How can bedside imaging help the NHS tackle its diagnostics backlog?

Faith Bose, UK sales director of Health Net Connections Limited, discusses the long-wait times of ultrasounds in the UK, and how bedside solutions could tackle the problem in months.

In early 2023, more than one in five patients in the UK waited over six weeks for a non-obstetric ultrasound, highlighting a persistent squeeze on access that creates knock-on delays across entire patient pathways. As we move through 2026, the challenge remains; a finite pool of radiologists and sonographers is facing an ever-rising tide of demand.

If we are to address the diagnostics backlog effectively, we must stop treating every clinical question as a departmental problem. It is time for the NHS to embrace point-of-care ultrasound (POCUS) as a strategic imperative for elective recovery and hospital flow.

Beyond the radiology gates

For too long, the debate around POCUS has been framed as a ‘turf war’. Will bedside imaging replace formal radiology? The answer is a categorical no. Instead, POCUS acts as a vital filter. By answering focused, binary questions at the bedside, Is there a pleural effusion? Is the bladder full? Is there a DVT? Clinicians can resolve uncertainty in minutes rather than days.

Industry commentary increasingly highlights this ‘right scan, right place’ approach. By offloading routine, focused questions from the main radiology departments, we allow specialists to concentrate on complex, comprehensive studies. This isn’t just about clinical convenience; it’s about ‘right-sizing’ our diagnostic spend. When a clinician can confirm pulmonary oedema at the bedside, a departmental booking is saved, a chest x-ray is avoided, and a bed-day is potentially reclaimed.

The evidence: efficiency in the palm of your hand

The data supporting this shift is becoming impossible to ignore. A large prospective cohort study of over 12,000 admissions found that POCUS availability for internal medicine teams was associated with significantly lower total hospital costs and reduced radiology costs, driven by a drop in unnecessary formal imaging.

Closer to home, UK-specific evidence is mounting. From the INSIGHT feasibility study at King’s College Hospital, which tests scheduled POCUS in ICUs, to qualitative studies into community POCUS, we are seeing that the less organised form of bedside imaging is over. When you combine handheld technology with robust governance, the results are safer, faster, and more cost-effective care. Even in general practice, POCUS is being identified as a tool to prevent avoidable referrals and ensure departmental slots are reserved for those who truly need them.

From Pilots to Policy

So, why isn’t POCUS ubiquitous across every trust and integrated care system (ICS)? The barrier isn’t the technology, it’s the implementation framework. To realise system-level benefits, we must move past fragmented pilots and implement a four-pillar strategy:

1. Standardised credentialing: we must adopt tiered competency frameworks so that POCUS becomes a core skill for hospitalists, ED clinicians, and advanced practitioners.
2. Digital governance: image archiving and expert review must be mandated to ensure quality assurance and a clear ‘paper trail’ for every bedside scan.
3. Pathway integration: we should prioritise high-impact areas where bedside answers directly accelerate discharge, such as undifferentiated dyspnoea pathways which have already shown a reduction in length of stay.
4. Economic realism: funding should be directed through innovation or winter pressure budgets, with ROI measured not just in device cost, but in reduced radiology demand and bed-days saved.

Call to action: a strategic roadmap for 2026

Every delayed scan is a delayed decision. In an era where ‘flow’ is the most valuable currency in the NHS, we cannot afford to leave diagnostic power locked behind the doors of a centralised department. To transition POCUS from a clinical luxury to a frontline standard, we call upon NHS leadership to take the following four steps:

• Establish national standards: NHS England, in partnership with the Royal Colleges, should publish a unified POCUS service standard. This must cover training tiers, archiving requirements, and the minimum datasets required for evaluation to ensure safety is never compromised.
• Fund outcome-driven pilots: ICSs should be empowered to fund 12-month POCUS programmes in high-pressure environments, specifically ED, acute medicine and community urgent care. These pilots must be tied to a mandatory evaluation bundle measuring radiology deferral counts and time-to-decision.
• Invest in digital infrastructure: we must stop treating POCUS devices as isolated hardware. Procurement must be conditional on full EPR and PACS integration, ensuring that every bedside scan is archived, auditable, and accessible to the wider multidisciplinary team.
• Measure what matters: move beyond simple ‘usage’ statistics. Trust boards should integrate POCUS impact into their performance dashboards, tracking how bedside imaging affects median wait times for departmental scans and overall length of stay.

The tools are ready, the evidence is clear, and the clinical will is there. By empowering clinicians at the point of care, we don’t just reduce waiting lists, we return time to the clinician and clarity to the patient. It is time for the NHS to make POCUS the standard of care, ensuring the right patients get the right scan, in the right place, at the right time.

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