The NHS has ‘clear opportunities’ to save £200 million and improve the quality of pathology care, a Nuffield Trust report has concluded.
The report states that ‘progress has been patchy’ with care quality and money savings because of staffing shortages.
‘The future of pathology services' report is based on a review of literature, interviews with leaders across England and an event attended by 60 senior clinicians, managers and policymakers.
Nuffield have recommended that all NHS leaders centralise services and create networks with sites focusing on different things to boost productivity, as well as standardising test definition to provide better care and avoid unnecessary procedures.
Programmes like Choosing Wisely, backed by the Royal College of Pathologists, are praised and NHS boards are advised to roll out these types of initiatives at a quicker rate.
Report authors warn that progress in pathology risks being held back by a shortage of doctors, with Royal College of Pathologists figures showing 40% of specialists in the field are over 55 and most of those plan to retire within five years. Financial investment, too, will be needed to support changes.
Report author Sasha Karakusevic, Senior Visiting Fellow at the Nuffield Trust, said: "Efficiency matters, but there needs to be a strong focus on improving what pathologists deliver to patients and the rest of the NHS. The greatest opportunities will come where pathologists work across the service - advising GPs and hospital colleagues on using tests better, or changing how they work to save time and money elsewhere in the system.
"The status quo of how pathology services are arranged is not an option, but centralisation isn't always the answer either. We need to work carefully to build networks of laboratories that suit the NHS in each area. But what can't happen is that chances to do better are overlooked, nationally or locally, by a narrative of integrated care that forgets the critical and ever more sophisticated role of doctors in laboratories."
