On 5 July 1948, in the aftermath of the Second World War, Aneurin Bevan introduced the radical concept of the National Health Service. This put into practice the fundamental principles of the availability of free diagnoses and treatments to all and healthcare delivery based on need rather than individual wealth.
On the 75th anniversary of the NHS, it is timely to focus not just on the pressures but to celebrate hard-earned successes. We, as pathologists, are at the forefront of many advances benefitting so many patients, focusing on improvements in prevention, diagnosis and supporting treatment across a broad spectrum of disorders. We cannot cover all our 17 specialties here and, indeed, so many subspecialties but we have thrown a spotlight on a few examples to share the achievements of colleagues.
Medical examiners – a success story
We start off with an article by past President Dr Suzy Lishman, celebrating the successes of the medical examiner (ME) scheme. Following the Shipman Inquiry in 2003, an independent system of medical practitioners was introduced to work with coroners in reviewing all deaths in England and Wales.
The College has worked closely with key stakeholders for many years to implement this important patient safety initiative, which is now moving towards a statutory footing, and has an ongoing pivotal role in the training of MEs and medical examiner officers (MEOs) and the development of guidance for ME services. It is gratifying to hear that almost all deaths in acute trusts are now reviewed by MEs. Bereaved families have welcomed the opportunity to talk to an independent medical examiner about their loved one’s final illness and death.
Promoting data-driven transfusion practice
Our second article addresses the evidence base for blood transfusions and related alternatives, which has greatly increased with high-quality trials supporting safer and more restrictive usage. Data Driven Transfusion Practice is the focus of 1 of 5 Blood and Transplant Research Units that have been initiated within a £20 million programme, co-funded by the National Institute for Health and Care Research and NHS Blood and Transplant.
Professor Simon Stanworth, Dr Hayley Evans and Louise Sherliker summarise the key aims of this research unit and outline the studies underway to support effective data collection and utilisation with improved integration and deployment of artificial intelligence in enhancing transfusion practice and supporting blood supply.
Patient and public engagement in research
A further article emphasises the need for patient and public involvement and engagement (PPIE) in healthcare research, with the need for greater inclusion and diversity towards addressing inequalities.
Dr Evans, Linda von Nerée and Professor Stanworth summarise their considerable efforts in inclusion of the patient and public voice in their research initiatives. The PPIE input in the Data Driven Transfusion Practice Research unit is highly evident in shaping the study programme, together with tackling important questions around data governance and custodianship in the digital age.
Paediatric and perinatal histopathology – a vital speciality in crisis
Professor Marta Cohen and Dr Srinivas Annavarapu highlight the contribution of paediatric and perinatal histopathology to the study of diseases and pathogenic mechanisms in fetuses, infants and children. Their work is essential for the diagnosis of variety of conditions with an infectious, metabolic, neoplastic or immunologic basis and/or secondary to chromosomal defects. In many cases, diagnoses can help to screen other family members who may be affected.
The authors raise the alarm that this vital area of pathology is in crisis and highlight the multiple issues facing this specialty, including underfunding and understaffing, but outline areas for further action to address increased demand.
Lab Tests Online-UK – promoting a patient-centred approach
Danielle Freedman and Rebecca Powney describe the history and ongoing successes of Lab Tests Online-UK (LTO-UK), a non-commercial website developed by NHS professionals, that informs patients with detailed, peer-reviewed information on laboratory test results and the relevant underlying diseases.
The article concludes that LTO-UK is in a unique position to empower patients with supporting a patient-centred approach to delivery of care. There are challenges to maintaining the site within its core principles, with a call for pathology colleagues to engage in the ongoing development and update of peer-reviewed information.
Immunisation – changing the face of healthcare
The final article summarises the history and impressive successes of vaccines that are estimated to prevent approximately 6 million deaths annually, saving 386 million life years and 96 million disability-adjusted life years globally. The article looks at a number of examples including the estimate that COVID-19 vaccines prevented 14.4 million deaths in 185 countries in the first year since their introduction. Despite the apparent successes, the authors highlight that the failure to achieve the 40% coverage target set by the WHO prevented the maximum potential benefit, with millions of lives lost as a result.
This thoughtful article concludes that, while vaccines have the increasing potential to change or eradicate many diseases, immunisation is fully dependent on equitable and fair access in a globalised world.
Thank you to all our contributors for taking the time to help us celebrate and showcase our specialities during this 75th anniversary of the NHS, with patients firmly at the heart of pathology services.
Author(s)
Dr Shubha Allard
