diff --git a/.env.sample b/.env.sample
index d24aa3de8..276a0ed0f 100644
--- a/.env.sample
+++ b/.env.sample
@@ -1,11 +1,14 @@
 ENV=dev
 DEBUG=True
+PIXL_DICOM_TRANSFER_TIMEOUT=120
+PIXL_QUERY_TIMEOUT=120
 
 # PIXL PostgreSQL instance
 PIXL_DB_HOST=postgres
 PIXL_DB_NAME=pixl
 PIXL_DB_USER=pixl
 PIXL_DB_PASSWORD=
+SKIP_ALEMBIC=false
 
 # EMAP UDS
 EMAP_UDS_HOST=
@@ -26,6 +29,15 @@ PIXL_EHR_API_PORT=
 RABBITMQ_PORT=
 RABBITMQ_ADMIN_PORT=
 PIXL_IMAGING_API_PORT=
+FTP_PORT=
+
+# PIXL EHR API
+PIXL_EHR_API_HOST=localhost
+PIXL_EHR_API_RATE=1
+
+# PIXL Imaging API
+PIXL_IMAGING_API_HOST=localhost
+PIXL_IMAGING_API_RATE=1
 
 # Hasher API
 HASHER_API_AZ_CLIENT_ID=
@@ -77,6 +89,7 @@ PIXL_EHR_API_AZ_STORAGE_CONTAINER_NAME=
 PIXL_EHR_COGSTACK_REDACT_URL=
 
 # RABBIT MQ queue. UI available at localhost:$RABBITMQ_ADMIN_PORT
+RABBITMQ_HOST=localhost
 RABBITMQ_USERNAME=
 RABBITMQ_PASSWORD=
 
@@ -88,4 +101,3 @@ PIXL_QUERY_TIMEOUT=10
 FTP_HOST=
 FTP_USER_NAME=
 FTP_USER_PASSWORD=
-FTP_PORT=
diff --git a/README.md b/README.md
index a9938270c..74bacf14c 100644
--- a/README.md
+++ b/README.md
@@ -146,10 +146,10 @@ This is one of `dev|test|staging|prod` and referred to as `<environment>` in the
 
 ### 2. Initialise environment configuration
 
-Create a local `.env` and `pixl_config.yml` file in the _PIXL_ directory:
+Create a local `.env` file in the _PIXL_ directory:
 
 ```bash
-cp .env.sample .env && cp pixl_config.yml.sample  pixl_config.yml
+cp .env.sample .env
 ```
 
 Add the missing configuration values to the new files:
diff --git a/cli/README.md b/cli/README.md
index 3e6d5b57a..deb22fe55 100644
--- a/cli/README.md
+++ b/cli/README.md
@@ -9,11 +9,6 @@ stopped cleanly.
 
 `PIXL CLI` requires Python version 3.10.
 
-The CLI requires a `pixl_config.yml` file in the current working directory. A
-[sample file](../pixl_config.yml.sample) is provided in the root of the repository. If you want to
-run locally during development, we recommend running `pixl` from the [`./tests/`](./tests/)
-directory, which contains a mock `pixl_config.yml` file.
-
 Running the tests requires [docker](https://docs.docker.com/get-docker/) to be installed.
 
 ## Installation
@@ -40,6 +35,39 @@ See the commands and subcommands with
 ```bash
 pixl --help
 ```
+### Configuration
+
+The `rabbitmq` and `postgress` services are configured by setting the following environment variables
+(default values shown):
+
+```sh
+RABBITMQ_HOST=localhost
+RABBITMQ_PORT=7008
+RABBITMQ_USERNAME=rabbitmq_username
+RABBITMQ_PASSWORD=rabbitmq_password
+
+POSTGRES_HOST=localhost
+POSTGRES_PORT=7001
+PIXL_DB_USER=pixl_db_username
+PIXL_DB_PASSWORD=pixl_db_password
+PIXL_DB_NAME=pixl
+```
+
+The `rabbitmq` queues for the `ehr` and `imaging` APIs are configured by setting:
+
+```sh
+PIXL_EHR_API_HOST=localhost
+PIXL_EHR_API_PORT=7006
+PIXL_EHR_API_RATE=1
+
+PIXL_IMAGING_API_HOST=localhost
+PIXL_IMAGING_API_PORT=7007
+PIXL_IMAGING_API_RATE=1
+```
+
+where the `*_RATE` variables set the default querying rate for the message queues.
+
+### Running the pipeline
 
