Dozens of trusts still not sharing single pathology service

Information presented by NHS England in a recent webinar showed 31 per cent of networks were described as “emerging”, meaning pathology services were still being run at trust level.

It comes five years after NHS Improvement, which has since become part of NHSE, ordered all NHS trusts to form 29 pathology networks in a bid to save hundreds of millions of pounds in efficiencies.

The instruction came after the 2016 Carter Review called for laboratories to be consolidated into “hub and spoke” models. NHSI wanted to link the 105 individual hospital pathology services by creating networks which would each serve populations of between 1.5 million and 2 million.

Four months before the pandemic, NHSE published an update which said trusts were on course to form networks by 2021.

Since then, the regulator has carried out a new assessment of networks’ progress, and has placed networks into three categories: Emerging, developing and maturing.

In a webinar held this summer, NHSE revealed 31 per cent of networks were in the “emerging” category, with another 31 per cent in the “developing” category.

The rest (38 per cent) were in the “maturing” category.

NHSE has defined the emerging category as “constituent pathology service within a network currently operate independently at trust level, but with a network programme board engaged to take forward trust board signed network-wide understanding and development of a network-wide plan”.

The regulator has not published which networks are in which categories. Networks have been judged in seven domains such as governance, leadership, IT and digital, workforce and supply chain.

HSJ has previously reported how some networks have struggled to reach agreement with all their trusts about membership and their pathology model.

Jane Mills, head of pathology for NHSE, told the webinar the regulator was “increasingly” using quality standards and maturity assessment tools to measure the networks’ progress.

She said some networks are in discussions about progressing their relationships further, which “may well result in mergers”.

NHSE expects all networks to be at the “maturing” stage by March 2025, she added.

The maturing stage is described as “fully established and implemented plans at network level, and where applicable realisation of benefits and further innovation and improvement [is] under way”.

Ms Mills told the webinar that networking remained NHSE’s plan for pathology services, and added: “We’ve learned through the pandemic experience it’s the best way to organise our operational response and support more rapid adoption of tech, and also to support eradication of unwarranted variation.”

NHSE was approached for comment.