The apparent absence of pathology from the the review
A letter to Lord Darzi from the BMA's consultants committee
12 December 2007
Dear Lord Darzi
We are writing to you on behalf of the BMA’s Central Consultants and Specialists Committee regarding the recent reform papers, 'Healthcare for London and Key Issues for the Next Stage Review'. These reports were discussed at a recent meeting of the CCSC Pathology Subcommittee and concerns were raised that neither report appears to recognise the provision of pathology services and their importance to the quality of healthcare provided to patients. The Chairman of the Pathology Subcommittee, Anne Thorpe, and I would welcome the opportunity to meet with you so that we can have a constructive discussion around the Subcommittee’s concerns.
As Lord Carter of Coles outlines in his comprehensive review of pathology services published in August 2006, 'Report of the Review of NHS Pathology Services in England', pathology services are essential to the delivery of many of the national targets of the NHS and it is estimated that 70 – 80 per cent of all healthcare decisions affecting diagnosis or treatment involve a pathology investigation, with individuals’ treatment decisions often dependent on a range of pathology-based tests and investigations.
We would like reassurance that the NHS Next Stage Review Team recognises the importance of the role of pathology services in the NHS and is anticipating that Lord Carter’s forthcoming recommendations, based on data collected form 12 pilot sites, will address provision of pathology and its alignment with patient need. The committee would also like confirmation that any pathology services provided “closer to home” will be fully accredited by Clinical Pathology Accreditation (CPA). It would be useful if we could discuss these issues in more detail with you.
We are also aware that the BMA’s General Practitioners’ Committee has recently written to you regarding the NHS Next Steps Review 'Interim Report' and we would like to take this opportunity to echo some of the concerns detailed in this letter, based on our most recent feedback. A number of clinicians participating in the clinical pathway groups have reported that the questions asked of members have been at times been loaded with seemingly pre-determined answers and the agenda highly politicised. We have also had similar reports from our members of a pre-set agenda at the deliberative events held at SHA level on 18 September. We understand that the GPC has requested increased LMC representation and involvement at the second round of deliberative events due to take place in January. We would also like to emphasise the importance of real involvement and dialogue at these events, if they are to bring meaningful conclusions.
We look forward to hearing from you and meeting in the near future to discuss these issues in greater detail.
Yours sincerely
Dr Jonathan Fielden
Chairman
Central Consultants and Specialists Committee
Dr Anne Thorpe
Chairman
CCSC Pathology Subcommittee