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

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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