Pathology services reform: making it work in practice

The painfully slow rate of progress following Lord Carter’s 2008 review of NHS pathology services has been a major disappointment, not least to Lord Carter himself, who has expressed his frustration at our faltering attempts to reconfigure into the managed pathology networks envisaged in his report.
 Despite Lord Carter’s promise of 20% savings and improved service, every success story (eg the Taunton, Somerset and Yeovil joint venture) has been matched by a crushing defeat (eg collapse of a £500 million project in the West Midlands).

At Gateshead’s Queen Elizabeth Hospital we have a success story of our own to tell. We are in the final phases of bringing three very different pathology teams together under one roof and are now providing a fully integrated service, processing over 10,000 samples a day for an area serving around 650,000 people. Our experience shows that the Carter reforms can be achieved, but also goes some way to explain why so many others have failed.

Reconfiguration and consolidation of services across multiple organisations is not an easy process. It requires the coming together of many disparate forces, the adoption of a common goal, overcoming the resistance to change, the burying of egos, the diplomacy skills of a United Nations envoy, and maintaining the support of management, staff and suppliers.