Community Diagnostic Hubs: Are imaging services adequately provisioned to improve the health of the wider communities in England? A scoping review of current evidence

Background: The NHS currently faces an unprecedented elective care backlog of around 6 million people. Community Diagnostic Hubs (CDHs) have emerged as a potential solution for improving healthcare accessibility and addressing regional inequalities by bringing sustainable diagnostic imaging services closer to communities. This secondary study (a) examines the current state of CDH implementation and (b) identifies key challenges in meeting the objectives outlined in the Richards Report (2020). Method: A scoping review of recent King's Fund (2022 – 2023) and government reports (published 2019) was conducted, using a systematic search strategy, to assess CDH service provision. Additional data from the Royal College of Radiologists (2024) and Society of Radiographers (2020-2024) were analysed to evaluate workforce challenges against requirements stipulated in the Richards Report. Results: Analysis revealed three key findings: (a) Mortality rates in England (2017-2022) showed greatest deficit in the North of England (conforming to inequality theory); (b) NHS service user satisfaction reached historic lows during this period; and (c) Primary implementation barriers included site acquisition costs and specialized workforce shortages, with deprived communities disproportionately affected, therefore supporting CDH expansion. Conclusions: The review indicates that CDHs represent a promising solution to diagnostic imaging delivery, although current implementation falls significantly short of the government's 17,000,000 test target. Findings indicate two critical requirements for successful CDH implementation: development of an expanded specialised diagnostic workforce (incorporating advanced radiographer practitioners supported by assistant practitioners) and substantial additional investment. These findings have implications for policymakers and healthcare providers in addressing regional healthcare inequalities and service delivery.