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1 Lower Marsh
London
SE1 7NT
Email: moira.mcgrath@nhs.net
Telephone: 0203 049 4481
April 14th 2014
Dear GP Practice
Re: Important information regarding the InHealth Diagnostic Contract.
You will have received a letter on 31st March highlighting that the InHealth diagnostic contract was being
discontinued with the exception of Audiology tests which are commissioned through a separate contract.
I would like to apologise for the late notice given regarding the change in contract. We were unable to inform
practices sooner due to clarification being sought on some financially sensitive information and the potential
implications for InHealth staff from the proposed change.
This letter gives further information on the management of patients who require diagnostics and how InHealth
will manage patients recently referred into the service.
Rationale for service change
As of 1st April 2014, the InHealth contract moved from a London wide contract to one managed by the
individual CCGs. Lambeth CCG had conducted a review of the InHealth service which identified that
- InHealth activity had been falling and within 2013/14 was at half the level contracted for Lambeth
- The largest area of activity hearing tests will remain as this was commissioned through Any Qualified
Provider (AQP) and this contract is continuing
- There had been reports from some GPs that some secondary care clinicians were requesting a repeat of
the diagnostics tests completed by InHealth and this was leading to a duplication of tests and a waste of
resources
- The second largest area of activity is MRIs. Our developed model is that Musculoskeletal (MSK) MRI
should be commissioned via our musculoskeletal pathway. This involves clinical assessment via a multidisciplinary team. This service is currently being tendered and has recently been advertised on
Supply2Health. In the meantime patients could be referred to acute trusts for MSK MRI until this pathway
is up and running
- The other main area of activity within the contract was ultrasound tests. This is available through direct
access from acute trusts and Clapham community ultrasound service (for gynaecology ultrasounds).
Our commissioning approach going forward is to commission against pathways of care rather than diagnostics
as a single intervention. The decision to discontinue diagnostics from InHealth was agreed by the Governing
Body in July 2013 following a detailed discussion due to the rationale outlined above.
Audiology Tests
Please continue to refer to In Health for Audiology tests
CCG Chair: Dr Adrian McLachlan
Chief Officer: Andrew Eyres
Management of New Patients Requiring Diagnostics
The direct access diagnostics tests previously provided by InHealth are listed below. We have advised where
patients can now be sent for these tests
 Ultrasound - GSTT, KCH, St Georges and Clapham Community Ultrasound service
 MRI – GSTT, St Georges (spine, knees and middle ear)
 24 hour ECG – KCH, GSTT, St Georges
 Echo – KCH, St Georges, GSTT
 24 hour BP monitoring – KCH, GSTT, St Georges and locality schemes
 DEXA scans – KCH, GSTT - within metabolic bone pathway
 ECG – KCH, GSTT, St Georges, Gracefield Gardens
Referral forms to the majority of the above services are available on the GP practice portal on the Lambeth
CCG website. As part of our work on improving appropriate referrals and supporting practices with the referral
process, we will be working with acute trust colleagues to move referral forms from paper to electronic formats.
In health management of patients currently within referral pathway
1) Patients referred into the service awaiting a diagnostic test will be appointed within the next 2 weeks
2) Appointments will occur over the next 4 weeks with all reports being completed and sent to referrers by
30th April
If you have any further queries regarding this, please contact Bisi Aiyeleso on 0203 049 4322.
Please ensure that this important message is copied to all practice staff, including locums.
Yours faithfully,
Moira McGrath
Director of Care Pathway Commissioning
Lambeth Clinical Commissioning Group
Cc Dr Adrian McLachlan
Dr John Balazs
Dr Hasnain Abbasi
CCG Chair: Dr Adrian McLachlan
Chief Officer: Andrew Eyres