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Feb 2019
Pathology services at Homerton

The Trust has now entered into exploratory talks with Barts Health NHS Trust about a potential collaboration between the two Trusts for the future provision of pathology services. Here we answer some of your questions about this.

Frequently asked questions

Why do you need to talk about changing pathology services at Homerton?
What have you done?
Would this collaborative arrangement mean no pathology services at Homerton in future?
What happens next?

Why do you need to talk about changing pathology services at Homerton?
Our pathology teams provide a high quality service to the hospital and to colleagues in primary care. But it is becoming difficult to work in the current location in the hospital because of demands on space and ageing equipment. The space issue restricts the ability of the teams to expand further to take on additional capacity. There are also stringent accreditation standards set by independent bodies which we must continue to meet. The current arrangements will make the service’s ability to meet these standards increasingly difficult.

What have you done?
In the spring of 2016, we commissioned independent consultants to review the options available to us in developing our pathology services in the future. The findings of that review were put before the Trust Board of Directors November of that year and the Board decided to pursue two options:

  • transferring the bulk of services to another provider
  • or the preferred option of  going into a collaborative arrangement with another NHS Trust.

Consolidating the provision of services has been a growing feature of pathology working in the UK over the last decade. It is a development which is in line with the main drive of Sustainability and Transformation Plans (STPs) being drawn up across the country and is strongly supported by NHS Improvement.

In London alone, multiple examples exist of NHS trusts pooling their pathology services in pursuit of mutual financial and quality benefits as well as attracting skilled staff.

This is one of the key reasons the Trust Board favours the idea of a close alliance with another NHS provider.

Would this collaborative arrangement mean no pathology services at Homerton in future?
We will have to retain some pathology services on the hospital site if we are to continue providing a full range of acute hospital services.

Parts of each of the main components of our pathology service provide vital support to key areas such as A&E. These could be described as ‘hot services’ and need to be available on site. But other parts of pathology offer ‘cold services’ such as routine testing which could be outsourced without affecting hospital services. For instance, we already have an agreement with Barts Health to provide much of the histopathology testing for the Trust.

If the collaboration was to go ahead, any hot services would be retained at Homerton in an Essential Services Laboratory (ESL), sometimes called a blood sciences lab, along with some services supporting areas such as maternity. Other services and staff might transfer to Barts.

What happens next?
Discussions with Barts Health about a potential collaborative arrangement have been going on for some time at a Chief Executive level but a full appraisal of the details around any future arrangements must be carried out to explore its viability.

A programme director will be appointed to look at these details and whether a collaborative arrangement is feasible; then set out a case for collaboration for both Trust Boards to consider. This work will be carried out over the next six months.

The Trust Board would then need to sign off on any agreement with Barts before a process of setting up the new service began. This process may take up to eight months to complete including any formal consultation with the staff affected, so we are not expecting any changes till late autumn 2019 at the earliest.

Pathology staff, and their staff side representatives, will be kept informed about this work as it progresses with face-to-face meetings. The Trust will give regular updates to other staff along with other interested groups and individuals.

This list of questions and answers will be adapted and changed as we become clearer on the direction of travel of this process and whether or not the alliance with Barts is viable going forward.

Last updated: 28 February 2019