Are community diagnostic centres ‘cutting’ NHS waiting lists?

Community diagnostic centres are cutting waiting lists and have now delivered over 4 million tests, checks and scans.

CDCs have delivered over 4 million checks, tests and scans for patients across the country since July 2021, cutting waiting lists and giving patients quicker access to care.

The health minister Will Quince tweeted on 9 June that Community Diagnostic Centres (CDCs) “are cutting waiting lists”.

The Department for Health and Social Care (DHSC) made a similar comment in a press release the same day.

CDCs are a new type of NHS facility that provide a range of different tests, checks and scans. They were introduced in England in July 2021, and are intended to increase the country’s diagnostic capacity and reduce the pressure on hospitals, thereby improving people’s health.

It is potentially misleading to say that CDCs are “cutting waiting lists”, because the meaning of the phrase is ambiguous. Neither Mr Quince nor DHSC made clear that they were comparing waiting lists with how they might look had CDCs not been introduced—not with how they looked in the past.

Both the main diagnostics waiting list and the overall elective treatment waiting list, as published by NHS England, have grown since CDCs were launched. (Health policy is devolved, so this article refers only to the NHS in England, which the UK government controls.)

Some of the longest waits have fallen recently though, and there are now fewer of the very longest than there were in July 2021.

Politicians, especially ministers and their departments, must be clear what they mean when making claims using official data to describe public services. Otherwise they risk misleading people about the government’s performance—and, in this case, access to the NHS.

Full Fact has written before about Rishi Sunak making a similar claim about overall waiting lists more generally.

DHSC told us that it has commissioned a report on the impact of CDCs on backlogs from the National Institute for Health and Care Research Economics, which it expects to be published in December 2023.

A DHSC spokesperson said: “It is a fact that waiting lists would be longer without community diagnostic centres, which have already delivered over four million additional checks and scans across the country since July 2021.”

What does the data on CDCs show?

DHSC told us that data showing that CDCs have so far carried out over four million checks, tests and scans had not been published at the time the claim was made, on 9 June. However on 21 June, while we were preparing this article, NHS England did belatedly publish data to substantiate the claim, and an earlier version of the same data series was also published last year. 

NHS England’s diagnostics data includes data from CDCs for March and April 2023. According to the NHS report on the data, it “should exclude services that have moved to the CDC from existing sites, making it additional activity”.

As far as we can tell,  DHSC and ministers have often announced figures for CDC activity before the data was published. This includes the announcement in May that “over 3.8 million” tests, checks and scans had been conducted, and statements in February 2023 and December 2022 that the figure was about three million, as well as the latest statement that it had reached four million.

It appears that none of the data behind these figures was available to the public, other than through a Freedom of Information request submitted by the Institute for Government, until it appeared as a supplementary publication from NHS England on 21 June 2023.

Ministers and Government departments must provide evidence for what they say, and ensure that any statistics and data they rely on to back up their claims are provided publicly in accordance with the Code of Practice for Statistics or relevant guidance.

What does the waiting list data tell us?

NHS England does not publish data on all the tests it carries out, nor all the cases waiting for them.

The most commonly used data on the number of cases waiting for treatment is the “Consultant-led Referral to Treatment Waiting Times”, often known as the RTT data. This doesn’t cover everyone waiting for any kind of NHS treatment, but it shows us the main body of cases where someone has been referred for elective treatment that has not yet started or been ruled out.

We also have diagnostics data, which counts the number of tests, checks and scans conducted and awaited from a list of 15 types. This means it does not include blood tests or X-rays, for example. Nor does it include people who are “waiting” for routine national screening appointments.

NHS England says it “monitors, on a less frequent basis, information on other diagnostics tests/procedures not covered by the monthly data collection”, but this information appears not to be published.

Both the RTT and the diagnostics waiting lists count the number of cases waiting, not the number of patients, because one patient can be waiting for more than one treatment or test.

Both the overall RTT waiting list (from 5.6 million to 7.4 million) and the diagnostics waiting list (from 1.38 million to 1.56 million) have grown longer since July 2021, as DHSC has confirmed. The Prime Minister indicated in May that the RTT waiting list may not begin to fall until the spring of 2024.  

However, as we have written before, these lists can be divided up in a number of ways—including by location, type of treatment or length of wait—and some of the lists when defined this way are falling.

Image courtesy of National Cancer Institute