 Populate queue for Imaging and EHR extraction
 
@@ -113,10 +141,9 @@ pip install -e ../pixl_core/ -e .[test]
 
 ### Running tests
 
-The CLI tests require a running instance of the `rabbitmq` service, for which we provide a
-`docker-compose` [file](./tests/docker-compose.yml). Spinning up the service and running `pytest`
-can be done by running
+Tests can be run with `pytest` from the `tests` directory.
 
 ```bash
-./tests/run-tests.sh
+cd tests
+pytest
 ```
diff --git a/cli/src/pixl_cli/_config.py b/cli/src/pixl_cli/_config.py
index 6f4fdb9ad..456cfa58c 100644
--- a/cli/src/pixl_cli/_config.py
+++ b/cli/src/pixl_cli/_config.py
@@ -12,21 +12,70 @@
 #  See the License for the specific language governing permissions and
 #  limitations under the License.
 
-"""Configuration of CLI from config file."""
+"""Configuration of CLI from environment variables."""
+
 from pathlib import Path
 
-import yaml
+from decouple import Config, RepositoryEmpty, RepositoryEnv
+
+env_file = Path.cwd() / ".env"
+config = Config(RepositoryEnv(env_file)) if env_file.exists() else Config(RepositoryEmpty())
+
+SERVICE_SETTINGS = {
+    "rabbitmq": {
+        "host": config("RABBITMQ_HOST"),
+        "port": int(config("RABBITMQ_PORT")),
+        "username": config("RABBITMQ_USERNAME"),
+        "password": config("RABBITMQ_PASSWORD"),
+    },
+    "postgres": {
+        "host": config("POSTGRES_HOST"),
+        "port": int(config("POSTGRES_PORT")),
+        "username": config("PIXL_DB_USER"),
+        "password": config("PIXL_DB_PASSWORD"),
+        "database": config("PIXL_DB_NAME"),
+    },
+}  # type: dict
+
+
+class APIConfig:
+    """API Configuration"""
+
+    def __init__(self, host: str, port: int, default_rate: float = 1) -> None:
+        """Initialise the APIConfig class"""
+        self.host = host
+        self.port = port
+        self.default_rate = default_rate
+
+    @property
+    def base_url(self) -> str:
+        """Return the base url for the API"""
+        return f"http://{self.host}:{self.port}"
+
 
+API_CONFIGS = {
+    "ehr_api": APIConfig(
+        host=config("PIXL_EHR_API_HOST"),
+        port=int(config("PIXL_EHR_API_PORT")),
+        default_rate=float(config("PIXL_EHR_API_RATE", default=1)),
+    ),
+    "imaging_api": APIConfig(
+        host=config("PIXL_IMAGING_API_HOST"),
+        port=int(config("PIXL_IMAGING_API_PORT")),
+        default_rate=float(config("PIXL_IMAGING_API_RATE", default=1)),
+    ),
+}
 
-def _load_config(filename: str = "pixl_config.yml") -> dict:
-    """CLI configuration generated from a .yaml file"""
-    if not Path(filename).exists():
-        msg = f"Failed to find {filename}. It must be present in the current working directory"
-        raise FileNotFoundError(msg)
 
-    with Path(filename).open() as config_file:
-        config_dict = yaml.safe_load(config_file)
-    return dict(config_dict)
+def api_config_for_queue(queue_name: str) -> APIConfig:
+    """Configuration for an API associated with a queue"""
+    api_name = f"{queue_name}_api"
 
+    if api_name not in API_CONFIGS:
+        msg = (
+            f"Cannot update the rate for {queue_name}. {api_name} was"
+            f" not specified in the configuration"
+        )
+        raise ValueError(msg)
 
-cli_config = _load_config()
+    return API_CONFIGS[api_name]
diff --git a/cli/src/pixl_cli/_database.py b/cli/src/pixl_cli/_database.py
index b935af77b..2c2a52f45 100644
--- a/cli/src/pixl_cli/_database.py
+++ b/cli/src/pixl_cli/_database.py
@@ -19,9 +19,9 @@
 from sqlalchemy import URL, create_engine
 from sqlalchemy.orm import Session, sessionmaker
 
-from pixl_cli._config import cli_config
+from pixl_cli._config import SERVICE_SETTINGS
 
