The Faster Answers report, published by Birmingham-based cancer diagnostics company Nonacus, warns access to evidence-backed diagnostics can still depend on local funding and commissioning decisions, even where there is growing evidence of clinical and NHS benefit. 

Nonacus says a non-invasive, urine-based test such as its GALEAS Bladder offers a way to ease pressure on cystoscopy capacity while catching cases earlier, before they escalate to emergency presentation.

Jayne Douglas-Moore, consultant urological surgeon at Leicester NHS Trust, one of eight NHS sites using the technology, said: ‘Bringing GALEAS Bladder into the NHS in Leicester represents a genuine turning point in bladder cancer diagnostics. A reliable non-invasive test to risk-stratify patients with haematuria has been long awaited, and the early results are promising.'

The Leicester pathway is supported by time-limited funding due to end in April 2027, leaving clinicians concerned about how the service can continue without a sustainable commissioning route.

Five-year survival is around 75% when bladder cancer is diagnosed at stage 1, falling to around 10% at stage 4. Around 1,700 people a year in England are diagnosed at stage 3 or 4.

Nonacus is calling on:

• NICE to consider the latest real-world evidence on urinary biomarkers as part of future bladder cancer guidance and to clarify how evidence-backed risk-stratification tools can be incorporated into the pathway
• NHS England and Getting It Right First Time to support more consistent evaluation and adoption of risk-stratification approaches across haematuria pathways, reducing variation between local systems
• DHSC to ensure funding, reimbursement and MedTech adoption routes allow evidence-backed diagnostics to move into routine NHS care where they demonstrate clinical and operational value.