NHS pathology labs are ripe for privatisation and cuts

“Every sample is a patient … Every sample is a patient …”

I repeat it like a mantra, so that amid the relentless workload we don’t lose sight of who we work for. We say it as we navigate crumbling floors – in one of our labs, a hole in the lino flooring has been patched up with heavy-duty gaffer tape.

In my work, I see only names, not faces. But every sample is a patient, and every patient has hopes, fears, family and friends. Doctors and nurses get to see their charges in the flesh, whereas I see only the flesh. Paramedics and porters see the blood spilt, I see only the blood. Some names become familiar – a premature baby on the neonatal unit, a 90-year-old with a broken hip – but we never see them recover, never witness the reunions and taxi rides home. Not that my colleagues and I need it, but we never hear their thanks. When we stop receiving their samples, we can but hope for the best.

I work in a pathology laboratory and they are involved in 70% of all diagnoses within the NHS, but very little of what we do is known to the public, or indeed, to many of our healthcare colleagues. We are the definition of behind the scenes, providing doctors with the vital information they need to assess and treat patients.

We are the definition of behind the scenes, providing doctors with the vital information they need to assess and treat

The inner-city microbiology lab where I work as a technician processes thousands of samples a week, from A&E departments, GP surgeries, intensive care, maternity units, and everywhere in-between. We run a full seven-day service (including bank holidays), and with biomedical scientists covering the lab throughout the night, I’m happy to say that we make a mockery of Jeremy Hunt’s calls for a 24/7 NHS.

Sadly, and as with the NHS as a whole, we are short-staffed, under-funded and often ill-equipped. I’m often expected to attempt the workload of two members of staff. What little morale remains is nurtured from the ground up, an esprit de corps forged in a shared adversity, and in taking inspiration from colleagues going about their duties with a quiet efficiency.

Throughout the day porters and couriers deliver a constant stream of samples that are immediately triaged. Urgent specimens are processed within a matter of minutes. What might seem to the untrained eye to be an overwhelming mound of bloods, swabs, tissues and every bodily fluid imaginable is swiftly organised; well-rehearsed procedures are carried out so that every diagnostic test is performed with the minimum of delay.

The sheer amount of equipment and consumables necessary for the lab to function often surprises visitors and those new to the job. The NHS is truly a system, with every part reliant on the other. The labs do not stand alone, and indeed, would be worthless if they did so. Just as the pen is of little use without the paper, so the NHS cannot treat its patients without laboratories. The staff themselves are of course any lab’s greatest asset, a biomedical scientist needs years of education and training to become qualified.

Even though it can be difficult to find a moment in which to draw breath, we are forced to confront our fears about the future. The vital ancillary services of estates, cleaning, security and portering (to name but a few) have been tendered out to the private sector within the trust where I am employed, as they have been across the wider NHS.

Financial pressures are causing more and more laboratories to merge, and it is now the case that many individual trusts no longer directly own their pathology services – instead there are “joint ventures” and “partnerships” forced to bid against one another for customers and business.

While efficiency savings are possible, fewer labs equal longer transport times, and longer transport times equal potentially life-threatening delays. At night, our (private) courier company sometimes has to send a driver from 30 miles away to bring an urgent sample to the lab from a hospital five miles from us.

Given how behind the scenes we are, and how fragmented the NHS is becoming, there is an acute dread that pathology is ripe for the picking in terms of
the work we do being tendered-out to private contractors, or the joint ventures themselves morphing into entities no longer under the control of NHS trusts.

We want to cooperate with our colleagues, not compete against them, even if not many realise what we really do. We want to use the best diagnostic tools, not the cheapest ones. We want the time to treat every sample we receive as a patient, not a commodity. Help us to help you.

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NHS pathology labs are ripe for privatisation and cuts

A day in the existence of ... a senior anatomical pathology technician

There has been a noticeable rise in the amount of female technicians in the pathology occupation, a shift from what was when a male-dominated region Photograph: Barbara Peters

Most folks are tucking into their breakfast when I begin operate on the initial autopsy of the day at about 7am, at St George’s hospital, London. The mortuary is a hectic location so we like to start early and check any overnight arrivals left by the hospital porters or designated funeral director.

A straight forward submit-mortem takes about 30 minutes and our job is to assist the pathologist in identifying lead to of death.

We record the height and bodyweight of each particular person then remove and bag their clothes and personal effects. Jewellery is often left on the entire body.

I have discovered some odd issues on bodies in excess of the many years, such as medicines, hypodermic needles and rolls of bank notes sewn within a woman’s bra.

We perform up to 5 publish-mortems per morning and, due to the nature of our perform, do all the publish-op cleaning ourselves.

The pathologist will carry out an external examination 1st to see if there are any clues indicating lead to of death. This includes obvious factors like a stab or gunshot wound, and unusual abrasions or cuts.

I eviscerate the entire body and eliminate the principal organs for the pathologist and then ‘reconstitute’ the deceased and wash, dry and rewrap them in a fresh shroud when the examination is full.

We usually pay attention to the radio even though operating and chat about daily factors, but we always deal with the deceased with respect.

I have observed fairly much every thing there is to see in my 10 many years as a mortuary technician, from accidental deaths by way of drowning and fire to traffic street accidents, suicides and murders.

I still bear in mind my 1st autopsy she was an older female who had died of pneumonia. I keep in mind a surreal detachment descending on me although viewing the process.

It might appear cold, but it is just a normal protective mechanism to aid you cope. I’ve carried out hundreds of autopsies because and perform on car-pilot with my emotions in check out.

The work of a mortuary technician is not for the faint-hearted, but neither is it the cold clinical world that is frequently misrepresented in Television dramas.

Mortuaries have a long standing track record for currently being dark, creepy locations populated by ghoulish folks. In actuality, mortuary technicians are just like everybody else and we perform hard to guarantee that, for going to family members, it is a place of warmth, respect and dignity.

St George’s is also a regional perinatal centre for south London and south-east England and I assist the pathologist in about 600 cases a yr, including premature and even now births.

I weigh, measure and take x-rays of the kids, which includes washing and redressing them soon after the autopsy.

I inspire parents to come in and see their infants which includes holding them and, the place suitable, washing and redressing them. It’s an crucial part of the healing procedure and enables them to invest time with their kid just before saying goodbye.

I am also clear about explaining what process the kid has undergone so they know why we have carried out an autopsy and make sure incision marks are covered with tape or bandages. Mother and father value candour and the truth that their kid is getting looked right after.

The job is not for everyone, but there has been a noticeable rise in the number of female technicians in what used to be a male dominated profession. Care, compassion and knowing are all important attributes in my line of work.

Our afternoons are generally set aside for viewings and paperwork it truly is surprising how much of the latter accompanies a person’s departure from daily life.

My day finishes at around 4.30pm when I hand all 13 of the mortuary keys into safety. I normally shake off the day’s perform on the 20 minute stroll home and unwind with my spouse and daughter.

Oh, did not I mention him? He’s an undertaker.

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A day in the existence of ... a senior anatomical pathology technician