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HEALTHCARE DELIVERY
Threat of consolidation ‘not the answer’
Pathology services will become strategically more, not less, important as we move into a world of preventive medicine. Paul Lindsell, from MindMetre Research, argues against the case for consolidation and calls for increased investment.
The massed voices of sensible commentators on healthcare in the UK (and Europe) now seem to agree that systemic change is needed. With various factors inexorably driving up healthcare consumption, radical reform is needed to make our healthcare system sustainable in the 21st century. The NHS Constitution notes that we as individuals must bear some responsibility for our own, and our family’s health. This notion is now being extended to an idea of creating more healthy societies through better information, public education, diagnosis, early intervention, accurate treatment and, ultimately, prevention.
Healthier societies require less treatment – attacking the problem of swelling healthcare demand at its root cause. Reaching this noble nirvana is, of course, a massive challenge.
Nevertheless, most would agree that pathology services – which provide that all important diagnostic input – will become strategically more, not less, important as we move into a world of preventive medicine. So surely more important means more investment? Apparently not. Lord Carter’s Pathology Report of February categorises pathology as a ‘back-
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office’ function, not a strategic building block for the health service of the future. NHS Improvement issued a letter2
to all acute
NHS Trusts indicating that pathology services should reach standard performance targets or face consolidation on a regional basis – with the deadline for early 2017. We can all agree that stringent demands for efficiency should continue. Nevertheless, this ‘guillotine’ approach to pathology services seems puzzling.
Paul Lindsell
More efficiency or more investment?
There is constant pressure to find areas within the NHS where efficiency gains can be made. These ‘efficiency savings’ are the subject of some controversy, but they are a firm commitment from Government and central authorities,3
and as such cannot be
swept under the carpet. Few nowadays would argue with the idea that there are efficiencies to be made – and any bombastic protest smacks of something between stubborn obduracy and protectionism, neither of which are in the interests of the patients that the health system serves, nor the taxpayers who ultimately fund the NHS. It is also true that the NHS was not originally structured to deal with the healthcare demand that presents itself today, and so properly funded investment in structural reform has to be on the policymakers table. Efficiency must never undermine the quality of patient care and outcomes. At all events, there is an urgent need to find areas of healthcare where greater investment may help reduce the requirement for other (more expensive) therapies and interventions down the line. Diagnostics must surely be a major focus of such initiatives to create earlier identification and intervention. Diagnostics is widely seen as an area where technological, process and performance improvements can have a disproportionately positive impact on patient outcomes, duration of treatment and overall cost.4
Specifically, there are three key
benefits from such improvements: accuracy and reliability of testing; speed of results; and access to results by clinicians and care professionals. Logically, therefore, diagnostics
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