Diagnostic tests or procedures are a critical element in the care of many patients. Shorter waiting times are beneficial, as they help people get quicker access to the treatments they need.
The six-week diagnostic wait was initially introduced as a ‘milestone’ in March 2008 to support the achievement of the 18-week referral to treatment (RTT) target, but diagnostic waiting times are now part of the NHS Constitution. This gives patients the legal right to have a diagnostic test within six weeks of the request being sent.
A review of NHS access standards is currently being undertaken. The Interim Report proposed that the maximum six-week wait for diagnostic tests, with the threshold set at 99%, would remain unchanged.
These indicators measure the waiting times of patients still waiting for any of 15 key diagnostic tests or procedures at the end of the month. See ‘About this data’ for more information.
The proportion of patients waiting six weeks or more for a diagnostic test fell dramatically up until March 2008, when the diagnostic wait 'milestone' was introduced. Since then, the proportion of patients waiting longer than the target has mostly fluctuated at less than 3%. Only in the last two years have waiting times have begun to increase again, reaching a peak of 4.1% in May 2019.
In June 2010, central performance management of targets was relaxed and this corresponds to the increase in waits of six weeks or more that were recorded around the summer of 2011. The NHS Operating Framework 2012/13 introduced a further expectation that less than 1% of patients should wait six weeks or longer for a diagnostic test. The impact of this can be seen clearly, as from February 2012 to November 2013 the proportion stayed around 1%. However, since then the 1% target has not been met. In July 2019, 3.5% of patients had been waiting six weeks or more for a diagnostic test.
In addition to looking at the proportion of people waiting six weeks or more for a diagnostic test, we can also examine changes in the median waiting time. In February 2008, the median waiting time fell to 1.9 weeks in anticipation of the introduction of the national target. The lowest median wait of 1.5 weeks occurred in January 2009. Since then, the overall median wait has been slowly increasing over time. This is demonstrated by the rise in the 12-month rolling average, from 1.7 weeks in 2009 to 2.1 weeks in 2019. In general, the median wait peaks in December every year – this is likely due to people not being able to schedule or attend appointments over the Christmas holidays.
The introduction of the six-week target also had a big impact on the total number of patients on the waiting list for a diagnostic test or procedure. In December 2008, the waiting list fell to a low of just over 400,000 patients. Since then, the list has been steadily increasing and in July 2019 over one million people were waiting for a diagnostic test. This should be seen in the context of a rapid increase in the number of diagnostic tests being undertaken each month; in June 2007, 995,098 diagnostic tests were carried out and this more than doubled to reach two million in July 2019.
About this data
These indicators measure the waiting times of patients still waiting for any of 15 key diagnostic tests or procedures at the month end. The waiting times are for patients who have been referred for a test, but whose test had not taken place by the end of the reporting period.
Once a decision has been made that a patient needs a diagnostic test or procedure and the request has been sent, they are on the waiting list and the clock starts for their diagnostic test waiting time. The clock stops once they have had their diagnostic test or procedure.
The 15 key diagnostic tests that are included are:
- Magnetic resonance imaging (MRI)
- Computerised tomography (CT)
- Non-obstetric ultrasound
- Barium enema
- Dual-energy x-ray absorptiometry (DEXA) scan
- Audiology assessments
- Neurophysiology – peripheral neurophysiology
- Respiratory physiology – sleep studies
- Urodynamics – pressures and flows
- Flexible sigmoidoscopy
For further guidance on these data, please see the NHS England website.