NHS England has undertaken detailed modelling to understand the diagnostic and workforce capacity required to support a reduction in the faecal immunochemical test (FIT) threshold within the Bowel Cancer Screening Programme in England. NHS England has worked with early adopter sites to test the operational impact of lowering the FIT threshold in real‑world settings. These sites have provided evidence on changes in referral volumes, colonoscopy demand, cancer and polyp detection rates, and the implications for endoscopy services. The findings are being formally evaluated and are informing assumptions within the national capacity modelling. The timing of wider roll‑out is directly linked to the outcomes of this modelling and evaluation work, as well as the availability of trained endoscopy staff.

NHS England continues to develop the endoscopy workforce, including the expansion of the screening colonoscopist workforce through Advanced Training Skills Module.

Alongside this, NHS England is progressing a wider programme of endoscopy transformation focused on releasing capacity and improving productivity. This includes the intelligent use of FIT testing, including coloFIT, to support more effective risk stratification, reduce unnecessary colonoscopies, and ensure that available endoscopy capacity is targeted towards those at highest risk. Embedding FIT‑led pathways supports earlier reassurance for lower‑risk individuals while prioritising timely investigation for those most likely to benefit.

The Design for Life (DfL) Roadmap sets out a new strategy to transition away from all avoidable single-use medical technology products towards a functioning circular system by 2045. The Department has shared a ‘One Year On’ update with its wider collaborative who have supported the policymaking, now numbering over 100 organisations. This update can be found publicly at the following link:

https://exeterce.org/wp-content/uploads/2025/11/20251127-DfL-One-Year-On-update.pdf

More reporting mechanisms will be developed as the programme matures, for example where the roadmap plans for the creation of specific targets and key performance indicators, such as in Action 3. Reporting is done on a quarterly basis to the DfL Advisory Group, which is comprised of key stakeholders, including those from United Kingdom governments, the National Health Service, industry, and academia.

Information on evaluating outcomes of the recent DfL pilots can be found on the Centre for Sustainable Healthcare’s website, who were our partner on these pilots, at the following link:

https://sustainablehealthcare.org.uk/activity/reusable-medtech-in-the-nhs-pioneering-sustainable-healthcare/

These pilots observed that in most cases both cost and carbon savings can be found and staff satisfaction can be either maintained or improved. The Department is building on these evaluations with a dedicated Priority Adoption Working Group, which includes clinical and procurement professionals, to identify the products with the strongest case for safe, immediate transitions to reusables across the NHS. To date this group has evaluated over 50 products.

These transitions will be supported by many technical assessments, including those relating to the readiness of supply chains, reprocessing infrastructure, and staff. The decision to commit to a transition, for example whether to support a transition of certain types of endoscopes or not, will be made on the basis that is it safe, feasible, and valuable in the long-term following these and other assessments. At this juncture these assessments are still underway and so estimates cannot be provided at this time.

NHS England does not hold or collect the information requested.

Increasing capacity to meet the demand for diagnostic services is a priority for the Government. We are committed to providing the National Health Service with the latest technology, replacing outdated equipment to make diagnosis more accurate and timely, and improving experience for patients. Plans for future funding will be informed by NHS England's assessment of priorities, and will be set out at the earliest opportunity.

It is our priority to take the steps necessary to return to waiting time standards for cancer, including the Faster Diagnosis Standard, which sets a target of 28 days from urgent referral by a general practitioner or screening programme to patients being told that they have cancer, or that cancer is ruled out.

Increasing capacity to meet demand for diagnostic services and returning to waiting time standards for cancer, including the Faster Diagnosis Standard, are both priorities for the Government.

It is our ambition to introduce a new Fit For the Future fund to provide the National Health Service with the latest technology and to replace outdated equipment to make diagnoses, including cancer diagnoses, more accurate and timely, and to improve the experience for patients.

More detailed plans for future funding will be informed by NHS England's assessment of priorities, and will be set out at the earliest opportunity.

