Underfunding of UK laboratories threatens cancer treatment, top doctor warns


Years of underfunding UK laboratory services threaten to delay cancer diagnoses and treatment as the NHS struggles to clear a massive backlog of cases, a prominent doctor has warned.

In an interview with the Financial Times, Professor Michael Osborn, president of the Royal College of Pathologists, also pointed out “a workforce crisis”, with a quarter of histopathologists, who diagnose the disease, aged at least. 55 years old and an urgent need for more interns.

A failure to invest enough in digital technology, which can enable remote reading of tissue samples, had left the NHS under-resourced to cope with a huge increase in workload as health services struggled. struggling to provide delayed treatment with Covid-19, he suggested.

“Without additional investment in pathology, you won’t be able to get rid of the backlog no matter how much money you invest in other areas of health,” Osborn said. “Poor pathology delivery has the ability to thwart absolutely anything the government wants to do in health care. “

In September, the government granted the NHS an additional £ 5.4bn for the second half of this fiscal year to cover the costs of Covid, including £ 500m of additional capital. Separately, as part of a new health care and social services tax, an additional £ 15.8 billion has been set aside to pay for running costs and reduce waiting lists over the next three years.

However, Osborn said the debate over the backlog and the allocation of that funding tended to focus on a shortage of frontline staff such as nurses and surgeons or a shortage of beds.

“Laboratory and diagnostic services are often very forgotten. So you risk, if this is not addressed by policy makers and those who hold the purse strings, of investing only in the initial and easily visible things – surgery, endoscopy, nurses, all of vital importance. of course – but then forgetting to support them. with pathology, ”he added.

All areas of pathology, which cover 17 different specialties, were affected. “Every aspect is underlined and every aspect is involved in resolving the backlog,” as well as dealing with new cases, Osborn said.

The most worrying pinch point was cell pathology, the branch of the discipline that diagnoses cancer and provides the information to decide on the best treatment. Cellular pathology is also used to assess the genetic makeup of a tumor so that clinicians can prescribe medications that are appropriate for each patient.

Even before the pandemic, Osborn said, insufficient staff and outdated computer systems were causing “significant problems”, affecting the speed and efficiency with which specimens were registered and tracked. “A result is quite useless if it is not reflected in the patient’s notes.

However, until Covid struck, most labs were “pretty much on the verge of hitting targets for turnaround times.” These were deteriorating now, he warned. Pathology departments used to work with limited resources but now had to “prioritize urgent cases over less urgent cases”.

There was a real danger that cancers would not be detected until they reached a more advanced stage, when the treatment “is more important, harder and more expensive and survival is less likely,” he said. .

The Department of Health and Social Affairs said, “Cancer diagnosis and treatment remains a top priority, and most cancer services are operating at or above pre-pandemic levels. “

The government had provided “a record investment to tackle the backlog,” he added, and was also deploying “more efficient means of providing additional appointments and treatment”, including 40 new centers community diagnostics.

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