The National Health Service is working to expand access to innovative diagnostic technologies for chronic obstructive pulmonary disease (COPD). Research into new diagnostic tests for COPD, such as computed cardiopulmonography and N-Tidal Diagnose, is underway.

Discussions on whether new diagnostic pathways could be developed will be dependent on the research findings.

NHS England continues to work closely with Respiratory Clinical Networks and bodies such as the British Thoracic Society to support improvements to services.

To enable faster diagnosis of asthma and chronic obstructive pulmonary disease (COPD) and earlier treatment, access to spirometry tests in community diagnostic centres (CDCs) is growing and will continue to do so as more sites come online. The first five months of 2025/26 saw an increase in CDC spirometry testing of approximately 2,000 tests per month more than in the previous year.

As of November 2025, CDCs are now delivering additional tests and checks in 170 sites across the country. 101 CDCs across the country now offer out of hours services, 12 hours a day, seven days a week, meaning patients can access vital diagnostic tests around busy working lives.

Research into new diagostic tests for COPD, such as computed cardiopulmonography and N-Tidal Diagnose, is underway. Discussions on whether new diagnostic pathways could be developed will be dependent on the research findings.

To enable faster diagnosis of asthma and chronic obstructive pulmonary disease (COPD) and earlier treatment, access to spirometry tests in community diagnostic centres (CDCs) is growing and will continue to do so as more sites come online. The first five months of 2025/26 saw an increase in CDC spirometry testing of approximately 2,000 tests per month more than in the previous year.

As of November 2025, CDCs are now delivering additional tests and checks in 170 sites across the country. 101 CDCs across the country now offer out of hours services, 12 hours a day, seven days a week, meaning patients can access vital diagnostic tests around busy working lives.

Research into new diagostic tests for COPD, such as computed cardiopulmonography and N-Tidal Diagnose, is underway. Discussions on whether new diagnostic pathways could be developed will be dependent on the research findings.

NHS England commissions the National Vascular Registry which provides information on the quality and outcomes of care for adults who had major vascular procedures in National Health Service hospitals. The registry produces quarterly and annual reports. It aims to support vascular services to provide high quality care for these people, and shares examples of good practice as well as highlighting areas which merit further investigation in order to improve care.

NHS England commissions vascular arterial care from a number of specialist centres to ensure appropriate management of peripheral arterial disease. The service specifications recommend a "hub and spoke" model, where a central, high-volume arterial centre, or the "hub", provides round-the-clock, specialist arterial surgery and complex endovascular interventions. A multi-disciplinary team approach is used and is hosted by the hub.

We inherited a broken National Health Service, and reducing elective waiting lists is a key part of getting it back on its feet and building an NHS that is fit for the future. To that end we have committed to achieving the NHS Constitutional standard that 92% of patients should wait no longer than 18 weeks from referral to treatment by March 2029. Cutting waiting times for diagnostic tests, including those for cardiology, is a crucial step in reducing the elective waiting list.

My Rt. Hon. Friend, the Chancellor of the Exchequer announced at the October statement £600 million of capital to support the reduction of diagnostic waiting lists, which includes continued investment in new and expanded community diagnostic centres (CDCs), new acute hospital diagnostic equipment, and investment in digital diagnostic capabilities.

Between July 2024 and August 2025, existing CDCs have carried out a total of 286,260 echocardiography tests and 260,040 electrocardiography tests. Many CDCs are also implementing innovative cardiac pathways to speed up diagnosis and access to treatment for patients with symptoms suggestive of cardiac disease. Our Elective Reform Plan commits to building up to five new CDCs in 2025/26, alongside increasing the operating hours of existing sites so that more offer services 12 hours a day, seven days a week.

The NHS is investing in digital health solutions to improve patient outcomes in cardiology. This includes enabling remote patient monitoring, early intervention, and greater patient engagement through personalised management plans and educational tools. These solutions allow for continuous data collection from home, which helps clinicians detect and respond to deterioration sooner, potentially preventing hospital admissions and improving long-term health management. They also support early detection, diagnosis, and monitoring.

