The Taskforce for Lung Health has recently published a position statement outlining the improvements required to ensure people with lung conditions have timely and equitable access to CT scanning in England. 

Early and accurate diagnosis is critical for people with lung conditions – without a diagnosis, people go untreated, putting them at risk of worsening symptoms and potential permanent lung damage and loss of function. Computed tomography (CT) scanning is a key diagnostic test for many lung conditions including interstitial lung disease, bronchiectasis, sarcoidosis and lung cancer, offering clinicians the sensitivity needed to diagnose these at an earlier stage when treatment can have a greater impact. 

However, access to CT scanning varies significantly leading to unequal and inequitable care. In 2021, the UK ranked 37^th out of 42 OECD countries for the numbers of CT scanners in hospitals at 10 per million and 30^th out of 33 for numbers of scans performed at just 94 per 1,000 population. The 2024 Darzi Review found that the UK has too many outdated scanners that are prone to breaking down, contributing to more than half of patients waiting over six weeks for a scan. 

To ensure people with lung conditions have timely and equitable access to CT scanning, the Taskforce for Lung Health is calling for: 

Improved use of GP Direct Access by expanding coverage and enhancing advice and guidance 

Since 2023, GPs have been able to refer patients directly for CT scans without the need for a hospital appointment, through the GP Direct Access scheme (GPDA). However, the proportion of CT scans requested via GPDA varies widely between trusts, with some referring this way almost 60% of the time and others less than 1%. 

To ensure equitable access, GPDA should be expanded across England, with published data on current coverage. GP surgeries should be provided with the education, clinical decision tools and resources to help them identify when direct referral to CT is appropriate.  

Increase scanning capacity, with an emphasis on the most poorly provisioned trusts and ICBs 

England does not have enough CT scanners to meet current demand, with many scanners outdated and more than half of trusts lacking the physical space to add a new scanner.  

ICBs should make funding available to replace end-of-life scanners where the manufacturer has stopped producing, supporting or guaranteeing parts for that model and increase capacity in targeted areas with the longest waiting lists. Community Diagnostic Centre programme teams should also work with local areas where CT scanning capacity is underutilised, to shift elective scanning away from hospitals and ease pressure. 

Tackle workforce shortages to boost radiology staffing numbers and reduce waits for reporting 

The NHS does not currently have the workforce to match current demand leading to reporting being routinely outsourced at a cost of £216m a year. This is exacerbated by one in five radiology departments freezing recruitment; a fall in retention rates; and a forecast that 26% of chest and lung CT specialists will retire within the next five years, putting pressure on workforce capacity. 

The 10 Year Workforce Plan should set clear targets for the number of trained radiologist posts by 2035. It should also set out how AI can be used to support diagnosis, while making clear that technology cannot solely be used to boost workforce capacity. 

Expanding GP Direct Access, investing in scanning capacity and tackling workforce shortages are vital steps needed to deliver timely, equitable CT scanning for people with lung conditions across England.