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.

Genomic testing in the National Health Service in England is provided through the NHS Genomic Medicine Service (GMS). Testing is directed by the National Genomic Test Directory, which sets out the eligibility criteria for patients to access testing.

Genomic testing for adult-onset neurodegenerative disorder is included in the Test Directory under specific clinical scenarios including amyotrophic lateral sclerosis, the most common type of motor neurone disease. The Test Directory is routinely reviewed to ensure that genomic testing continues to be available for all patients for whom it would be of clinical benefit, while delivering value for money for the NHS. The directory and associated supporting material are available at the following link:

https://www.england.nhs.uk/publication/national-genomic-test-directory-supporting-material/

The strategic and systematic embedding of genomic medicine in end-to-end clinical pathways and clinical specialities is supported by a network of seven regional NHS GMS Alliances, which play an important role in achieving equitable access to standardised end-to-end pathways of care, including genomic testing, clinical genetics and genetic counselling services.

A non-invasive pre-natal test (NIPT) was introduced as an evaluative rollout in England on 1 July 2021, as part of the NHS Fetal Anomaly Screening Programme. The UK National Screening Committee (UK NSC) is being kept informed annually on the progress of this rollout.

NHS England has extended the evaluative rollout of the NIPT to March 2026, so that pregnancy outcomes can be included in the final report. The report is expected to go to the UK NSC at the end of 2026.

The National Institute for Health and Care Excellence’s guidance, Chronic kidney disease: Assessment and management [NG203], updated in November 2021, sets out the best practice for clinicians in the diagnosis and management of chronic kidney disease (CKD). The guidance covers monitoring for those patients at risk as well as pharmacological management and referral, where appropriate, and is available at the following link:

https://www.nice.org.uk/guidance/ng203

In addition to evidence-based guidance to support clinicians in diagnosing problems of the kidney, we are also working to detect people at risk of kidney disease through the NHS Health Check Programme. The programme, which is available for everyone between the ages of 40 and 74 years old who are not already on a chronic disease register, assesses people’s health and risk of developing certain health problems. Using this information, patients are supported in making behavioural changes and accessing treatment which helps to prevent and detect kidney disease earlier.

We are investing in new delivery models for the NHS Health Check, including nearly £17 million for the development and roll-out of an innovative new national and digital NHS Health Check, which will be rolled out this spring, and will give people a choice about where and when to have a check.

The UK National Screening Committee (UK NSC) reviewed CKD and glomerulonephritis in 2011 and concluded that a population-wide screening programme would not be recommended, and has not looked at the evidence for a targeted programme. The UK NSC can be alerted to any new peer-reviewed evidence published which may suggest the case for a new screening programme. Proposals to change or review a topic early can be submitted via the UK NSC’s annual call, which will open in July 2024.

The National Institute for Health and Care Excellence’s guidance, Chronic kidney disease: Assessment and management [NG203], updated in November 2021, sets out the best practice for clinicians in the diagnosis and management of chronic kidney disease (CKD). The guidance covers monitoring for those patients at risk as well as pharmacological management and referral, where appropriate, and is available at the following link:

https://www.nice.org.uk/guidance/ng203

In addition to evidence-based guidance to support clinicians in diagnosing problems of the kidney, we are also working to detect people at risk of kidney disease through the NHS Health Check Programme. The programme, which is available for everyone between the ages of 40 and 74 years old who are not already on a chronic disease register, assesses people’s health and risk of developing certain health problems. Using this information, patients are supported in making behavioural changes and accessing treatment which helps to prevent and detect kidney disease earlier.

We are investing in new delivery models for the NHS Health Check, including nearly £17 million for the development and roll-out of an innovative new national and digital NHS Health Check, which will be rolled out this spring, and will give people a choice about where and when to have a check.

The UK National Screening Committee (UK NSC) reviewed CKD and glomerulonephritis in 2011 and concluded that a population-wide screening programme would not be recommended, and has not looked at the evidence for a targeted programme. The UK NSC can be alerted to any new peer-reviewed evidence published which may suggest the case for a new screening programme. Proposals to change or review a topic early can be submitted via the UK NSC’s annual call, which will open in July 2024.

The National Institute for Health and Care Excellence’s guidance, Chronic kidney disease: Assessment and management [NG203], updated in November 2021, sets out the best practice for clinicians in the diagnosis and management of chronic kidney disease (CKD). The guidance covers monitoring for those patients at risk as well as pharmacological management and referral, where appropriate, and is available at the following link:

https://www.nice.org.uk/guidance/ng203

In addition to evidence-based guidance to support clinicians in diagnosing problems of the kidney, we are also working to detect people at risk of kidney disease through the NHS Health Check Programme. The programme, which is available for everyone between the ages of 40 and 74 years old who are not already on a chronic disease register, assesses people’s health and risk of developing certain health problems. Using this information, patients are supported in making behavioural changes and accessing treatment which helps to prevent and detect kidney disease earlier.

