Early diagnosis of chronic kidney disease (CKD) is supported through widespread access to blood and urine tests across the National Health Service. Phlebotomy is a key part of this pathway. The NHS delivers over one billion blood tests each year, supporting the diagnosis and monitoring of a wide range of conditions, including CKD.

Community diagnostic centres (CDCs) are increasing diagnostic capacity and improving access to testing closer to patients’ homes. Phlebotomy services are currently available in 119 CDCs. CDCs have delivered approximately 1.6 million tests between April 2025 and the end of February 2026. In addition, non-obstetric ultrasound, also used to examine kidneys, is available in 152 CDCs and delivered approximately 1.01 million tests over the same period.

NHS England continues to work with integrated care boards to expand diagnostic capacity and improve referral pathways, helping clinicians access the tests needed to support earlier diagnosis and monitoring of long-term conditions, including CKD.

The Government is guided by the UK National Screening Committee (UK NSC), an independent scientific advisory committee which makes its recommendations based on internationally recognised criteria and a rigorous evidence review and consultation process. It is only where the UK NSC is confident that to screen would provide more good than harm that a screening programme is recommended, as all medical interventions carry an inherent risk.

A review by the UK NSC of the evidence in 2019 of supplementary ultrasound for women with dense breasts and negative mammograms showed insufficient evidence to balance the risks, benefits, and costs. In the field, there are concerns that undertaking notification of increased density without provision of any modification of screening may increase inequity and capacity issues, as well as leading to increased anxiety and confusion.

The UK NSC is considering the best approach for women with dense breast tissue. It reviewed the evidence relating to the provision of additional breast screening for women who have dense breast tissue and invited stakeholders’ feedback on the findings to inform future work. The consultation closed in August 2025. Further work is needed to understand the clinical impact and costs of adding breast density to the screening pathways in the United Kingdom.

In the meantime, the Breast Screening Risk Adaptive Imaging for Density (BRAID) trial is looking into the use of supplementary imaging techniques for women within the standard breast screening programme who are found to have radiographically dense breast tissue. The different tests include magnetic resonance imaging and ultrasound. The UK NSC is in contact with the researchers and is reviewing this evidence as it becomes available. It will make recommendations to ministers in light of this.

The NHS Breast Screening Programme advises all women, as part of its literature, that cancer may be missed and that breast symptoms should be reported even if they have recently had a negative screening mammogram.

The Government is guided by the independent scientific advice of the UK National Screening Committee (UK NSC). It is only where the offer to screen provides more good than harm that a screening programme is recommended. The UK NSC makes its recommendations based on internationally recognised criteria and a rigorous evidence review and consultation process. The UK NSC is currently considering the responses to a public consultation on their draft recommendation to:

- offer a targeted national prostate cancer screening programme to men with confirmed BRCA1/2 gene variants every two years, from the age 45 years old to age 61 years old;

- not recommend population screening;

- not recommend targeted screening of black men;

- not recommend targeted screening of men with family history; and

- collaborate with the Transform trial team to answer outstanding questions on screening effectiveness for black men and men with a family history, as soon as trial data becomes available, and await the results of the study to develop and trial a more accurate test than the prostate specific antigen test alone, to improve the balance of the benefits and harms of screening.

The evidence that supports this recommendation can be found on the following link:

https://nationalscreening.blog.gov.uk/

The modelling used to arrive at the recommendation included cost benefit analysis.

On 28 November 2025, the UK National Screening Committee opened a 12-week public consultation on a draft recommendation on screening for prostate cancer. This consultation has now closed, and the Committee is considering the responses.

We anticipate a final recommendation soon. After this, my Rt Hon. Friend, the Secretary of State for Health and Social Care, will make a decision on whether to accept the recommendation, and what next steps are needed. At that point, he will make a decision on implementation, including any resources that may be required for general practitioners and other healthcare professionals to support his decision.

As part of the evolving NHS Genomic Medicine Service infrastructure, a new delivery model will be in place from April 2026 to deliver the genomics commitments in the 10-Year Health Plan, the National Cancer Plan, and other national strategies.

Currently, there is variable access to freezers for fresh frozen tissue in the NHS with the associated complexity of cold chain transport. Providing adequate freezer storage for fresh frozen tissue is necessary to ensure that there is equitable regional access to whole genome sequencing (WGS) testing.

