Pathology services in the east of England

A survey of pathology in the east of England in 2007 estimated total pathology expenditure to be £209m - £216m. The GP/community work accounts for 40-50% by volume, but mainly consists of a limited range of tests that can be performed via highly automated methods.  In consequence, the GP/community work only accounts for about a quarter of pathology expenditure and is estimated to be between £50m - £60m.

The Carter report concluded that rationalisation of pathology could reduce costs by 10-20%, which equates to approximately £20m - £40m per annum in the east of England. Detailed modelling by the Carter team indicated total savings of between £21m - £29m in the east of England, based on a variety of different delivery scenarios. Performing the high volume/low complexity testing required by primary and community care in a high efficiency, high throughput laboratory is estimated to offer cost reductions in the order of £10m - £12m across the region per annum. Consequently reconfiguration of remaining pathology work could yield a further £11m - £17m across the region.

On behalf of NHS East of England, the Strategic Projects Team has been holding discussions with the commissioners and providers of pathology services across the region. Additional discussions have been held with the independent sector providers of pathology services, and with the directors of six pathology rationalisation projects that are ongoing in other areas of the country.

These discussions, and previous NHS East of England reports on pathology services, indicate that rationalisation of laboratory pathology will provide significant benefits including improved quality and efficiency of service as well as better value for money across the east of England.