In July 2023, Cheshire and Merseyside Integrated Care System (ICS) delivered 1,997 more gastroscopy procedures in July 2023 than in July 2018. Alongside this increase of almost 2,000 procedures, 70% of patients who require a gastroscopy are now seen within six weeks.

Cheshire and Merseyside ICS has also secured funding to support the delivery of more than 1,000 additional endoscopy procedures across Cheshire and Merseyside by the end of December 2023. Cheshire and Merseyside’s Diagnostic Programme is also progressing a number of workforce initiatives including a collaborative staff bank for the endoscopy workforce and an endoscopy academy to provide training and upskilling for the endoscopy workforce.

Cutting National Health Service waiting lists, including for endoscopy services, is one of this Government’s top priorities. This is a shared ambition amongst ICSs, including the Cheshire and Merseyside ICS.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of community diagnostic centres up to 160 by March 2025, including a number delivering endoscopy services.

Whilst patients on coeliac endoscopy pathways will be recorded, there are currently no plans to publish specialty level data for coeliac endoscopy National Health Service waiting lists.

NHS England collects and publishes monthly referral to treatment (RTT) data which is used to monitor NHS waiting times performance against the standards set out in the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012.

RTT data currently includes waiting list data for 23 treatment pathway categories, where one of these is gastroenterology.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years, to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of Community Diagnostic Centres up to 160 by March 2025, including a number delivering endoscopy services.

The Government has not made an assessment of the barriers to reducing endoscopy waiting lists in the Humber and North Yorkshire Integrated Care System (ICS) and across the Vale of York. It is the responsibility of individual ICSs to work with NHS England to understand local barriers to delivering the required diagnostics services, including endoscopy and implement appropriate waiting list solutions based on local need.

This information is not held in the format requested.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of Community Diagnostic Centres to 160 by March 2025, including a number delivering endoscopy services.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of Community Diagnostic Centres up to 160 by March 2025, including a number delivering endoscopy services.

Cutting National Health Service waiting lists, including for endoscopy services, is one of this government’s top priorities. This is a shared ambition amongst integrated care systems (ICSs), including the NHS Hampshire and Isle of Wight ICS. Priorities are set locally through joint strategic needs assessments as part of joint forward plans across the ICS and partnering NHS trusts.

There are currently nine sites delivering diagnostics for Hampshire and the Isle of Wight. This includes the provision of endoscopy services at some sites.

In the South East Hampshire Locality which includes Portsmouth, Fareham and Gosport, 1,908 additional endoscopy tests have been delivered closer to people’s homes, increasing earlier access to endoscopy procedures.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, including a number delivering endoscopy services.

In 2022/23, Kent and Medway Integrated Care System spent a total of £92,251,788 on all diagnostic services collected on DM01. DM01 includes the 15 key diagnostic tests and procedures. Of this, £51,185,316 (55.5%) was spent on diagnostic endoscopy procedures.

Cutting National Health Service waiting lists, including for endoscopy services, is one of the Government’s top priorities. This is a shared ambition amongst integrated care systems (ICSs), including Kent and Medway ICS. Priorities are set locally through joint strategic needs assessments as part of joint forward plans across the ICS and partnering NHS trusts.

NHS Kent & Medway ICS is actively working with providers across Kent & Medway, including Ashford, to support waiting list reduction through waiting list validation, providing additional capacity and the redesign of patient pathways. This includes endoscopy procedures.

The Government has not made a recent assessment of the barriers to reducing endoscopy waiting lists in the NHS Kent and Medway integrated care system. It is the responsibility of individual ICSs to work with NHS England to understand local barriers to delivering the required diagnostics services, including endoscopy, and to implement appropriate waiting list solutions based on local need.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, including a number delivering endoscopy services.

In 2022/23, Kent and Medway Integrated Care System spent a total of £92,251,788 on all diagnostic services collected on DM01. DM01 includes the 15 key diagnostic tests and procedures. Of this, £51,185,316 (55.5%) was spent on diagnostic endoscopy procedures.

