The College has provided a comprehensive response to the Department of Health and Social Care’s NHS 10-Year Workforce Plan call for evidence.
The pathology workforce is pivotal to delivering the 3 shifts - from hospital to community, analogue to digital, and sickness to prevention.
Pathology services are involved in over 85% of patient pathways. Demand for pathology services is projected to rise significantly - through increased screening, testing and monitoring, community-based diagnostics, point-of-care and direct-to-consumer testing, precision medicine, genomics and more.
College position on workforce investment
Despite overall NHS staff growth, some pathology specialties continue to face severe workforce shortages. The College’s established position has always been to seek investment for increased training and consultant capacity. While that is still true, there are nuances across pathology and some opportunities through innovation that may help stabilise the investment required year-on-year in terms of workforce numbers.
Pathology is prepared to adapt and innovate, however working differently and innovatively also requires targeted investment. In this context there is a clear and evidence-based case for strategic investment and dedicated workforce planning in pathology recognising the following:
- Pathology is fundamental to healthcare delivery, underpinning the ambitions of the 10-Year Health Plan for England and the National Cancer Plan.
- Demand for pathology services is projected to rise significantly, while current capacity remains constrained.
- Modernisation efforts – including automation, digital pathology, AI integration, and expanded roles for scientists – can partially mitigate but not resolve workforce gaps.
- Targeted investment in training is essential, particularly in disciplines with critical shortages or at risk of service failure.
- Diagnostic stewardship must be resourced and prioritised to manage pathology demand while the benefits of investment in workforce and innovation are realised.
- Infrastructure investment – in buildings, IT systems, and workforce – will enhance productivity across pathology and the wider healthcare system.
Success of the 10 Year Health Plan depends on robust systems, skilled teams, and sustained investment in technology and workforce. Upfront investment in pathology is essential to prevent escalating costs and to safeguard patient care.
RCPath response to the NHS 10 Year Workfore Plan for England
The government consultation asked for evidence across 4 areas:
- the 3 shifts
- modelling assumptions
- productivity gains linked to the wider 10-Year Health Plan
- culture and values.
The College’s submission covers each of these in detail and includes case studies of innovative practice that illustrate how – with investment – pathology can increase productivity, support the workforce and improve outcomes for patients across the health system.
You can read more about each theme, along with case studies and a full set of the College's reccomendations at the end of each response document in the expandable sections below.
Section 1: the 3 shifts
Pathology enables safe community-based diagnostics through expert oversight of point-of-care and direct-to-consumer testing, ensuring accurate interpretation and reducing health inequalities. Pathology underpins prevention strategies and precision medicine, supporting early detection, screening, and population health initiatives that play a significant role in improving outcomes for patient.
Investment in infrastructure, technology, IT, automation, digital pathology is needed first to realise these goals.
Section 2: modelling assumptions
Workforce planning for pathology remains fragmented and reactive. The data underpinning this planning lacks consistency, accuracy and robustness, making it difficult to accurately model current capacity and forecast future need. To ensure that investments translate into sustainable improvements, centralised workforce planning for pathology is essential. This should include modelling based on current establishments, vacancies, projected retirements, workforce attrition, less-than-full-time (LTFT) working, service redesign, and centrally collected and analysed pathology diagnostic data to inform workforce planning.
Section 3: productivity gains
Productivity gains in pathology by improving workforce productivity or reducing demand are vital to realise the ambitions of the 3 shifts in the NHS 10-year plan. Investment in cutting edge technologies (and their associated efficiencies) and a focus on diagnostic stewardship are key areas for focus.
Section 4: cultures and values
The pathology workforce faces significant pressures that threaten both service sustainability and patient care. Rising clinical demand, increasing retirements, and persistent workforce shortages are placing considerable strain on staff. Building a positive culture in pathology through increased protected time, flexible working, administrative support and clear career pathways is essential to enable a workforce that is valued and able to develop the skills needed for safe and effective practice.
Next steps
In line with the RCPath Workforce Strategy initiatives are needed to train, retain and reform the workforce, alongside contingency measures that prioritise patient care by making the most efficient use of the workforce. The College will continue to engage with the government advocate for investment in pathology to deliver the ambitions outlined in the NHS 10-year health plan.
The College organisational response was prepared by the Workforce and Engagement Team within the Professional Practice Directorate informed by feedback from Specialty Advisory Committees and data from the College 2025 Workforce Census.
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