Improvements are needed to the way pathology departments across the country are organised and quality assessed, a Royal College of Pathologists investigation has found.
The college has called for national changes following a joint investigation with the Care Quality Commission into how women with breast cancer came to be given inaccurate test results by Sherwood Forest Foundation Trust.
The trust recalled 79 women in October 2012 after discovering its testing had wrongly concluded they were unsuitable for a particular type of hormone treatment.
The RCP said its findings had uncovered problems with the wider quality assurance of pathology departments and that there was a need for better management of quality assurance processes, including better communication between organisations with a responsibility for monitoring quality.
Its findings will form part of a national review of quality assurance arrangements for NHS pathology services announced in December following the problems at Sherwood Forest’s Kings Mill Hospital.
The CQC published a separate report on its findings at the trust on Friday.
The RCP investigation found concerns around testing at the hospital were raised as far back as 2004. Between 2004 and 2010 a series of peer review visits “did not identify the technical and cultural problems [in the department] or did not emphasise these sufficiently in their reports.”
It concluded: “This investigation shows that, beyond Sherwood Forest Hospitals NHS Foundation trust, wider changes are needed, from the organisation of pathology departments in general and the distribution of work between them to allow external monitoring of the quality of laboratory services.”
It added: “Decision making was finance driven, with too little attention given to clinical considerations.
“The NHS is run for the benefit of patients, but takes cost into account. However, in Sherwood Forest Hospitals NHS Foundation Trust, finance appeared to take priority.
“The overall impression formed by the investigation team is of a department isolated physically from the rest of the pathology service, trying hard to put things right, and struggling to leave behind an outdated culture of ‘make do’. It operates in a climate of severe financial constraints and is not necessarily getting the full support of the trust in terms of funding and support for quality improvements, staffing and IT support.”
A spokesman for the Royal College of Pathologists said: “The findings of our report have implications far wider than Sherwood Forest Foundation Trust. The report raises important questions about the organisation of pathology departments and their workload, and the effectiveness of pathology quality assurance.
“The Royal College of Pathologists is examining potential improvements to existing quality assurance processes and will develop and implement a core set of principles that improve the system and its oversight.”