Cutting National Health Service waiting lists, including for endoscopy services, is one of the Government’s top priorities. This is a shared ambition amongst integrated care systems (ICSs), including Kent and Medway ICS. Priorities are set locally through joint strategic needs assessments as part of joint forward plans across the ICS and partnering NHS trusts.

NHS Kent & Medway ICS is actively working with providers across Kent & Medway, including Ashford, to support waiting list reduction through waiting list validation, providing additional capacity and the redesign of patient pathways. This includes endoscopy procedures.

The Government has not made a recent assessment of the barriers to reducing endoscopy waiting lists in the NHS Kent and Medway integrated care system. It is the responsibility of individual ICSs to work with NHS England to understand local barriers to delivering the required diagnostics services, including endoscopy, and to implement appropriate waiting list solutions based on local need.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, including a number delivering endoscopy services.

In 2022/23, Kent and Medway Integrated Care System spent a total of £92,251,788 on all diagnostic services collected on DM01. DM01 includes the 15 key diagnostic tests and procedures. Of this, £51,185,316 (55.5%) was spent on diagnostic endoscopy procedures.

Cutting National Health Service waiting lists, including for endoscopy services, is one of the Government’s top priorities. This is a shared ambition amongst integrated care systems (ICSs), including Kent and Medway ICS. Priorities are set locally through joint strategic needs assessments as part of joint forward plans across the ICS and partnering NHS trusts.

NHS Kent & Medway ICS is actively working with providers across Kent & Medway, including Ashford, to support waiting list reduction through waiting list validation, providing additional capacity and the redesign of patient pathways. This includes endoscopy procedures.

The Government has not made a recent assessment of the barriers to reducing endoscopy waiting lists in the NHS Kent and Medway integrated care system. It is the responsibility of individual ICSs to work with NHS England to understand local barriers to delivering the required diagnostics services, including endoscopy, and to implement appropriate waiting list solutions based on local need.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, including a number delivering endoscopy services.

In 2022/23, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (ICS) spent a total of £24,790,510 on all diagnostic services. Of this, £5,179,888 (21%), was spent on diagnostic endoscopy procedures at Buckinghamshire Healthcare NHS Trust.

Cutting National Health Service waiting lists, including for endoscopy services, is one of the Government’s top priorities. This is a shared ambition amongst ICSs, including Buckinghamshire, Oxfordshire and Berkshire West ICS. Priorities are set locally through joint strategic needs assessments as part of joint forward plans across the ICS and partnering NHS trusts.

In October 2021, Buckinghamshire, Oxfordshire and Berkshire West ICS opened West Berkshire Community Hospital CDC. West Berkshire Community Hospital CDC has since delivered 4,492 additional endoscopy tests closer to people’s homes, supporting earlier access to endoscopy procedures. Additional endoscopy capacity from new CDCs within the ICS will also start to come onstream later this year. This includes North Bedfordshire CDC (Whitehouse Health Centre), which will be located in the Buckingham constituency. Endoscopy services at these CDCs may be offered to the Buckingham population where convenient, to improve their access to diagnostic care.

The Government has not made a recent assessment of the barriers to reducing endoscopy waiting lists in the Buckinghamshire, Oxfordshire and Berkshire West ICS. It is the responsibility of individual ICSs to work with NHS England to understand local barriers to delivering the required diagnostics services, including endoscopy, and to implement appropriate waiting list solutions based on local need.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, including a number delivering endoscopy services.

In 2022/23, North East and North Cumbria Integrated Care System spent a total of £245,092,935 on all diagnostic services. Of this, £1,565,858 (0.64%), was spent on diagnostic endoscopy procedures in South Tyneside.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, including a number delivering endoscopy services.

In 2022/23, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (ICS) spent a total of £24,790,510 on all diagnostic services. Of this, £5,179,888 (21%), was spent on diagnostic endoscopy procedures at Buckinghamshire Healthcare NHS Trust.

