This information is not collected centrally.
It is for local health communities to work together to decide the best setting to deliver diagnostic services for their patients. However, direct access to diagnostics from primary care can help with delivery of the 18 weeks target by improving the quality of referrals to secondary care by reducing the number of unnecessary referrals to secondary care outpatient clinics, and removing unnecessary steps from the patient pathway. A number of initiatives are underway to support direct access diagnostics.
The payment by results for 2008-09 contains a number of indicative tariffs to support unbundling of services, for example for imaging scans. Unbundling diagnostics provides incentives for primary care trusts to commission diagnostics via direct access prior to referral.
The 18 weeks team have been working with clinical colleagues to develop commissioning pathways to support commissioners in challenging existing practice and transform services. The pathways, developed in conjunction with clinical colleagues, are based on best practice and include direct access diagnostics where this is appropriate.