Everyone understands the importance of greater automation within the laboratory. Meeting that need, however, requires managements to understand the role that leveraging finance plays in accessing critical technologies, argues Sally-Anne Whybrow.
The National Health Service is struggling to meet its targets for diagnostic waiting times. In January 2024, more than 1.5 million people were waiting for a diagnostic test with NHS England , an increase of 150% from a decade ago. Of this number, just over a quarter were waiting six weeks or more , far surpassing the NHS target of <1%.
The situation is exacerbated by the lack of specialist workers available to meet demand. According to the NHS’s Long Term Workforce Plan, the service could be faced with a shortfall of between 260,000 and 360,000 staff by 2036/37. The report further elaborates that this shortfall “is already impacting patient experience, service capacity and productivity, and constrains our ability to transform the way we look after our patients” [details below].
Similarly, in pathology, growing demand for services has outpaced the available workforce, resulting in only 3% of labs being sufficiently staffed to meet clinical demand. This can mean that services are unable to meet critical care targets. In fact, the stated goal of 85% of people receiving treatment within two months of an urgent referral was last met in 2015.
As the NHS works to address these critical blockages, the impetus is on private sector providers to invest and fill the gap.
There has already been a rise in the amount spent by English NHS trusts on private care, from £1.66 billion on care contracted out in 2019/20 to £3.12 billion by 2022/23. Patients themselves are also increasingly seeking private care. Across the UK, there has been a 30% increase in the number of people paying for hospital care since the pandemic.
When it comes to diagnostics, a study by The Patients Association found that 60% of surveyed patients would consider paying for tests privately if they faced long waits on the NHS [for details of the above, see footnote]. This means private services need to take their own measures to meet growing demand efficiently and effectively.
Must-have, not nice-to-have
Given the urgent need to improve efficiency in healthcare, automation is not simply a nice-to-have for labs; rather it is a vital tool to help the sector overcome the challenges described above.
The intelligent integration of automated robots in the laboratory can help speed up the testing process by automating time-consuming tasks – such as aliquoting (dividing solutions into equal parts), centrifugation (separating fluids of different densities or liquids from solids), or recapping tubes – thereby increasing test volumes, better utilising staff and reducing costs. Larger labs can benefit from complete automation systems which are vendor-neutral, for comprehensive pre- and post-analytical processing.
Pathologists and technicians that would previously have to spend a large amount of time manually preparing samples are then freed up to concentrate on more complex or strategic duties, tasks that require specialist knowledge, or simply verifying results produced by automated tools, i.e. quality control. Automation has the added benefit of standardising testing, enhancing result accuracy and reducing discrepancies.
For automation to be successful, it is important that laboratories take a holistic view to understand where processes could be streamlined and where digitalisation would make sense – rather than introducing automation for the sake of automation. However, even with this intelligent evaluation, cost remains a barrier to integrating automation more broadly into clinical practice.
Niche knowledge
To achieve optimal productivity and process improvement, a combination of investment and specialist knowledge is needed. Such a combination cannot usually be found in generalist financiers. Specialist financiers have an in-depth understanding of diagnostics equipment and technology as well as its applications, which allows them to expertly evaluate any associated risks. This means they are more inclined and able to offer financing packages tailored to the specific requirements of each individual laboratory, rather than standard terms that may be offered by a generalist provider.
There are a variety of financing solutions to help facilitate investment in new technology without the need for businesses to commit large sums of capital.
The stated goal of 85% of people receiving treatment within two months of an urgent referral was last met in 2015
Transition finance is an option that delays payment for a new system or solution until it has all been set up, trialled and tested. This means that the laboratory avoids paying for both the original and replacement technology at the same time. Specialist finance can also be deployed to offer protection against obsolete technology, with arrangements that offer the option to upgrade or add to the technology, either during or at the end of the financing period.
Managed Service Contract arrangements that guarantee an agreed level of equipment uptime are becoming increasingly popular, along with lease and pay-for-outcomes arrangements. Such financing solutions spread the cost of the technology over an agreed period, with payments arranged to align with the expected benefits of the technology, such as improved operational efficiency. These arrangements remove the need for an up-front investment, which improves cash flow and allows organisations to retain working capital. Additionally, businesses have the option to incorporate other costs such as installation, as well as introducing future technology upgrades affordably, in line with technology developments.
Automated technologies are essential to keeping pace with testing demand but represent a significant investment for labs that stretched healthcare budgets are unable to meet alone. Specialist financiers can help labs to overcome this challenge by spreading the cost of the technology and preserving cash flow, allowing laboratories to acquire state-of-the-art, productivity-boosting technology to meet ambitious testing goals.
Sally-Anne Whybrow is healthcare business development manager – Siemens Financial Services UK
References:
NHS England, Monthly Diagnostics Data 2023-24, January 2024
NHS Long Term Workforce Plan, June 2023 Lessons To Learn From The UK’S Pathology Challenges And Its Technology-Centric Strategy To Deliver Quality Diagnostic Services’, 11 January 2024 (Proscia.com)
How has the role of the private sector changed in UK health care? (Nuffield Trust)
Patients place huge importance on diagnostic services but face barriers to access – new report, 13 February 2024 (Patients Association)
Siemens Healthineers, Laboratory Automation
Munari, E., Scarpa, A., Cima, L. et al. Cuttingedge technology and automation in the pathology laboratory. Virchows Arch 484, 555–566 (2024) https://doi.org/10.1007/s00428-023-03637-z
