News / Major shake-up of pathology services targets £200m savings

The oversight body has spent the last year collecting and validating data from 105 hospitals providing pathology services. Together these services undertake 1.2 billion tests a year at a cost of £2.2bn. Earlier reviews and the more recent Carter review of acute hospital productivity have highlighted unwarranted variation in productivity and cost.  NHS Improvement believes the restructuring of services into 29 networks will improve efficiency, enhance pathology careers, maximise the contribution pathology can make to healthcare and save at least £200m by 2020/21.

Each network would serve the needs of 1.5 million to 2 million people. Essential laboratory services will continue to be provided on each hospital site, with high volume and more complex tests centralised within hubs. There may be cross network arrangements for the most advanced investigations using genetic and molecular techniques.

The configuration of the 29 networks has been reviewed by NHS Improvement’s Pathology Optimisation Delivery Board, which recognises that adjustments ‘may be needed to accommodate progress already made in some regions and to reflect established patient pathways’. 

Trusts have been asked to confirm agreement with the composition of their proposed pathology network by the end of September – or to make a case for being part of a different cluster. They should also confirm that renewals of any existing managed service contracts will be postponed. 

Workshops are being organised for each network in the autumn and by the end of January trusts are required to provide written confirmation of their agreed partnership or outsourcing model to rationalise pathology services. Implementation of the plans is expected to take three years. 

A letter to trusts from NHS Improvement’s operational productivity director Jeremy Marlow and national clinical productivity director Professor Tim Evans acknowledges that capital and change management capacity will be ‘important enablers’. ‘Trusts should prioritise resources already available to them to support delivery of network formation and service consolidation as an investment in recurrent benefits for patients and the NHS’s finances,’ it said. It added that Carter-compliant business cases would be prioritised for approval where NHS Improvement sign-off is necessary.