Foreword
Pathology and laboratory medicine services inform approximately 70% of clinical decisions in NHS Scotland. The core pathology and laboratory medicine services provided by each of the Health Boards are of high standard as evidenced by the Scottish Government's recommendation that all clinical laboratory services should be registered with an approved accreditation organization.
Specialised pathology and laboratory medicine services are, by definition, not universally available. Such services relate to rare or complex conditions and they often require specialised equipment and skill to undertake the investigation and interpret the result. In recognition of the importance of specialised pathology and laboratory medicine services, a number of National Reference Laboratories have been centrally funded over the years through the National Services Division of National Services Scotland. These services are now commissioned by Health Protection Scotland.
However, many specialised pathology and laboratory medicine services are not recognised or supported at national level. These services have been provided on an ad hoc basis with financial support coming on an historical basis from Health Boards. Increasingly, such services were perceived as being at risk through loss of expert skills, absence of modern equipment and insecurity of future funding. Laboratory medicine professionals were also reporting difficulty in introducing the latest specialised services required to support modern medicine.
This review was conducted in order to define and map the specialised pathology and laboratory medicine services in Scotland. The review identifies a large number of specialised services that are not subject to any national oversight or support and it provides evidence that some of these services can be considered at risk. The review also recommends a managed network model for the national oversight of specialised pathology and laboratory medicine services in order to ensure that in future NHS Scotland can benefit from a comprehensive range of modern services delivered to high quality in a cost effective manner.
I am grateful to the members of the Project Working Group for their expertise and commitment to the project. I acknowledge the many laboratory professionals from across Scotland who provided the data that underpins the review. I also acknowledge positive contributions from National Services Scotland, the Regional Planning Groups, the National Partnership Forum and the Diagnostics Steering Group.
Graham H Beastall CBE (Chairman of the Project Working Group)