Medical teams have warned that some NHS diagnostic services are “close to failure”, with more than 184,000 patients in England waiting three months or more for key tests.
Children in some specialist hospitals are among those waiting several weeks for diagnostic procedures, in breach of government targets.
Under the NHS constitution, patients must wait less than six weeks for such tests, which include magnetic resonance imaging (MRI) scans, non-obstetric ultrasounds, heart procedures and lung function tests.
Doctors and radiographers say they are working at “overcapacity” and that the current approach to reducing waiting times in the face of staff shortages is “reckless and unsustainable”.
An Observer analysis of the latest waits for diagnostic tests at the end of October found:
Patients at University Hospitals Leicester NHS Trust face some of the longest waiting times in the country. The latest figures show 14,437 patients at the trust waited 13 weeks or more for key diagnostic tests.
At Great Ormond Street Hospital for Children NHS Foundation Trust in London, 194 patients waited six weeks or more and 30 patients waited 13 weeks or more for diagnostic procedures. Some children wait several weeks for MRIs and echocardiograms, used to evaluate the structure and function of the heart.
In some of the country’s largest trusts, more than half of all patients referred for tests waited six weeks or more. These include Lancashire Teaching Hospitals NHS Foundation Trust; United Lincolnshire Hospitals NHS trust; and York and Scarborough Teaching Hospitals NHS Foundation Trust.
Source: NHS England. Note: this data is for NHS trusts and excludes private providers contracted by the NHS
Richard Evans, chief executive of the Society of Radiographers, the professional body for the imaging and radiotherapy workforce, said: “Requiring exhausted radiographers and others to work unprofessionally and unsafely strikes at the core of the values that keep the NHS afloat.”
At the end of October 2022, 426,003 patients were waiting six weeks or more in England for 15 key diagnostic tests and procedures, which is 27.5% of the total number of patients waiting. The number of patients waiting 13 weeks or more was 184,187.
The operating standard is that less than 1% of patients have to wait six weeks or more. More than 2 million diagnostic procedures are carried out in the NHS in England each month for a range of purposes, including diagnosing cancer, identifying heart disease and assessing the extent of musculoskeletal disorders.
The government is opening new community diagnostic centres, but despite this extra investment, many patients are waiting several weeks for tests.
There are also big differences in waiting times. At United Lincolnshire hospitals NHS trust 8,370 patients out of 21,661 (38.6%) faced a wait of 13 weeks or more for diagnostic tests, while at King’s College Hospital NHS Foundation Trust only 70 patients out of 11,808 (0.6% ) face waits of 13 weeks weeks or more.
In just three of the large specialist children’s trusts – Great Ormond Street, Alder Hey Children’s NHS Foundation trust in Liverpool and Sheffield Children’s NHS Foundation trust – more than 300 patients waited a total of 13 weeks or more for key diagnostic tests. These include an MRI scan; respiratory physiology tests that look at lung function for possible sleep disorders; and urodynamics, which measures bladder function.
A briefing paper published last month by the Imaging and Oncology Forum, which includes the Society of Radiographers and the Royal College of Radiologists, warned that imaging services were “brought close to failure”. It states: “Working at excess capacity threatens patient safety, harms healthcare professionals and challenges the quality of service.”
Dr Catherine Halliday, president of the Royal College of Radiologists, said: “We weren’t coping before Covid but the pandemic has made it much worse. It is worrying that people feel they are not offering a good service. Patients wait a lot longer and most things get worse while you’re waiting.”
A spokesman for Great Ormond Street Hospital said: “Referrals are risk assessed and all urgent diagnoses will be prioritized and patients reviewed six weeks in advance. Our latest figures show that 15% of patients are waiting more than six weeks for a diagnostic test. The spokesperson said that the new community centers are mainly intended for adults.
A spokesman for Alder Hey Children’s NHS Foundation Trust said it had “robust” plans to reduce waiting times for all diagnostic tests to under six weeks by April. The spokesman said many diagnostic services, such as radiology, provided all tests within six weeks in November.
A spokesman for Lincolnshire United Hospitals NHS Trust apologized for the longer waiting times and said it had “processes in place to ensure that those who urgently need diagnostic tests receive them in a timely manner”. . It said an arson at Lincoln County Hospital this year destroyed a scanner and reduced capacity.
An NHS spokesman said: “Despite ongoing pressure on services exacerbated by flu hospitalisations, problems in social care where we can’t discharge patients who are ready and record numbers needing emergency care, NHS staff continue to and working to reduce some of our longest waits for care, including tens of thousands more people getting needed diagnostic tests and screenings in October compared to the previous month.
“The NHS is launching more than 100 community diagnostic centers so even more people can get tested, along with expanding its imaging and endoscopy capacity in the new year.”
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