In addition, NHS England has invested in digital capability which is helping to speed up the reporting of tests routinely used in cardiology services, including artificial intelligence cardiac computed tomography and magnetic resonance imaging.

My Lords, in the 10-year plan we announced that we would deliver the first ever modern service framework for frailty and dementia to reduce unwanted variation and narrow inequality in diagnosis and care for those living with dementia. It will set national standards and redirect NHS priorities to provide the best care and support, which will be central, along with access to a timely and accurate diagnosis.

In our development of the modern service framework for frailty and dementia we are engaging with a wide group of partners, because we need to understand what should be included to ensure the best outcomes. I hope my noble friend will welcome that we are going to be considering what interventions should be supported to improve diagnosis waiting times—which are, I certainly agree, too long in

many areas. In addition, we are considering all the options to help reduce variation, including reviewing metrics and targets, as my noble friend refers to.

Each medical school in the England sets its own undergraduate curriculum which must meet the standards set by the General Medical Council (GMC) in its Outcomes for Graduates. The GMC would expect that, in fulfilling these standards, newly qualified doctors are able to identify, treat and manage any care needs a person has, including chronic spontaneous urticaria (CSU) and similar conditions. The training curricula for postgraduate trainee doctors is set by the relevant Royal College and must also meet the standards set by the GMC.

To support clinicians in the diagnosis, treatment, care and support of patients with CSU, the National Institute for Health and Care Excellence (NICE) has developed an online Clinical Knowledge Summary (CKS) for the management of the condition. Patients can usually be managed with either antihistamines or steroids, but the guidance also makes clear that patients with CSU should be considered for a referral to a dermatologist where symptoms are severe, persistent, or unresponsive to first-line treatments.

The NICE CKS and Technology Appraisal is on the NICE website in an online-only format.

Skin lesion analysis tools that use an artificial intelligence (AI)-based fixed algorithm are currently being trialled in several National Health Service trusts. These AI tools have the potential to free up dermatology capacity and reduce waiting times by effectively triaging patients with skin lesions where there is a suspicion of cancer. Data from trials in 2023/2024 suggests these tools could help with diagnosing and discharging around 30% of cases from the pathway. This will allow more patients to be seen and get a diagnosis in a timely manner.

Our health system has struggled to support those with complex needs, including those with dementia. Under the 10-Year Health Plan, those living with dementia will benefit from improved care planning and better services.

We recognise the importance of a timely diagnosis and remain committed to increasing diagnosis rates. The Government’s Dame Barbara Windsor Dementia Goals programme has already invested £13 million into a range of biomarker innovation projects, which include a broad range of biomarker technologies, ranging from an artificial intelligence tool designed to improve the accuracy of blood tests for dementia, to using retinal scans to detect early-onset dementia decades before symptoms. Some of these innovations could support improved diagnosis in the future, if validated for clinical use.

We will deliver the first ever Modern Service framework for Frailty and Dementia to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, expected in 2026.

The Government’s Dame Barbara Windsor Dementia Goals programme has already invested £13 million into a range of biomarker innovation projects, which include a broad range of biomarker technologies, ranging from an artificial intelligence tool designed to improve the accuracy of blood tests for dementia, to using retinal scans to detect early-onset dementia decades before symptoms.

Some of these innovations could support improved diagnosis in the future, if validated for clinical use.

The Government is committed to transforming diagnostic services and will support the National Health Service in England to increase diagnostic capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners.

The National Cancer Plan will cover the entirety of the cancer pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention, research, and innovation. It will seek to improve every aspect of cancer care, including improving diagnostic performance.

We are committed to transforming diagnostic services and will support the National Health Service to increase diagnostic capacity to meet the demand for diagnostic services through investment in new capacity, including magnetic resonance imaging and computed tomography scanners.

Full roll out of non-specific symptom (NSS) pathways, designed to speed up the diagnosis of cancer, has been achieved across England. NSS pathways introduce a route to possible diagnosis for patients who display symptoms that could indicate cancer, but which do not align to specific cancers. The new non-specific pathway complements current cancer diagnostic pathways, as well as providing elements that can be applied to existing pathways.

