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.