A new report has warned that diagnostic services in England are struggling to keep pace with rising demand, with nearly 2 million patients already waiting for tests and the backlog projected to exceed 2 million by 2027 unless significant changes are made.
The report, Strengthening the Backbone: Reimagining NHS Diagnostics in England, commissioned by healthcare technology company Magentus, argues that pressures on diagnostic services now extend beyond capacity alone and require a more connected, system-wide approach to care.
Analysis of National Health Service (NHS) England data found that 1.92 million people were waiting for a diagnostic test in March 2026, an 83 percent increase compared with pre-pandemic levels. More than one in five patients (21.2 percent) had waited longer than six weeks for a test – far above the one percent excess tolerated by the NHS constitution. Median waiting times have increased by 56 percent since before the pandemic.
Despite near-record activity levels, with more than 2.6 million diagnostic tests delivered in March 2026, demand continues to outstrip capacity. Since January 2022, the diagnostic waiting list has increased by almost 473,000 patients. The report estimates that an additional 90,000 tests per month would be needed to clear the backlog above pre-pandemic levels within a year.
The analysis also highlighted substantial regional variation. Nearly 30 percent of patients in the East of England were waiting longer than six weeks for a test, compared with around 13 percent in the North West. Areas with longer diagnostic waits were more likely to miss cancer diagnostic targets and reported poorer performance in specialties including cardiology, gastroenterology, and ear, nose, and throat services.
Workforce shortages were identified as a major contributor to delays. Since January 2020, the diagnostic waiting list has grown by 83 percent, while the clinical radiology workforce has increased by 33 percent and the histopathology workforce by 24 percent. The report noted that demand has grown more than twice as fast as reporting capacity.
To address these challenges, the authors set out eight recommendations. These include:
Redesigning diagnostics as connected pathways rather than isolated services
Expanding reporting and specialist workforce capacity
Improving interoperability and data sharing
Making better use of community diagnostic centers
Introducing diagnostics earlier in patient pathways
Improving communication with patients
Aligning funding with whole-pathway care
Improving the quality of referrals
Marlen Suller, Managing Director, Clinical Diagnostics EMEA at Magentus, said, “NHS teams are delivering extraordinary levels of activity, but the report shows that simply doing more tests will not solve the underlying challenge. The opportunity now is to create a more connected diagnostic system, making better use of technology to support clinicians, reduce duplication of tests, and improve the experience of care for patients.”
Newsletters
Receive the latest pathologist news, personalities, education, and career development – weekly to your inbox.
