NHS Recovery and Productivity: Diagnostics are the place to start

Drawing on his experience as a Health Minister and Chair of the Health and Social Care Select Committee, GK’s strategic advisor Steve Brine argues that diagnostics are the critical but often overlooked foundation of NHS recovery, productivity and prevention.

Diagnostics rarely grab headlines in the way that waiting lists do. Yet during my time as a Health Minister, and later as Chair of the Health and Social Care Select Committee, I came to a simple conclusion – if you want to improve outcomes, reduce elective waits and modernise the NHS, they are the place to start.

The reality is that no patient can begin the right treatment until the clinicians know what is wrong. Whether it is cancer, heart disease or a musculoskeletal problem, diagnosis is the gateway through which every effective pathway runs.

Too often, however, diagnostics are viewed as a ‘supporting service’ rather than the critical infrastructure on which the entire system rests.

That is why I have been encouraged by the development of Community Diagnostic Centres (CDC’s) under the last government and continued under this administration.

The concept is straightforward but powerful; bring scans, tests and investigations closer to where people live, rather than requiring patients to navigate busy acute hospitals. It is one of the clearest examples of the much-discussed shift from hospital to community becoming more than words on a page and something that patients can see.

When I was a Minister, we spoke frequently about prevention and early intervention. Now it’s the talk of the town.

For my money, diagnostics sit at the heart of both. A CT scan, MRI scan or PET scan (Positron Emission Tomography, which is particularly important in cancer diagnosis and treatment planning) is not simply a test. It is an opportunity to identify disease earlier, provide reassurance quicker, and avoid patients deteriorating while waiting for answers.

As Select Committee Chair, I often heard evidence about the pressures facing the NHS workforce and the challenge of delivering constitutional standards. The current debate about the 18-week elective target is important, but it is worth remembering that elective recovery ultimately depends on diagnostic recovery. You cannot clear waiting lists if patients are waiting months for scans, endoscopy or reporting.

That is why diagnostics should be seen as a productivity issue as much as a clinical one. Faster access to tests means quicker clinical decisions, more efficient use of outpatient appointments and better use of operating theatres. Every delayed diagnosis creates friction elsewhere in the system and, most important of all, spikes anxiety in patients. The dreaded diagnosis ‘odyssey’.

The challenge now is ensuring that CDC’s become a permanent part of NHS infrastructure rather than simply a waiting-list initiative. That means investing not only in buildings and scanners, but also in the workforce; radiographers, radiologists etc.

If ministers are serious about restoring performance (which as we will explore further in this series of blogs I am writing for GK Strategy is only part of the story), improving cancer outcomes and delivering care closer to home, it’s hard to look past diagnostics as the place where the next chapter of NHS reform must begin.