GHFT Pathology Managed Service

Gloucestershire Hospitals NHS Foundation Trust (GHFT) Pathology department is critical in supporting the delivery of a high-quality, first-class clinical service that can meet the demand and needs of the acute Trust and our One Gloucestershire partners (Gloucestershire Primary care, Gloucestershire Health and Care NHS Foundation Trust), South Worcestershire Primary care, private healthcare providers and other out of county NHS healthcare organisations. The Pathology departments are spread across two sites (Gloucestershire Royal Hospital (GRH) and Cheltenham General Hospital (CGH)), with Haematology, Blood transfusion, and Chemical Pathology provided at both sites due to the acute clinical services at each site. Cellular Pathology services are consolidated and are based at CGH, and Immunology and Microbiology services are consolidated and are based at GRH.

THE NECESSITY OF PATHOLOGY SERVICE TRANSFORMATION
Pathology services form the backbone of modern healthcare, with 70-80% of clinical decisions and 95% of chronic disease pathways relying on their input. Several managed service contracts that support these critical services at GHFT are due to expire, and replacing these contracts is a minimum requirement to ensure the ongoing provision of pathology services, which are fundamental to almost every aspect of patient care.

INCREASING DEMAND AND COMPLEXITY
Over the past decade, national and local demand for pathology services has surged, becoming more complex and diverse. However, the ability to deliver a fit for the future pathology service is currently constrained by the estate occupied by the Pathology departments. Each discipline within Pathology has unique requirements for space, processing capacity, storage capacity, temperature control, and layout. Presenting workflow challenges that need to be reconfigured to achieve operational efficiency, lean processes, and income-generating capacity.

THE CASE FOR CHANGE
The case for transforming pathology services has been outlined from two primary sources: a review of the strategic context (national, local, organisational, and departmental) and initial engagement with internal stakeholders. These sources have aligned in identifying key areas that need to be addressed:
- Upcoming Contract Expirations: Pathology have three critical managed equipment service contracts nearing their expiration dates within the next 12 to 18 months. To maintain uninterrupted service provision, proactive measures must be taken. 
- Aging Equipment: Outdated and increasingly unreliable equipment is leading to delays in service provision.
- Insufficient and Inefficient Use of Space: The current facilities do not optimally utilise available space, hindering efficient operations.
- Capacity and Process Inefficiencies: Growing demand and inefficient processes are straining the ability to meet current service requirements.
- Inefficient Resource Utilisation: Resources are not being used optimally, due to lack of lean and automated processes, leading to inefficiencies and potential waste.
- Ineffective Contract Management: Existing contract arrangements and contract management practices hinder effective supplier performance management.

THE PATH FORWARD
To address these challenges, a comprehensive transformation of pathology services is necessary. This transformation should encompass facility upgrades, process optimisations, equipment modernisation, and effective contract management strategies. By doing so, GHFT Pathology can not only meet the growing demand for services but also position itself as a provider of bespoke analytical suites, generating additional revenue streams through collaborations with other NHS organisations, research and innovation entities, and private sector partners.