Source · Select Committees · Public Accounts Committee
Recommendation 24
24
Accepted
Diagnostics require further investment and greater integration across the entire health system.
Conclusion
Lord O’Neill told us that although DHSC and its arm’s-length bodies have done a decent job in some key areas, they have not really progressed diagnostics. He is of the view that diagnostics should be embedded across the entire health system, which would improve productivity as well as addressing AMR.62 Dr Partridge told us that while there was progress in getting test results more quickly the NHS should be trying to move more diagnostic tests to where the patient is receiving care, and relying less on an external laboratory.63 We also received a number of submissions emphasising the need to invest further in diagnostics. These included 54 Qq 40–41, 86; C&AG’s report, para 5 55 C&AG’s Report, para 1.8; Public Health England, Research reveals levels of inappropriate prescriptions in England, press release, 27 February 2018 56 C&AG’s Report, para 2.13 57 Q 85 58 Q 40 59 Q 85 60 C&AG’s Report, paras, 2.11, 2.13, 2.35, Figure 11 61 HM Government, Confronting antimicrobial resistance 2024 to 2029, May 2024 62 Qq 6–7 63 Qq 3, 8 15 evidence from the Cystic Fibrosis Trust, which highlighted the need to prioritise diagnostics because fast diagnosis of AMR lung infections was critical for people with cystic fibrosis.64
Government Response Summary
The government agrees with the conclusion, setting a target implementation date of Spring 2027 for related diagnostic initiatives. They are developing an infection diagnostics framework by 2027, launching point-of-care test pilots in Q3 2025-2026, and exploring rapid laboratory tests to enhance diagnosis and appropriate antimicrobial use.
Government Response
Accepted
HM Government
Accepted
4.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2027 4.2 The government is working to fulfil Outcome 6 of the NAP, which commits to cross- sector working to develop diagnostics as a tool to tackle AMR. DHSC, through National Institute for Health and Care Research (NIHR), has invested over £18 million into research AMR diagnostics research. DHSC also funds the NIHR HealthTech Research Centres, which accelerate development of healthcare technologies, including diagnostics. 4.3 NHSE is streamlining diagnostic innovation through hosting the cross-sector ‘Moving Forwards Infection Diagnostics’ events series. Engagement will inform an ‘infection diagnostics framework’ by 2027, and the identification of target product profiles for diagnostics needed in the NHS. A rapid review pipeline to identify optimal tests within the market and assess how existing diagnostics can be optimised is also being produced. 4.4 NHSE has developed clinical pathways for Pharmacy First, which support pharmacists in treatment decisions, guiding appropriate antibiotic use or antibiotic-sparing. Pathways function as diagnostic tools, encompassing clinical decision-support tools and risk- stratification, and are already in daily use. Pilot schemes to gather evidence on clinical impact of point-of-care tests are being scoped for several primary care patient pathways, including community pharmacy, launching in Q3 2025-2026 and reporting in 2026-2027. 4.5 UKHSA will explore the application of rapid laboratory tests, used to assess whether a pathogen is killed by existing or novel antimicrobials, to enable identification of novel therapeutic approaches and support translation into clinical evaluation. 4.6 UKHSA and VMD are partners in the UKRI-funded Accurate, Rapid, Robust and Economical One Health DiagnoSTics for antimicrobial resistance Network, which aims to support new AMR diagnostics and detection methods progress into use in real life settings.