Point of care testing
rapid access to endoscopic assessment is essential for early detection and intervention. For example, the Devon Diagnostic Centre in Exeteroffers TNE,7
and the Finchley Memorial
Hospital CDC offers TNE as well as cell collecting capsules.8 Several pilot studies of CDC care for
gastroenterology, urology and ENT have shown promising results for reducing the time from referral to diagnosis by completing all tests on the same day and reducing additional referrals.9 However, in practice, endoscopy services remain absent or limited in most large CDCs, meaning that the care patients receive will very much vary depending on their location.
Workforce challenges in the NHS There are different reasons why some CDCs haven’t adopted endoscopy, but it may partly be due to ongoing infrastructure and workforce limitations. Even prior to the COVID-19 pandemic, endoscopy was recognised as one of the most overstretched areas of NHS diagnostic provision, which Professor Richards outlined in his report.3
Since then, the pressures have only
intensified. The COVID-19 pandemic encouraged early retirements and part-time roles,10
and
chronic workforce shortages are now the dominant constraint, limiting the ability of many services to meet rising demand. The Get It Right First Time (GIRFT) review further highlighted that a significant proportion of NHS Trusts are operating with outdated or insufficient facilities, constraining throughput and limiting opportunities to expand capacity.3 These systemic pressures have been exacerbated by sustained growth in demand for gastrointestinal procedures. Between 2015 and 2020, the number of gastroscopies performed in England increased by roughly three per cent annually, potentially driven by ageing populations, improved cancer screening
awareness and greater use of endoscopy for surveillance and chronic disease management. Despite the scale of this unmet need, endoscopy has not yet become a routine feature within most CDCs. This reluctance may lie in how the procedure is perceived: it is inherently invasive, space intensive and dependent on specialist staff and close clinical supervision, so was historically aligned with surgical departments. Consequently, when establishing new diagnostic hubs, many regions have favoured services such as imaging or laboratory testing that are easier to deploy at scale and with fewer staffing or infrastructure barriers. Unless addressed, this cautious approach risks perpetuating the existing gap in access to gastrointestinal diagnostics across the NHS.
Point of care testing: a practical enabler for community diagnostics The CDC model offers an ideal environment
to extend the use of POCT. Unlike traditional laboratory diagnostics that depend on central processing, POCT technologies provide rapid, clinically actionable results within the same care setting. This immediacy supports faster decision making, reduces unnecessary hospital referrals and shortens the interval between symptom presentation, diagnosis and treatment. The underlying principle of CDCs – to deliver timely care closer to patients’ homes – aligns closely with the purpose of modern POC in vitro diagnostics, which are specifically designed for use by trained clinical staff without the need for complex laboratory infrastructure. POCT assays – such as BIOHIT HealthCare’s
GastroPanel Quick Test for atrophic gastritis and Peptest for reflux – represent a valuable opportunity to strengthen early diagnostic pathways. Integrating these tools into CDC workflows allows effective triage and risk stratification: patients at low risk can be managed within the community, while those with concerning profiles can be referred promptly for further evaluation, such as an endoscopy. This approach enables diagnostic resources
to be deployed more efficiently, helping to mitigate the mounting workforce pressures in secondary care services and allowing specialist teams to concentrate on complex cases. The innate simplicity of POCT over traditional, invasive imaging techniques means that it does not necessarily need to be employed by highly specialised clinical personnel. With the appropriate training and QCs, a wide range of clinical staff can administer these tests, such as a GP with an extended role in ENT, helping to limit the drain on already limited staffing pools. The benefits of embedding POCT in CDCs extend beyond efficiency and workforce
May 2026 I
www.clinicalservicesjournal.com 41
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