NHS England pilots a pocket-sized DNA sequencer that types brain tumours during surgery

The BBC reported in September 2026 that the NHS has started using a rapid genomic test that cuts the time to an accurate brain-tumour diagnosis from up to eight weeks to two hours. There are around 150 types of brain tumour, each responding differently to treatment, and diagnosis normally relies on molecular and genetic analysis that takes six to eight weeks to come back.

Small tissue samples from the tumour go to the pathology lab and are loaded into a shoebox-sized sequencing machine made by Oxford Nanopore, which uses software developed at the University of Nottingham with hospital clinicians. DNA molecules pass through a nanopore, a tiny hole, which reveals the tumour's genomic fingerprint. In the case the BBC followed, after the machine had run for 20 minutes the neuropathology team phoned the theatre to say the tumour was likely a glioblastoma, so surgeons had the result while still operating.

That timing can change the surgery. Consultant neurosurgeon Stuart Smith said that for curable types the surgery needs to be as radical as possible, while for aggressive types beyond what surgery can remove, surgeons would be more cautious to lower the risk of brain damage. A full genetic profile also gives faster access to clinical trials. Consultant neuropathologist Dr Simon Paine said the test gives a comprehensive molecular classification where he could only make an informed guess down a microscope.

The slow part was sending samples away for full molecular analysis, not the analysis itself.

A sequencer small enough to sit in a hospital lab lets the test run next to theatre.

Knowing tumour type mid-operation tells surgeons how radical to be.

A full genetic profile also speeds up trial access.

Moving a slow lab test into the room where the decision is made can change the decision itself, not just speed up the paperwork.

NHS England is piloting the test in five specialist centres in Nottingham, Birmingham, London and Newcastle, to be extended later to sites in Bristol, Oxford, Leeds and Manchester. The pilot builds on an earlier project in Nottingham and Birmingham. NHS England's chief scientific officer said the ambition is to build the evidence for it to become part of routine NHS care.