Dear Royal Surrey County Hospital NHS Foundation Trust,

NHS Improvement wrote to the chief executives of all non-specialist acute trusts in England on or around 7th September 2017 in relation to their proposal for pathology hubs and spokes, which divided English NHS hospitals into 29 groups. Chief executives were required to reply by September 30th 2017, either agreeing to commit resources to forming a pathology hub and spoke with the other trusts defined for them by NHS improvement, or to submit an alternative proposal. In relation to this, please answer the following questions:

a. Has the chief executive of your trust written to confirm their acceptance of the proposal from NHS Improvement

b. If the answer to a) is ‘no’, do they plan to and if so by when?

c. If the answer to a) is ‘no’, has the trust submitted an alternative proposal

d. Are the trust considering (either in alignment with the NHS Improvement proposal, or as an alternative) any solutions which would involve partnerships with or outsourcing (we are excluding the sending of low volume specialist tests to these companies from the definition of outsourcing) to private sector laboratory companies (defined as companies which manage laboratories such as TDL, Sonic, HSL, synlab, Labco, Viapath, and not companies which provide equipment such as Siemens, Abbott laboratories, or Roche)

e. Have the trust, either individually, or collectively with the other trusts in its group, ruled out any form of partnership or outsourcing the management of their laboratories as defined above, for the foreseeable future.

Yours faithfully,

J Graham