Commenting on the NHS Recovery Plan to tackle the elective care backlog over the next three years Professor Mike Osborn, President, The Royal College of Pathologists said:

‘Without investment in pathology, it will not be possible to tackle the diagnostic backlog.

‘The announcement sets out how the COVID-19 backlog of elective care will be tackled and it is encouraging to see the focus on investment in areas such as digital pathology, imaging and Artificial Intelligence.

‘However, the pathology workforce is key to reducing the backlog, especially in cancer diagnosis and is also crucial to disease prevention, infection control and good antibiotic stewardship. It is vital that investment is targeted at pathology services to alleviate workforce pressure and meet increased demand.’

The College has identified the following key areas that need to be addressed to help tackle the backlog:

Workforce

There has been historic and longstanding underinvestment in the pathology workforce and as a result significant investment is needed across pathology services to alleviate workforce pressures and meet increased demand. There needs to be more training places and better information technology (IT) for day-to-day work so staff can work more efficiently and flexibly.

The COVID-19 pandemic has once again highlighted the importance of laboratory tests and laboratory professionals within healthcare. As we emerge from the pandemic, it is vital that such services are reinforced and supported to optimise healthcare recovery both for COVID-19 related illness and for the current healthcare backlog.

Infection Prevention and Control

The COVID-19 pandemic has highlighted the vital importance of managing infection, which has often been overlooked when compared to cancer and cardiovascular disease. It is critical to have good stewardship of antibiotics, and clear leadership on vaccination and infection prevention. The College is ideally placed to contribute to this and is working hard to do so.

Many Trusts have been unable to fill microbiology posts over recent years, and workforce pressures are keenly felt. This is important as these members work on infection control and diagnostic testing, including for COVID-19. Throughout the COVID-19 pandemic our microbiology, virology and infection control team members have continued to support patients, the public and College members despite these many pressures. Capacity will always be required in this vital area and must be addressed.

Innovation and Technology

The confirmation from NHS England, in December 2021, that pathology services will receive £140m for digital pathology and Laboratory Information Management Systems (LIMS) this financial year was welcome news.

While the advent of artificial intelligence (AI) in pathology is exciting, and the NHS should be a world leader in the development and use of AI in pathology thanks to investments in this area to date, however a great deal of work is required to get to the point where AI is fully developed and used safely in healthcare. As a result, it is very unlikely that AI will address the severe workforce gaps we see in the short term, but rather will contribute to future developments in medical safety and efficiency in the medium term.

Community Diagnostic Centres

The government’s commitment to building more community diagnostic centres is a major step in the right direction. We welcome the move to introduce easier access to diagnostic services centred around patients.

Quicker, easier access through a ‘one stop shop’ will lead to earlier diagnoses which leads to better outcomes for patients and can save lives. However, these new diagnostic centres need to be introduced with sufficient resources, in terms of staffing, IT provision and connectivity with other systems (such as pathology networks and GP practices).