Tackling investment challenges ahead

NHS Trusts will face many challenges in the coming months. Mandatory operational data collected from all NHS Trusts indicates a growing financial strain on services, even before the first UK lockdown.¹ This includes an increase in the total costs of running the NHS estate and a £9bn backlog. The pressures of the pandemic are made yet more severe by a lack of funding and issues with failing or outdated facilities and equipment.² NHS Providers report that old and outdated equipment and buildings hinder their ability to increase capacity and respond to the current demands of the crisis.³ NHS Trusts across the UK highlight, for instance, the urgent need for investment in imaging equipment to clear the backlog of scans for cancer and other conditions, built up during the pandemic. This adds up to a previous shortage in diagnostic equipment, with the UK lagging behind most OECD countries in terms of numbers of CT and MRI scanners.⁴

This has led to a significant increase in the use of private sector investment across the estate to invest in new equipment and buildings, as well as improving existing facilities.⁵ A report from the Independent Review of Diagnostic Services for NHS England notes: “To deliver the increase in diagnostic activity required now and over the coming years, and to provide safe, patientcentred pathways for diagnostics, new service models are needed” and that these “will require major investment in facilities, equipment and workforce, alongside replacement of obsolete equipment”.⁶

The report also calls for the establishment of Community Diagnostic Hubs (CDHs). Such sites would provide diagnostic centres for cancer, cardiac, respiratory and other conditions while keeping these services separate from locations serving patients affected by COVID-19.⁷ There is a major need to expand diagnostic services, and CDHs can relieve the pressure on acute hospital sites by helping to accommodate the backlog and optimising clinical resources.