Are New Zealand’s pathology and laboratory services ready to respond proactively to future changes and challenges?

Pathology, laboratory and diagnostic imaging services are a critical, often invisible part of the patient’s clinical pathway. They are involved at multiple stages of the patient pathway and cross community, primary, secondary and tertiary service boundaries.

Laboratory testing plays a critical role in clinical decision making providing clinicians with information that supports and expedites diagnosis and treatment. Laboratory tests also underpin disease screening for risk factors, determination of disease severity, recovery likelihood, therapeutic selection, monitoring and investigation of adverse outcomes. At the population health, level clinical laboratories are critical in the identification of hospital acquired infections, identifying antimicrobial resistance patterns, and in the control of infectious disease outbreaks and exposures to toxic substances.

It is generally accepted that approximately 70% of diagnoses rely on output from pathology, diagnostic imaging or laboratory services. Significant change will occur in the New Zealand public health system over the next ten years which will impact on the pathology and laboratory service sector. There is a dire need for policy-makers, managers and practitioners to balance quality of care with the cost of services. 

Earlier this year, the New Zealand institute of Medical Laboratory Science (NZIMLS) submitted a full and comprehensive review of the very real crisis facing the medical laboratory profession and workforce. The medical laboratory workforce has shrunk in the past 12 months by 5% in the single busiest and most disruptive period of our medical laboratory history. Workplace conditions, career progression and qualification recognition require urgent attention to address poor staff retention, Māori and Pacific recruitment require prioritising and incentivising to address longstanding cultural inequities.

In a similar manner, public radiology departments are under pressure from staff and space shortages but qualified practitioners keen to work in the sector are often finding the registration paperwork hurdles prohibitive, according to reports. In five out of the seven at-risk radiology departments identified by independent standards inspection body IANZ - most clustered around the central North Island - "insufficient personnel" was one of the problems flagged.

How then do we future proof our pathology and diagnostic imaging service sector for the challenges that lie ahead?