X

Contact Us

Request a Consult

Thank you! Your submission has been received!
Close Window
Oops! Something went wrong while submitting the form.
Friday, September 19, 2025

Why Diagnostic Resilience Must Go Beyond Locum Contracts

Friday, September 19, 2025
Share This Article
Written by
Prof. Runjan Chetty
Chief Medical Officer at Diagnexia

The end of the locum safety net

For decades, NHS pathology departments have relied on locum pathologists to plug service gaps. At first, the model worked. The pool of highly qualified locums was large enough to cover shortfalls, and departments could lean on temporary contracts as a quick fix.

But today, that safety net has worn thin. The number of available locums has plummeted, while demand for pathology services has soared, particularly in subspecialist areas such as paediatric, ophthalmic, and perinatal pathology.

The scale of the problem is stark:

  • 97% of NHS histopathology departments report insufficient staff to meet clinical demand (RCPath, 2018).
  • Most departments rely on outsourcing, locums, or overtime just to keep services afloat.
  • Post-COVID backlogs remain severe, with pathology among the top bottlenecks for cancer and elective care recovery (UK Parliament PAC, 2023).

Behind these statistics are patients waiting longer for vital answers, sometimes weeks for a cancer diagnosis and clinical teams forced into unsustainable overtime just to keep services moving. What was once a stop-gap is now a critical vulnerability. Locum contracts are harder to fill, more expensive, and less efficient. NHS departments need more than short-term fixes: they need a sustainable way to secure diagnostic resilience.

A system ready for digital transformation

The timing has never been better. Over the last five years, NHS pathology has undergone a quiet but significant shift.

  • Many Trusts have invested in whole-slide scanners.
  • Laboratory Information Systems (LIS) are being upgraded for digital workflows.
  • The COVID-19 pandemic accelerated the adoption of remote MDTs and virtual collaboration.

Concerns about digital equivalence have also been resolved. Large-scale validation studies confirm that whole-slide imaging (WSI) matches the diagnostic quality of glass slides and in many cases, offers faster turnaround and better subspecialist access.

Every day saved in reporting time can mean faster treatment decisions, earlier interventions, and less anxiety for patients. Digital pathology isn’t just about efficiency, it’s about giving clinicians the timely information they need to save lives.

The foundation for a more resilient, modern service model is already in place. The question is how to scale it.

Why Diagnexia offers a better model than locums

At Diagnexia, we’ve built a network of GMC-registered, subspecialist pathologists working on our proprietary, AI-enhanced digital pathology platform. Unlike the locum model, we don’t require onboarding delays, physical desk space, or IT setup. Instead, we integrate directly into your existing workflow, whether through local scanners and LIS systems, or via digitisation at our scanning centres in Oxford and Exeter.

The result is a seamless, virtual extension of your diagnostic team, offering:

  • Instant, scalable capacity to cover both planned and unplanned shortages
  • Deep subspecialist expertise across ophthalmic, soft tissue, paediatric, and perinatal pathology
  • Rapid second opinions, returned within hours or a few working days
  • AI-powered safety checks, improving diagnostic confidence and consistency
  • Remote MDT participation, aligning with today’s hybrid care models

A complex sarcoma or paediatric case shouldn’t wait for the right expertise to be found. With Diagnexia, subspecialist knowledge is always within reach, ensuring patients receive accurate diagnoses and care plans without delay. This isn’t a temporary patch. It’s a long-term, integrated service that makes diagnostic resilience achievable.

Beyond objections: the cut-up challenge

One frequent objection to remote pathology is the issue of specimen dissection (cut-up). Historically, this required onsite pathologist presence. But the reality is evolving:

  • Many NHS Trusts are training Biomedical Scientists to perform cut-up.
  • Departments are reallocating time and resources to balance routine casework with dissection needs.
  • Hybrid models combine onsite lab presence with offsite reporting, maintaining both efficiency and quality.

