- Published:
- 22 January 2026
- Author:
- The Workforce team
- Read time:
- 10 Mins
This article provides an update on the first year of the Workforce Strategy’s delivery, showing how we have progressed across our strategic aims. In Year 1, we focused on building robust workforce intelligence, and engaging and influencing stakeholders. These foundations are essential to securing meaningful solutions to the workforce crisis affecting pathology services and the professionals who deliver them.
In January 2025, the College launched its first dedicated Workforce Strategy, setting out a clear plan to address the growing pressures facing the pathology workforce. Since then, challenges have not eased. Chronic shortages, rising workloads, widening recruitment and retentions gaps, and declining morale continue to affect services across the UK. In some areas, including paediatric and perinatal pathology (PPP) and immunology in Scotland, the situation remains critical.
The Workforce Strategy is being delivered in phases over 4 years, recognising that meaningful reform depends on strong evidence and understanding, coupled with continued engagement. In 2025, our focus was on ensuring that pathology workforce issues are better understood, better evidenced and better represented.
This has required sustained effort across data collection, reporting, policy engagement and advocacy. It has also relied on the continued participation of members, whose time and expertise remain central to the College’s ability to progress our strategic aims.
Central to the strategy is the recognition that workforce planning cannot rely on incomplete or outdated data. Pathology has historically been served by fragmented datasets, inconsistent reporting and limited visibility of workload pressures. The College continues to advocate for pathology to be prioritised in national workforce planning, while working to address this data gap internally.
The Workforce Census 2025
The Workforce Census remains a crucial element of the College’s intelligence gathering. In 2025, we expanded and refreshed the Census to capture a more detailed picture of the workforce across all 17 specialties. This included insights from pathologists in training and a deeper focus on key areas such as morale, wellbeing, working patterns, retirement intentions and service sustainability.
The findings reinforced that there are insufficient staff to meet current and future demands, which – alongside declining job satisfaction, retirement intentions and flexible working patterns – represents a significant risk of workforce attrition. These themes continue among trainees who reported uncertainty around training capacity, support and career prospects.
The census closed with a strong response rate and we are grateful to all members who contributed. Findings from the census have been used to evidence our census spotlights and specialty reports, influence national consultations and guide discussions with policymakers and NHS leaders. You can read the workforce census spotlights on our website.
Specialty-specific evidence
The College prioritised specialty-specific data collection, recognising that workforce challenges and solutions are nuanced across the 17 specialties. In 2025, we completed data collection for immunology, paediatric and perinatal pathology, forensic pathology, and neuropathology. Work will be complete for microbiology, virology, clinical biochemistry and toxicology in the first quarter of 2026, with data collection for cellular pathology. In 2026, we will extend this model to genomics, haematology, transfusion medicine, reproductive science, histocompatibility and immunogenetics, and veterinary pathology.
We know data collection can be time-consuming, and we continue to refine our approach to ensure outputs are meaningful and impactful. Thank you to everyone who supported and engaged in our specialty-specific data collection in 2025.
Informing future modelling and contingency planning
While Year 1 focused primarily on data collection, this lays the groundwork for predictive workforce modelling in future phases of the strategy. Understanding current staffing, workload and attrition trends is essential if we are to anticipate future shortages, particularly where risks are greatest.
Specialty-specific reporting
Several major workforce reports were published in 2025, including the College’s report on PPP. The report highlights how long-standing shortages and lack of workforce planning have led to critical service fragility in PPP and, in some cases, service collapse.
Close engagement with patient charities and policymakers saw the report gain traction at key events, including the All-Party Parliamentary Group on Baby Loss in December 2025, and an engagement event in November 2025 where the College met MPs from areas most affected by the shortage of pathologists to carry out paediatric post-mortems. The report sets out clear recommendations and the College continues to work with professionals and partners to ensure PPP services receive the resources they need.
Our report on the clinical immunology workforce highlighted consultant shortages, unsustainable workloads and risks to patient safety. The College will continue working with the British Society for Immunology to ensure this small but vital specialty receives the resources needed so that patients across the UK can access timely immunology and allergy care.
Responding to national workforce and health consultations
The College submitted detailed responses to a wide range of consultations, including the NHS 10-Year Workforce Plan, the NHSE Medical Training Review, the Men’s Health Strategy for England and the NHS Productivity Commission. Responses drew on workforce evidence to highlight the risks of underinvestment for diagnostic capacity, cancer pathways and patient safety.
We also engaged beyond England. Responses to the Scotland Future Medical Workforce Project and proposed NHS Scotland mergers emphasised the importance of recognising specialty-specific pressures and avoiding unintended impacts that mergers may have on training and recruitment.
Consultation on the draft Genomic Medicine Service specification highlighted the impact of service configuration on turnaround time, access, quality and cost.
In 2026, engagement will continue across genomics, the National Maternity Review, the National Pathology Programme for Wales, the National Cancer Plan and the Carter Review.
Training reform and the future workforce
Training capacity and reform remain central to long-term sustainability for pathology services. The College welcomed progress on postgraduate medical training reform, while stressing that workforce planning is essential to actively align the number and distribution of training posts with local and regional need. Bespoke solutions are needed for different specialties and regions to ensure residents are attracted and recruited into pathology and that they feel heard, valued and supported.
Advocating for system reform
Workforce pressures are driven not just by numbers but by inefficient systems and unsustainable working practices. In 2025, the College worked with partners, including the Royal College of Radiologists, to call for reform of multidisciplinary team meetings.
Our response to the 10-Year Workforce Plan called for actions across train, retain and reform, including a dedicated pathology workforce plan, modernised IT systems and infrastructure to support digital pathology adoption and interoperability.
Addressing these systemic pressures contributes to retention, improving job satisfaction and sustainability, even where staffing remains constrained. These areas of advocacy will remain a priority through 2026.
While many workforce challenges will take time to resolve, several important themes have already emerged from Year 1 of delivery.
Policymakers are increasingly recognising the fragility of pathology services in certain specialties, though work remains across all 17 specialties. Evidence-based reporting has helped shift discussions beyond workforce numbers, providing a clearer understanding of service risks and patient impact. We will continue to grow this evidence base to inform advocacy and decision-making.
Morale and wellbeing have moved higher up the agenda, reflecting the importance of retention as workforce challenges take time to resolve. Census findings on job satisfaction and burnout highlight the need for strengthened action on workload, supportive training environments and career development opportunities.
Finally, the high level of engagement from members reinforces the value of communication and transparency. Our advocacy is strongest when grounded in lived experience; the College remains committed to listening to and representing both the profession and our members.
As we enter 2026, there will be a continued focus on intelligence gathering and increasing stakeholder engagement, while expanding work across our ‘train’ aims.
We will be running the Workforce Census again in 2026 and encourage all invited members to participate. The census gives us the most up-to-date picture of the workforce, helps us track and benchmark change over time and feeds directly into our reports. It’s also a straightforward way for members to tell us about workforce pressures, challenges and possible solutions, helping build the evidence we need to feed into workforce planning.
Data collection will continue across our remaining specialties, with outputs produced in collaboration with members, key stakeholders and charities, ensuring they can be used effectively for advocacy. In addition, we will begin exploring workforce wellbeing in greater detail through a funded research project.
Workforce remains one of the most pressing issues facing pathology and a priority area for the College. We will continue to update members throughout 2026, sharing evidence, findings and progress against our Workforce Strategy.
If you have any questions, please contact the Workforce team at [email protected].
