The Department of Health should put in place IT connectivity for NHS pathology services as a matter of priority, a two-year review has concluded.

The review of pathology services, chaired by Lord Carter of Coles, calls for DH electronic order communications pilots for primary care to be rolled out as soon as possible and suggests they should be extended in future to cover pharmacies in primary care settings.

The independent review emphasises that good electronic communication is an essential element of any efficient and effective service.

“In pathology, it can help to address unnecessary and inappropriate demand and reduce the risk of errors. The collection and analysis of IT-based data can improve the way that pathology enables decisions about diagnosis and treatment to be made,” it adds.

The report is the second produced by the review team since the DH commissioned Lord Carter to review pathology services in 2005. It focuses on improving quality and efficiency and identifying the mechanisms for change.

It concludes there is a strong case for transforming pathology and makes 20 recommendations, including the development of pathology networks with a single integrated management structure and improvements in turn-around times. The report argues that between £250m and £500m could be saved by consolidating pathology services.

The DH said it will conduct an impact assessment on the recommendations, which will be published for consultation in summer 2009. Three strategic health authorities – East of England, Yorkshire and Humber and South East Coast – will examine the practical implications.

On IT connectivity, the DH said it supported the review’s recommendations and was already working with NHS Connecting for Health on a range of projects.

It said interoperability was being achieved by the roll-out of IT standards such as the National Laboratory Medicine Catalogue, SNOMED-CT coding and HL7v3 messaging.

In addition, it said a major project was underway to support the development of electronic test requesting by and results reporting to GPs using the Spine. Other projects under consideration include:

• Using Choose and Book for phlebotomy and investigations requiring the patient to be in the laboratory;

• The inclusion of screening results, whether neonatal or for cancer, in the electronic clinical record;

• Lab2Lab communications – for those analyses undertaken only in specialist laboratories – to ensure accuracy of results by avoiding the need for transcription and to save laboratory time; and

• Decision support through links between the National Laboratory Medicine Catalogue and pathology information sources.

The Royal College of Pathologists said it supported Lord Carter’s calls for the development of improved IT connectivity, including a national ‘pathology formulary’ of diagnostic tests that are available to the NHS.


Report of the Second Phase of the Independent Review of NHS Pathology Services in England

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