The Royal College of Pathologists response to the Report of the Second Phase of the Independent Review of NHS Pathology Services in England (The 'Carter Report')

The College expresses its gratitude to Lord Carter and his team for the hard work involved in what has undoubtedly been a very thorough review. The College is committed by its Charter to work towards high quality pathology services, for the benefit of the public. For this reason we welcome the many sound recommendations in Lord Carter’s report that we believe will enhance the quality of the service, if they are implemented.

We also recognise that NHS laboratory services must work within a finite budget. We therefore agree with the need to maximise efficiency. Lord Carter’s first report pointed out that the efficiency of NHS pathology services already compares well with the pathology services in other developed countries. We nevertheless agree that improved efficiency is possible, and that this report has identified routes towards greater efficiency. However, we are also aware that the steady increase in demand for pathology services that we have seen over many years is likely to accelerate in the near future, and that new, more sophisticated laboratory investigations are likely to be more expensive to implement. For these reasons we believe that the overall budget of the NHS laboratory service will need to increase. We are concerned by the absence of any assurance in the Department of Health’s response that cost savings in the pathology service will be reinvested in improvements to that service, as Lord Carter envisaged.

The Report is published in the context of Department of Health policy which is encouraging local NHS organisations to test the cost-effectiveness of their suppliers of services, including suppliers of pathology services. We are concerned that – unlike Lord Carter – local commissioners are unlikely to appreciate detailed aspects of what constitutes high quality in pathology services, and that as a result they may agree to contracts that unwittingly result in a lower standard of service than is currently provided by NHS laboratories. We are pleased to see several recommendations in Lord Carter’s report that should, if implemented, address this problem, at least in part. The Report makes 20 main recommendations. For further information please view the Royal college Website.