ACB responds to UK Government plan for tackling the COVID-19 backlog of elective care in England

ACB welcomes the plan published this week for tackling the COVID-19 backlog of elective care. We want to work hand in hand with the Government and the NHS to achieve the aims in this plan, given the scale of backlogs and the other challenges facing the health service.

Pathology services are critical across healthcare.  Therefore, the pace and intensity of the proposed increased activity will need matched increases in pathology capacity and efficiency. To achieve the ambitious targets for diagnosis and treatment, especially around cancer services, it is vital that the essential pathology components of the plan are adequate, potent, and available.

Pathology service delivery is crucially dependent on ensuring we have enough pathologists, scientists, and other vital staff groups. Significant gaps already exist and are forecast to deteriorate in the coming years. A medium-to-long-term solution is possible but we also need a “here and now” contingency to optimise service capacity over the crucial next few years.

Recruitment, especially from overseas, needs to be urgently considered given we do not have enough UK based specialists/scientists to fill the predicted vacancies.

Retention of existing staff is vitally important, especially in the short term – so a focus on promoting wellbeing, delayed retirement, facilitating post-retirement working and addressing pension issues that promote premature early retirement needs consideration.

Increased pressures on pathology services are inevitable. It is vital that staff wellbeing is protected to minimise sickness absence and that NHS occupational support services are equipped to provide the necessary support.

For the longer term, training numbers need to increase across all disciplines for both pathologists and scientists.

Better intelligence on the workforce, including a number of existing posts, vacancies, training posts and workload trends will help to manage national provision and also identify regional shortfalls.  We are well placed to work with Government to address this data gap to support short and long-term planning. 

Digital Pathology is also crucial going forwards to make the system more efficient and increase interoperability across the entire NHS but will not solve the immediate workforce crisis in cellular pathology. Much needed investment and improvements in Lab IT systems are also vital but will take many years to develop and implement. We are ready and able to share our knowledge and expertise to identify innovative short-term solutions alongside contributing to long term strategic IT planning.

Appropriate use of pathology tests can ensure correct decisions and pathways are utilised. Demand optimisation strategies to educate healthcare professionals combined with patient-facing information, such as provided by LabTestsOnline, will help ensure inappropriate testing does not lead to inappropriate care and waste of scarce NHS resources.

The pandemic is not over, and further variants and new pandemics may impact in the coming years. Ensuring we have sustainable and potent Infection Prevention and Control services to deal with this is crucial.

Overall, to begin impacting the huge waiting lists and treatment backlogs, NHS capacity and efficiency need to improve significantly. Ensuring pathology services are equipped with the right services matched for this anticipated increased activity, with adequate staffing and IT to deliver it, will be a vital part of that ask. The ACB is primed to assist in helping make this happen both in the short and long-term.


Bernie Croal, President of the Association of Clinical Biochemistry and Laboratory Medicine (ACB)