key: cord-0963655-pie7qe0q authors: Banatvala, Jangu title: COVID-19 testing delays and pathology services in the UK date: 2020-05-27 journal: Lancet DOI: 10.1016/s0140-6736(20)31037-0 sha: 67dbdfbc12a981f416475be4a81809fc445bdf3b doc_id: 963655 cord_uid: pie7qe0q nan 10 years of austerity have left the UK National Health Service inadequately resourced and ill prepared. During the reorganisation of pathology services, recommended by the 2008 Carter report, 2 many hospital laboratories have disappeared with the introduction of so-called hub and spoke models. This has been at the expense of what had previously been a high-quality service for diagnosis, surveillance, and epidemiology. Furthermore, there has been a failure to stockpile laboratory consumables and reagents, despite shortages during the 2009 H1N1 influenza pandemic. 3 What is particularly inexcusable is the shortage of swabs to take sam ples from patients and health-care workers during the current COVID-19 pandemic. Our reliance on China as a global supplier for such supplies has compromised the UK's COVID-19 response. Many manufacturers, sup pliers, and hospital services are inevitably finding it difficult to meet the demand for testing of both patients and staff. The centralisation of pathology services into a hub and spoke model has resulted in the hub being located at a site distant to some acute services. The reduction in the number of senior scientific staff to reduce costs has failed to increase enthusiasm for what should be an exciting and attractive career for both doctors and scientists. The geographical and intellectual separation of service and academic activities precludes an interactive approach to diagnosis, management, and research. In many medical schools, there has been a reduction in pathology teaching in the undergraduate curriculum, such that students are not interested in some of the major developments in medicine. The Royal College of Pathologists and the other pathological societies should be more vocal in recognising the importance of their disciplines. It is disappointing that other specialties that are dependent on pathology have not spoken up to express their views at a local or national level in the face of damaging reorganisation and cuts in pathology. In short, the disciplines that manage infections, microbiology, and virology, have been undervalued and underresourced for a long time. Only if things change will we be able to improve responses to new infections. I declare no competing interests. School of Medicine and Dentistry, Kings College London, London WC2R 2LS, UK Offline: COVID-19 and the NHS-"a national scandal Report of the review of NHS pathology services in England Flu onset exposed supply problems