Our response to the Scotland Future Medical Workforce Project highlights that pathology is vital to Scottish healthcare, supporting 95% of patient pathways – across 17 specialties – through screening, diagnosis, treatment and monitoring. However, services face strain due to understaffing and limited funding.  

Demands on the pathology workforce will increase as care moves to prevention and early intervention in the community. 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 response highlights that innovation and technology can support, but not replace, pathologists.  

Pathologists play a central role in developing safe and effective services. Investment in core pathology capacity is needed alongside advancement and investment in solutions to enable modern and efficient pathology services.  

Key areas the response called for:  

Train 

• Invest in new training posts – and expand consultant training capacity.
• Commit funding for consultant posts so that those completing training can secure employment.
• Develop a dedicated Scottish pathology workforce strategy to fill vacant training posts, vacant consultant posts and retain the current pathology workforce.
• Fund the Higher Specialist Scientist Training (HSST) pathway for clinical scientists in Scotland.  

Retain 

• Improve efficiency by increasing administrative staff to work alongside medical and scientific staff who run the laboratories. 
• Increase protected time for consultants to undertake professional development including research, development, innovation, quality improvement and training. 

Reform 

• Scottish government to commit to pathology workforce modelling for now and in the future. 
• Strengthen multidisciplinary collaboration to improve communication across patient pathways to support shifts to community care. 
• Invest in upskilling professionals to support greater use of genetic and molecular testing. 
• Improve interoperability of IT systems and implement digital pathology to enable consideration of safe, efficient use of AI.  
• Improve timely access to personalised cancer testing in Scotland. 

Prioritise patient care (contingency) 

• Support services and patients to prioritise tests that offer the greatest value and benefit. 
• Continue work to improve pathology classifications and pathology standards implementation. 
• Enhance the development of realistic medicine initiatives. 

The Future Medical Workforce Project will help shape reform in NHS training, recruitment and workforce planning over the next 15–20 years. Phase 1 will help the government better understand the current pressures facing the profession and how best to respond to the challenges of delivering care. The College will continue to engage with the second phase of the project, beginning in January 2026, focusing on reform, improving recruitment and redesigning of medical education. 

The College's organisational response was prepared by the Workforce and Engagement team within the Professional Practice directorate informed by feedback from the Scotland Regional Council and data from the College 2025 Workforce Census.