Diagnostics sit at the frontline of early detection, effective treatment, and system efficiency. Over the past year, the NHS has delivered a 25% increase in diagnostic activity compared to pre-pandemic levels, a major achievement under immense operational strain. But the question now is not what has been achieved, but what can be sustained.

This blog explores the implications of the diagnostic surge, the underlying pressures and risks, and what system leaders must do to protect and embed this critical capacity into the fabric of NHS recovery and transformation.

The Scale of the Diagnostic Surge

Performance Milestones

• A 25% rise in diagnostic activity compared to baseline.
• Expanded use of Community Diagnostic Centres (CDCs) to bring services closer to home.
• Improved turnaround times for key cancer pathways and urgent care investigations.

 

Key Drivers

• Backlog recovery imperatives, particularly for cancer and elective care.
• Increased public engagement with health services post-COVID.
• System-level coordination between Trusts and ICBs to pool diagnostic resources.

Strategic Takeaway: The surge in activity was hard-won and resource-intensive. It is not guaranteed to persist without structural support.

 

The Pressures Behind the Gains

1. Workforce Shortages

• Radiographers, sonographers, and pathologists remain in short supply.
• Reliance on bank and agency staff has been necessary to meet demand.

2. Equipment and Infrastructure Strain

• Ageing diagnostic equipment and limited physical capacity in many sites.
• CDCs remain unevenly distributed and variably resourced across regions.

3. Digital and Data Challenges

• Lack of interoperability between imaging systems and patient records.
• Variability in digital maturity slows productivity and continuity.

4. Rising Demand

• Ongoing growth in referrals and increased complexity of patient needs.
• Pressure from national targets on cancer, RTT, and urgent care pathways.

Strategic Takeaway: Without addressing these underlying constraints, diagnostic gains may reverse under the weight of unmet structural needs.

 

The Throughput Paradox: Diagnosing Faster, But Then What?

The system’s diagnostic engine may be accelerating, but the question is whether the rest of the system can keep up. Diagnosing more patients faster is only valuable if treatment pathways, surgical theatres, and specialist care are sufficiently staffed to act on the findings.

Yet, the NHS is undergoing active workforce reductions and agency spend cuts, a strategy that risks rendering diagnostic gains meaningless if treatment delays persist or worsen. Without an aligned strategy to build clinical capacity post-diagnosis, we risk creating a pipeline of patients diagnosed earlier, only to wait longer for care.

The logic is fractured: you cannot treat your way to efficiency on a shrinking workforce, especially amid a surge in care demand and a crippling national backlog.

Leadership Insight: Diagnostic strategy cannot be divorced from workforce reality. A system that diagnoses but cannot treat is not just inefficient, it is unethical.

 

What System Leaders Must Focus on Now

1. Sustain and Scale Community Diagnostic Centres

• Embed CDCs as permanent system assets, not temporary fixes.
• Expand operational hours and modalities offered.
• Link CDCs directly to primary care and virtual consultation pathways.

2. Invest in Diagnostic Workforce Pipelines

• Prioritise recruitment, training, and retention of key diagnostic staff.
• Leverage workforce planning to balance use of substantive, bank, and agency resources.
• Develop regional academies or training collaboratives to address shortages.

3. Adopt Smart Technology and AI Tools

• Introduce AI-supported triage and interpretation tools to extend workforce capacity.
• Ensure technology is clinically validated and embedded within governance frameworks.

4. Optimise Workflow and Referral Pathways

• Reduce unnecessary referrals through clinical decision support.
• Improve scheduling systems to reduce DNAs and maximise throughput.

5. Data, Interoperability, and Visibility

• Improve integration of diagnostic systems with EPRs and ICB-level dashboards.
• Use real-time data to monitor demand, capacity, and performance.

Strategic Takeaway: Sustainable diagnostic performance will depend on integrated leadership across workforce, capital, digital, and clinical design.

 

Final Word from Altin Biba, MBA, AMBA Chief Executive of ProMedical

Diagnostics are the gateway to effective care, but a gateway means little if there’s no path beyond it. The NHS’s diagnostic surge is an achievement, but the system now faces a critical test: can it translate detection into timely intervention, or are we merely diagnosing earlier waits and deeper frustrations?

This challenge is compounded by a workforce under strain: over 27,000 nurses left the register last year, with around 12,000 doctors and specialists exiting over the past two years. Retention is no longer just a workforce issue, it is a system survival issue.

At ProMedical, we understand that diagnostics do not exist in isolation. We partner with NHS systems to fortify the entire care pathway, aligning workforce resilience, clinical capacity, and operational agility. Because true health system strength is not just about what we can see, but what we can treat. The question for leadership is not whether we can diagnose more, it’s whether we can do more with what we now know.

References

1. NHS England Board Meeting Minutes, July 2025
2. NHSE Integrated Operational Performance Report, July 2025
3. NHS Diagnostic Recovery and Transformation Plan, 2024/25
4. Health Education England – Diagnostic Workforce Strategy
5. The King’s Fund – Diagnostics and the NHS Backlog
6. Nuffield Trust – Digital Maturity in Diagnostics