HSJ’s special supplement looks at ways NHS providers are improving efficiency in the areas of pathology, outsourcing patient letters and funding for drugs.

Download HSJ’s new efficiency supplement

Roundtable: pathology

The idea of radically reshaping pathology to create a more efficient service has been around since Lord Carter’s 2006 report recommending far-reaching rationalisation of the service. With the bidding process for reshaped services finally underway, experts gathered to discuss how to move to new service models and make best use of technology to promote the goal of a paperless process and “end-to-end” automation.


The piles of material waiting to be typed in the intrays of medical secretaries are ballooning. Sending patient letters abroad to be typed has, in the past, been
controversial but more and more trusts are seeing it as a quality assured solution − and a useful way to free up staff time to focus on improving the service to patients.


The 2006 controversy and expensive legal dispute over the funding of herceptin for one patient illustrates the legal and political minefield around individuals requesting funding for particular treatments. Now there are worries that expertise built up by primary care trusts in dealing with such requests will be lost in the move to clinical commissioning groups. There are further concerns that GPs may risk becoming personally associated with decisions not to fund particular drugs. What is clear, say experts, is that clinical commissioning groups urgently need to establish clear policies to deal with individual funding requests.

HSJ’s latest efficiency supplement is free to download