STRUCTURE: Four trusts in the south of England are in detailed discussions about merging their pathology services.

Royal Berkshire Foundation Trust is in talks with a joint venture comprising of three neighbouring trusts that already share one centrally governed service for running blood tests.

Surrey Pathology Services, which was established in 2012, provides pathology functions to Ashford and St Peter’s Hospitals, Frimley Health and Royal Surrey County Hospital foundation trusts.

A spokeswoman for the joint venture told HSJ the trusts have been talking for several months but a final decision on whether to proceed with full integration had not been made.

A memorandum of understanding has been signed by all providers to produce a full business case for approval by their boards.

A Royal Berkshire spokeswoman said a merger was under discussion in order to ensure local pathology services were “fit for the future”, in line with recommendations made by Lord Carter in his 2008 review into the pathology sector.

The trust has suggested that consolidation of its pathology services would require “significant capital” investment, according to recent board papers.

The trust spokeswoman said: “The proposal is currently under discussion internally and an update will be provided to the trust board at its April meeting, however the need to find capital may be a constraining factor.”

She declined to give more detail on the value of any required capital spending.

A Surrey Pathology Services spokeswoman said: “Discussions have been taking place over a number of months between Royal Berkshire Hospital Foundation Trust and Surrey Pathology Services regarding the possibility of Royal Berkshire Hospital joining the partnership.

“Financial benefits will be determined based on any final solution and various options are being explored as part of ongoing discussions. No final decision has been made.”

The Department of Health commissioned Labour peer Lord Carter to review pathology services across England, the second and final part of which was published in 2008.

The Carter review concluded that savings of 10-20 per cent and quality improvements were achievable by consolidating services into networks.

The peer told HSJ in October 2013 that he had been disappointed by the slow pace of reform in the sector.