ORIGINAL ARTICLE

Proactive management of histopathology workloads: analysis of the UK Royal College of Pathologists’ recommendations on specimens of limited or no clinical value on the workload of a teaching hospital gastrointestinal pathology service

S S Cross¹, J L Stone²

¹ Academic Unit of Pathology, Section of Oncology and Pathology, Division of Genomic Medicine, School of Medicine and Biomedical Science, University of Sheffield, South Yorkshire S10 2RX, UK
² Department of Histopathology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Glossop Road, Sheffield S10 2UL, UK

Correspondence to:
Correspondence to:
Dr S S Cross, Academic Unit of Pathology, Section of Oncology and Pathology, Division of Genomic Medicine, School of Medicine and Biomedical Science, University of Sheffield, Beech Hill Road, South Yorkshire S10 2RX, UK;
s.s.cross{at}sheffield.ac.uk

Aims: To investigate the effect on the workload of a gastrointestinal pathology service of implementing the recommendations of the Royal College of Pathologists’ (RCPath) working party on specimens of limited or no clinical value (LONCV).

Methods: All endoscopic gastrointestinal pathology reports for the first three months of 2001 at a large teaching hospital were reviewed against the RCPath recommendations. Specimens in the category of LONCV were recorded and the final histopathology diagnosis noted.

Results: The biopsies in the LONCV category were 30% of oesophageal, 61% of gastric, 0.5% of duodenal, and 7% of colorectal origin.

Conclusions: Implementing the RCPath recommendations would reduce the number of requests for the examination of gastrointestinal endoscopic specimens by 3500 specimens each year in this department. None of the specimens in the LONCV category showed an abnormality that could not have been detected by a more efficient and less invasive method. In the UK, where there is a severe shortage of trained histopathologists, the implementation of these recommendations would ensure that these scarce resources are not misused.

Keywords: workload; diagnostic histopathology; clinical value; evidence based medicine

Abbreviations: LONCV, specimens of limited or no clinical value; RCPath, Royal College of Pathologists

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