Acacium Group’s Digital Pathology Think Tank: Helping to shape the future of healthcare

Introduction

Acacium Group’s Digital Pathology Think Tank brought together experts to advise on how best to apply a digital pathology workforce to existing clinical pathways.

The meeting of the Think Tank was held on Tuesday 9 November 2021 and focused on the digital delivery of pathology services. The Think Tank was attended by representatives from across the clinical community,

This note:

• Provides a brief background on the current pathway, and challenges facing pathology departments
• Summarises the presentation delivered by Pasindu De Silva and Kathryn Allison on the development of a digital pathology workforce model, developed by Acacium’s Pathology Group division
• Summarises key themes from the wider discussion which followed

Background

Pathology services in England are facing increasing pressures because of a combination of rising demand, greater caseload complexity, and growing vacancies. In 2018, a workforce survey found that only 3% of histopathology departments had enough staff, with 137 out of 158 departments using various coping mechanisms, such as locums, outsourcing and overtime to meet service demands. This has resulted in extensive national pathology backlogs with clinicians and patients having to wait extended periods of time for the results of tests.

Pathology services are crucial for modern clinical diagnosis, monitoring and treatment of a wide range of diseases and disorders. It is therefore, vital that pathology departments are supported to create more sustainable services to help tackle the diagnostics backlog and continue to support national ambitions, including cancer diagnosis and care.

Recognising these challenges, pathology services have been going through a period of transformation supported by NHS England. The transformation aims to create 29 Pathology Networks across the country with pathology work more efficiently delivered within and between them. However, Pathology Networks have progressed slowly – particularly in some areas of the country – and more needs to be done to support individual pathology services to deliver more efficiently whilst Pathology Networks are still being established.

One possible solution is a new digital pathology workforce model, which could be embedded within the NHS’s post-COVID service recovery and redesign.

Development of a digital pathology workforce model

Since 2008, the Pathology Group, a part of Acacium Group, has specialised in the provision of histopathologists, haematologists, microbiologists and oncologists to the NHS, as the UK’s sole specialist recruitment agency for placing pathology doctors.

Over 1,200 histopathologists are currently registered with the Pathology Group, covering all specialisms, enabling departments to access the staff to increase their capabilities and improve turnaround times while improving standards of patient care.

Building on this experience, the Pathology Group is currently developing a new digital pathology solution which will offer departments additional flexibility to increase capacity and responsiveness to respond to rising demands and workforce stresses. The model delivers a combined digital and workforce pathology model. A technology provider delivers state-of-the-art digital tooling and systems integration capability. Pathology Group manages the end-to-end service delivery of all things related to people, training, and performance, inclusive of commercial innovation. A single point of contact with the trust would enable the trust to simply and strategically manage the solution.

The model will manage the examination of slides using the latest scanning and cloud computing technologies, with registration, processing and preparation done in the usual way, allowing specialist pathologists to work remotely. Recognising the need for flexibility, the model will provide a versatile workforce model to allow NHS providers to scale-up and down when demand requires, while continuing to offer value for money and delivery. The pathway is expected to take 24-48 hours, and with a global network of pathologists, the solution can run 24/7, speeding up an approach that usually takes 7-10 days, while reducing the burden on departments.

Reflections on the digital pathology workforce model

The Think Tank noted that:

• The flexibility of the digital workforce solution would add value to existing pathology services while enabling the NHS to better reach its targets for pathology waiting times. A flexible digital pathology workforce model could provide the additional capacity needed to meet rising demands and address the growing backlog with solutions tailored to need, such as managing referral workloads and different levels of case complexity.
• Variation in the capabilities of hospital trusts is a recognised barrier to the increased use of digital technologies in the NHS. A digital pathology model which provides tailored solutions depending on where a provider is in their digital transformation journey would help to address this issue, offering the right level of support and services to meet their individual needs.

• A complete digital pathology model is desirable, but the variation in readiness across the country, and the challenges inherent in transforming the service model at a time when pathology services cannot afford to reduce capacity, means that flexibility will be key to delivering real benefits for NHS trusts. “Part digitisation” models were also discussed, which would effectively involve setting up an independent off-site lab to digitise slides and enable the trust to begin seeing the benefits of digitisation without the need to commit to a major estate change.
• The Department of Health and Social Care has recently announced £250 million in funding to support the digital transformation of NHS pathology services. In light of this, the service model will likely need to focus less on securing external financing to support service transformation. However, the role of Acacium Group in supporting the business-case development for digital services would support their ability to access the central funding.
• Connecting people can be as powerful as capacity benefits. The ability of a future digital pathology solution to connect clinicians with an extensive network of global specialists is a benefit in itself, beyond the immediate capacity benefits to pathology departments. Within England, the connectivity of a digital solution would also accelerate the move to Pathology Networks by virtue of connecting clinicians in a way that has been relatively slow to date.
• In addition, a digital solution could utilise the capabilities of biomedical scientists, to support consultants, which would increase through-put. Acacium Group agreed to explore how biomedical scientists could be provided in the workforce solution.
• A digitised pathology solution will create a model that allows the pathology workforce to be trained more easily. The ability to share and review digitised slides and to engage with trainees either face-to-face or virtually increases the opportunities for training dramatically – whether for students or as part of upskilling biomedical scientists – creating stronger career paths and greater resiliency across the pathology workforce.
• Any support provided for the training of NHS staff as part of digital service model would also improve the capability of departments and be welcomed by NHS services. This could involve support for individual staff through a curriculum-based approach, or ‘parachuting’ a team into a trust during the transition to a digital service to train staff on the job.

Contact information

We hope this short briefing is helpful. If you are interested in knowing more, please get in touch via info@acaciumgroup.com. You can also read our previous Think Tank article Children and Young People’s mental health here