A comprehensive review by NHS Midlands and Lancashire’s Improvement Unit has created a roadmap for improving quality, efficiency and sustainability across histopathology services in the Midlands.

Background

Histopathology plays a pivotal role in diagnosing diseases. However, laboratories face significant challenges striving to balance turnaround time targets with year-on-year increases in service demand. This increase also requires implementing continuous improvements in local practices and processes.

Histopathology services in the Midlands are facing some key challenges. An aging estate impacts their ability to meet increasing demand. Upcoming workforce demographic changes, implementing digital pathology and accessing capital and revenue funding all create further difficulties.

NHS England (NHSE) commissioned NHS Midlands and Lancashire’s Improvement Unit to review histopathology local improvements. This involved:   

• Providing region-wide understanding of histopathology improvements, impacts and benefits 
• Supporting networks to embed a continuous improvement and learning culture   
• Recommendations to improve performance of individual laboratories and wider pathology networks in support of their move to digitisation.  

Action

We conducted a comprehensive review of histopathology services across the Midlands, with the aim of improving overall performance of laboratory sites and the wider pathology network.

Key activities: 

• Defining scope and priorities: Establishment of governance and reporting structures to ensure clarity and accountability throughout the review. A collaboration with histopathology network stakeholders to define review scope and key focus areas
• Initial stakeholder engagement: Engagement with key network and laboratories contacts establishing clear communication channels ensuring alignment and collaboration across all areas
• One-to-one engagement sessions with laboratory sites: The team conducted in-depth, one-on-one sessions with key stakeholders across the laboratory sites gathering critical intelligence local issues and opportunities for improvement
• Site visits: To gain practical, on-the-ground understanding of laboratory processes, operational challenges and how previous improvement activities had impacted performance
• Virtual feedback session: To share initial findings with network representatives and subject matter experts, allowing further feedback to refine recommendations
• Initial data analysis: Thorough analysis of the data collected from desktop reviews, process mapping and feedback from virtual workshop to support identification of themes, challenges and opportunities for improvement across the network
• Second engagement session – face-to-face workshop: Held jointly with laboratory teams and NHSE to present progress and celebrate successes, reinforcing the cultural importance of LEAN and continuous improvement
• Final reporting: Outlining key findings, strategic recommendations and guidance for continuing to drive performance improvements.

Impact

Clear roadmap, strategic and actionable recommendations and LEAN improvement guide: Based on thorough engagement and analysis, a clear roadmap for improving quality, efficiency and productivity was created. It focused on specific areas for improvement addressing challenges within laboratory processes and workflows.

Cultural shift and stakeholder alignment: There was a shift in culture towards continuous improvement, aligning stakeholders across the histopathology network to embrace improvement methodologies and resolve challenges collaboratively.

Sustainable and long-term impact: We helped establish a strategic foundation for sustainable improvements, ensuring networks are sighted on future challenges and demands.

Operational efficiency and performance enhancements: The collated learning and improvement examples have been shared. This shared learning can be optimised, leading to better resource allocation, improved efficiency and the adoption of best practices.

The adoption of shared learning will also lead to expected improvements in diagnostic accuracy and reduced turnaround times, directly benefiting patient care and service delivery.

For more information

For more information, visit our Improvement Unit section and contact us.