Date Published: 2 August 2006

Reforming pathology around the patient, UK Gov Health News

The UK Department of Health has today announced:

• Lord Warner publishes review of pathology services
• £1m to support 12 new pilot schemes

Health Minister Lord Warner today set out plans to reform pathology services and bring about higher quality, more efficient, effective and responsive services for patients.

The plans are a response to recommendations set out in the Report of the Review of NHS Pathology Services in England, undertaken by Lord Carter of Coles, which is published today.

Pathology services mainly cover blood tests, but also include taking other specimens from patients - such as tissue samples - and post mortem examinations. Pathology is at the heart of patient care - it is estimated that 70% of all diagnoses involve a pathology investigation and demand has been rising by 10% a year. Overall, pathology services cost the NHS around £2.5bn a year.

Lord Carter's review found that, over time, several different models of service delivery have evolved within pathology, from small in-house laboratories to larger networks which has resulted in fragmentation of services.

The plans to reform pathology services include:

• £1 million funding to support 12 pilot projects to road-test the recommendations of the review and to gather improved data on activity, cost and performance of pathology services; and
• in future, bringing in new providers of pathology services, especially in regard to routine tests.

Lord Warner said:

" I am very grateful to Lord Carter and his panel for this thorough and comprehensive report whose direction of travel I support.

_ Pathology is a vital service for patients. The review has found much good work already underway. But pathology is a key part of diagnosing seven in ten patients' conditions and the number and range of tests continue to increase.

_ The review has confirmed we need to improve efficiency and provide better, more convenient and speedier services for patients. I believe that patients can benefit from greater networking of services to help us use capacity better.

_ There are clearly issues to be tackled in terms of improving transportation of samples and notifying patients of results. We need to explore, as other countries have done, what lessons there are to be learned from the independent sector, particularly in providing routine tests. We need to look for substantial efficiency gains through new ways of working that can be fully implemented in 2008/09. I am looking for at least a 10% gain.

_ I have therefore asked Lord Carter to oversee a programme of pilot projects which will trial the way forward in partnership with the NHS, and provide robust evidence to guide future reforms. I want to move forward with a change programme for pathology services that benefits patients, taxpayers and staff, and do so on a fully consultative basis involving all interests."

Lord Carter of Coles said:

" Pathology is a vital aspect of the NHS and we have been consistently impressed by the quality and commitment of the people who work within it, especially given the steady rise in demand for pathology over recent years. Yet we believe that staff, NHS commissioners and patients are often poorly supported by a system that is both fragmented and inefficient.

_ We believe therefore that there is a need for a much more integrated pathology service to improve both its quality and status within the NHS, and its responsiveness to patients. Our recommendations reflect this goal.

_ There is however a need to ensure that change of this sort is supported by key stakeholders, as well as by good information and evidence, and we consider it very important that our approach is piloted before being introduced across the NHS."

The objective of the pilots would be to identify a new model for commissioning and organising NHS pathology services that offers increased quality and responsiveness to patients and reduces NHS costs.

Other recommendations of the Review include:

• drawing up a clear commissioning specification or plan of regional pathology requirements;
• further work be undertaken to ensure end-to-end IT connectivity and national availability of order communications and decision support within pathology; and
• reform of the pathology workforce and greater clarity with respect to roles, functions and equivalence in terms of education and training requirements.

Lord Carter will chair a project board that will oversee the pilot projects. The projects' operational phase will begin in January 2007, with roll-out across Strategic Health Authorities from autumn 2007 once the pilots have been evaluated, in line with commissioning plans, and following full consultation with staff, professional and other interests.

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