What is Physiological Measurement?

1 82109-COI- Physiological Meas 2 2/5/07 16:07 Page ofciWhat is Physiological measurement ? A guide to the tests and procedures conducted by Physiological measurement diagnostic services 82109-COI- Physiological Meas 2 2/5/07 16:07 Page ifcii82109-COI- Physiological Meas 2 2/5/07 16:07 Page iWhat is Physiological measurement ? A guide to the tests and procedures conducted by Physiological measurement diagnostic services May 2007 82109-COI- Physiological Meas 2 2/5/07 16:07 Page iiDH INFORMATION READER BOX Policy HR/Workforce Management Planning Clinical Estates Performance IM & T Finance Partnership Working Document purpose For Information Gateway reference 6233 Title what is Physiological measurement ?

2 A guide to the tests and procedures conducted by Physiological measurement diagnostic services Author Department of Health Publication date May 2007 Target audience PCT CEs, NHS Trust CEs, SHA CEs, Care Trust CEs, Foundation Trust CEs, Medical Directors, Directors of PH, Directors of Nursing, Local Authority CEs, PCT PEC Chairs, NHS Trust Board Chairs, Special HA CEs, Directors of HR, Directors of Finance, Allied Health Professionals, GPs, Communications Leads, Emergency Care Leads, Those collating data for the national diagnostic census Circulation list Description A practical guide for a range of audiences.

3 It is designed to promote basic understanding of these services and assist in working towards achieving 18 weeks referral to treatment times. It provides a comprehensive overview of the eight areas involved, including a breakdown of all the key diagnostic procedures. Cross reference N/A Superseded documents N/A Action required N/A Timing N/A Contact details Mark Cohen Physiological measurement Policy and Implementation 18 Weeks Commissioning Directorate 4N14 Quarry House Leeds LS2 7UE aspx?main=true&load=ArticleViewer For recipient s use 82109-COI- Physiological Meas 2 2/5/07 16:07 Page iiiContents Section I.

4 Introduction i. Physiological measurement and 18 Weeks 6 ii. Physiological measurement Services 6 iii. Physiological measurement Workforce 9 iv. Physiological measurement and Children 10 v. what is Physiological measurement ? 10 II. The eight areas of Physiological measurement 1. Audiology 14 Audiology Tests Summary 16 2. Cardiac Physiology 26 Cardiac Physiology Tests Summary 29 3. Gastrointestinal (GI) Physiology 34 Gastrointestinal (GI) Physiology Tests Summary 37 4. Neurophysiology 39 Neurophysiology Tests Summary 42 5.

5 Ophthalmic and Vision Science 45 Ophthalmic and Vision Science Tests Summary 49 6. Respiratory Physiology (including Sleep Physiology) 56 Respiratory Physiology (including Sleep Physiology) Tests Summary 59 7. Urodynamics 67 Urodynamics Tests Summary 70 8. Vascular Technology 72 Vascular Technology Tests Summary 75 Acknowledgements 78 iii 82109-COI- Physiological Meas 2 2/5/07 16:07 Page iv82109-COI- Physiological Meas 2 2/5/07 16:07 Page 1 Foreword Professor Sue Hill CBiol, FlBiol, Hon MRCP, OBE: Chief Scientific Officer & National Clinical Lead for Physiological measurement , Department of Health Physiological measurement is one of four diagnostic programmes at the Department of Health, central to the delivery of the 18 weeks implementation programme.

6 The term Physiological measurement has been adopted to reflect those services that predominantly focus on assessing the function of major organ systems ( neurophysiology involves investigating the function of the central and peripheral nervous system and the impact of different pathologies). In some instances, these services may also restore function through a range of therapeutic intervention strategies. Locally, the clinical services that are included within this term may be dispersed across provider organisations and are not usually part of a distinct Physiological measurement department or unit.

7 Access to diagnostic services is recognised as a major rate-limiting step in achieving the 18 week patient pathway by December 2008, which encompasses all stages that lead up to treatment, including outpatient consultations and diagnostics tests/procedures. Significant focus has now been given to resolving bottlenecks caused by long waits for diagnostics, including Physiological measurement services. These services have traditionally had a low profile and been poorly understood, often embedded within block contract arrangements and not recognised as an integral service entity.

8 However, Physiological measurement is a major area of the diagnostic service portfolio, providing a wide range of specialist investigations and elements in the care pathway that are essential in achieving more rapid treatment for patients. This document provides a comprehensive overview of the tests and procedures conducted by Physiological measurement diagnostic services. It has been developed to provide information about these services for providers, commissioners and for those individuals who have ultimate strategic and operational management responsibility for delivery.

9 Crucial to the development of these services is a clear understanding of demand for and capacity of current services and an exploration of how services can be delivered differently. Service transformation involves synchronising technology, processes and the skills and competences of the workforce, all working together to deliver efficient and effective services for the patient. It also means considering the broader agenda for delivering services closer to patients, as outlined in Our health, Our care, Our say (2005), and finding longer term, sustainable solutions.

10 As the National Clinical Lead for Physiological measurement , I am delighted that NHS commissioners and providers of NHS services are now giving attention to Physiological measurement services, which have perhaps been neglected in the past. I hope that this document receives the wide circulation that it deserves and that it helps people to understand this complex area, which is crucial to improving the services we deliver to patients. 1 82109-COI- Physiological Meas 2 2/5/07 16:07 Page 282109-COI- Physiological Meas 2 2/5/07 16:07 Page 3 Foreword Professor Dame Carol Black FMedSci, FRCP, DBE: Chair of the Academy of Medical Royal Colleges and former President of the Royal College of Physicians.