The paediatric and perinatal pathology workforce report highlights the extent of the workforce crisis in paediatric and perinatal pathology (PPP). The workforce is unable to meet demand and families are suffering. There are a substantial number of vacant consultant posts and a dwindling number of resident doctors coming into the specialty.   

PPP consultants have a crucial role in the diagnosis and treatment of a variety of conditions in fetuses, infants and children. In many cases, diagnoses can help to screen other family members who may be affected. They also undertake post-mortem examinations which provide information about cause of death and – where relevant – give information that aides treatment in subsequent pregnancies. 

Dr Clair Evans, Chair, RCPath Specialty Advisory Committee for Pre/Perinatal/Paediatric Pathology said:

"Our service is in crisis. This is having a significant and distressing effect on families who regulary report long and harrowing waits for post-mortem repots. 1 in 5 families are now waiting 6 months or more, and some longer than 12 months. There are simply not enough consultants to undertake this work and families are suffering. Due to the severe resource issues, paediatric and perinatal pathologists tell us their inability to provide high quality care to their patients is leaviing them feeling stretched, stressed and burnt out."

In Northern Ireland there has not been a paediatric and perinatal consultant in post since 2019 and the service has totally collapsed. Post-mortem examinations are currently being carried out on an interim basis at Alder Hey Children’s NHS Foundation Trust in Liverpool. This means that if a baby or child needs a post-mortem, their body must be transported from Northern Ireland by either ferry or by plane to England. Dr Alison Watt, Chair, RCPath Northern Ireland Regional Council said:

"All parents should have the option to know why their child has died. The process of moving a baby or child's body long distances out of Northern Ireland brings significant distress for families."

The report provides solutions to address these challenges through investment and commitment from all 4 UK governments to enable the provision of resilient and sustainable services in PPP for UK families for the foreseeable future. 

Key findings

• The UK has 52 PPP consultants working 46.35 whole-time equivalents (WTE). This comprises 43 in England, 7 in Scotland and 2 in Wales. 
• There are no PPP consultants working in Northern Ireland, and in the South West and Midlands areas of England, which has led to total service collapse in these areas.
• 37% of PPP consultant posts in the UK are currently vacant. 
• Recruitment is almost impossible due to a national shortage of qualified candidates; 83% of PPP consultants report issues with recruitment in their departments. 
• Only 3% of PPP consultants believe that current staffing levels are adequate to ensure the long-term sustainability of their service.  
• 25% of the consultant PPP workforce are expected to retire within the next 5 years. 
• There are only 13 resident doctors in PPP specialist training posts. This is insufficient to combat both longstanding vacancies and to cover expected retirements, let alone future workforce needs. 
• Bereaved families are facing a major increase in waiting time – or transfer out of their region – for post-mortem examination of their babies and children. 1 in 5 are now waiting 6 months or more, and some longer than 12 months.

Urgent action is needed

To address the significant challenges faced by PPP services across the UK, RCPath is calling on policymakers and employers across the UK to: 

• Introduce a phased expansion of PPP training posts up to 37 (31.1 WTE) across the UK by 2030 to help manage current consultant vacancies and help ensure succession planning.  This should be supported by a dedicated, funded and flexible recruitment strategy including support for potential international candidates
• Increase protected time and funding for professional development to enable consultants to have time to train the next generation and support their own personal development
• Increase workforce support with dedicated biomedical scientists, anatomical pathology technicians and administrative support in each paediatric pathology unit – delivered flexibly to meet the needs of the service, together with managerial support that recognises the unique pressures facing paediatric and perinatal services. 
• Commit funding and resources to continue the development of 10 fellowships; an advanced training program in paediatric and perinatal pathology
• Upskill scientists and histopathologists to engage in placenta reporting 
• Commit resources to workforce planning to determine the number of PPP consultants required to provide a resilient service now and in the future
• Continue prioritisation and outsourcing as effective ways of managing excess workload informed by clear guidance so that workload aligns with that of the highest value.

Download the full report and briefings

How are we using the report

Multiple approaches are needed to increase capacity within the PPP workforce. We continue to make the case for urgent action to NHS leaders and governments, and this report provides further evidence to strengthen our advocacy efforts. In November 2025 the College met with MPs from the areas most affected by the shortage of pathologists to carry out paediatric post-mortems. We continue to engage with charities and the All-Party Parliamentary Group (APPG) on baby loss and will present the report at a meeting of the APPG in December.  

As national workforce strategies develop, including the NHS 10 Year Workforce Plan in England, equivalent plans across the devolved nations, forthcoming actions to deliver the aims of the 10 Year Health Plan and the Medical Training Review, the College will continue to engage at every opportunity. 

Our priority is to ensure PPP services receive the resources they need so that parents and families across the UK can access safe, high-quality care and support.