 'units', equipment and staff, across institutional boundaries and therefore allows resources to be shared between commissioning organisations.

Echotech employs an innovative strategy to deliver echocardiography in primary care, thereby providing the local, early and accurate diagnosis of cardiac abnormalities.

Echotech Delivering Quality

Echotech holds Departmental Accreditation from the British Society of Echocardiography (BSE). The award of this status in August 2008 followed a comprehensive assessment of Echotech’s clinical and operational processes.

'It means that they [Echotech] can tell others, just like those hospital departments that have gained accreditation, that they are offering an assured and assessed quality service.’
Dr Kevin Fox
President British Society of Echocardiography 2007-2008

The importance of BSE Departmental Accreditation is jointly recognised by the British Society of Heart Failure, the Heart Improvement Programme, the Primary Care Cardiovascular Society and the BSE in the publication Community Echocardiography for Heart Failure, where a consensus statement reads:

'Organisation of [community echocardiography] services should be based around a BSE accredited department.’
British Journal Cardiology 2004;11:399-402

Echotech has been a partner with the NHS in the delivery of cardiac ultrasound since 2001. Over this time, Echotech has developed a set of challenging quality targets which have been consistently exceeded. For example, more than 30% of all studies are reviewed on a weekly basis for peer review and quality assurance purposes. In addition, other measurable factors such as DNA rates are visible to management to enhance quality and maximise efficiency. Consequently, the Echotech Patient Management Centre demonstrates a DNA rate of less than 2%.  The national average DNA rate is 11%. All these criteria are reported in Echotech’s Quality Accounts which are readily available to commissioners and regulatory authorities.

Echotech are currently scanning up to 1800 NHS patients every month, across more than 30 commissioning bodies.  By comparison, an average DGH would expect to scan approximately 500 patients per month. Moreover Echotech has invested in an IT and organisational infrastructure to secure future growth of services without any loss of quality.

Echotech prides itself on employing cardiac physiologists, who are all individually accredited by the BSE. All staff undergo a programme of continued education and professional development through the process of Peer Review and company sponsored training and conference attendance. Additionally, staff are equipped with cutting edge technology to ensure the highest standards of reporting consistency and accuracy are maintained.

Echotech Delivering Value

In the 2008 NHS Next Stage Review, there is significant emphasis on the importance of rapid access to diagnostics closer to the patient’s home and also the need for services to develop and innovate.

The Echotech service model is that of a 'virtual’ department of clinicians, cardiac physiologists and support staff. This virtual department provides cardiac diagnostics in the primary care setting, and thus displays the innovative and efficient characteristics as required in the NHS Next Stage Review.

Delivery of high quality care in the community reduces the overall cost burden for managing heart failure, including a reduction in inappropriate secondary care attendances and the more efficient and appropriate use of specialist teams.

In 2009 Echotech commissioned a study to compare the Echotech (community echocardiography) care pathway to the more 'traditional’ pathways. Specifically, the cost of various Referral to Treatment (RTT) pathways were compared, for patients with suspected cardiac abnormalities.

The study demonstrates a cost saving of 61% for the Echotech pathway when compared to the cost of the traditional Outpatients route. As an additional benefit, the maximum waiting time for Echo is currently two weeks (Echotech Patient Management Centre), allowing the 18 week RTT target to be comfortably achieved.

Echotech Service Specification Overview

1. Community Echocardiography service provided by a BSE Accredited Clinical Department (only Independent Sector Provider to hold this distinction)

2. 'End to End’ service -  from patient booking and administration to real time (on line) access to reports and study images

3. Full adherence to Clinical Governance Framework (including clinical supervision, staff training / development and clinical audit)

4. Leading-edge technology allows delivery of Echotech service across full range of community based locations

e.g. Echotech has pioneered the use of Ultralinq, a web based image archiving system to (a) streamline the QA / peer review process and (b) make images easily available to secondary care physicians thus avoiding the need for re-scanning in the acute sector

5. Free of charge GP educational support (including community echo seminars and GP echo handbook)