Additionally, general practice (GP) direct access enables GPs to directly request diagnostic tests, including several imaging modalities, such as ultrasound, x-ray, computed tomography, and magnetic resonance imaging, rather than first requiring a patient be referred to a specialist in an outpatient appointment. Performing diagnostic tests at this stage ensures that patients receive test results more quickly.

We remain committed to improving the lives of people living with rare diseases, such as primary biliary cholangitis. One of the four priorities of the UK Rare Diseases Framework is increasing awareness of rare diseases among healthcare professionals. Our fourth England action plan, published in February 2025, reports on progress.

The Royal College of General Practitioners (RCGP) has a holistic curriculum of training, with a specific section on women’s health, including menopause. To support practicing general practitioners, the RCGP has developed a Women’s Health Library with educational resources and guidelines on women’s health, which includes a specific section on menopause.

Primary biliary cholangitis has a set of commonly found symptoms, and work is underway to raise awareness of them. NHS England, through the Hepatobiliary and Pancreas Clinical Reference Group, is working closely with partners to raise awareness and understanding of primary biliary cholangitis and its treatments. Plans include the production of a treatment algorithm for use by emergency departments, which may also be helpful for general practitioners.

Heart valve disease (HVD) affects over 1.5 million people over the age of 65 years old in the United Kingdom, and this number is expected to increase in line with general population growth and the increase in the number of older people. Continuous improvements have been made in the HVD pathway for service users, but there remains unwarranted variation and inequalities in gender.

A review of health inequalities for all specialised cardiac services, including aortic stenosis services, a type of HVD, is currently being undertaken. This will specifically consider the presentation of males versus females with aortic stenosis. In addition, work to improve HVD outcomes includes:

• NHS England working with providers to implement a single point of access pathway for severe aortic stenosis;
• the NHS Long Term Plan, published in 2019, includes a number of key ambitions to improve care and outcomes for those individuals with cardiovascular disease, such as HVD, including enhanced diagnostic support in the community, better personalised planning, and increasing access to cardiac rehabilitation;
• NHS England publishing a learning package for healthcare professionals on heart failure and HVD, which supports clinicians across primary care and community settings to better recognise the symptoms, diagnose, manage, and support patients with heart failure and HVD, as well as support on palliative and end of life care; and
• an NHS England commission of the Primary Care Cardiovascular Society to develop a new referral form to support the investigation of HVD to guide primary healthcare teams to confidently refer patients with suspected, or known, HVD for specialist assessment or echocardiography, or both, where appropriate.

An assessment has been carried out by NHS England to understand how the COVID-19 pandemic affected access to spirometry testing. Work is ongoing to bring the number of spirometry tests back to pre-pandemic levels. Healthcare systems also have access to various resources to meet the needs of their populations, including providing diagnostic testing.

We are committed to tackling deaths from cardiovascular disease (CVD), of which there are far too many, and setting a goal for fewer lives being lost to the biggest killers, including CVD. The development of the Major Conditions Strategy was paused following the general election. NHS England’s 2019 Long Term Plan sets out a number of actions that aim to help prevent up to 150,000 heart attacks, strokes, and dementia cases by 2029, and progress towards this is ongoing. To deliver the National Health Service Long Term Plan priorities, a CVD programme has been established which is clinically led by national clinical directors and national specialty advisors, and supported by senior clinicians from a breadth of cardiac and stroke specialties, and primary care, as part of expert advisory groups.

Tackling waiting lists and ensuring that patients receive the care they need when they need it is a key part of our Health Mission. Funding announced in the Autumn Budget will support the delivery of an additional 2 million operations, scans, and appointments during our first year in Government, which is the equivalent to 40,000 per week, as a first step in our commitment to ensuring patients can expect to be treated within 18 weeks.

The NHS Health Check programme, England’s CVD prevention programme, finds people aged 40 to 74 years old who are at risk of CVD and supports them to reduce their risk, preventing approximately 500 heart attacks or strokes each year. To improve access and engagement with the life-saving programme, we are developing a digital NHS Health Check which will be ready for testing in early 2025, and will enable people to undertake a check at home. We are also trialling the delivery of heart health checks to over 130,000 people in workplaces across the country, all of which would improve earlier diagnosis of CVD.

