Community Diagnostic Hubs (CDHs) are a new NHS initiative aimed at building diagnostic capacity in England and relieving pressure on hospitals in relation to diagnostic testing. They are to be multi-diagnostic facilities, separate from acute hospitals and placed in local communities. As part of the regional planning process, NHS England and Improvement in London commissioned us to explore patient, public and staff expectations, must dos and red lines in relation to the implementation of CDHs in London.

Our engagement involved 40 Londoners and 30 diagnostic staff across two phases:

• Phase 1: participants were asked for their current views on diagnostic services in London and their feelings about potential new ways of accessing diagnostic services.
• Phase 2: brought together a smaller cohort from Phase 1 across public/patients, diagnostics staff and advocates to co-design principles for the roll-out of CDHs.

Alongside this we also carried out 15 depth interviews with members of, and advocates for, patient groups that may experience additional barriers to accessing and using services. 

Through using the patient journey as a structure (from booking an appointment to the results) participants were able to come up with design principles. These principles were then stress-tested using clinical expert feedback and fictional personas, which encouraged participants to root their discussions in a real-life context. The result was a set of feasible and inclusive principles, which are currently informing local design at ICS level.