The author of an influential review of pathology services has expressed disappointment at the slow pace of reform but said he had not yet “given up hope” it can be achieved.

Lord Carter, who advocated a widespread reconfiguration of pathology services, spoke exclusively to HSJ as the sector braced itself for two rulings by the Office of Fair Trading that are likely to have a major bearing on whether the sort of projects he endorsed can proceed.

The OFT’s involvement had added “complexity” to the process but its judgements would provide greater clarity, Lord Carter said. “The pace of change is disappointing but there are some… people trying to make this work,” he added.

“It’s a mixed picture. There are places, like Taunton, where they are delivering but then there are places like the West Midlands where there is a high degree of frustration because things are not happening.”

In May Taunton and Somerset and Yeovil District Hospitals foundation trusts opened a joint venture pathology service with private sector partner Integrated Pathology Partnerships, serving a population of 500,000. A £500m project to restructure services in the Midlands was all but destroyed when clinical commissioning groups abandoned two procurement exercises.

Lord Carter’s review of NHS pathology services, the second part of which was published

in 2008, concluded savings of 10-20 per cent and quality improvements were achievable by consolidating services into networks.

The OFT will announce this month whether it will refer a joint venture between University College London Hospitals and the Royal Free London foundation trusts and a private firm to the Competition Commission. It is also expected to make a decision in the coming months about the Transforming Pathology Partnership, a venture between seven East of England trusts.

Meanwhile, the Royal College of Pathologists has urged NHS England to intervene to resolve the “chaotic vacuum for commissioning and providing service”.

College president Archie Prentice told HSJ he had yet to receive a reply from NHS England, three weeks after writing to it demanding assurance that “delays and amendments to the tendering process” would not impact on quality.

He also expressed concern that cost rather than quality had become the key determinant for choosing pathology providers.