Point of care testing
Transforming diagnostic delivery with POCT
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. Reducing long waiting lists has long been
one of the biggest challenges in the NHS and, recognising the urgent need to expand capacity, the transformation of diagnostics provision has become a national priority. The development of CDCs is central to this effort. These dedicated facilities have been established to deliver high volume testing outside of acute
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hospital environments, in locations closer to where people live, such as in shopping centres, community hospitals and university campuses. The idea is that these centres are extremely accessible and patients do not need to travel as far for tests, causing less disruption to their lives and improving adherence to testing. This also reduces the burden on hospital diagnostic services, freeing up capacity for urgent care. The concept was first outlined in Diagnostics:
Recovery and Renewal (2020), authored by Professor Sir Mike Richards.2,3
The report set
out a blueprint for modernising diagnostic services through the creation of standalone hubs designed to accelerate access, reduce inequalities and relieve pressure on hospitals. This vision continues to guide policy direction under the new Labour government,1
as the
health system seeks sustainable ways to deliver faster, more equitable diagnostic care. £600 million capital funding has been committed to transform diagnostic services amidst growing demands in 2025 and 2026, including funding up to five additional CDCs, alongside extending
opening hours for all CDCs at evenings and on weekends.4
Current CDC offerings CDCs now occupy a pivotal place within NHS England’s long-term vision to expand diagnostic capacity.5
To date, around 170 permanent centres
have been established across England, offering a broad spectrum of services spanning imaging modalities (MRI, CT and ultrasound), laboratory diagnostics (blood tests and biomarker analysis) and physiological assessments (ECG, blood pressure monitoring and visual field testing). 7.2 million CDC tests and scans have been delivered since July 2024, equating to 1.6 million more than the previous year.4 The services at each CDC vary, but typically
include a combination of imaging, pathology and physiological science.5
In larger hubs,
gastrointestinal investigations – such as gastroscopy, transnasal endoscopy (TNE) and colonoscopy – can also be provided. Ideally, these procedures should be prioritised in areas with high disease prevalence,6
where
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