Here’s my opinion of how the NHS’s 10-year modernisation agenda is set to use diagnostics—including point-of-care testing (POCT)—to widen access, cut inequality and hard-wire equity into everyday care.
The 2019 Long Term Plan—and the post-pandemic Richards Review—reset diagnostics as a system-wide priority: expand capacity, separate urgent from elective demand, digitise results, and move routine testing out of hospitals and into community settings. That blueprint directly shaped the national Community Diagnostic Centre (CDC) programme and a wave of POCT guidance for virtual wards and urgent community response teams. Together, these reforms aim to shorten time-to-diagnosis, reduce travel and time costs for patients, and standardise pathways so the same quality is available whether you live in a city centre or a coastal town. (NHS England, PMC)
Community Diagnostic Centres: capacity and convenience at scale
CDCs are one-stop shops for imaging, physiological tests and pathology, deliberately placed in accessible locations—city centres, near major travel routes, close proximity to high footfall areas—to remove barriers such as transport and work-time loss. By August 2024, 165 of 170 approved CDC sites were operational (some more mature than others); the programme continues to extend opening hours so people can attend evenings and weekends. Early evidence shows material gains in access: the NHS delivered over 1.6 million more tests and scans (July 2024–June 2025 vs the prior year), and new policy now pushes many CDCs to open 12 hours a day, 7 days a week. These moves specifically help lower-income workers, carers and people reliant on public transport. (NHS England, The Guardian)
The intent is equity by design: site selection criteria include local deprivation, ethnicity, and travel times so that investment closes rather than widens gaps. Regional data echo the scale—almost 1.5 million attendances across Midlands CDCs alone—with many centres now running out-of-hours lists. (UCLPartners, NHS England)
Point-of-care testing: faster answers, fairer outcomes
POCT moves key blood and infection tests to the bedside, a patient’s home, a pharmacy or a community clinic, returning actionable results in minutes rather than days. NHS England’s guidance set out how to integrate POCT into urgent community response and virtual wards so clinicians can decide—on the spot—who needs hospital conveyance and who can be safely managed at home. That speeds decision-making, prevents avoidable admissions, and is particularly valuable for housebound patients or those in rural/underserved areas. (NHS England). This initiative has been accelerated by the 10 year health plan which seeks to reduce hospital activity through prevention measures and improved community access for all.
Concrete examples already show impact:
- COVID Oximetry @home (CO@h): Pulse oximeters plus remote monitoring enabled early detection of “silent hypoxia,” reducing deterioration and avoiding some admissions. Evaluations demonstrate feasibility at scale and association with improved outcomes when implemented as part of a supported pathway—an approach that has since informed wider virtual ward practice. (NHS England, PMC)
- Home blood pressure (BP@Home): Large NHS programmes supplied validated monitors to support remote hypertension management, aimed explicitly at reducing cardiovascular inequalities by empowering patients outside traditional clinic hours and venues. Evaluations highlight improved self-management and pathway redesign that reduces in-person visits—important for people juggling multiple jobs, caring responsibilities and keeping pets. (Health Innovation Network)
- CRP testing for respiratory infections in primary care: Point-of-care C-reactive protein tests safely cut unnecessary antibiotics for coughs/sore throats, supporting antimicrobial stewardship without disadvantaging patients who can’t return for lab results. NICE has profiled these tests and international evidence confirms reductions in prescribing—benefits that are amplified when deployed via community pharmacies and same-day services. (NICE, PMC). There is a similar call for the use of POCT Streptococcus A testing, to reduce the inappropriate use of antibiotics, but as yet, NHS England have not recommended it.