Far from being a limitation, this evolution frees pathologists to focus more time on what matters most: expert diagnosis and patient care. Diagnexia supports local strategies to ensure this step of the workflow is fully covered.

Why the locum model no longer works

Let’s be clear: reliance on locum contracts introduces systemic risks that NHS departments can no longer ignore. Locums create:

  • Onboarding delays before reporting can begin
  • IT and workspace overheads
  • Training requirements for every new contract
  • Variable productivity tied to contract terms
  • Administrative burden managing agencies and contracts

Meanwhile, departments still face rising costs, scarce availability, and increasing turnaround pressure. It’s not just inefficient, it’s unsustainable.

By contrast, Diagnexia provides always-on, specialist capacity at a fixed, predictable cost, without the administrative complexity.

Building diagnostic resilience for the future

Pathology is not just a laboratory function, it is the foundation of cancer and elective care. When diagnostic reporting stalls, entire patient pathways stall. Locum contracts may once have bridged the gap, but today they put both patient timelines and clinician wellbeing at risk.

With Diagnexia, NHS departments gain:

  • Immediate access to expert reporting without staffing delays
  • Subspecialist coverage on demand
  • Seamless LIS integration for efficient reporting
  • Predictable costs and reduced administrative load
  • A partner committed to clinical quality and resilience

This is about more than contingency planning. It’s about embedding resilience at the heart of diagnostics, so departments can keep pace with national targets, safeguard patient outcomes, and future-proof against workforce shortages.

Time to move beyond short-term fixes

Every week lost to contract negotiations, onboarding, or delays adds to the backlog of patients waiting for answers. Locum contracts cannot deliver the resilience the NHS needs.

With Diagnexia, you can secure expert reporting, subspecialist access, and digital resilience, without the inefficiencies of temporary staffing.

Speak to our team today and take the first step toward building a sustainable, resilient diagnostic service.

Continue reading...

To continue reading this article, please complete the form below.

Diagnexia is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please tick below to say how you would like us to contact you:

You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.By clicking submit below, you consent to allow Diagnexia to store and process the personal information submitted above to provide you the content requested. Read our privacy policy here.

Thank you! Your article will be revealed in a matter of seconds
Oops! Something went wrong while submitting the form.
  • rrr

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.

This is some text inside of a div block.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Continue reading...

To continue reading this article, please complete the form below.

Thank You!

Thank you for sharing your details. Please click the button below to reveal the rest of the article.
show article

The end of the locum safety net

For decades, NHS pathology departments have relied on locum pathologists to plug service gaps. At first, the model worked. The pool of highly qualified locums was large enough to cover shortfalls, and departments could lean on temporary contracts as a quick fix.

But today, that safety net has worn thin. The number of available locums has plummeted, while demand for pathology services has soared, particularly in subspecialist areas such as paediatric, ophthalmic, and perinatal pathology.

The scale of the problem is stark:

  • 97% of NHS histopathology departments report insufficient staff to meet clinical demand (RCPath, 2018).
  • Most departments rely on outsourcing, locums, or overtime just to keep services afloat.
  • Post-COVID backlogs remain severe, with pathology among the top bottlenecks for cancer and elective care recovery (UK Parliament PAC, 2023).

Behind these statistics are patients waiting longer for vital answers, sometimes weeks for a cancer diagnosis and clinical teams forced into unsustainable overtime just to keep services moving. What was once a stop-gap is now a critical vulnerability. Locum contracts are harder to fill, more expensive, and less efficient. NHS departments need more than short-term fixes: they need a sustainable way to secure diagnostic resilience.

A system ready for digital transformation

The timing has never been better. Over the last five years, NHS pathology has undergone a quiet but significant shift.

  • Many Trusts have invested in whole-slide scanners.
  • Laboratory Information Systems (LIS) are being upgraded for digital workflows.
  • The COVID-19 pandemic accelerated the adoption of remote MDTs and virtual collaboration.