At the 2024 Autumn Budget, my Rt Hon. Friend, the Chancellor of the Exchequer announced £1.5 billion of capital funding for new surgical hubs and diagnostic scanners. This will build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests, as well as new beds which will create more treatment space in emergency departments, reduce waiting times, and help shift more care into the community. We will also address the challenges in diagnostic waiting times, providing the number of computed tomography, magnetic resonance imaging, and other tests that are needed to reduce elective and cancer waits. Finally, the NHS is prioritising roll-out of additional diagnostic capacity, delivering the final year of the three-year investment plan for establishing Community Diagnostic Centres, with capacity prioritised for cancer diagnostics.

Improving health outcomes for the 20 million people in the United Kingdom who live with a musculoskeletal condition, including osteoporosis, forms a key part of the Government’s missions to build a National Health Service fit for the future, cut waiting times, and kick-start economic growth.

Fracture Liaison Services (FLS) play an important role in fracture prevention, helping to prevent fragility fractures and support patients who sustain them. The Government has launched a public engagement exercise to help shape its 10-Year Health Plan, which will be underlined by three big shifts in healthcare, one of which is from treatment to prevention. Officials have been working closely with NHS England on how to ensure better quality and access to FLSs, including on how best to support systems.

The Government has not made a specific estimate or assessment of the cost savings, economic impacts, or hospital bed occupancy pressures referenced in the question.

The Department is currently considering the next steps to improving diagnostic assessment and support for autistic people. It is the responsibility of integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including autism assessment and support services, in line with National Institute for Health and Care Excellence guidelines.

On 5 April 2023, NHS England published a national framework and operational guidance to deliver improved outcomes in all-age autism assessment pathways. This guidance will help ICBs and the National Health Service to deliver improved outcomes for children, young people, and adults referred to an autism assessment service. The guidance also sets out what support should be available before an assessment, and what support should follow a recent diagnosis of autism, based on the available evidence.

In 2024/25, £4.3 million is available nationally to improve services for autistic children and young people, including autism assessment services.

Timely diagnosis of dementia is vital to ensure that a person with dementia can access the advice, information, care and support that can help them to live well with the condition and remain independent for as long as possible.

In 2021/22, the Government allocated £17 million to the National Health Service to address dementia waiting lists and increase the number of diagnoses. In accordance with the Government’s commitments, we will also double funding for dementia research to £160 million per year by 2024/25. This will span all areas of research, including diagnosis.

NHS England continues to monitor the monthly dementia diagnosis rate and analyse trends at national, regional and integrated care board level, and is committed to recovering diagnosis rates to the national ambition.

They have a proactive national dementia programme in place, which includes monitoring international trial data, funding diagnosis improvement projects and informing ongoing research into the identification and management of dementia.

There are no current plans to conduct a national clinical trial of blood tests. The National Health Service is working in partnership with the Government established Dame Barbara Windsor Dementia Mission, which has a national leadership role working with academic and industry partners to discover, validate and operationalise a suite of clinically actionable and decision-enabling biomarkers. Alongside the very welcome linked investments being made in research by the National Institute for Health and Care Research (NIHR) and charities, it is hoped that validated Alzheimer’s blood tests will become available for use in front line NHS care in the next few years.

NHS England has established a dedicated national programme team which is working in partnership with other national agencies and with local health systems to co-ordinate the preparations for the potential roll out of new treatments for use in the earlier stages of Alzheimer’s disease. These plans assume that, if these new treatments are approved by the regulators, significant additional diagnostic capacity, including amyloid PET-CT, lumbar puncture and MRI, will be needed both to identify patients who are most able to benefit and to provide important safety monitoring for potential adverse effects during treatment.

NHS England is also working with partner agencies to support and inform further research into other diagnostic modalities, including blood-based biomarker and digital tests, which will help improve identification and management of Alzheimer’s disease.