-connection_config = cli_config["postgres"]
+connection_config = SERVICE_SETTINGS["postgres"]
 
 url = URL.create(
     drivername="postgresql+psycopg2",
diff --git a/cli/src/pixl_cli/_io.py b/cli/src/pixl_cli/_io.py
index b9a368d52..8d928692c 100644
--- a/cli/src/pixl_cli/_io.py
+++ b/cli/src/pixl_cli/_io.py
@@ -47,19 +47,23 @@ def messages_from_state_file(filepath: Path) -> list[Message]:
     return [deserialise(line) for line in filepath.open().readlines() if string_is_non_empty(line)]
 
 
-def config_from_log_file(parquet_path: Path) -> tuple[str, datetime]:
-    log_file = parquet_path / "extract_summary.json"
+def project_info(resources_path: Path) -> tuple[str, datetime]:
+    """
+    Get the project name and extract timestamp from the extract summary log file.
+    :param resources_path: path to the input resources
+    """
+    log_file = resources_path / "extract_summary.json"
     logs = json.load(log_file.open())
     project_name = logs["settings"]["cdm_source_name"]
     omop_es_timestamp = datetime.fromisoformat(logs["datetime"])
     return project_name, omop_es_timestamp
 
 
-def copy_parquet_return_logfile_fields(parquet_path: Path) -> tuple[str, datetime]:
+def copy_parquet_return_logfile_fields(resources_path: Path) -> tuple[str, datetime]:
     """Copy public parquet file to extracts directory, and return fields from logfile"""
-    project_name, omop_es_timestamp = config_from_log_file(parquet_path)
+    project_name, omop_es_timestamp = project_info(resources_path)
     extract = ParquetExport(project_name, omop_es_timestamp, HOST_EXPORT_ROOT_DIR)
-    project_name_slug = extract.copy_to_exports(parquet_path)
+    project_name_slug = extract.copy_to_exports(resources_path)
     return project_name_slug, omop_es_timestamp
 
 
diff --git a/cli/src/pixl_cli/main.py b/cli/src/pixl_cli/main.py
index 78fcfbc1d..74e75cc3b 100644
--- a/cli/src/pixl_cli/main.py
+++ b/cli/src/pixl_cli/main.py
@@ -25,13 +25,13 @@
 from core.patient_queue.producer import PixlProducer
 from core.patient_queue.subscriber import PixlBlockingConsumer
 
-from pixl_cli._config import cli_config
+from pixl_cli._config import SERVICE_SETTINGS, api_config_for_queue
 from pixl_cli._database import filter_exported_or_add_to_db
 from pixl_cli._io import (
-    config_from_log_file,
     copy_parquet_return_logfile_fields,
     messages_from_parquet,
     messages_from_state_file,
+    project_info,
 )
 from pixl_cli._logging import logger, set_log_level
 from pixl_cli._utils import clear_file, remove_file_if_it_exists
@@ -98,7 +98,7 @@ def populate(parquet_dir: Path, *, restart: bool, queues: str) -> None:
             sorted_messages = filter_exported_or_add_to_db(
                 sorted_messages, messages[0].project_name
             )
-        with PixlProducer(queue_name=queue, **cli_config["rabbitmq"]) as producer:
+        with PixlProducer(queue_name=queue, **SERVICE_SETTINGS["rabbitmq"]) as producer:
             producer.publish(sorted_messages)
 
 
@@ -113,7 +113,7 @@ def extract_radiology_reports(parquet_dir: Path) -> None:
     PARQUET_DIR: Directory containing the extract_summary.json
     log file defining which extract to export radiology reports for.
     """
-    project_name, omop_es_datetime = config_from_log_file(parquet_dir)
+    project_name, omop_es_datetime = project_info(parquet_dir)
 
     # Call the EHR API
     api_config = api_config_for_queue("ehr")
@@ -143,10 +143,9 @@ def extract_radiology_reports(parquet_dir: Path) -> None:
     "--rate",
     type=float,
     default=None,
-    help="Rate at which to process items from a queue (in items per second)."
-    "If None then will use the default rate defined in the config file",
+    help="Rate at which to process items from a queue (in items per second).",
 )
-def start(queues: str, rate: Optional[int]) -> None:
+def start(queues: str, rate: Optional[float]) -> None:
     """Start consumers for a set of queues"""
     if rate == 0:
         msg = "Cannot start extract with a rate of 0. Must be >0"
@@ -186,10 +185,7 @@ def _update_extract_rate(queue_name: str, rate: Optional[float]) -> None:
 
     if rate is None:
         if api_config.default_rate is None:
-            msg = (
-                "Cannot update the rate for %s. No default rate was specified.",
-                queue_name,
-            )
+            msg = f"Cannot update the rate for {queue_name}. No valid rate was specified."
             raise ValueError(msg)
         rate = float(api_config.default_rate)
         logger.info(f"Using the default extract rate of {rate}/second")
@@ -299,7 +295,7 @@ def consume_all_messages_and_save_csv_file(queue_name: str, timeout_in_seconds:
         f"{timeout_in_seconds} seconds"
     )
 
