Histopathology Staff Shortages 'Affecting Cancer Diagnoses'

Nicky Broyd

September 17, 2018

The Royal College of Pathologists has issued a report highlighting staff shortages in hospital histopathology departments.

The document, Meeting pathology demand: Histopathology workforce census, is the result of information gathered in 2017. Three-quarters of histopathology departments across the UK took part and only 3% said they had enough staff to cope with the demand for testing.

Staffing gaps were often filled by locum and agency workers at a higher cost to the NHS.

As well as staffing problems, the report says histopathologists face an increased workload from NHS screening programmes, pressures from out-dated computer systems, and new complex demands from personalised cancer treatments.

The report also shows recruitment problems are set to worsen as experienced histopathologists retire. A quarter of current staff are at least 55-years-old and 36% of these are aged 60 or older.

'Delays in diagnosis'

In a statement, Professor Jo Martin, president of the Royal College of Pathologists, said: "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."

Prof Martin continued: "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."

Action Plan

The Royal College of Pathologists has proposed solutions to help solve highlighted issues in the short and long-term. These include:

  • Increasing funded histopathology training places

  • Offering 'golden hellos' in problem recruitment areas for specialist histopathology trainees

  • Improved IT systems and investment in digital pathology technology

  • Developing advanced clinical practitioners to work alongside medically-qualified histopathologists


Reacting to the report, Emlyn Samuel, Cancer Research UK’s head of policy development, said: "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."

For the NHS in England, a Department of Health and Social Care spokesperson said: "There are hundreds more pathologists in the NHS compared with 2010 and hospitals have reduced spending on temporary agency staff by over half a billion pounds in the last year.

"We are listening to staff, encouraging more flexible working and have increased medical training places for home-grown doctors by 25%, to ensure the NHS has the workforce it needs for the future."

A Scottish Government spokesperson said: "We recognise the importance of pathology specialisms, that's why we increased training places for paediatric pathology in 2016, histopathology in 2017 and diagnostic neuropathology in 2018 to ensure we support our health workforce to meet patient needs. We are currently considering a request for additional pathology trainees for 2019."

A Welsh Government spokesperson said: "Like the rest of the UK, we are facing challenges in recruiting pathologists. We are working closely with the service, including the Royal College of Pathologists, to develop a national plan to address this issue."


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