DIGITAL PATHOLOGY Emerging


Constituent pathology services within a Network currently operate independently at Trust level, but with a Network programme board engaged to take forward network-wide understanding and development of a Network-wide plan.


Pre-emerging Constituent pathology


service providers within a Network operate independently at Trust level.


emerging Pre- Fig 1. Stages of maturity for pathology networks in England.


and complex system, and its regional diversity requires careful coordination to successfully deliver large-scale service transformation which can benefit patients from all geographical pockets of the UK. The NHS’s 2022/23 Operational Planning Guidance commits to classifying all pathology networks as ‘mature’ in digital capability by 2024/2025, with a focus on driving digital interoperability within and between departments and a focus on maximising the digitisation of histopathology service delivery (Fig 1). According to an April 2024 review, across the 27 pathology networks in England, only 12 networks were considered maturing or above, and 15 networks considered developing. While there is progress taking place in ensuring all pathology networks are now in the development phase of digital maturity, the majority of pathology networks will require strategic guidance to maintain momentum for digital transformation.


Barriers to large-scale digital pathology


A significant challenge within the NHS’s historic operational structure lies in the fragmented delivery of services. The distribution of resources, budget allocations, and specialist expertise vary considerably across regions, leading to inequitable progress in achieving digital maturity across pathology networks. Notably, there is a vast array of laboratory information management systems (LIMS) throughout the NHS, which further limits the potential for improved connectivity achievable through digital innovations. These regional disparities have resulted in inconsistencies in the adoption of digital pathology, preventing the NHS from establishing a cohesive, high-performing histopathology service at a national scale. In recent years, substantial funding has been allocated towards


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advancing digital pathology, with NHS England committing millions to digital transformation initiatives, including digital imaging and interoperable reporting systems. However, the effectiveness of this investment depends on strategically implementing these funds to ensure they drive meaningful change. Without a coordinated effort to accelerate digital integration across clinical workflows, there is a risk that these funds may go underutilised and yield suboptimal returns. If the transition to digital pathology is not accelerated across clinical workflows as a collective, the NHS will continue to face mounting challenges in meeting the rise in demand for diagnostics. The reliance on outdated systems, and therefore the lack of nationwide interoperability, may also exacerbate workforce pressures, increasing the burden on already stretched pathologists, biomedical scientists, and other clinical and operational staff. The absence of consistent digital maturity across histopathology departments affects not only those departments but the broader healthcare system, and therefore, the stagnation in digitisation cannot be viewed in silo.


National Working Group for Digital Pathology In response to this, a National Working Group for Digital Pathology was formed. The primary aim of the Group was to shape key recommendations for accelerating the transition to digital pathology nationally, that sits alongside and further supports the NHSE 6-point histopathology plan. The subsequent aim was to outline the imperative for ringfenced funding for histopathology departments, with a critical set of recommendations on how best to utilise this budget for large-scale success. The Working Group, chaired by Debra


Padgett (IBMS Past President, North East and North Cumbria [NENC] Pathology Operational Lead) comprises essential stakeholders in UK histopathology service delivery, including key NHS clinical and operational leaders, representatives from the Institute of Biomedical Science and The Royal College of Pathologists and related organisations, as a well as a partial industry seat. The upcoming whitepaper, scheduled for release in December 2024, is designed as an advisory resource to address the challenges and harness the opportunities in implementing large-scale digital pathology across the NHS. With members of the Group actively engaged in on-the-ground operations, their insights offer a valuable bridge to national decision-makers, fostering a collaborative approach that maximises the potential for successful digital transformation.


Recommendations By focusing these recommendations on a clear, structured path to digitisation, the NHS can better navigate the challenges of integrating digital pathology into its existing healthcare system. The key to success lies in a coordinated national strategy, inclusive stakeholder engagement, and sustained investment in infrastructure, training, and innovation.


1. Foster a cultural shift A cultural shift is essential to fully realise the benefits of digital pathology. The NHS must create a shared understanding that digital histopathology is not just a technological upgrade, but a critical step in improving the quality and efficiency of services. This cultural change should be supported through targeted educational programmes, continuing professional development, and the promotion of digital pathology as a key enabler of modern healthcare. Emphasising the role of digital pathology in enhancing patient


DECEMBER 2024 WWW.PATHOLOGYINPRACTICE.COM Thriving Developing


Joint-working across Network with implementation of network-level plan underway.


Developing Emerging Maturing Thriving


Fully integrated Network operation, and collaboration with other Networks within the region for regional academies, best practice evidence and standardisation across region.


Maturing Fully established and


implemented plans at Network level, and where applicable realisation of benefits and further innovation and improvement underway.


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