There is a shopping centre in England where, somewhere between a coffee chain and a phone shop, you can now have your blood taken, your heart traced, your lungs measured and your ultrasound done, and be on your way with results moving toward a decision before you have finished your parking. No hospital gown. No hospital car park. No hospital at all. This is a community diagnostic centre, and if you want to see where UK diagnostics is heading, you should go and stand in one.
The scale is no longer a pilot. Community diagnostic centres are an NHS England programme built to bring tests and scans closer to home, in ordinary high street and shopping centre settings, and by April 2025 around 169 sites were operational. In 2024 to 2025 those centres delivered over 96,000 point-of-care tests, while still connecting to central laboratories for the samples that belong there. Around £600 million was committed for 2025 to 2026 to expand diagnostic capacity, and the programme keeps growing. This is not a gesture. It is a structural bet on decentralised diagnostics.
Here is my thesis, and I hold it with more hope than caution. Community diagnostic centres are the clearest chance we have to prove that decentralised testing and rigorous quality are not opposites. They sit close to the patient, which is where testing wants to be, and they sit inside pathology governance, which is where testing needs to be. Point-of-care testing has a natural home in them, done at scale, with real quality management, owned by people who understand what a result costs to get wrong. If the CDC programme treats point-of-care testing as a serious, quality-managed modality rather than a convenience bolted on to a waiting room, it can model what good decentralised testing looks like for everyone else. If it treats it as a shortcut, it will teach the opposite lesson just as loudly.
What a community diagnostic centre actually is
Strip away the branding and a community diagnostic centre is a simple, powerful idea: take the diagnostic work that does not need to happen inside an acute hospital, and move it somewhere the public can actually reach. Phlebotomy, imaging, cardiology and respiratory tests, and a growing menu of point-of-care assays, delivered in a setting people pass on their way to the supermarket rather than one they dread and delay.
The purpose is threefold, and each part matters. The first is speed and access: a test close to home, at a convenient time, without the friction that makes people put off the appointment that would have caught the thing early. The second is relieving the acute hospital: every straightforward scan or blood test done in the community is a slot freed in a pressured hospital diagnostic department for the work that genuinely needs to be there. The third is catching disease earlier, when it is cheaper, kinder and more survivable to treat. These are not competing goals. A centre that does all three at once is doing exactly what the programme was designed to do.
The word that changes everything, and the one most easily overlooked, is pathology. A community diagnostic centre is not a freestanding kiosk answering to nobody. It is connected to central laboratories for sample processing, and it operates within a pathology governance framework. That connection is the reason a CDC is not just another place a test happens. It is a place testing outside the main laboratory can be done with laboratory-grade governance, because the laboratory is in the room, at least in spirit and increasingly in system. Hold that thought, because it is the whole argument.
Where point-of-care testing fits, and where it does not
Point-of-care testing earns its place in a community diagnostic centre for one reason above all others: it collapses the loop. A conventional pathway sends a sample away, waits, and calls the patient back, or worse, loses them in the gap. A well-chosen point-of-care test lets a patient be sampled, resulted, assessed and advised in a single visit. For the anxious, the elderly, the working parent who cannot take a second morning off, that single visit is not a convenience. It is the difference between a diagnosis made and a diagnosis missed.
But not everything belongs at the point of care, and pretending otherwise is how good programmes get a bad name. The honest question is not "can we test this here" but "should we". The decision turns on three things: clinical urgency, volume and complexity. A result that must change the next few minutes of care, run in modest numbers, on an assay that is robust in non-expert hands, is a strong candidate for immediate turnaround. A result that can wait a day, runs in high analytical volume, or demands the analytical range, calibration discipline and multiplex breadth of a core analyser, belongs on the sample transport to the central laboratory. A centre that chooses well on this axis gets the best of both worlds. A centre that chooses badly ends up with a bench analyser doing work it was never built for, or a patient waiting for a result that could have been in their hand.
The question is never "can we test this at the point of care". It is "should we". Get that decision right and the CDC becomes the best of both worlds. Get it wrong and it becomes neither.
Done this way, point-of-care testing in a CDC is not a lesser version of laboratory testing. It is a deliberate division of labour, where the immediate answer is delivered immediately and the complex answer is delivered properly, and the patient experiences one joined-up service rather than two disconnected ones.
The real prize: proving decentralised and rigorous can coexist
For years the argument about point-of-care testing has been framed as a trade-off. You can have testing close to the patient, the story goes, or you can have laboratory-grade quality, but not both, because the moment you leave the accredited laboratory you leave the quality system behind. That framing has done real harm. It has made some laboratories suspicious of decentralisation and made some enthusiasts careless about governance, and it is wrong.
The community diagnostic centre is where that false choice can finally be retired. Because pathology is involved from the start, a CDC has something a high street pharmacy or a care home running its own device does not automatically have: a direct line to the discipline, the standards and the people who do quality for a living. The current international standard for medical laboratories, ISO 15189:2022, already brings point-of-care testing inside the laboratory quality standard, replacing the withdrawn ISO 22870. The standard says, in effect, that testing is testing and the place it happens does not change what a good result requires. A CDC is the ideal proving ground for that principle, because it has both the decentralised setting and the laboratory relationship in one place.