-    with PixlBlockingConsumer(queue_name=queue_name, **cli_config["rabbitmq"]) as consumer:
+    with PixlBlockingConsumer(queue_name=queue_name, **SERVICE_SETTINGS["rabbitmq"]) as consumer:
         state_filepath = state_filepath_for_queue(queue_name)
         if consumer.message_count > 0:
             logger.info("Found messages in the queue. Clearing the state file")
@@ -325,51 +321,3 @@ def inform_user_that_queue_will_be_populated_from(path: Path) -> None:  # noqa:
         f"state files should be ignored, or delete this file to ignore. Press "
         f"Ctrl-C to exit and any key to continue"
     )
-
-
-class APIConfig:
-    """
-    Class to represent the configuration for an API
-
-    Attributes
-    ----------
-    host : str
-        Hostname for the API
-    port : int
-        Port for the API
-    default_rate : int
-        Default rate for the API
-
-    Methods
-    -------
-    base_url()
-        Return the base url for the API
-
-    """
-
-    def __init__(self, kwargs: dict) -> None:
-        """Initialise the APIConfig class"""
-        self.host: Optional[str] = None
-        self.port: Optional[int] = None
-        self.default_rate: Optional[int] = None
-
-        self.__dict__.update(kwargs)
-
-    @property
-    def base_url(self) -> str:
-        """Return the base url for the API"""
-        return f"http://{self.host}:{self.port}"
-
-
-def api_config_for_queue(queue_name: str) -> APIConfig:
-    """Configuration for an API associated with a queue"""
-    config_key = f"{queue_name}_api"
-
-    if config_key not in cli_config:
-        msg = (
-            f"Cannot update the rate for {queue_name}. {config_key} was"
-            f" not specified in the configuration"
-        )
-        raise ValueError(msg)
-
-    return APIConfig(cli_config[config_key])
diff --git a/cli/tests/conftest.py b/cli/tests/conftest.py
index f8d0f69d8..c97401690 100644
--- a/cli/tests/conftest.py
+++ b/cli/tests/conftest.py
@@ -14,6 +14,7 @@
 """CLI testing fixtures."""
 from __future__ import annotations
 
+import os
 import pathlib
 
 import pytest
@@ -21,6 +22,26 @@
 from sqlalchemy import Engine, create_engine
 from sqlalchemy.orm import Session, sessionmaker
 
+# Set the necessary environment variables
+os.environ["PIXL_EHR_API_HOST"] = "localhost"
+os.environ["PIXL_EHR_API_RATE"] = "1"
+os.environ["PIXL_EHR_API_PORT"] = "7006"
+
+os.environ["PIXL_IMAGING_API_HOST"] = "localhost"
+os.environ["PIXL_IMAGING_API_RATE"] = "1"
+os.environ["PIXL_IMAGING_API_PORT"] = "7007"
+
+os.environ["RABBITMQ_HOST"] = "localhost"
+os.environ["RABBITMQ_USERNAME"] = "rabbitmq_username"
+os.environ["RABBITMQ_PASSWORD"] = "rabbitmq_password"  # noqa: S105
+os.environ["RABBITMQ_PORT"] = "7008"
+
+os.environ["PIXL_DB_USER"] = "pixl_db_username"
+os.environ["PIXL_DB_PASSWORD"] = "pixl_db_password"  # noqa: S105
+os.environ["POSTGRES_HOST"] = "locahost"
+os.environ["POSTGRES_PORT"] = "7001"
+os.environ["PIXL_DB_NAME"] = "pixl"
+
 
