Chris Hudson, Director of Access and Innovation at Roche Diagnostics UK & Ireland, calls for a greater emphasis on rolling out innovative diagnostic pathways nationally. He argues that we need a diagnostic revolution: because if not now, then when?
The NHS is at a crossroads. Winning such a significant majority in July 2024 handed the new Labour Government a mandate to take action and, with the post-election honeymoon period well and truly over, expectations are high both among those who provide and run our health services, and those who use them.
With increasing demand straining health and care services and systems up and down the country, and public sector finances more stretched than ever before, there’s an urgent need and perhaps, I would argue, a unique opportunity to take a fundamentally different approach.
Later this year, I’m retiring after a 40-year career in healthcare, and I’ve been doing lots of reflecting on how much the NHS has evolved over the decades, but also how increasingly fragile the extreme pressure (particularly of the last five years) has made it. What seems clear to me is that, if the Government seizes this chance to shift focus and push bold reforms, we can tackle the immediate, inherited issues and challenges, and strengthen the NHS for the decades beyond the next general election.
Since taking office, Labour has commissioned and published The Darzi Report and launched a public consultation to shape its 10-Year Health Plan, set to debut later this year. These efforts signal some intent but simply confirm what we already know – that the NHS is grappling with severe challenges, from stretched resources to workforce shortages and low morale.
The Government’s recent decision to abolish NHS England is a bold move towards streamlining decision-making and delivering much-needed financial efficiencies. However, less bold is the consistent deprioritisation of key NHS commitments, including those relevant to women’s health and the diagnosis of dementia, which will hold serious implications for patients who need diagnoses in order to receive treatments or be able to plan for the future.
I can completely understand why the Government is bringing laser focus to the 18-week diagnosis to treatment target, but it is missing a trick if it ignores expanding access to all the diagnostic tools at our disposal, as a fundamental part of the plan. In addition, when they do talk about expanding access to diagnostics, ministers need to look beyond simply ‘providing more scanners’ to see the far-reaching potential of in vitro diagnostics (IVDs) and point of care (POC) testing in reducing patient waiting times – freeing up acute and specialist service capacity, and delivering cost-efficient system-wide improvements.
Without the ambition, courage, and imagination needed to prioritise prevention and the breadth of diagnostic services and solutions, this Government risks repeating the mistakes of previous administrations and having little impact on the overall health of the NHS.
The issue of investment
Health Secretary, Wes Streeting, has identified three pivotal shifts needed in the NHS: moving from sickness to prevention, from analogue to digital, and from hospitals to community care. There is a vast range of IVD and/or POC solutions that could help turn these high-level ambition statements into positive change and measurable outcomes.
Take prevention: one of the keys to delivering this agenda will be boosting diagnostic capacity in primary and community care. We know diagnosing patients at an earlier stage can accelerate their journey to the right treatment and support, it can also enable better self-management of long-term conditions like heart failure. This, in turn, can prevent or slow down deterioration and the onset of more serious illness which is more likely to require costly hospital treatment and/or specialist care.
The last Government’s introduction of community diagnostic centres (CDCs) was, in theory, a step in the right direction. However, the aim of bringing diagnostic services closer to patients has not yet been realised in practice, as almost 50% of the CDC sites approved to date are either on acute hospital estates or community hospital sites.1
Labour has wisely pledged to expand CDCs as part of its elective care plan, but announcements around diagnostics have once again focused heavily on imaging solutions, which is a disappointingly limited outlook. The possibilities offered by in vitro diagnostics and POC testing, for reducing the NHS backlog, need to be a bigger part of the CDC conversation, as does the pursuit of productivity improvements through pathway transformation.
In January, the Government dropped a central NHS pledge that two-thirds of dementia patients should receive a diagnosis and support, insisting that this would help hospitals focus on reducing waiting lists. I know I am not alone in believing that this U-turn on dementia diagnosis is disappointingly short-sighted and fails to understand the potential power of IVDs in this pathway
Dementia is the country’s biggest killer, and its prevalence is on the rise, with 1.4 million people in the UK expected to be living with the condition by 2040.2,3 Inadequate infrastructure around dementia diagnosis and support is a key factor in the mounting pressure on acute services.
There are currently two ways to medically confirm a diagnosis of Alzheimer’s disease: with a PET scan, for which there are huge waiting lists made up largely of people with suspected cancer. Or a cerebrospinal fluid (CSF) test, which can be relatively quick, inexpensive, and conducted in a range of healthcare settings.
