A long-running project to create a so-called “pathology hub” for the region would have seen routine testing of a range of specimens requested by GPs and outpatient departments moved from seven individual hospitals across the patch to a new facility in Samlesbury.
However, NHS bosses have now decided to “pause” any further work on developing the laboratory in order to ensure that they have “fully engaged” with staff working in the existing service about the proposed change.
The LDRS understands that the legal process to transfer workers from their existing employers to Lancashire Teaching Hospitals NHS Foundation Trust – which runs the Royal Preston Hospital and is set to host the hub – has also been halted and will not now happen as planned on 1st July.
The £31m overhaul was conceived more than five years ago and was intended to save £11m per year compared to the current system. The boss of the programme says that the four Lancashire NHS trusts involved – Lancashire Teaching Hospitals, Blackpool Teaching Hospitals, East Lancashire Hospitals and University Hospitals of Morecambe Bay – remain committed to it.
However, the move has been opposed throughout by the Unite union, which has previously raised concern over the length of time it could take to ferry samples from some of the farthest reaches of the region to a new centralised base.
Keith Huston, regional officer for Unite, welcomed the planned review – but said that NHS leaders must abandon their apparent belief that building a single super lab is the only option to modernise the service.
“We have always been in favour of collaboration [between the trusts that currently process the tests], but the model proposed doesn’t make any sense.
“They have got their eyes on a £31m grant from the government – and they are trying to put forward a model to get the money, rather than looking at a clinically-led process.
“There is only one reason [for what is being proposed] – and that’s to privatise the service later on. You take all the cheap, easy-to-do laboratory stuff and then sell it off five or six years down the line to a private company.
“There have been more questions than answers. We weren’t happy with it from a clinical or an ideological point of view – but we need to make sure that any model meets the needs of the people of Lancashire and South Cumbria,” Mr. Hutson said.
He also told the LDRS that the pause was prompted by disquiet at a senior level at two of the trusts within the collaboration – Blackpool Teaching Hospitals and University Hospitals of Morecambe Bay – over what they felt was a disconnect between their own understanding of how the collaboration was evolving and the concerns raised by staff in a collective grievance.
The LDRS understands that the grievance – which also covered a third trust – was lodged in relation both to the proposed model for the new hub and the official process of protecting employees’ rights when they move to a new employer, as dictated by the Transfer of Undertakings (Protection of Employment), or TUPE, regulations.
At a meeting of Lancashire County Council’s health scrutiny committee last September, Mark Hindle – the managing director for the Lancashire and South Cumbria Pathology Collaboration – acknowledged in a presentation that while there had been “significant clinical engagement” over the planned hub, it had yielded “variable clinical agreement”.
At the time, he told members that the hub would lead to a “better quality service” and generate an £8.32 return for every £1 investment – in efficiency and not having to spend money on the existing estate.
Explaining the reasoning behind the pause in the process and addressing the points made by Unite, Mr. Hindle told the LDRS:
“Work has been progressing to form a single pathology service for Lancashire and South Cumbria and there is an absolute commitment from all partners in the collaboration to deliver the benefits this will bring in relation to quality, resilience and improved outcomes for patients.
“All acute trust partners are represented on the Pathology Collaboration Board and have been fully involved in the development of the plans to date and sighted on the direction of travel. The strategic case and outline business case for the future service has been agreed by all trusts at their respective trust boards.
“At this stage, the Pathology Collaboration Board has taken a pragmatic decision to pause any further work on the development of a single service and the full business case associated with the future delivery model for the service. There are good reasons for this; we want to ensure that we have fully engaged and listened to all employees who work in pathology services to develop our vision for how the service will run in future.
“We also want to ensure that all options have been explored for securing the capital required for developing the future service. There are no plans for any privatisation initiatives in any form for pathology services across Lancashire and South Cumbria.
“We see this pause in the programme of work as a positive opportunity to do some further and more in-depth engagement with the pathology workforce. This will be done with transparency and undertaken in partnership so that we can be confident as a Board that all options have been explored before moving forwards together with this important work,” Mr. Hindle added.
Blackpool Teaching Hospitals and University Hospitals of Morecambe Bay were approached for their own comments in relation to the union’s claims, but both chose to respond via the pathology collaboration itself.
Under the so-called “hub and spoke” model, each of the hospital sites that currently process pathology samples would continue to analyse tests whose results were needed urgently, for instance by patients admitted to hospital in an emergency.
The plan was to build the hub for routine tests at the Samlesbury Enterprise Zone, with an intended opening date – prior to the announcement of the pause – of 2024.
Previously, sites in Lancaster and Leyland had been identified as possible locations for the centralised service.
Unite has previously criticised the cost of developing the hub proposal after it found via a freedom of information request that £1.2m had been spent, largely on staffing costs, between 2016 and 2019.