As part of National Pathology Week, College Registrar Dr Rachael Liebmann reflects on the increasing need to address shortages in the pathology workforce

Last month, I and the College’s other Honorary Officers met Philip Dunne, Minister of State at the Department of Health, as part of our commitment to raise awareness of pathology among politicians.

We gave the Minister a taste of the wonderful developments in our profession and the important role played by our Fellows in healthcare. We outlined advances in cancer diagnosis, the importance of digital pathology, informatics and genomics. We also raised the need for a sense of proportion in consolidation plans, movement on the national laboratory medicine catalogue and the introduction of medical examiners (which has been recently announced).

A recurring theme

However, for me, the most striking aspect of the meeting was the fact that we kept returning to one central issue – the dwindling number of qualified professionals available to keep our services afloat.

Workforce as an issue overshadows all others when considering our ability to maintain current services. Without stabilising our workforce we cannot hope to respond to the needs of an aging population, more people being diagnosed with cancer and the anticipated demand following on from the genomic revolution.

Retaining mature professional colleagues in pathology is difficult, given the changes in pension taxation and the pressure of a relentless, ever-increasing workload. In histopathology, for example, we anticipate losing one in five of the skilled workforce to retirement by 2021. This strain cannot be borne by our colleagues forever. The uncertainties and loss of continuity from constant service reconfiguration do not help.   

The ability to recruit new colleagues is also a challenge, and subject to great regional variation, so much so that in some areas of the country there are no applications for consultant advertisements. From January to June 2017, 29% of haematology, 39% of histopathology and 46% of microbiology consultant posts had no suitable applicants.

After several unsuccessful attempts to fill vacancies some departments will simply give up. Work is outsourced as a routine, despite the usually higher costs that this incurs.

Moving forward

There are, however, steps we can take to insure the future of pathology services. 

As a College, we are continually undertaking surveys of our membership, to better understand the challenges on the ground. Histopathologists have responded to our most recent survey, and we now have up-to-date facts and figures to support our concerns. These will be outlined in two specific reports, to be published in The Bulletin in 2018. A clinical biochemistry survey is also under way.

For clinical scientists we are working with the Association for Clinical Biochemistry and Laboratory Medicine (ACB) to ensure we get a clear picture of the clinical scientist workforce in all specialties, including trainees. We also intend to develop a telephone census to provide annual updates on 100% of our members’ employment and retirement intentions. 

Finally, I and other Honorary Officers will continue to engage with politicians and decision-makers, to ensure issues with recruitment and retention stay firmly on the table. At our meeting with Phillip Dunne, all of the Honorary Officers also added their voices to a plea for recognition of pathology as a ‘shortage specialty’, a priority status that makes it easier to fill posts.

As a College, we want to create efficient, effective and sustainable pathology services nationally. It seems self-evident that to sustain the service we need to sustain our workforce. We will continue to do what we can as a College and also to lobby for the political changes we need.