‘Test and treat’ influenza community pathway

Influenza can cause severe complications, especially in older adults and high-risk groups. Flu-related illnesses can occupy approximately 5,400 hospital beds daily and consume over 100,000 bed days in a single month. Early identification and treatment of flu can help reduce visits to A&E departments and hospital admissions.

About the ‘test and treat’ influenza community pathway

To support early diagnostic and treatment decisions, Health Innovation Yorkshire & Humber initiated a service evaluation to evaluate a ‘test and treat’ influenza community pathway between January and April 2024.

It aimed to determine whether fast, community-based diagnosis and treatment pathways that incorporated a Point of Care Testing could help health care professionals make informed clinical decisions and provide appropriate treatment, potentially reducing deterioration and easing pressure on the health and care system.

By facilitating clinical decision making it enables timely antiviral use, reduces unnecessary antibiotic prescriptions, helps prevent deterioration, improves patient outcomes and reduces the need for hospitalisations.

Our support

This was a collaborative working project between Health Innovation Yorkshire & Humber, Roche Diagnostics Ltd, and Roche Products.

• Original pathway initiated by Health Innovation North West Coast.
• Further pathway development and implementation from Health Innovation Yorkshire and Humber.
• Evaluation support.
• Delivered across multiple sites in Yorkshire, comprising care homes, GP settings and community hospital wards.

Impact

• The rapid diagnostic test altered prescribing decisions 35.6% of cases.
• There was a potential 25.4% reduction in the unnecessary prescribing of antibiotics.
• No patients attended A&E within 30 days due to flu symptoms.

This approach could support over 21 million people in the UK aged 65+ or at clinical risk; reducing the burden on the NHS and tackling the growing threat of infectious disease and antimicrobial resistance.

An independent analysis run on a population of 100,000 over a 12 month period, predicted:

• 96% reduction in hospitalisations from 77 to 3.
  94% reduction in the number of deaths from 49 to 3.
• 91% cost reduction per person in care home and ward settings going through the pathway, saving over £1000, in both settings.
• 64% cost saving in the GP walk-in patient setting, saving approximately £34 per patient.

Next steps

Data is being consolidated from multiple evaluations to build the case for further regional and national spread.