Multi-site haematology: consolidation and efficiency savings in Cardiff

Ever since the publication of Lord Carter’s first pathology services reports back in 2006 and 2008, and now NHS Improvement, there have been ongoing pressures for pathology services to consolidate, reconfigure and modernise in order to improve quality, patient safety and efficiency. It is recognised by The Royal College of Pathologists¹ that measures to reduce unwarranted variation and ways of supporting closer collaboration and networking could support optimal provision of pathology services. However, the focus should be on the value delivered, ensuring that quality remains high while cost savings are achieved by seeking efficiencies. This is where user confidence in pathology services must be maintained.

          Increased user confidence in pathology services is achieved through demonstration by laboratories that they have reached accreditation standards and regulatory compliance. Key to demonstration of quality and competence in medical laboratories is of course the ISO15189:2012 United Kingdom Accreditation Service (UKAS) quality standard, which requires a very comprehensive validation process for new equipment. Following this, demonstration of continuing improvement and competence assessment within laboratories is also essential.

          Another consideration is the fact that there is no ‘one size fits all’ approach to pathology consolidation, as this looks different in differing specialties. For example, maintaining blood sciences at every acute hospital site is necessary in order to ensure ready access for critical services such as blood transfusion. Additionally, there is a drive for patients to be treated as locally as possible and to prevent unnecessary admissions to hospitals, for which rapid blood test results are often a key clinical decision-making factor.