One of the many benchmarks by which the NHS – and the public it serves – measures the effectiveness of the service is how long a patient has to wait in a queue. Kate Woodhead RGN DMS asserts that diagnostic services are a key element of this as, at this stage, the patient often doesn’t know if they are unwell or just has a collection of annoying or worrying symptoms.
How long a patient has to wait is variable, depending on the tests they need, the local capacity for those tests and whether those tests are available in their area. The six week diagnostic waiting time was introduced initially as a ‘milestone’ from March 2008 onwards, achieving the standard ‘referral to treatment’ wait of 18 weeks by December 2008. Diagnostic waiting times now form part of the pledges made to patients, cited within the NHS Constitution, that patients should not have to wait longer than six weeks for a diagnosis.1
Diagnostic services underpin 80% of clinical pathways and account for around £8 billion of NHS annual expenditure. With improvements in diagnostics and targeted interventions which will be possible with the development of genomics, personalised medicine and other enhanced treatment schedules for cancers, this is set to increase in volume and complexity going forward.2
Endoscopy services – and bowel screening specifically – have increased the volume of GI tract endoscopies exponentially in the last few years. The age range has recently been expanded. Initially, the programme sends an occult blood testing kit to individuals every two years between 60 to 74 years of age. In recent times, the lower age limit has been moved to 50 years old. Anyone with an abnormal result from this screening is offered a colonoscopy.
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