The College hosted its second Celtic Nations Summit online on Tuesday 3 February 2026. The event brought together representatives from Northern Ireland, Scotland and Wales alongside College officers and senior staff.
The Celtic Nations Summit 2026 covered important themes, including future configuration of services, workforce sustainability, quality and accreditation. It provided an opportunity to discuss the Carter Review and its potential impact on pathology services across the UK. Concern was raised regarding the pace and transparency of the review process and, while the review contents have not yet been shared, there is concern that it may focus on efficiency savings and consolidation rather than much needed long-term investment. The Summit noted that pathology services are already fragile and under significant pressure, so any future strategy should prioritise addressing workforce challenges and improving digital infrastructure and IT, before service reorganisation is considered.
Summit discussions highlighted that there is no single model for pathology service delivery. Approaches should be flexible enough to include collaboration, distributed services or selective consolidation, depending on local and regional needs. Devolved nations’ representatives emphasised that health is a devolved matter, and there was no expectation of automatic adoption of the Carter Review’s eventual recommendations outside of England.
Increasing workforce pressures continued to be seen as the most critical challenge facing pathology and laboratory medicine. Rising demand, expanding cancer targets, demographic change and increasing multimorbidity are intensifying the burden on already stretched services. Insufficient training numbers and high vacancy rates in some specialties were observed with concern. While digital pathology, automation and artificial intelligence were recognised as important developments, attendees agreed these measures alone could not resolve projected workforce deficits.
The College highlighted progress in strengthening its workforce evidence base, including the publication of workforce spotlights and specialty-specific reports. There was strong support for more sophisticated service-based workforce modelling, by integrating medical and scientific data and working closely with governments to inform long-term planning. Retention, training capacity and the increasing contribution of the Portfolio Pathway route to specialist registration were also considered.
Quality and patient safety formed a further key element of discussion. UKAS accreditation continues to present challenges in relation to cost, scope and clinical relevance. Although ISO 15189:2022 was intended to introduce a more clinically focused model, implementation has been constrained by difficulties in recruiting sufficient medical assessors. The College is committed to continued engagement with UKAS to improve proportionality and relevance.
Significant concern was also raised about gaps in external quality assessment (EQA) oversight following the withdrawal of College-associated mechanisms for monitoring persistent poor laboratory performance. Emerging discussions with the Medicines and Healthcare products Regulatory Agency regarding post-market surveillance of diagnostic manufacturers were noted, though proposals remain at an early stage. Work is underway within the College to develop a more sustainable approach to quality oversight.
UK-wide updates highlighted distinct but related delivery models. Northern Ireland continues work on its Pathology Blueprint Programme and the proposed Special Agency. Scotland is progressing service transformation through its Service Renewal Framework and Diagnostics Transformation Plan. Wales is advancing national laboratory information management systems implementation and digital pathology while maintaining a collaborative, distributed model.
Across the devolved nations, shared priorities were clear: addressing workforce shortages, investing in infrastructure and technology, strengthening quality systems, and developing sustainable, regionally responsive service models. The Summit reiterated the value of UK-wide collaboration and the College’s commitment to leading evidence-based advocacy to support the future of pathology services.
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