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Geographic inequalities in diagnostic testing delays in England before and after COVID

White, B.; Barclay, M. E.; Lyratzopoulos, G.; Swann, R.; Francetic, I.; Sutton, M.

2025-11-07 health systems and quality improvement
10.1101/2025.11.06.25339656 medRxiv
Show abstract

Diagnostic testing delays worsened during the COVID-19 pandemic, but it is unclear whether geographic inequalities have deepened. Using publicly-available data in England for nine tests, we compared waiting times across 106 local areas in 2019 and 2024-25. The national median proportion of patients waiting over six weeks increased from 2.2% to 18.8%, while geographic variation tripled. The greatest variation in 2024-25 occurred for flexible-sigmoidoscopy, colonoscopy, and echocardiography. These findings show that pandemic-related diagnostic delays persist and pre-existing geographic inequalities have deepened. Further research should examine how widening inequalities in waiting times influences downstream test demand and disease outcomes.

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