Only 3% of NHS histopathology departments have enough staff to meet clinical demand, a workforce census by the Royal College of Pathologists shows. The census, Meeting pathology demand, focuses on the histopathology workforce – the specialty vital to cancer management from initial diagnosis to guide patients’ treatment.
Professor Jo Martin, President of the Royal College of Pathologists, commented: "The cost of staff shortages across histopathology departments is high for both patients and for our health services. For patients, it means worrying delays in diagnosis and treatment.

"For NHS hospitals, it means spending more resources on locum doctors to fill staffing gaps or outsourcing services. We estimate this costs £27m each year across the UK health service  – money that could be better invested in staff and new diagnostic equipment.

"Safe and effective high-quality patient care depends on having the right number of staff in the right places. Demand for pathology services has grown significantly in recent years and continues to grow. The pathology workforce has not increased in line with this demand. If this trend continues unchecked, clinical services could be in jeopardy. Making sure pathology services can cope with current and future demand is essential if we are to ensure early diagnosis and improve outcomes for patients."

The report highlights the intense pressures that histopathologists face from increased workloads, such as new NHS screening programmes. In addition, services are facing more complex work as personalised medicine develops and guides new therapies. Outdated IT systems compound these pressures.  

The census highlights:

An approaching retirement crisis – a quarter of all histopathologists are aged 55 or over.

Ensuring pathology services can cope with current and future demand is vital to improve outcomes for patients. The Royal College of Pathologists is proposing a range of solutions to address the shortage of histopathologists in the short and longer term, including:

  • more funded training places, and ‘golden hellos’ for specialist histopathology trainees in hard-to-recruit areas
  • better IT for day-to-day work
  • capital investment to implement digital pathology more widely, so staff can work more efficiently and flexibly
  • development of advanced clinical practitioners to work alongside medically-qualified histopathology colleagues.

Emlyn Samuel, Cancer Research UK’s head of policy development called for health officials to do more to protect the histopathology workforce which is vital to cancer care. 

“This report is another compelling example of why the Government and NHS must address staff shortages in professions, like pathology, which are vital in the diagnosis and treatment of cancer."