The National Optimal Lung Cancer Pathway (NOLCP), a streamlined care pathway to improve the speed of lung cancer diagnosis, staging and treatment in the UK, was a central topic of the British Thoracic Oncology Group (BTOG) Annual Conference 2018, held in Dublin, Ireland. Speaking from the meeting, Sanjay Agrawal, MBBS, of the University Hospitals of Leicester NHS Trust, Leicester, UK, discusses the session that he chaired on the topic: Implementing the NOLCP across the UK: all hospitals vs. diagnostic centers? Dr Agrawal highlights the pros and cons of each option.