Symptom-based testing and digital pathway tools combatting delayed breathlessness diagnosis

A new collaboration between Leicester and Hinckley Community Diagnostic Centres (CDCs) and Lenus Health is seeking to digitally transform the breathlessness diagnostic pathway to enhance patient care and streamline healthcare delivery.

Breathlessness is a distressing symptom which affects around 10 per cent of the UK population. It is often notoriously complex to diagnose and can result in long delays to treatment for patients, with over 66 per cent of cases caused by underlying cardiorespiratory diseases.

The project will transform an existing symptom-based care pathway, using digital tools, to reduce delays to diagnosis. It will combine triage, parallel testing and a streamlined, integrated and structured approach to diagnosis data capture. By configuring the Lenus Diagnose pathway product, supplied by Lenus Health, the project aims to evidence significant reductions in time to diagnosis and treatment by bringing in remote specialist input earlier into decision making.

Jim McNair, Director, Lenus Health said: “Breathlessness diagnosis is complex and we are delighted to be working in partnership across Leicestershire healthcare providers to optimise activities and join up data to speed up diagnosis and time to treatment.

“This not only helps the patients themselves but reduces pressure at our hospital front doors because of undiagnosed and untreated disease.”

The project, led by Leicester, Leicestershire and Rutland Integrated Care Board, includes primary care, secondary care and academia to support its implementation. At the forefront of this initiative will be the utilisation of the existing Leicester CDC and the new Hinckley CDC when the latter becomes operational in early 2025, both of which are run by University Hospitals of Leicester NHS Trust. Patients’ test results will be integrated into the pathway aligning with the GP Direct Access guidelines.

Dr Louise Ryan, GP and clinical lead for respiratory illness at Leicester, Leicestershire and Rutland (LLR) ICB, said: “Breathing difficulties affect many patients in our local area and this initiative will help us, in many cases, to diagnose the underlying cause in GP practices, without having to refer patients to secondary care. This will speed up diagnosis for patients and means that they can be treated sooner, without having to visit a hospital.”

Dr Rachael Evans, respiratory Consultant Physician and clinical lead for the existing breathlessness LLR pathway at University Hospitals of Leicester NHS Trust, said: “Our research at University of Leicester shows delays to diagnosis are associated with worse patient outcomes and hospital admissions, and that earlier parallel testing can help. This project has the potential to improve the local situation by effective implementation of the diagnostic breathlessness pathway through the CDC and Lenus software enabling remote earlier specialist input where needed.”

To complement the CDC project, an InnovateUK funded AKT2i project between the University of Leicester and Lenus Health will support, among other activities, evidence generation of the benefits of different interventions.

Dr Gillian Doe, research programme manager and respiratory physiotherapist at the University of Leicester, concluded: “Our team is committed to research in improving the pathway to diagnosis and symptom management for individuals living with breathlessness. The Innovate UK and CDC funding will support the digital optimisation of the Breathlessness pathway in Leicester, Leicestershire and Rutland. We are excited to work in partnership with Lenus and NHS partners to deliver this project.”

The project builds on the Lenus Diagnose product successfully implemented in Heart Failure, wider CVD, and COPD pathways where it has significantly reduced time to diagnosis and treatment and delivered service efficiencies to the healthcare system.