New community diagnostic centres may struggle to live up to ministers’ promises to improve access to services and reduce the NHS backlog, warns a new briefing on NHS diagnostics from health think tank, The King’s Fund.
There are currently more than 1.5 million people waiting for a key test or scan in England.
However, historical underinvestment; significant staff shortages across specialist areas such as radiology; and outdated equipment including MRI scanners and X-ray machines, has meant the ‘standard’ six-week wait target for a diagnostic test has not been met since February 2017.
In response to the rising demand for diagnostics, and the growing backlog – which has been worsened by the COVID-19 pandemic – the Government has proposed to deliver 160 community diagnostic centres (CDCs) across the country by 2025.
Ministers have said the aim of these centres, which are based in community settings such as shopping centres and football stadiums, is to speed up diagnostic times by offering tests ‘closer to home’ and eliminating unnecessary hospital trips.
Years of underinvestment in equipment, coupled with severe staffing shortages across all areas of diagnostics, mean people are waiting too long for vital tests, and demand continues to balloon
However, the new briefing from The King’s Fund warns that, although CDCs may increase the physical capacity to deliver services with more facilities, better equipment, and potentially-closer proximity to patients; there may not be enough skilled staff to run both new centres and pre-existing facilities.
And, without a diagnostic workforce strategy, staff shortages and skills gaps may undermine the additional community capacity the centres are aiming to create.
CDCs could also help to address access issues to diagnostics by reducing the time and cost associated with travelling to hospitals.
However, of the 92 centres that have been set up so far, half – 47% – are on existing hospital sites, raising questions over how much impact they will have on reaching the people they need to.
Charlotte Wickens, policy advisor at The King’s Fund, and author of the briefing, said: “Easier access to timely and effective diagnostic services is critical to providing high-quality care, reducing waiting times for treatment, and improving health outcomes.
While the rollout of these new diagnostic centres is very welcome, more effort must be made to deliver on the promise of CDCs being located in more-convenient community locations
“However, years of underinvestment in equipment, coupled with severe staffing shortages across all areas of diagnostics, mean people are waiting too long for vital tests, and demand continues to balloon.
“The Government has claimed that CDCs will be key to ‘busting the backlog’. However, the location of many centres around existing healthcare facilities should raise questions over whether the Government really will achieve its goal of moving diagnostic tests closer to people’s homes.
“Looking at the current locations, it appears that only one in five sites are not on a traditional healthcare site such a hospital or a primary care centre.
“And, if we look back to the COVID-19 vaccine rollout, vaccines were provided, not only in GP practices or hospitals, but in places that were convenient and familiar, and this was particularly important to offering equal access to everyone, wherever they lived.”
She added: “While the rollout of these new diagnostic centres is very welcome, more effort must be made to deliver on the promise of CDCs being located in more-convenient community locations.
“And, ultimately, without action from the Government to tackle the workforce crisis, their potential to increase the number of diagnostic tests the NHS delivers, and provide quicker access to all, will be limited.”
The report also questions how effective CDCs will be in breaking down barriers to access and tackling health inequalities – something the Government has said is a key priority.
It has widely been shown that people living in more deprived areas have lower life expectancy, poorer quality of life, and suffer higher prevalence of long-term conditions.
Without action from the Government to tackle the workforce crisis, their potential to increase the number of diagnostic tests the NHS delivers, and provide quicker access to all, will be limited
And CDCs have the potential to address these inequalities by offering easier access to diagnostics generally, and to people who wouldn’t traditionally visit health services.
The King’s Fund report says a shift to new and trusted community sites will be crucial to widening access and improving uptake, but warns: “While this is cause for optimism, there is also a need for realism.”
“Overall, there is huge potential for diagnostics to play an even-greater role in driving better health outcomes across England, but going forward the Government must be clear on how it will address and assess health inequalities and tailor strategies and investment to ensure the most impact,” said Wickens
