They were arguably the flagship health policy of the Boris Johnson government, introduced during Covid-19 to reduce hospital visits and allow patients to benefit from earlier diagnostic tests closer to home. And they continued to grow during Rishi Sunak’s time as Prime Minister.

But will Community Diagnostic Centres (CDCs) maintain their growth under the new Labour government? And how successful have they been so far?

What is the background?

In October 2021, 40 new community diagnostic centres were launched across England in a range of settings – everywhere from football stadiums to local shopping centres.  

They were designed as one-stop-shops for checks, scans and tests, with the aim of achieving earlier diagnoses for certain conditions, a reduction in hospital visits, a reduction in waits and a contribution to the NHS’s net zero ambitions by providing multiple tests at one visit, ‘reducing the number of patient journeys and helping to cut carbon emissions and air pollution’.  

At the time of launch, Amanda Pritchard, NHS chief executive, said in a government press release: “Rapid diagnosis will save lives and these one stop shops for checks, scans and tests in the heart of local communities will not only make services more accessible and convenient for patients but they will also help us to improve outcomes for patients with cancer and other serious conditions, ultimately sparing more patients and families the pain and trauma of disease.”

As of March 2024, there were 155 CDCs operating across the country, delivering more than 7 million tests since launch. The previous government promised there would be 160 CDCs, carrying out up to 17 million tests for the NHS, by March 2025.

How are they performing?

In June 2022, we wrote an article in the HSJ exploring how successful the earliest adopters of CDCs had been.  

Our research found that many of the CDCs declared as “up and running” at the time were still in the process of developing the required workforce needed to perform the range of tests aligned to local population needs, with evidence of heavy involvement from the private sector and agency staff.

Workforce shortages and skills gaps were limiting the diagnostic capabilities and capacities of the centres at that early stage.

By April 2022, 73 centres were open and said to be providing 30,000 additional tests a week. However, the absence of data made it difficult to understand the real contribution of the CDCs when it came to increasing diagnostic capacity and facilitating earlier diagnosis. These numbers also only equated to 411 tests per week per CDC.

More recently, in October 2023, the King’s Fund looked into how CDCs were doing two years on from launch. While there had been increased diagnostic activity, with an 8.9% uplift in the number of the 15 key diagnostic tests performed during August 2023 compared to August 2022, the think tank said there were question marks about how much of this activity was being carried out by CDCs.

It claimed that the vast majority of diagnostic tests were taking place outside of CDCs, with these centres only conducting 6.3% (139,000) of the tests carried out in August 2023.

Overall, the King’s Fund seemed unconvinced that CDCs were fulfilling their original goal – as set out in Sir Mike Richards’ review of NHS diagnostics capacity – of bringing diagnostics into the community ‘with the scope to improve patient pathways and expand accessibility’.

“The real value of CDCs is in realising the vision of doing diagnostics differently, and this is where the focus needs to be,” the analysis concluded. “Otherwise, there is a risk that with staffing and financial pressures, coupled with the small volume of activity being delivered, that CDCs are side-lined or scaled back in favour of traditional diagnostic provision.”

Despite this, patient satisfaction with CDCs remains high, according to a recent survey by the NHS’s patient champion, Healthwatch England. The findings revealed that most people appreciated the speed with which they were seen, locations that are easy to reach and the service they received. Some 87% said they had a positive experience with CDCs.  

They were also praised by the president of the Royal College of Pathologists, who said CDCs could ‘save lives’, and the senior team at the North Central London ICB, who told the Guardian that the introduction of a CDC in a Wood Green shopping centre in 2022 had ensured that just 9% of its patients wait longer than six weeks – less than half the national average of 21%.

Are they still growing?

Last month, it was announced that construction work had begun at Walton Hospital, to allow patients across Chesterfield and North Derbyshire to utilise a ‘one-stop-shop’ CDC from spring next year.

Meanwhile, construction work is underway for two new CDCs in Lincolnshire, while work is ongoing for CDCs in Nottingham and Hull which are expected to open in 2025. There are also sites at various stages of the construction process in Hereford, Grimsby and Mansfield. Additionally, some existing CDCs are expanding their facilities.  

Despite this, there has been no mention of CDCs – as far as our research could tell – by the incoming Labour government or the new Health Secretary, Wes Streeting. We reached out to the Department of Health and Social Care to see if the new government is committed to CDCs moving forward, but have so far received no response.

In its manifesto before the general election, Labour talked about trialling Neighbourhood Health Centres, to bring healthcare closer to home. It also said it would shift the NHS away from a model geared towards late diagnosis and treatment, to a model where more services are delivered in local communities, but it didn’t specifically mention CDCs anywhere in its literature.

The King’s Speech immediately after the election talked about reducing waiting times and focusing on prevention, but didn’t go into much more detail than that. So, in all likelihood, we will have to wait until the Autumn Budget, held on October 30 – and Rachel Reeves’ first as Chancellor – to find out if the CDC programme will receive any more funding, or if the government will focus on alternatives.

The government may, understandably, be keen for a clean break from the past – and CDCs could be a victim of that.  

A blast from the past influencing the future?

For an idea of where Labour might go with community diagnostics, we can look to a recent report from the Tony Blair Institute for Global Change, which set out the role of AI and digital health records in transforming the NHS.

Blair, the last Labour PM before Sir Kier Starmer, is known to be close to the Labour leadership – while Streeting spoke at the Tony Blair Institute’s Future of Britain Conference just after the election.

In the report, it was argued that digital health records would be crucial in delivering the shift away from hospital-focused medicine to community-based care. The paper also called for a network of super primary care centres caring for up to 250,000 patients, consolidating GP practices and grouping patients based on healthcare needs rather than geography.

It seems, then, that there will still be a major focus from the new government on community healthcare and earlier diagnosis – but whether CDCs continue to be at the forefront of that very much remains to be seen. While their success remains up for debate too.              

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