 @pytest.fixture(autouse=True)
 def export_dir(tmp_path_factory: pytest.TempPathFactory) -> pathlib.Path:
diff --git a/cli/tests/pixl_config.yml b/cli/tests/pixl_config.yml
deleted file mode 100644
index d93eadd1e..000000000
--- a/cli/tests/pixl_config.yml
+++ /dev/null
@@ -1,30 +0,0 @@
-#  Copyright (c) University College London Hospitals NHS Foundation Trust
-#
-#  Licensed under the Apache License, Version 2.0 (the "License");
-#  you may not use this file except in compliance with the License.
-#  You may obtain a copy of the License at
-#
-#     http://www.apache.org/licenses/LICENSE-2.0
-#
-#  Unless required by applicable law or agreed to in writing, software
-#  distributed under the License is distributed on an "AS IS" BASIS,
-#  WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
-#  See the License for the specific language governing permissions and
-#  limitations under the License.
-rabbitmq:
-  host: localhost
-  port: 5672
-  username: guest
-  password: guest
-ehr_api:
-  host: localhost
-  port: 9000
-  default_rate: 5  # ~queries per second
-imaging_api:
-  default_rate: 5  # queries per second
-postgres:
-  host: host
-  port: 5432
-  username: username
-  password: password
-  database: database
diff --git a/pixl_config.yml.sample b/pixl_config.yml.sample
deleted file mode 100644
index 7d3e1febd..000000000
--- a/pixl_config.yml.sample
+++ /dev/null
@@ -1,19 +0,0 @@
-rabbitmq:
-  host:
-  port:
-  username:
-  password:
-ehr_api:
-  host:
-  port:
-  default_rate: 5  # ~queries per second
-imaging_api:
-  host:
-  port:
-  default_rate: 0.1  # queries per second
-postgres:
-  host:
-  port:
-  username:
-  password:
-  database:
diff --git a/test/.env b/test/.env
index b77a670fd..6edcf534c 100644
--- a/test/.env
+++ b/test/.env
@@ -32,6 +32,15 @@ RABBITMQ_PORT=7008
 RABBITMQ_ADMIN_PORT=7009
 FTP_PORT=20021
 
+# PIXL EHR API
+POSTGRES_HOST=localhost
+PIXL_EHR_API_HOST=localhost
+PIXL_EHR_API_RATE=1
+
+# PIXL Imaging API
+PIXL_IMAGING_API_HOST=localhost
+PIXL_IMAGING_API_RATE=1
+
 # PIXL Orthanc raw instance
 ORTHANC_RAW_USERNAME=orthanc_raw_username
 ORTHANC_RAW_PASSWORD=orthanc_raw_password
@@ -59,6 +68,7 @@ VNAQR_MODALITY=UCVNAQR
 PIXL_EHR_COGSTACK_REDACT_URL=http://cogstack-api:8000/redact
 
 # RabbitMQ
+RABBITMQ_HOST=localhost
 RABBITMQ_USERNAME=rabbitmq_username
 RABBITMQ_PASSWORD=rabbitmq_password
 
diff --git a/test/README.md b/test/README.md
index 0ee56ab9e..0e3ad87e7 100644
--- a/test/README.md
+++ b/test/README.md
@@ -36,10 +36,6 @@ Run the following to teardown:
 
 ## File organisation
 
-### PIXL configuration
-
-A test `pixl_config.yml` file is provided to run the PIXL pipeline.
-
 ### Docker compose
 
 `./docker-compose.yml` contains the docker compose configuration for the system test.
diff --git a/test/pixl_config.yml b/test/pixl_config.yml
deleted file mode 100644
index d185ccac0..000000000
--- a/test/pixl_config.yml
+++ /dev/null
@@ -1,32 +0,0 @@
-#  Copyright (c) University College London Hospitals NHS Foundation Trust
-#
-#  Licensed under the Apache License, Version 2.0 (the "License");
-#  you may not use this file except in compliance with the License.
-#  You may obtain a copy of the License at
-#
-#     http://www.apache.org/licenses/LICENSE-2.0
-#
-#  Unless required by applicable law or agreed to in writing, software
-#  distributed under the License is distributed on an "AS IS" BASIS,
-#  WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
-#  See the License for the specific language governing permissions and
-#  limitations under the License.
-rabbitmq:
-  host: localhost
-  port: 7008
-  username: rabbitmq_username
-  password: rabbitmq_password
-ehr_api:
-  host: localhost
-  port: 7006
-  default_rate: 1
-imaging_api:
-  host: localhost
-  port: 7007
-  default_rate: 1
-postgres:
-  host: localhost
-  port: 7001
-  username: pixl_db_username
-  password: pixl_db_password
-  database: pixl