OPINION
After Pathology Networks: future diagnostic services
Noman Manzoor, Laboratory Director for
Pathology and Transfusion Services at Great Western Hospital NHS Foundation Trust
The last decade has witnessed one of the most significant periods of change in NHS pathology. The creation of Pathology Networks has been a major milestone, bringing laboratories together to improve resilience, standardise services and deliver beter value. While much has been achieved, networking should not be viewed as the destination. Rather, it is the foundation upon which the next phase of transformation must be built. Healthcare demand continues to rise. Patients expect faster diagnoses; clinicians require rapid access to high- quality laboratory information; and the NHS continues to face unprecedented financial and workforce pressures. These challenges cannot be addressed by simply doing more of the same. The future of pathology depends on embracing innovation, technology and a genuine culture of collaboration.
Integrated diagnostic systems Many Pathology Networks have successfully harmonised testing, consolidated services and improved procurement. However, the next stage requires a shift in mindset. Instead of viewing laboratories as separate entities competing for resources, we must see ourselves as one integrated diagnostic service. Success will depend on replacing phrases such as ‘my laboratory’, ‘my department’ or ‘my section’ with ‘our network’, ‘our laboratories’ and ‘our workforce’. This cultural change is just as important as any technological advancement. True networking means sharing expertise, balancing workloads, supporting neighbouring laboratories during periods of pressure and collectively developing specialist services. The strongest Pathology Networks will be those that function as a single team rather than a collection of individual organisations.
Redesigning pathways Community Diagnostic Centres (CDCs) represent one of the biggest opportunities to redesign diagnostic pathways. As CDCs continue to expand across
England, pathology services must evolve alongside them. Laboratory medicine will play a central role in supporting earlier diagnosis, cancer pathways, chronic disease management and preventive healthcare. This requires robust specimen transport systems, integrated digital requesting, standardised laboratory processes and sufficient analytical capacity within Pathology Networks. Rather than viewing CDCs as additional workload, they should be recognised as catalysts for redesigning services around patients. The future laboratory may no longer be defined solely by the walls of a hospital. Instead, it will become part of a broader diagnostic ecosystem connecting hospitals, community services, primary care and patients themselves.
Capacity, not just consolidation Increasing diagnostic demand means that many laboratories are approaching or exceeding their operational limits. Although consolidation has improved efficiency in many areas, there remains an urgent need to expand laboratory capacity. This cannot be achieved without significant capital investment. Automation is key as expansion here
will reduce manual handling, improve traceability, minimise transcription errors and shorten turnaround times. Importantly, automation also improves staff wellbeing by reducing repetitive manual processes and allowing scientists to concentrate on more complex analytical and clinical work. Capital investment should not be
viewed simply as expenditure but as an investment in patient safety, productivity and long-term sustainability.
Solutions for workforce challenges Perhaps the greatest challenge facing pathology is workforce availability. Recruitment difficulties, an ageing workforce and increasing workload create a situation that cannot be solved by recruitment alone. While training and retaining remains essential for biomedical scientists, clinical scientists, pathologists and support staff; technology must become an active partner in delivering services. Automation, artificial intelligence and digital systems should not replace professionals; they should enable professionals to focus on activities
About Noman Manzoor Noman Manzoor DVM MSc MBA FIBMS, is the Laboratory Director for Pathology and Transfusion Services at Great Western Hospital NHS Foundation Trust, where he leads strategic, operational, financial, and quality management functions. With over 15 years’ experience in pathology leadership, laboratory informatics, service transformation and healthcare management across the NHS, his research interests include microbiology, antimicrobial resistance, infection prevention and epidemiology.
where human expertise adds the greatest value. The future workforce will increasingly require skills in data interpretation, digital technologies, quality improvement and innovation alongside traditional scientific expertise.
Collaboration, not competition One of the greatest barriers to transformation is organisational culture. Working in silos limits innovation, duplicates effort and reduces resilience. In contrast, collaborative networks encourage shared learning, common protocols and collective problem-solving. Future pathology leaders must foster a culture where success is measured by the performance of the network rather than individual departments. The question should no longer be:
‘How is my laboratory performing?’ Instead, we should ask: ‘How is our network delivering for patients?’ That subtle shift in language reflects a much deeper transformation in thinking.
Beyond the horizon The next decade offers tremendous opportunities for pathology. Digital technologies, automation, AI and CDCs will continue to reshape diagnostic services. However, technology alone will not transform pathology. Transformation will require investment, leadership, workforce development and, above all, collaboration. The pathology profession has
repeatedly demonstrated its ability to innovate, most notably during the COVID-19 pandemic. The same spirit of collaboration and innovation must now drive the next generation of diagnostic services. Networks should not simply connect laboratories. They should connect people, expertise, ideas and innovation. Only then will pathology truly deliver faster diagnoses, beter patient outcomes and a sustainable future for the NHS.
PPi August 2026
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