Pathology has undergone many changes over the years. It seems there is always another major change waiting to be implemented. It seems the next major change is the forming of 29 pathology networks up and down the country (https://improvement.nhs.uk/resources/pathology-networks/).
There are already several networks up and down the country that have formed from previous re-organisations as people understand the logic for forming a network. Forming a network with neighbouring hospitals allows the laboratories to standardise on the same equipment and thereby getting more savings from diagnostics companies due to increase scale. These kind of savings would never be possible to hospitals working in isolation.
The level of integration of the hospitals sometimes depend on geographic reasons and the services provided by the various hospitals. If there are two close by hospitals, any patients living in-between them, might end up going to either hospital. When that patient is being seen at that hospital, having a full history of the patient would be important to the clinician. Having just access to the visits that patient made to just that hospital might lead to important information being missed.
When the network does form, one of the key issues is the need to harmonise processes. Sometimes there are reasons why some things can’t be harmonised at that point in time e.g. differences in instrumentation. For everything else, there is a compelling case for driving everything to be done the same way.
This could be something initial as simple as supporting the network. Having one way of doing a particular workflow means one orderable and therefore makes mapping a lot simpler. Having one way of doing things means work can be moved around as the same process will occur regardless of where it is analysed. Also means the clinical validation process can then potentially be site independent as the post analytical decision process will be using the same cut-offs for all sites for example.
In a future post, I will discuss the issues in a bit more depth.