In efforts to address this variability NHS England has produced national sample handling guidance to support approaches to the handling of fresh tissue and more recently the use of tissue stabilisers has been introduced to provide an alternative to frozen tissue and still meet the requirements for WGS. NHS England is also currently working with the British Neuro-Oncology Society to map where freezer storage facilities for fresh frozen tissue are required.

Fresh tissue pathways are dependent on system engagement and work is ongoing between the NHS Genomics, Cancer, and Pathology programmes to develop and optimise these pathways and ensure that all appropriate cancer patients, including brain and central nervous system and rare cancers, get the optimal genomic testing for their tumour type.

A number of NHS Genomic Networks of Excellence are also developing the evidence for developing fresh tissue pathways for WGS.

The Government is guided by the independent scientific advice of the UK National Screening Committee (UK NSC). It is only where the offer to screen provides more good than harm that a screening programme is recommended. The UK NSC makes its recommendations based on internationally recognised criteria and a rigorous evidence review and consultation process. The UK NSC is currently considering the responses to a public consultation on their draft recommendation to:

- offer a targeted national prostate cancer screening programme to men with confirmed BRCA1/2 gene variants every two years, from the age 45 years old to age 61 years old;

- not recommend population screening;

- not recommend targeted screening of black men;

- not recommend targeted screening of men with family history; and

- collaborate with the Transform trial team to answer outstanding questions on screening effectiveness for black men and men with a family history, as soon as trial data becomes available, and await the results of the study to develop and trial a more accurate test than the prostate specific antigen test alone, to improve the balance of the benefits and harms of screening.

The evidence that supports this recommendation can be found on the following link:

https://nationalscreening.blog.gov.uk/

The modelling used to arrive at the recommendation included cost benefit analysis.

For screening programmes, the Government is guided by the independent scientific advice of the UK National Screening Committee (UK NSC). It is only where the offer to screen provides more good than harm that a screening programme is recommended.

The UK NSC considers all of the latest scientific evidence when reviewing the case for screening for different conditions. As the policy is based on the benefits and harms to whole populations, the screening decisions are based on the effect on the whole population, rather than individual circumstances. Where there is a lack of evidence, the committee cannot be confident that screening would benefit the population as a whole. In these circumstances, the proportionate approach is to screen within the range that has evidence to support the policy.

The National Health Service bowel screening programme in England was recently extended from 60 – 74 years old to 50 – 74 years old. This aligns with the evidence of where the screening programme can do the most good with the least harm caused. Harm can include increased anxiety, misdiagnosis, over diagnosis (where unnecessary and invasive follow up tests are offered), or unnecessary treatment.

The UK NSC is awaiting the results of the AgeX trial which is looking at extending the upper and lower age thresholds for breast screening. The Committee is also working with researchers in Australia who are considering whether vaccination would have an impact on the lower age of cervical screening.

The UK NSC keeps these age brackets under review. The Committee recognises that screening programmes are not static and that, over time, they may need to change to be more effective.

The Government’s policy on groups eligible for vaccination programmes is based on the recommendation of the independent expert advisory committee, the Joint Committee on Vaccination and Immunisation (JCVI). When advising on programme eligibility, including any upper and lower age limit for vaccination programmes, the JCVI evaluates clinical data from a wide range of sources including disease epidemiology, age specific estimates of disease burden including deaths and hospitalisations, as well as age-specific vaccine efficacy and cost-effectiveness analyses.

Patient outcomes, including early diagnosis, morbidity, mortality, and health inequalities are influenced by multiple health factors. It would therefore not be possible to make an accurate assessment of how age threshold for screening and immunisation alone impacted those outcomes.

NHS England has undertaken detailed modelling to understand the diagnostic and workforce capacity required to support a reduction in the faecal immunochemical test (FIT) threshold within the Bowel Cancer Screening Programme in England. NHS England has worked with early adopter sites to test the operational impact of lowering the FIT threshold in real‑world settings. These sites have provided evidence on changes in referral volumes, colonoscopy demand, cancer and polyp detection rates, and the implications for endoscopy services. The findings are being formally evaluated and are informing assumptions within the national capacity modelling. The timing of wider roll‑out is directly linked to the outcomes of this modelling and evaluation work, as well as the availability of trained endoscopy staff.