If the programme gets this right, the benefit reaches far beyond the centres themselves. A CDC that runs point-of-care testing with genuine quality control, real competency assessment, external quality assessment and clean connectivity becomes a working demonstration that decentralised does not mean degraded. Pharmacies, care homes, ambulances and clinics watching it can copy the pattern. The CDC becomes not just a place that does testing, but a place that teaches how testing outside the laboratory should be done. That is a bigger prize than the throughput figures, and it is entirely within reach.
What it actually requires
Optimism is not a plan, so let me be concrete about what "done properly" demands. None of it is exotic. All of it is load-bearing, and the temptation under throughput pressure will be to treat these as optional. They are not.
Connectivity to the wider record
A result that lands only on a printout, or only on the analyser's own screen, is a result that will be repeated, lost or ignored. In a CDC, where the patient's GP, the referring clinician and the host pathology service all have a stake, a point-of-care result must flow into the wider record automatically, attributed to the right patient, with its reference range and its provenance intact. Manual re-keying is not a workaround. It is a source of error and a governance failure waiting to be found. The connectivity is not a technical nicety. It is what makes the whole point-of-care proposition safe, because a result nobody else can see cannot be acted on by anyone but the person standing next to the machine.
Competency for CDC staff
The people running tests in a community diagnostic centre may not be biomedical scientists, and that is fine, provided the competency system treats that honestly. Every operator should be trained against the instructions for use, formally assessed as competent, and reassessed on a schedule. Sample technique in particular, the part that hides its errors inside a plausible-looking number, must be taught, watched and confirmed rather than assumed. A CDC has an advantage here: the host pathology service already runs competency frameworks for its own staff and can extend them, rather than inventing quality from nothing.
Quality control and EQA
Internal quality control at a defined frequency, checked against acceptance rules, with a hard rule that stops patient testing when a control is out, is the non-negotiable spine of trustworthy testing. So is enrolment in external quality assessment through a scheme such as UK NEQAS or WEQAS, which sends blind samples and compares performance against peers, exposing the blind spots a service cannot see in itself. A CDC connected to a laboratory has no excuse to skip either, and every reason to run both at full laboratory standard. This is precisely where the pathology relationship pays for itself.
Clear ownership between the CDC and the host pathology service
The failure I would watch for most closely is not technical. It is the accountability gap. When something goes wrong with a point-of-care result, who owns the fix? Who signs off the method? Who investigates a failed EQA return? Who decides an analyte should move from the bench to the central laboratory, or the reverse? If those questions do not have named answers agreed in advance between the CDC and its host pathology service, they will be answered badly in a crisis, or not at all. Clear ownership, written down before it is needed, is what turns two organisations into one accountable service.
What this means for your service
If you run, commission or support a community diagnostic centre, or a service that will feed one, this is not a warning to slow down. It is a checklist for building the quality in from the start, while it is cheap, rather than retrofitting it under audit pressure later, when it is not. In the order I would take them:
- Decide the point-of-care menu on clinical logic, not vendor enthusiasm. Score each candidate test on urgency, volume and complexity, and be willing to send some things to the central laboratory even when a bench device could technically run them. The right menu is a decision, not an accident.
- Wire results into the record before you go live. Insist that every point-of-care result flows electronically to the wider record, correctly attributed, with reference ranges and provenance. Treat any manual re-keying step as a defect to be designed out, not tolerated.
- Extend the host laboratory's competency framework to CDC staff. Do not build a parallel, weaker system. Train against the instructions for use, assess and sign off every operator, put sample technique under direct observation, and set the reassessment date on day one.
- Run internal QC with real stop rules, and enrol in EQA for every analyte. Record controls, act on failures by halting testing, and treat a poor EQA return as an investigation, not a filing task. This is the cheapest way to discover a problem before a patient does.
- Write the ownership map down. Name, in a shared document, who owns method sign-off, QC failure response, EQA investigation and the decision to move an analyte between the point of care and the central laboratory. Rehearse the escalation route so it exists in practice, not just on paper.
If you are standing this up from scratch, the free POCT Fundamentals course covers exactly this ground, quality control, competency, sample technique and escalation, in plain language for a non-laboratory setting, and our wider training goes deeper for teams taking on more analytes. When you are ready to formalise the arrangement between a CDC and its host pathology service, our consultancy helps you build a proportionate quality system and a clean ownership map that will survive an audit without smothering the throughput. And when you are choosing which assays belong at the point of care, our analyte reference is a practical place to weigh urgency, volume and complexity test by test.
Model the future, do not just move it
Community diagnostic centres are one of the better ideas in UK healthcare in a decade. They take diagnostics out of the hospital and put it within reach of the people who need it, and they do it at a scale that is already real. The opportunity in front of the programme is larger than the tests it runs. It is to show the whole system that testing can be close to the patient and rigorously governed at the same time, that decentralised and trustworthy are not enemies but partners. Point-of-care testing, done properly, is how a CDC proves it. Do that, and the centres will not just move diagnostics closer to home. They will model what good looks like for everyone else who is trying to.