A new report from independent research organisation MindMetre has summarised the evidence for return-on-investment from pathology services in the NHS and questioned any urgent pressure to consolidate pathology laboratories – within and between NHS trusts.
The MindMetre report, which reviewed the range of existing evidence and also canvassed views among a sample of 30 laboratory managers and principal biochemists in England and Wales, was conducted in response Lord Carter’s latest report, Operational productivity and performance in English NHS acute hospitals: Unwarranted variations (February 2016).
The Carter report notes that, “If benchmarks for pathology are unlikely to be achieved [by the deadline of April 2017], trusts should have agreed plans for consolidation and outsourcing to, other providers by January 2017.” The MindMetre review and research cautions against such a tight deadline being imposed, arguing that merger planning is not a substitute for within-laboratory efficiency and improvement drives.
The MindMetre review suggests that a mandatory pathway is set for laboratory productivity improvement (particularly turnaround time reduction), recognising that all aspects of the NHS have to deliver efficiency savings in the current policy environment. However, the review also suggests that the high value offered by pathology services be re-appraised at the strategic level to determine their position in the NHS service funding priorities.
Evidence covered in the review suggests that the immediate and knock-on effects of pathology service capacity and efficiency/productivity are more considerable than service funding would suggest, and could make an even more disproportionately positive contribution to patient outcomes, rapid diagnosis and the avoidance of unnecessary interventions and chronic condition development further down the line.
Paul Lindsell, Mind Metre Managing Director, comments: “A knee-jerk push to consolidate pathology labs is not an easy universal panacea. There is evidently significant headroom for efficiency and productivity gains in pathology workflows and emerging technology. Our report recognises frustrations that greater productivity gains have not yet been achieved. However, we also suggest that the through-the-line benefits that pathology services offer mean it would be a mistake to potentially squeeze such resources in the NHS. In fact, there may be a rationale to put greater resources into pathology services, so long as they are strictly pegged to productivity improvements.”