NHS England continues to develop the endoscopy workforce, including the expansion of the screening colonoscopist workforce through Advanced Training Skills Module.

Alongside this, NHS England is progressing a wider programme of endoscopy transformation focused on releasing capacity and improving productivity. This includes the intelligent use of FIT testing, including coloFIT, to support more effective risk stratification, reduce unnecessary colonoscopies, and ensure that available endoscopy capacity is targeted towards those at highest risk. Embedding FIT‑led pathways supports earlier reassurance for lower‑risk individuals while prioritising timely investigation for those most likely to benefit.

NHS England has undertaken detailed modelling to understand the diagnostic and workforce capacity required to support a reduction in the faecal immunochemical test (FIT) threshold within the Bowel Cancer Screening Programme in England. NHS England has worked with early adopter sites to test the operational impact of lowering the FIT threshold in real‑world settings. These sites have provided evidence on changes in referral volumes, colonoscopy demand, cancer and polyp detection rates, and the implications for endoscopy services. The findings are being formally evaluated and are informing assumptions within the national capacity modelling. The timing of wider roll‑out is directly linked to the outcomes of this modelling and evaluation work, as well as the availability of trained endoscopy staff.

NHS England continues to develop the endoscopy workforce, including the expansion of the screening colonoscopist workforce through Advanced Training Skills Module.

Alongside this, NHS England is progressing a wider programme of endoscopy transformation focused on releasing capacity and improving productivity. This includes the intelligent use of FIT testing, including coloFIT, to support more effective risk stratification, reduce unnecessary colonoscopies, and ensure that available endoscopy capacity is targeted towards those at highest risk. Embedding FIT‑led pathways supports earlier reassurance for lower‑risk individuals while prioritising timely investigation for those most likely to benefit.

The Government is guided by the independent scientific advice of the UK National Screening Committee (UK NSC). It is only where the offer to screen provides more good than harm that a screening programme is recommended. The UK NSC makes its recommendations based on internationally recognised criteria and a rigorous evidence review and consultation process.

Every sudden cardiac death of a young person is a tragedy. The UK National Screening Committee (UK NSC) is currently re-examining the evidence for sudden cardiac death screening in young people, including those involved in organised sports, and will open a public consultation on this in the spring.

The Government welcome the UK NSC’s robust and rigorous approach to evaluating the benefits and harms of screening, as it is vital that screening policy is based on scientific evidence.

We are currently working with experts, including general practitioners, to co-design the menopause content for the NHS Health Check.

The inclusion of menopause in the NHS Health Check will support eligible women across England to access high quality information on the menopause, including advice on managing symptoms and where to seek support.

We will ask local authorities to implement this addition in the NHS Health Checks later this year and will urge them to implement it as quickly as possible.

The UK National Screening Committee (UK NSC) is currently re-examining the evidence for sudden cardiac death screening in young people and will open a public consultation on this in the spring.

The UK NSC secretariat is not aware of the audit referred to in this question. However, as the literature review needs to be completed and analysed before a consultation is published, any evidence published in February of this year will not be part of the UK NSC consultation.

Newborn Hearing Screening in England for babies before the age of 12 weeks is part of the nationally approved commissioned screening services. The services are monitored by the Screening Quality Assurance Service (SQAS) to ensure they meet national standards. The SQAS undertakes a continuous improvement cycle of pathway reviews and onsite quality assurance visits to identify areas for improvement across antenatal and newborn screening programmes where a concern is identified, involving appropriate professional clinical advisors from each screening discipline to support the process. Continuous performance data monitoring of services and representation at screening governance boards by the SQAS and commissioners supports this process and there is ongoing targeted work with services identified as needing improvements.

There are no nationally approved screening hearing services for children over 12 weeks of age.

For clinical referrals, integrated care board commissioners are responsible for ensuring NHS Audiology services meet the needs of patients and that they are delivered to the appropriate quality.

My Rt. Hon. Friend, the Secretary of State for Health and Social Care, commissioned the recently published, independent Kingdon review of children’s hearing services in England. Twelve recommendations were made, including focus on commissioning, governance, data and training amongst others. No assessment has yet been made of the potential implications on policies for the recommendations. We are progressing an early analysis of implementation requirements for the recommendations, including resource.