Concerns about digital equivalence have also been resolved. Large-scale validation studies confirm that whole-slide imaging (WSI) matches the diagnostic quality of glass slides and in many cases, offers faster turnaround and better subspecialist access.

Every day saved in reporting time can mean faster treatment decisions, earlier interventions, and less anxiety for patients. Digital pathology isn’t just about efficiency, it’s about giving clinicians the timely information they need to save lives.

The foundation for a more resilient, modern service model is already in place. The question is how to scale it.

Why Diagnexia offers a better model than locums

At Diagnexia, we’ve built a network of GMC-registered, subspecialist pathologists working on our proprietary, AI-enhanced digital pathology platform. Unlike the locum model, we don’t require onboarding delays, physical desk space, or IT setup. Instead, we integrate directly into your existing workflow, whether through local scanners and LIS systems, or via digitisation at our scanning centres in Oxford and Exeter.

The result is a seamless, virtual extension of your diagnostic team, offering:

  • Instant, scalable capacity to cover both planned and unplanned shortages
  • Deep subspecialist expertise across ophthalmic, soft tissue, paediatric, and perinatal pathology
  • Rapid second opinions, returned within hours or a few working days
  • AI-powered safety checks, improving diagnostic confidence and consistency
  • Remote MDT participation, aligning with today’s hybrid care models

A complex sarcoma or paediatric case shouldn’t wait for the right expertise to be found. With Diagnexia, subspecialist knowledge is always within reach, ensuring patients receive accurate diagnoses and care plans without delay. This isn’t a temporary patch. It’s a long-term, integrated service that makes diagnostic resilience achievable.

Beyond objections: the cut-up challenge

One frequent objection to remote pathology is the issue of specimen dissection (cut-up). Historically, this required onsite pathologist presence. But the reality is evolving:

  • Many NHS Trusts are training Biomedical Scientists to perform cut-up.
  • Departments are reallocating time and resources to balance routine casework with dissection needs.
  • Hybrid models combine onsite lab presence with offsite reporting, maintaining both efficiency and quality.

Far from being a limitation, this evolution frees pathologists to focus more time on what matters most: expert diagnosis and patient care. Diagnexia supports local strategies to ensure this step of the workflow is fully covered.

Why the locum model no longer works

Let’s be clear: reliance on locum contracts introduces systemic risks that NHS departments can no longer ignore. Locums create:

  • Onboarding delays before reporting can begin
  • IT and workspace overheads
  • Training requirements for every new contract
  • Variable productivity tied to contract terms
  • Administrative burden managing agencies and contracts

Meanwhile, departments still face rising costs, scarce availability, and increasing turnaround pressure. It’s not just inefficient, it’s unsustainable.

By contrast, Diagnexia provides always-on, specialist capacity at a fixed, predictable cost, without the administrative complexity.

Building diagnostic resilience for the future

Pathology is not just a laboratory function, it is the foundation of cancer and elective care. When diagnostic reporting stalls, entire patient pathways stall. Locum contracts may once have bridged the gap, but today they put both patient timelines and clinician wellbeing at risk.

With Diagnexia, NHS departments gain:

  • Immediate access to expert reporting without staffing delays
  • Subspecialist coverage on demand
  • Seamless LIS integration for efficient reporting
  • Predictable costs and reduced administrative load
  • A partner committed to clinical quality and resilience

This is about more than contingency planning. It’s about embedding resilience at the heart of diagnostics, so departments can keep pace with national targets, safeguard patient outcomes, and future-proof against workforce shortages.

Time to move beyond short-term fixes

Every week lost to contract negotiations, onboarding, or delays adds to the backlog of patients waiting for answers. Locum contracts cannot deliver the resilience the NHS needs.

With Diagnexia, you can secure expert reporting, subspecialist access, and digital resilience, without the inefficiencies of temporary staffing.

Speak to our team today and take the first step toward building a sustainable, resilient diagnostic service.

Play Audio
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. View our Privacy Policy for more information.