Acute trusts across Kent have agreed to create a joint venture to deliver a single pathology service for the county, despite years of work, developing two services in the county.

Further consolidation to a single site for all non-urgent pathology work for the county has not been ruled out but trust leaders said essential service laboratories would continue to be provided at all major acute emergency centres.

The decision to look again at where central services could be asked comes despite significant recent investment at Darent Valley Hospital in the north of the county. If agreed, further changes could be made by 2021.

Sarah Carpenter, head of health at Unite the Union, said: “Unite are concerned about what the impact of the proposals will be on the service that needs to be delivered, and in particular on the skilled staff who are needed to deliver that service. Kent is a huge geographical area which poses a number of transport challenges for staff and pathology samples.”

Medway Foundation Trust and Dartford and Gravesham Trust have recently integrated pathology services with the Darent Valley Hospital in Dartford now handling all microbiology, GP and outpatient work from Medway. The cost of the move is not known but it involved a refurbishment of the Dartford laboratory with an automated track and state-of-the-art blood analysers.

Maidstone and Tunbridge Wells Trust and East Kent Hospitals University FT had planned to work in partnership as far back as 2012, after the two other trusts decided not to join a county wide partnership. A 2014 business case envisaged splitting central services between the William Harvey Hospital in Ashford and Maidstone Hospital with essential services at the five main sites across the two trusts. Despite the extensive work on this, including advertising for someone to run the services, the changes have not been implemented.

Proposals for the new service note that trust partnerships have had “historic difficulties” and there has been “organisational mistrust and suspicion which permeates to the pathology leadership community.”

To overcome this, the chief executives of the trusts have signed up to principles, including each trust benefitting from the single service with “no loss” compared with their current services, an “agnostic” approach to where direct access pathology and other services are located, and development of a “Team Kent pathology” mindset with a pathology consortium in place by the first quarter of 2019, although some partners could join later. Other trusts in the south who might want to join the consortium will be approached.

The proposed countywide pathology service will aim for at least £5.6m in savings by 2020-21, compared with the individual services. Trusts will also be looking for three per cent efficiency savings in their own services. It will also aim for a more sustainable service in the county using new technologies and suited to new ways of working.

“We are actively engaging pathology leaders and trust representatives. We will now be engaging staff and unions as we build on the success of closer partnership working over the past few years in Kent and Medway pathology services,” said Lesley Dwyer, chief executive of Medway FT and chair of the pathology review steering group.