Abstract

Background
This was a collaborative project between Health Innovation Yorkshire & Humber (HIYH), Roche Diagnostics, and Roche Products, delivered for West Yorkshire ICB.

Influenza can cause severe respiratory illness and hospitalisations, contributing to NHS winter pressures. Distinguishing between influenza, COVID-19, and chest infections (or other chest infections) can be challenging without additional testing, and traditional lab results often arrive too late for timely diagnosis and antiviral treatment1. Patients waiting for a diagnosis may therefore be prescribed unnecessary antibiotics, fuelling antibiotic resistance2.

Aim
A service evaluation assessed whether introducing community pathways that included a rapid diagnostic test for identifying Flu A/B and SARS-CoV-2 could enhance diagnostic confidence. This supports NHS and UKHSA ambitions for early detection, accurate diagnosis and improved decision-making, to reduce the impact of infectious diseases and antimicrobial resistance.

Methods
A total of 59 patients aged 65+ or clinically ‘high-risk’ (per UKHSA) were tested in GP practices, care homes and community hospital wards. Data on symptoms, test results, and prescriptions were collected at consultation. Follow-up after 30 days assessed impact on the prescribing decision and any A&E attendance.

Results
• The rapid diagnostic test altered prescribing decisions in 21 cases (35.6%). There was no impact in 8 (13.8%), and influence was unclear in 30 cases (50.8%)3.
• Of the 21 changed cases, 15 patients were not prescribed antibiotics, suggesting the inappropriate use of antibiotics reduced by 25.4% (15/59 cases).
• Of 9 flu-positive patients, 6 (66.7%) received antivirals, only 1 (11.1%) received antibiotics and zero attended A&E.
• 100% of surveyed staff found the test beneficial, 61% said it helped guide the prescribing decision and 66% felt it increased the patient’s confidence in the decision.

Conclusions
Introducing ‘test and treat’ influenza community pathways incorporating a rapid diagnostic test enhanced clinical decision-making, reduced unnecessary antibiotic use and enabled timely antiviral treatment to decrease the impact of winter pressures. This supports the “hospital to community” and “sickness to prevention” big-shifts expressed by the UK Government.

1. Nottingham University Hospitals NHS Trust. Available at https://www.nuh.nhs.uk/news/rapid-diagnostic-test-helps-stop-the-spread-of-flu-at-nuh-3334/ Accessed: Jun 2025.
2. Cole A. BMJ. 2014 Aug 19;349:g5238.
3. HIYH Report. Ref M-GB-00022125. Apr 2025.