- Pharmacy First sore throat pilots (with POCT): Evaluations from UK pilots show that using rapid tests in community pharmacies allows most patients to be managed without antibiotics, with only about a quarter requiring antibiotic treatment. This shifts convenient, evidence-based care into high-street locations, widening access and relieving GP pressure. (BSO HSCNI)
Cancer pathways: faster, earlier, closer to home
The Faster Diagnosis Standard (diagnose or rule out cancer within 28 days of urgent GP referral) galvanised pathway redesign, with rapid/combined diagnostics and CDC imaging capacity central to the lift. New digital tools (for example, data platforms that help teams track and expedite work-ups) are being rolled out to reduce variation and support the 28-day standard. CDCs also host straight-to-test pathways (e.g., CT colonography, chest CT) and multi-cancer rapid diagnostic services for people with non-specific symptoms—particularly helpful for older patients and those with complex or atypical presentations. (NHS England, PMC)
Why diagnostics reform reduces inequality
- Travel and timing barriers shrink. Evening/weekend CDC sessions and local venues mean fewer lost wages and childcare costs—key drivers of missed appointments in deprived communities. (The Guardian)
- Care comes to the home. Virtual wards with POCT and remote monitoring support shielded, frail or mobility-limited people, improving safety and convenience. (The Guardian, NHS England)
- Standardised, data-driven pathways. Faster, clearer routes reduce “diagnostic odysseys” that disproportionately affect people navigating multiple conditions or language barriers. (NHS England)
- Prevention and stewardship. CRP POCT supports targeted antibiotic use, and home BP monitoring intensifies cardiovascular prevention where risk is highest. (PMC, Health Innovation Network)
Areas of care the policy focuses on for improvement
- Cancer: Faster Diagnosis Standard, rapid diagnostic services for non-specific symptoms, expanded imaging capacity within CDCs, and pathway tracking tools to hit 28- and 62-day targets. (NHS England, The Guardian)
- Cardiovascular disease: Expanded detection and management of hypertension (BP@Home), atrial fibrillation and lipid disorders through remote monitoring plus accessible phlebotomy/ECG at CDCs. (Health Innovation Network)
- Respiratory infections & antimicrobial stewardship: POCT (e.g., CRP, strep A where appropriate) to support prescribing decisions across GP, urgent care and Pharmacy First, reducing unnecessary antibiotics. (PMC, BSO HSCNI)
- Urgent community response & virtual wards (frailty/COPD/HF): On-the-spot tests (blood gas, lactate, electrolytes, troponin where governed appropriately) to triage in the home and avoid conveyance. (NHS England)
- Imaging backlogs and elective recovery: MRI/CT/ultrasound shifted from acute hospitals to CDCs with out-of-hours access to flatten peaks and cut waits. (NHS England, The Guardian)
- Primary care and community pharmacy access: Same-day high-street testing and treatment for common conditions, easing GP demand and improving convenience for working-age populations. (BSO HSCNI)
What success looks like (and how we’ll know)
- Time to test and time to diagnosis fall, especially for people in the most deprived quintiles and in rural areas—measured through CDC throughput, extended opening hours and 28-day cancer standard performance. Early figures already show substantial growth in test volumes and out-of-hours availability. (The Guardian)
- Avoidable admissions drop via virtual ward/urgent community response teams using POCT to make earlier, safer decisions; evaluations of CO@h provide the template, now applied more broadly. (NHS England)
- More equitable prescribing through POCT-guided antimicrobial stewardship and home BP programmes that reach high-risk populations, tracked via practice- and ICB-level data. (PMC, Health Innovation Network)
Implementation essentials
To sustain equity gains, three enablers matter. First, governance and quality management for POCT (training, connectivity to lab information systems, external quality assurance) to ensure a test in a village hall is as reliable as one in a tertiary centre. Second, digital interoperability so every result follows the patient across providers—core to the 10 year plan, recent Richards Review and to cancer pathway tools. Third, pro-equity commissioning: locate CDCs and POCT services using population-health analytics, fund evening/weekend clinics, and partner with community groups to raise awareness in underserved populations. (NHS England)
Bottom line: The NHS’s 10-year plan doesn’t treat diagnostics as a back-office function; it places them at the front door of care—on the high street, in people’s homes and in community hubs. With CDCs boosting capacity and convenience, and POCT enabling faster, safer decisions, diagnostics become a practical engine for access, inequality reduction and true healthcare equity. Early results—from millions of additional tests, extended hours, safer antibiotic prescribing and proven remote monitoring models—show the direction of travel is both realistic and already delivering. (NHS England, The Guardian, PMC, Health Innovation Network)