The must read stories and debate in health policy

Lab work

As hospital managers brace themselves for busier emergency departments over winter, activity within another service away from the front door is gathering pace.

The thorny question of pathology consolidation is back on the agenda after NHS Improvement published proposals for new networks of trusts’ laboratories, which the regulator hopes will deliver savings of up to £200m.

While there is a nationally agreed consensus that consolidation can lead to significant efficiencies, the question of how to go about it is not easy to answer.

NHSI’s announcement came at an awkward time for some trusts, which had already invested time and money planning and costing their own networks.

Four trusts in the Black Country and another three or four in Lancashire may have to change detailed plans for their networks to accommodate more trusts in line with the regulator’s proposal.

A quick search of the latest available board papers reveals other trusts expressing a wish to pursue a different option than that proposed by NHSI, such as Milton Keynes Foundation Trust and Barking, Havering and Redbridge Trust.

If trusts can show their own ideas make more sense than NHSI’s then the regulator will give its blessing, but you would place low odds on the chance of disagreements between local managers and the centre.

Once agreements have been struck there is the small matter of implementation.

New Royal College of Pathologists president Professor Jo Martin has flagged up concerns over IT and workforce, and overcoming these will be key to the success of the whole programme.