Cutting National Health Service waiting lists, including for endoscopy services, is one of the Government’s top priorities. This is a shared ambition amongst ICSs, including Buckinghamshire, Oxfordshire and Berkshire West ICS. Priorities are set locally through joint strategic needs assessments as part of joint forward plans across the ICS and partnering NHS trusts.

In October 2021, Buckinghamshire, Oxfordshire and Berkshire West ICS opened West Berkshire Community Hospital CDC. West Berkshire Community Hospital CDC has since delivered 4,492 additional endoscopy tests closer to people’s homes, supporting earlier access to endoscopy procedures. Additional endoscopy capacity from new CDCs within the ICS will also start to come onstream later this year. This includes North Bedfordshire CDC (Whitehouse Health Centre), which will be located in the Buckingham constituency. Endoscopy services at these CDCs may be offered to the Buckingham population where convenient, to improve their access to diagnostic care.

The Government has not made a recent assessment of the barriers to reducing endoscopy waiting lists in the Buckinghamshire, Oxfordshire and Berkshire West ICS. It is the responsibility of individual ICSs to work with NHS England to understand local barriers to delivering the required diagnostics services, including endoscopy, and to implement appropriate waiting list solutions based on local need.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of community diagnostic centres (CDCs) up to 160 by March 2025, including a number delivering endoscopy services.

In 2022/23, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (ICS) spent a total of £24,790,510 on all diagnostic services. Of this, £5,179,888 (21%), was spent on diagnostic endoscopy procedures at Buckinghamshire Healthcare NHS Trust.

Cutting National Health Service waiting lists, including for endoscopy services, is one of the Government’s top priorities. This is a shared ambition amongst ICSs, including Buckinghamshire, Oxfordshire and Berkshire West ICS. Priorities are set locally through joint strategic needs assessments as part of joint forward plans across the ICS and partnering NHS trusts.

In October 2021, Buckinghamshire, Oxfordshire and Berkshire West ICS opened West Berkshire Community Hospital CDC. West Berkshire Community Hospital CDC has since delivered 4,492 additional endoscopy tests closer to people’s homes, supporting earlier access to endoscopy procedures. Additional endoscopy capacity from new CDCs within the ICS will also start to come onstream later this year. This includes North Bedfordshire CDC (Whitehouse Health Centre), which will be located in the Buckingham constituency. Endoscopy services at these CDCs may be offered to the Buckingham population where convenient, to improve their access to diagnostic care.

The Government has not made a recent assessment of the barriers to reducing endoscopy waiting lists in the Buckinghamshire, Oxfordshire and Berkshire West ICS. It is the responsibility of individual ICSs to work with NHS England to understand local barriers to delivering the required diagnostics services, including endoscopy, and to implement appropriate waiting list solutions based on local need.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of Community Diagnostic Centres (CDCs) up to 160 by March 2025, including a number delivering endoscopy services.

In July 2021, Cheshire and Merseyside Integrated Care System opened St Helens CDC, which has since delivered 2,164 additional endoscopy tests closer to people’s homes, increasing earlier access to endoscopy procedures for the Knowsley population.

In 2022/23, Cheshire and Merseyside Integrated Care System spent a total of £46,608,474 on diagnostic scoping services. Of this, £3,268,694 (7.0%), was spent on diagnostic endoscopy procedures in Knowsley.

Data on funding for all diagnostics is not held in the format requested.

£2.3 billion was awarded at the 2021 Spending Review to transform diagnostic services over the next three years to increase diagnostic capacity, including for endoscopy services. This funding will also increase the number of Community Diagnostic Centres (CDCs) up to 160 by March 2025, including a number delivering endoscopy services.

In July 2021, Cheshire and Merseyside Integrated Care System opened St Helens CDC, which has since delivered 2,164 additional endoscopy tests closer to people’s homes, increasing earlier access to endoscopy procedures for the Knowsley population.

In 2022/23, Cheshire and Merseyside Integrated Care System spent a total of £46,608,474 on diagnostic scoping services. Of this, £3,268,694 (7.0%), was spent on diagnostic endoscopy procedures in Knowsley.

Data on funding for all diagnostics is not held in the format requested.