The forensic pathology workforce report highlights how the mixed model of service delivery and employment models across the UK is contributing to many workforce issues including geographic inequity in vacancies and restricted training opportunities.   

Bereaved families report experiencing a service that is fragmented, disjointed and inconsistent in its standards and delivery. Inadequate staffing numbers and facilities, e.g. mortuaries – are causing families to wait months for post-mortem results and slowing down legal investigations. Delays in reporting are frequently driven by dependencies on other specialist services that are critical for complex cases, including toxicology, neuropathology, and paediatric and perinatal pathology, which are themselves facing workforce shortages. 

Professor Ralph Bouhaidar, Chair of the College Specialty Advisory Committee for Forensic Pathology, said: 

Forensic pathology is a cornerstone of the justice system, providing vital evidence in the investigation of suspicious and unexplained deaths. Yet our findings raise some concerns about the sustainability of this highly-specialised workforce.

Consultant numbers have remained largely unchanged for almost a decade, despite rising and more complex post-mortem caseloads, placing increasing pressure on a small and expert profession. With some services already reporting difficulties meeting demand and over 30% of the workforce approaching retirement, urgent action is needed to strengthen the training pipeline and secure the future of forensic pathology service

Forensic pathologists focus on the investigation of deaths that are sudden, unexpected or suspicious, including homicide. They specialise in performing post-mortem examinations for medical and legal purposes, to understand the cause and manner of death and are sometimes called on to interpret the injuries of live victims to assist criminal cases. They provide expert opinions to coroners (procurators fiscal in Scotland), police and courts, often giving evidence in trials. 

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 forensic pathology services for UK families for the foreseeable future.

Key findings 

• There are 39 (39.1 WTE) filled posts in England and Wales, 17 (19.2 WTE) in Scotland and 5 (4 WTE) in Northern Ireland. 
• Vacancies are highest in Scotland, and Aberdeen does not currently have a substantive consultant in post.  
• 44% of forensic pathologists in England, 67% in Wales, 90% in Scotland and 100% in Northern Ireland believe that current staffing levels are inadequate. 
• 30% of the consultant forensic pathology workforce are expected to retire within the next 10 years. There are concerns about whether the current training pipeline is sufficient to replace these retirements and support the expansion of the workforce to meet increasing demand. 
• Workload and demand are increasing owing to growing complexity 
• On top of filling existing vacancies, it is estimated that there is a need for an additional 16 consultant forensic pathology posts across the UK to allow the workforce to meet current demand. 

Action is needed 

To address the significant challenges faced by forensic pathology services, RCPath is calling on policymakers across the UK to: 

• Establish 6 new training posts in the next 5 years. As a priority the Home Office in England and Wales should increase the number of forensic pathology trainees to 8 from the current 6.  
• Investigate ways that forensic pathology training posts can be supported in services where there is currently no training provision 
• Implement initiatives to encourage resident doctors in forensic pathology training to stay in regions where they train – particularly in Scotland and Northern Ireland where there are consultant vacancies 
• Invest in dedicated forensic pathology administrative support, facilities and equipment, including mortuary facilities 
• Revisit previous reviews of forensic pathology to determine service, employment and training models 
• Establish locally organised specialised centres of excellence where post mortems would be carried out to provide consistent and high-quality services 
• Engage with primary care and death management teams to help ensure that non-suspicious cases are not referred inappropriately to the forensic system 

Download the full report and briefing 

How we are using the report 

Multiple approaches are needed to increase capacity within the forensic pathology workforce. We continue to make the case for action to NHS leaders and governments in all 4 countries. This requires coordinated action from multiple bodies across the UK including the Home Office, Ministry of Justice, Department of Health and Social Care, Crown Office and Procurator Fiscal Service (Scotland), Department of Justice (Northern Ireland), coronial services, NHS workforce and training bodies, and professional and regulatory organisations 

Our priority is to ensure forensic pathology services receive the resources they need to help families and communities across the UK to access safe, high-quality care and support.