Graham Johnson argues that although conventional invasive procedures (such as endoscopy) will remain an indispensable component of care, their limited presence in community diagnostic centres and lengthy waiting times underscore the need for alternative strategies that are both clinically sound and operationally sustainable.
Community diagnostic centres (CDCs) are transforming diagnostics delivery across the NHS, enabling faster, more accessible, patient-centred care. However, more invasive procedures — such as endoscopies — are somewhat limited in smaller CDCs, as they require significant space, staffing and resources. This reduces the accessibility of certain disciplines, such as gastroenterology and ear, nose and throat (ENT) medicine. Point of care testing (POCT) can offer a scalable approach to early detection and triage for these disciplines that can be more easily administered in the community, complementing traditional endoscopy and supporting more robust diagnostic pathways.
Diagnostic services underpin over 85 per cent of all NHS clinical decisions.1 From confirming a suspected infection to staging cancer or monitoring chronic disease, the accuracy and timeliness of diagnostic testing shape the entire trajectory of care. Unfortunately, access to these critical services has not kept pace with clinical demand for various reasons. Persistent shortfalls in diagnostic capacity have left NHS providers unable to meet national standards for timely testing for more than a decade, which is reflected in waiting lists exceeding 7.6 million people.1
For many patients, this backlog creates a delay at the very first step in their care journey while, for clinicians, referrals accumulate and services become overburdened. The impact is felt across the system, from emergency departments managing undifferentiated cases, to elective services struggling to progress treatment pathways.
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