Unlocking value through reimagining NHS diagnostic imaging

Despite targeted investments to expand diagnostic imaging capacity, such as the Community Diagnostic Centres, the total number of patients waiting for a scan has increased from 400,000 in 2008 to 1,622,000 in January 2025, just over a 300 percent increase.

Sustainable productivity improvements require system-wide change, not just an expansion of underlying capacity. While initiatives such as Community Diagnostic Centres were designed to alleviate pressure, their impact has been limited by insufficient integration and coordination with the wider NHS. To truly address ongoing challenges and reduce waiting and turnaround times for critical scanning and reporting activities, key drivers of Referral-to-Treatment (RTT) and Emergency Department (ED) performance, NHS Trusts may benefit from exploring more innovative, integrated, and digitally enabled models of care.

How can Trusts and systems move forward:

1. Harness system integration to optimise imaging capacity – move from fragmentation to functional integration
   NHS Trusts are encouraged to move away from siloed operations and start functioning as unified imaging systems with shared governance, pooled resources, and interoperable digital platforms across Trust boundaries.
2. Collaborate across care settings to reduce acute demand – embed community diagnostics into the core pathway
   Rather than acting solely as overflow facilities, Community Diagnostic Centres could be more effectively integrated into referral pathways. ICSs may want to explore embedding smart triage and digital scheduling within primary care to support this.
3. Unlock productivity and efficiency through digital transformation – scale AI-enabled imaging as standard practice
   AI tools like Harrison.ai have the potential to become part of the core infrastructure rather than remaining pilot initiatives. NHS England might consider setting national benchmarks for AI adoption in radiology, aligned with measurable improvements in turnaround time, diagnostic accuracy, and workforce productivity.

Harnessing system integration to optimise imaging capacity

System integration across imaging services is essential for transforming delivery, enabling earlier diagnosis, optimising patient demand, and reducing pressure on acute care. Imaging Networks are, conceptually, the vehicle to deliver this, uniting organisations to maximise resources across Trust boundaries. They support earlier diagnosis, ease pressure on acute hospitals and streamline the patient journey by consolidating capacity and expertise. For example, the Merseyside and Cheshire Sustainability and Transformation Plan (STP) implemented a hub-based on-call model across its acute imaging services, enhancing efficiency and responsiveness, which ensured earlier diagnosis through ‘on call’ cover across all sites. However, for Imaging Networks in the NHS to truly succeed, it is important to move beyond trust-level silos and evolve into fully integrated systems - digitally connected, workforce-flexible, and governed as one.

Collaborating across care settings to reduce acute demand

While Imaging Networks offer a strategic approach to resource sharing, out-of-hospital models such as Community Diagnostic Centres provide a complementary solution focused on accessibility and demand management. Strategically located in accessible, non-acute settings, such as shopping centres and university campuses, Community Diagnostic Centres provide coordinated, same day scanning that accelerates clinical decision-making and improves outcomes. With over 165 centres now operational across England, delivering millions of scans annually, Community Diagnostic Centres are not just expanding access; they’re actively reducing health inequalities, supporting NHS sustainability goals, and serving as hubs for innovation and integrated care.

However, the full potential of Community Diagnostic Centres has yet to be realised and unlocking their benefits relies on deeper integration with local Trusts, Integrated Care Systems (ICSs), and primary care. To help shift demand away from acute settings, Community Diagnostic Centres could consider adopting smarter scheduling models and enabling self-booking for patients. Leveraging digital tools and strategic triaging solutions can help divert high-volume, low-complexity imaging demand into community settings, unlocking efficiency and relieving pressure across the system. A welcome development announced in September 2025 is the NHS England’s Virtual Hospital model. Set to launch in 2027, this initiative will use AI-powered triage via the NHS App to route patients directly to Community Diagnostic Centres, enabling self-booking to support accessibility and efficiency of diagnostic testing.

Unlocking productivity and efficiency through digital transformation 

To fully realise the benefits of integration and collaboration, the NHS may need to embrace digital transformation, a key enabler of productivity, efficiency, and improved clinical outcomes. At the heart of this transformation lies the integration of digital systems across primary and secondary care organisations, essential for delivering a collaborative, networked model of care that spans organisational boundaries.

The Northeast and North Cumbria (NENC) region offers a compelling example of this approach. In 2024/25, the region invested £5.1m to advance digital diagnostics, focusing on cloud-based infrastructure, regional order communications, and AI-powered imaging tools. These investments have streamlined referral pathways and improved access to diagnostic results across care settings, laying the groundwork for more connected and responsive services.

However, the future of diagnostics extends beyond improving digital infrastructure. It lies in the intelligent application of advanced digital tools to optimise scanner utilisation, enhance clinical decision-making, and support earlier interventions. A standout innovation is Harrison.ai’s chest X-ray AI solution, now deployed across more than 40 NHS Trusts. Capable of detecting up to 124 findings per scan, the tool has demonstrated a 45 percent improvement in diagnostic accuracy and a 12 percent increase in staffing efficiency, acting as a second pair of eyes for clinicians and prioritising cases based on findings.

These technologies do more than improve workflow, they elevate clinical confidence, reduce missed diagnoses, and enable faster, more targeted treatment. The NENC model illustrates how digital integration, when combined with AI-driven tools, can significantly enhance the resilience, responsiveness, and sustainability of diagnostic services.

As the NHS continues to evolve, embracing digital innovation will be critical not just for operational improvement, but for delivering better patient outcomes and building a future-ready health system.

Building a future-fit diagnostic imaging infrastructure

To sustainably transform diagnostic imaging services, the NHS could consider evolving from reactive, capacity-driven responses to a more integrated, digitally enabled model of care. While Imaging Networks, Community Diagnostic Centres and AI-powered tools have already shown measurable improvements in access, efficiency, and clinical outcomes, realising these benefits at scale requires more than isolated innovation - it demands sustained leadership prioritisation, strategic alignment, and a shift toward system-wide collaboration.

Understandably, many providers remain focused on managing immediate pressures, but this often comes at the expense of broader integration and limits the capacity for transformative change. By embedding digital innovation and interoperability into the core of diagnostic strategy, and by fostering collaboration across trusts and systems, the NHS can unlock new efficiencies, reduce variation, and build a more resilient, equitable, and future-ready diagnostic imaging infrastructure.