We are investing in new delivery models for the NHS Health Check, including nearly £17 million for the development and roll-out of an innovative new national and digital NHS Health Check, which will be rolled out this spring, and will give people a choice about where and when to have a check.

The UK National Screening Committee (UK NSC) reviewed CKD and glomerulonephritis in 2011 and concluded that a population-wide screening programme would not be recommended, and has not looked at the evidence for a targeted programme. The UK NSC can be alerted to any new peer-reviewed evidence published which may suggest the case for a new screening programme. Proposals to change or review a topic early can be submitted via the UK NSC’s annual call, which will open in July 2024.

Cervical screening is not recommended for women below the age of 25 years old, as cervical cancer is rare in under-25s. Screening at a younger age can lead to unnecessary and potentially harmful investigations and treatments.

Women of any age who are experiencing symptoms such as bleeding between periods or after sex, pain or discomfort during sex, or abnormal vaginal discharge should see their general practitioner. They may be offered a pelvic examination and referral to colposcopy or gynaecology if needed.

The NHS Lateral Flow Device (LFD) tests supply service for patients potentially eligible for COVID-19 treatments was launched on 6 November 2023. Information about how many pharmacies have supplied LFD tests will not be available until pharmacies have claimed for the delivery of the service.

Lateral flow device (LFD) tests which are privately purchased cannot currently be registered on GOV.UK and there is no requirement to report these results to the provider. There are currently no plans to change the policy on reporting private COVID-19 test results.

For citizens that are eligible to order free LFD tests from the UK Health Security Agency, these tests can still be registered on GOV.UK.

During the COVID-19 pandemic, timed appointments were no longer deemed feasible for the recovery of services, based on expert opinion. Services moved to an ‘open appointment’ system where women contacted services to agree a time slot suitable for them.

All services have now recovered, and some have returned to the timed appointments. Several services have retained an open system as they have noted increased uptake and patient satisfaction.

NHS England have commissioned a series of national evaluative projects being led by Professor Stephen Duffy and his team at Queen Mary’s University of London, to provide evidence to inform NHS England on the most appropriate invitation methodology to underpin future pathway changes and improvements in the national screening programme. These are due to report March 2024.

Wastewater monitoring for COVID-19 and its variants was stood down in April 2022 in response to the Government policy change to Living with COVID-19. Therefore, in England, there has been no wastewater testing for COVID-19 within the last 12 months.

Wastewater sampling, and subsequent analysis, has the benefit of detecting the virus regardless of whether people have symptoms or whether they are tested.

Environmental factors such as rainfall dilution can influence the detection of variants in wastewater. Therefore, low total detections on some days may not be reflective of low community infection levels.

Wastewater monitoring cannot currently estimate the number of cases associated with a detection with a high degree of confidence. For example, in small catchment areas it is possible, but highly unlikely, that a detection is due to a single individual. In larger catchment areas detections are likely to be related to a higher number of cases in the population.

Information on all representations from medical professionals and patients groups about access to free lateral flow tests for immunocompromised patients and close contacts of immunocompromised patients after October 2023, could only be provided at a disproportionate cost.

As set out in the Written Ministerial Statement on 30 March 2023, in 2023/24 the Government will maintain a range of capabilities to protect those at higher risk of severe illness from COVID-19. Given the continued effectiveness of vaccines and improved treatments, for most people there is a much lower risk of severe illness compared to earlier in the pandemic.

Appropriate levels of testing remain to support diagnosis for clinical care and treatment and to protect very high-risk individuals and settings. Those who are clinically extremely vulnerable and immunocompromised are part of the group who are eligible for COVID-19 treatments in the community enabling them easy access to anti-viral treatments.

Testing of symptomatic staff remains in a very limited number of high-risk settings to protect particularly vulnerable people, such as in some hospices and some NHS settings where staff work with profoundly immunocompromised patients. Information on testing in these settings is available at the following link: https://www.gov.uk/guidance/covid-19-testing-during-periods-of-low-prevalence

As set out in the Living with COVID-19 strategy published last February, we are continuing to offer some COVID-19 testing for those in high-risk settings. Currently, symptomatic or immunocompromised patients who are admitted to hospital for maternity or emergency care receive a Polymerase Chain Reaction test. Residents, patients, or staff in high-risk settings who are symptomatic are also tested and testing can be used to manage an outbreak in these settings.