A network of acute trusts in Greater Manchester has been set the biggest savings target in the country under NHS Improvement’s national pathology networking plan.

Central Manchester University Hospitals Foundation Trust and Pennine Acute Hospitals Trust will become “hub” locations where high volume and complex tests are carried out, while six neighbouring trusts will retain laboratories to provide essential services for their hospitals. They are expected to reduce costs by £15.6m per year by 2020-21.

NHSI has proposed that pathology services in England be gathered into 29 networks, which comprise between two and ten trusts.

The regulator hopes that savings of up to £200m can be achieved by 2020-21, with the NHS spending an estimated £2.2bn on pathology tests annually.

The hubs that will lead their local networks are (savings target in brackets):


  • Imperial College Healthcare Trust (£2.4m);
  • Barts Health Trust (£5.3m); and
  • St George’s University Hospitals FT (£1.6m).

Midlands and East

  • The Royal Wolverhampton Trust (£5.2m);
  • Nottingham University Hospitals Trust and University Hospitals of Leicester Trust (£11m);
  • University Hospitals Birmingham FT (£448,000);
  • University Hospitals Coventry and Warwickshire Trust (£838,000);
  • Norfolk and Norwich University Hospitals FT (£0); and
  • Cambridge University Hospitals FT (data not available).

North Midlands

  • Sheffield Teaching Hospitals FT (£6.2m);
  • Northern Lincolnshire and Goole Foundation Trust (£5.5m); and 
  • University Hospitals of North Midlands (£3.3m).


  • The Newcastle Upon Tyne FT and Gateshead Health Trust (£8.6m);
  • Leeds Teaching Hospitals Trust (£10.6m);
  • Lancashire Teaching Hospitals FT (£5.7m);
  • Royal Liverpool and Broadgreen University Hospitals Trust (£9m); and
  • Central Manchester University Hospitals FT and Pennine Acute Hospitals Trust (£15.6m).


  • Plymouth Hospitals Trust (£10.7m);
  • North Bristol Trust (£8.2m);
  • Oxford University Hospitals FT (£3.6m);
  • Frimley Health FT (£5.1m);
  • University Hospitals Southampton FT (£8.2m);
  • Brighton and Sussex University Hospitals Trust (£6.3m); and
  • East Kent Hospitals University FT (£5.7m).

HSJ understands five of the proposed networks have not been given a “hub” provider becase some trusts use the private sector for pathology services. NHSI does not have full data for those networks and has therefore not yet proposed a “hub” location. 

The five networks are in the following areas:

  • North West London (£3.5m);
  • South East London (£3.8m);
  • Bedfordshire (£2.4m);
  • Essex (£2.2m); and 
  • Somerset (Data not available to NHSI).

The networks’ savings targets add up to £151m. NHSI hopes the rest of the savings which make up the £200m target will come from “other effiencies” as a result of service consolidation, according to a source close to the scheme.


NHSI reveals nationwide pathology network plan