A new report calls for redesign of NHS diagnostic services as one in five patients are currently waiting longer than the NHS target of six weeks, against a backdrop of rising demand that could see the waiting list pass two million people next year.
The number of patients in England waiting for an NHS diagnostic test has reached 1.92 million, an 83% increase compared with pre-pandemic levels, according to a new report.
The report, Strengthening the Backbone: Reimagining NHS Diagnostics in England, warns that despite the NHS delivering more than 2.6 million diagnostic tests in a single month, demand is continuing to outstrip capacity, creating growing pressure across the health system.
More than one in five patients (21.2%) now waits longer than six weeks for a diagnostic test - more than twenty times higher than the NHS operational standard that only 1% of patients should wait beyond this threshold.
Delays in diagnostics are increasingly affecting wider NHS performance, including cancer pathways and treatment times. The report shows that expanding activity alone will not be enough to reverse the trend.
Marlen Suller (pictured), Managing Director, Clinical Diagnostics EMEA at Magentus, which commissioned the report said: “NHS teams are delivering extraordinary levels of activity, but the report shows that simply doing more tests will not solve the underlying challenge. As demand continues to grow, the NHS needs diagnostic services that work more effectively at scale, make better use of information and technology, and support patients through more efficient pathways of care. The opportunity now is to create a more connected diagnostic system, making better use of technology to support clinicians, reduce duplication of tests and improve the experience of care for patients.”
New analysis in the report reveals:
- Despite the NHS delivering more than 2.6 million tests in a single month, demand continues to outpace delivery
- 1.92 million people are currently waiting for a diagnostic test in England (83% higher than before the pandemic)
- More than one in five patients (21.2%) waits longer than six weeks for a test, compared with the NHS target of 1%
- Significant regional variation persists, with long waits ranging from around 13% to nearly 30% depending on where patients live
- The diagnostic waiting list has grown faster than reporting workforce capacity, contributing to delays across wider treatment pathways.
Professor Erika Denton, Professor of Radiology at Norfolk and Norwich University Hospital and member of the report steering group, said: “Diagnostics underpin almost every clinical decision made in the NHS. While teams are working incredibly hard, demand has evolved faster than the systems supporting it. The challenge now is not simply adding more activity - it is making services work more effectively together so that patients move through pathways more quickly and more consistently.”
The report recommends:
- Move diagnostics earlier in pathways to support prevention and faster intervention: Too often, patients must navigate multiple referrals before reaching a diagnostic test. Expanding direct access to diagnostics can streamline pathways, support earlier diagnosis and enable faster intervention.
- Improve patient communication and navigation, making diagnostic journeys clearer and easier to understand: Patients often experience uncertainty and poor communication throughout the diagnostic process. Clearer information provided along with test results can improve experience and help people move through pathways more confidently.
- Use existing capacity more effectively, including Community Diagnostic Centres (CDCs) and networked working models: capacity is not aligned with demand; making better use of CDCs and networked approaches can help reduce variation and improve access to testing.
- Improve interoperability and data sharing across systems and organisations: diagnostic information is often trapped within organisational boundaries, leading to inefficiencies and repeat testing. Better interoperability can support faster decisions and more joined-up care.
- Expand workforce capacity, particularly in reporting roles and specialist diagnostic expertise: workforce shortages, especially in reporting and specialist roles, are increasingly constraining performance. Growing capacity and making better use of expertise will be essential to meeting rising demand.
- Design diagnostics as connected pathways, rather than isolated services or departments: fragmented services can create delays, duplication and poor coordination. Diagnostics should be designed as integrated pathways that connect services, clinicians and settings around the patient.
- Align incentives and funding models to support integrated, whole-pathway care: current funding arrangements can encourage activity within individual services rather than collaboration across pathways. Incentives should support coordinated care and shared responsibility for outcomes.
Click here to read the full report Strengthening the Backbone: Reimagining NHS Diagnostics in England.