However, the huge potential of biomarker testing is not being realised.4 Only a handful of sites in England, including King’s College London and Manchester, are driving this potentially game-changing CSF pathway forward. In other words, the opportunity to provide patients with mild cognitive symptoms access to an early, accurate diagnosis of Alzheimer’s disease, and all the benefits that this offers (to patients, carers, and health and social care services), is currently being missed – as is the opportunity to ready the NHS for diagnostic blood tests for Alzheimer’s Disease, which are coming this year. The disease-modifying therapies could really change the trajectory of this disease and reduce the impact it has on our health and social care services. We know that patients and their families place huge value on early, accurate diagnosis, even without access to disease modifying therapies. So, surely the Government should be focused on improving access to this for as many people as possible?
The solution
All IVDs offer solutions to NHS resource and capacity challenges, and some of the best examples of IVD innovation are seen in POC testing. POC tests are a subset of IVDs – but rather than samples needing to be sent to a laboratory for analysis, POC testing can be conducted in a range of settings. This means that results are available far more quickly, often in a matter of minutes, allowing for more rapid intervention.
We saw the benefits of this for patients, and the NHS more widely, in a recent community flu ‘test and treat’ pilot we ran with NHS partners. Using rapid POC testing to diagnose flu A/B and COVID-19 across GP surgeries, care homes, and respiratory hubs in the north of England, patients with respiratory symptoms were diagnosed and (where appropriate) treated more quickly, relieving pressure on primary care – and potentially reducing the burden of more serious illness in secondary care
While the COVID-19 pandemic significantly raised patients’ understanding of, and improved confidence in POC testing, it is not limited to respiratory diseases. For example, the LumiraDx handheld POC instrument, which Roche acquired last summer, is used in a variety of community and primary care settings – including as part of an incredibly successful testing pilot with Everton in the Community, using NT-proBNP testing to diagnose heart failure. This type of pioneering POC testing initiative shows exactly how a bolder and more creative approach to diagnostic testing can deliver benefits to patients, clinicians, and the wider NHS.
If the Government is serious about healthcare reform, it would seem wise to back innovations like these at a national level to eliminate postcode lotteries and reduce health inequalities - providing more tangible change for patients beyond organisational reform.
Where do we go from here?
Their substantial majority hands this Government the power and opportunity to make 2025 a real turning point for the NHS. We showed during the pandemic what is possible if we truly collaborate and all pull in the same direction towards one goal.
My genuine hope, as my career in healthcare comes to an end, is that diagnostics, in all its forms, feature explicitly in any strategy, and that historic biases can be overcome to recognise and utilise the additional expertise and resources that industry partners bring to the table. We are on the same team, striving for the same outcomes and, most importantly, we can and want to help.
About the author
Chris Hudson – Director of Access & Innovation, Roche Diagnostics has 25+ years’ experience of In Vitro Diagnostics and Medical Devices. He is highly experienced in the launch, market access and adoption of IVDs in the UK and worldwide. Chris joined Roche in 1998 and in the last 25 years, he has held several Senior Leadership positions both in the UK & Globally.
He is currently the Director of Access and Innovation (A&I). A&I encompasses: Medical Affairs, Public Affairs, Market Access (incorporating Health Economics) plus two strategic functions, Business Development, and Innovation
Prior to Roche, Chris worked in Marketing for several international healthcare companies, Multinationals and SMEs, in the UK and USA.
Outside of Roche, Chris is currently an Executive Committee member of the Association of British HealthTech Industries (ABHI), member of DHSCs DIAG (Diagnostics Industry Advisory Group). Formerly, Chris was Co-chair of Life Sciences Council – health data subgroup and sat on the LSC. He was also the Diagnostic Industry representative on MTAC (Medical Technologies Advisory Committee) for NICE from 2017- 2021.
References
1. https://www.rcpath.org/static/c131184d-fc49-4b75-837303c677817071/APPG-for-DiagnosticsCDC-Report-Jan-2024.pdf. Last accessed February 2025
2. https://www.alzheimersresearchuk.org/news/ dementia-is-the-uks-biggest-killer-we-need-political-action-to-save-lives/#:~:text=Using%20 data%20from%20the%20Office,2023%2C%20 claiming%20over%2075%2C000%20deathsLast accessed February 2025
3. https://www.alzheimers.org.uk/about-us/policy-and-influencing/economic-impact-of-dementia#:~:text=Key%20 Findings,%C2%A390%20billion%20by%202040. Last accessed February 2025
4. https://www.rcpsych.ac.uk/docs/defaul--source/improving-care/ccqi/national-clinical-audits/national-audit-of-dementia/ nad-round-6-(2023-2024)/mas-r6/nad--- memory-assessment-services-2023-regional-report.pdf?sfvrsn=e4b5a250_9. Last accessed February 2025
