Pathology

Most patient interactions with the NHS involve the use of pathology services – tests are requested by providers in primary care, the community, and secondary care. Labs in England carry out 1.12 billion tests per year – roughly 20 tests per person in England. Pathology labs have also played a significant role to support COVID-19 testing and enabling the ongoing recovery of NHS services.

The GIRFT national report for pathology aims improve the patient experience ‘end-to-end’ – widening the focus of NHS pathology to look across the entire service, from the point at which a clinician considers a test to the patient’s interpretation of the results.

A key outcome of the report for GIRFT’s clinically-led team has been the development of an overarching quality framework – called the Clean Framework – to help pathology networks and labs widen their focus to include the pre-analytical and post-analytical stages of the diagnostic pathway.

See also Diagnostics and Radiology>

Dr Tom Lewis

Joint Pathology Clinical Lead

Consultant microbiologist at Northern Devon Healthcare NHS Trust

Following a degree in natural sciences, Tom obtained a PhD in cancer research, before studying medicine in the West Midlands. He has published on a variety of topics, from assessment of hospital cleaning to the first description of using whole genome sequencing of MDR-Acinetobacter to study a hospital outbreak.

Tom was appointed as consultant microbiologist at North Devon Healthcare NHS Trust in 2010. As lead clinician for antibiotic stewardship, he has been involved in a number of interventions to improve prescribing habits, focusing in particular on the behavioural science behind this.

Over the past few years, he has been particularly interested in how pathology can be used to redesign health systems. Working closely with colleagues in primary and secondary care, they have shown that paying attention to the needs of the patient is an effective way to improve quality and reduce costs.

Dr Marion Wood

Joint Pathology Clinical Lead

Retired consultant clinical and laboratory haematologist with 25 years' experience, and a former chair of the Council of the Association of Clinical Pathologists

Marion has been a consultant clinical and laboratory haematologist for 25 years. Following a short spell in a specialist haemostasis and thrombosis unit, she has been entirely based in a district general hospital. The laboratory service was recently part of the East of England Pathology Partnership, with which Marion took on a part time management role and thus has first-hand experience of the challenges of networking.

Alongside her clinical work, Marion has undertaken several other management roles at local, regional and national level. These have included deputy medical director and medical director at Colchester University Hospital NHS Foundation Trust, current chair of Council of the Association of Clinical Pathologists and a member of the Pathology Alliance.

Dr Martin Myers MBE

Senior Clinical Advisor, Pathology

Consultant clinical biochemist and associate divisional medical director for pathology at Lancashire Teaching Hospitals NHS Foundation Trust

Dr Myers is a consultant clinical biochemist at Lancashire Teaching Hospitals NHS Foundation Trust (LTH), Royal Preston Hospital, and associate divisional medical director for pathology, having previously been clinical director of pathology for 14 years. Dr Myers is also the lead scientist for the trust.

Dr Myers has taken a lead role in a continuous programme of pathology redesign, improving the clinical and operational effectiveness of pathology delivery while improving productivity.

His interests include the use of automation, point of care testing and informatics in improving the quality of the diagnostic process and redesigning pathology delivery. This spans pathology delivery using state of the art robotics and advanced technology through to the use of point of care devices used anywhere.

He is involved in several projects for the direct delivery of diagnostics to BAME communities and vulnerable groups and is working with the NHSE chief scientific officer’s team on the delivery of point of care diagnostics in patients with learning difficulties and patients experiencing mental health issues. He has also been involved in translating NICE diagnostic recommendations into service delivery models.

Dr Myers has worked on many clinical pathways where the introduction of novel decision diagnostics has improved the patient pathway and resulted in reduction in total pathway costs.

Useful information

Read more about the GIRFT pathology project and the Pathology Consolidation Programme

Far-reaching pathology framework in GIRFT report aims to shape a more effective and efficient service for patients

A robust framework designed to help shape the future of NHS pathology services is outlined in the Getting It Right First Time (GIRFT) national report for pathology, aiming to ensure the right test is carried out at the right time, with the right answer for each patient.

The Clean Framework aims to support and guide pathology labs across England to improve the patient experience by prioritising quality and value throughout the ‘end-to-end’ process – from the point at which a clinician considers a test to the patient’s understanding of the results.

The report encourages a view of pathology as an end-to-end service, starting with the first clinical encounter that leads to the right test being requested, and ending with the right results going back to the right patient in a way that they can understand and in the right timeframe.