Increasing NHS diagnostics speed and capacity – the role of community diagnostics centres

The NHS 2023/24 priorities and operational planning guidance was released just before Christmas 2022. In this NHSE sets out targets for the year ahead together with some detail of how these may be achieved. Key objectives for the year are to:

• Recover core services and productivity; 
• Make progress in delivering key ambitions in the NHS Long Term Plan; and
• Continue transforming the NHS for the future.

The guidance also refers to the NHS ‘implementing one of the most comprehensive strategies on early diagnosis anywhere in the world’ with Cancer Alliances (partnerships between health and social care providers aiming to transform cancer treatment in their localities) and Integrated Care Boards delivering this national strategy locally. Neither this aim, nor the objectives set out above, can be achieved without progress being made on increasing diagnostics capacity. There is an overall target to ensure that by March 2025, 95% of patients receive diagnostic tests within six weeks, and the guidance also refers to £2.3 billion of capital funding to 2025 having been allocated to support diagnostic service transformation.
 
The ongoing establishment of community diagnostics centres (CDCs) is a central pillar of the strategy to achieve these aims and the £2.3 billion of funding is stated to include money for these. CDCs, (or ‘hubs’ as they were originally known) created via networks of providers were flagged in the Long Term Plan and are intended to provide a broad range of elective diagnostic services away from acute facilities, maximising existing diagnostic capacity and improving access to diagnostics specialists. 2023/24 is the second year of a three year investment plan to provide new centres and upgrade existing ones. 
 
Our work to date on a number of CDCs underlines the different approaches being taken to implementing them, and the options available to do so. For now, these are being determined based on prevailing local factors – drivers for the types of diagnostic services most urgently required, the speed at which capacity is needed, and the types of sites and broader opportunities available. While the intention was to site CDCs away from acute centres, we are seeing some being set up within existing facilities on NHS Trust sites, a theoretically quick fix solution, while other longer term more ambitious projects are bringing together the public and private sector to deliver purpose-built centres. Initial intentions to repurpose existing units in, for example, shopping centres and within existing primary care facilities, are theoretically attractive but on a practical basis can be difficult.
 
As the CDC project matures, it will be interesting to understand the key factors which go into delivering the most value from CDCs both immediately in terms of the costs of establishing the centres, the speed at which they can be put in place and their ability to deliver to the March 2025 target; and longer term in respect of their ability to deliver outcomes which matter to patients, and which bring about the transformative impacts required to achieve broader current healthcare aims of improving population health and decreasing health inequalities. 
 
We have expertise in advising on the establishment of CDCs. Please do get in touch directly with us if you have any queries in this area.

We are hosting a webinar on lessons learned from early CDC schemes and what will likely happen next, featuring speakers with direct experience of progressing CDCs from both the public and private healthcare sector. Please click here to sign up to the webinar.