Staff working in newborn hearing screening services are required to achieve the training standards set out in national guidance, and regional commissioners work with services to assure compliance with both minimum staffing levels and training requirements.

Audiologist training is supported via pathways including the Scientist Training Programme and Higher Specialist Scientific Training programmes. NHS England has undertaken a skills survey across services to assess current capacity and training needs. Support has been put in place for training to ensure practitioners meet nationally agreed standards. This work will provide targeted support to strengthen delivery, and ensure safe, consistent care for children and families.

The UK National Screening Committee has not been asked to look at frailty as a screening programme and no specific assessment has been made of the potential impact of York Frailty Hub on the Department's screening and prevention agenda.

The provision of frailty health care services is the responsibility of local integrated care boards (ICBs), and may include services like the York Frailty Hub, which contain an element of frailty prevention. We expect ICBs to commission services based on local population needs, taking account of National Institute for Health and Care Excellence guidelines.

The 10-Year Health Plan sets out how we will work towards a Neighbourhood Health Service, which will give us a significant opportunity to radically change how resources are deployed across health, social care, and wider services in local communities. There needs to be a stronger focus on prevention and early intervention, both to improve outcomes for people and to reduce pressure on both National Health Service and local government services.

We will also deliver the first ever Frailty and Dementia Modern Service Framework to deliver rapid and significant improvements in quality of care and productivity. This will be informed by phase one of the independent commission into adult social care, which is expected this year. The Frailty and Dementia Modern Service Framework will seek to reduce unwarranted variation and narrow inequality for those living with dementia and will set national standards for dementia care and redirect NHS priorities to provide the best possible care and support.

Data on the provision of this equipment is held by local integrated care boards.

Dental screening is not recommended due to a lack of evidence that it effectively reduces dental disease. Professionals working in general practice, pharmacy, and community-based services have an important role to help people prevent oral disease and access dental services.

Evidence-based advice has been published to support health professionals to improve and maintain the oral and general health of their patients or members of the public. This is available at the following link:

https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention.

Other resources are also available including those for adults and children, which are available, respectively, at the following two links:

https://www.gov.uk/government/publications/adult-oral-health-applying-all-our-health/adult-oral-health-applying-all-our-health#further-reading-resources-and-good-practice

https://www.gov.uk/government/publications/child-oral-health-applying-all-our-health.

Signposting to dental services should follow local commissioning arrangements. Our commitment to neighbourhood health will provide further opportunities to bring together teams of professionals closer to people’s home in the community, which could include dental therapists and dental nurses.

Integrated care boards are responsible for assessing the health needs of their local population and for commissioning primary and secondary eye care services to meet them, which could include glaucoma referral filtering services.

The National Institute for Health and Care Excellence’s guideline on the diagnosis and management of glaucoma, reference code NG81, recommends that people planning eye care services should consider commissioning referral filtering services, for example, repeat measures, enhanced case-finding, or referral refinement, for chronic open angle glaucoma and related conditions. This guideline is available at the following link:

https://www.nice.org.uk/guidance/ng81

The Getting It Right First Time programme is currently developing best practice guidance for glaucoma services to support the adoption of high standards across the pathway, from detection onwards.

It is the responsibility of the integrated care boards (ICBs) to make available appropriate provision to meet the health and care needs of their local population, including support for neurodivergent people. We expect ICBs to have due regard to National Institute for Health and Care Excellence (NICE) guidelines when commissioning services, and for healthcare professionals to take these guidelines into account for the care and treatment of patients. NICE guidelines are developed by experts based on a thorough assessment of the available evidence and through extensive engagement with stakeholders. The NICE guidelines on autism and those on attention deficit hyperactivity disorder highlight that, as part of the diagnostic process, clinicians should include an assessment of the person’s needs, co-existing conditions, and physical health, including fine and gross motor skills.

In April 2023, NHS England published a national framework and operational guidance for autism assessment services, which can be found at the following link:

www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance

This guidance intends to help the NHS improve autism assessment services and the experience for those referred to an autism assessment service. The guidance highlights that physical health, and needs and difficulties, should feature as themes for discussion during the assessment process.