The Royal College of Pathologists has made a submission to Phase 2 of the Government's Spending Review, which will deliver the government’s Plan for Change. In our feedback on government spending priorities we ask for investment in the pathology workforce, IT, and estates.

In the NHS, pathology diagnostic services are involved in over 95% of patient pathways, making it central to a functioning health-care system.

• Screening, diagnosis, monitoring and treatment all heavily depend upon pathology services.
• Pathology services affect patients from birth to death. Important pathways, like cancer, need pathologists to detect, diagnose treat and monitor to ensure the best outcomes for patients.
• Capacity to correctly diagnosis is vital. Without it treatment cannot begin.
• The pathology workforce needs sustained investment to effectively meet the current and growing demand for its services.

There are not enough pathologists and scientists to enable services to be delivered safely, effectively and equally across the UK. Without appropriate workforce planning and investment, pathology becomes a bottleneck contributing to significant delays for patients.

Cellular pathology has major roles in cancer diagnosis. As well as initial diagnosis, cellular pathology is crucial in determining patient prognosis and treatment strategies, together with patient monitoring. Advances in and expansion of other specialties that use cellular pathology rarely lead to more resources for cellular pathology and other pathology services. All pathology disciplines are involved in cancer pathways. 

Concerns

• The UK has a growing aging and increasingly sicker population, with rising levels of obesity and complex chronic diseases which is driving demand for clinical pathology services.
• The UK has a higher rate of cancer cases than Europe, on average, but proportionally fewer cancer healthcare staff and less equipment to treat patients. There are widespread shortages in histopathology. These are the pathologists who provide the definitive diagnosis for cancer.
• It can take 15 years plus to train a pathologist, we need a strong focus on retaining the existing, experienced workforce.

Asks

• There needs to be significant and sustained investment in modernising the pathology infrastructure, from digital pathology, AI and IT to the laboratory buildings.
• Funding for skilled IT support staff for laboratories is key to implement and maintain new systems and software needed in the future.
• The spending review needs to ensure resource spending for pathology, to allow the necessary expansion in consultant posts to safeguard patient care.

The Royal College of Pathologists' submission to the Government's Spending Review