A 15 year contract worth around £900 million for pathology services across much of Essex has been awarded to a company that suffered a massive cyber attack in June this year, the consequences of which are still being felt today.
The German company Synlab has been given preferred provider status for the contract across Mid and South Essex, serving all GPs in the area, as well as the trust’s Southend, Basildon and Broomfield Hospitals. At present, Mid and South Essex NHS FT’s (MSEFT) pathology service is split between an in-house service in Mid Essex, and an existing joint partnership with Synlab called Pathology First in Basildon and Southend.
Synlab is one of the leading providers of pathology services within the NHS and already controls pathology across much of south and east London. The extent to which it is embedded in the NHS was highlighted by the effect recent cyber attack on its London-based joint venture with the NHS, Synnovis
Synnovis, a joint venture with Guy’s and St Thomas FT, and King’s College Hospital FT, was hit by a ransomware attack carried out by an organisation known as Qilin on 3 June 2024. As well as Guy’s and King’s, Synnovis’s 15 year contract worth around £2.25 billion provides pathology services to most of south east and central London, covering pathology services to South London and Maudsley FT, Oxleas FT, the Royal Brompton and Harefield FT, as well as GP practices in the area. The ransomware attack, therefore, caused major disruption to pathology systems and is considered to be the largest to date in terms of impact.
The attack led to the suspension of blood transfusions and large numbers of blood tests in primary care, plus many other planned procedures being cancelled. Major trauma cases had to be diverted from King’s College to elsewhere in London.
Putting the situation right has taken months of work and things are still not back to normal. On 22 August an NHS England update noted that so far 1,696 elective procedures and 10,083 acute outpatient appointments have been postponed at King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust since 3 June.
Testing services for GP practices in Bexley, Lewisham and Greenwich only returned to Synnovis on 15 August, and testing services for the remaining three south east London boroughs, Bromley, Lambeth and Southwark are planned to return to Synnovis over September.
The full restoration of blood transfusion services, however, has not yet taken place, but is planned for early autumn.
The attack was the second to hit Synlab in 2024, with its facilities in Italy targeted by hackers in April.
Synlab already has a joint venture with MSEFT known as Pathology First which covers Southend and Basildon. In 2023 Pathology First filed papers in the High Court claiming that neighbouring Hertfordshire and West Essex ICB had broken procurement rules over a £500m pathology contract. As a result, the rollout of a new integrated pathology service across Hertfordshire and West Essex ICB was delayed. A confidential settlement was reached in early 2024.
Outside of London/Essex, Synlab has a partnership with The Christie in Manchester. The Christie extended its contract with Synlab just three days before the cyber attack in London. But the extension is just for a year rather than the expected new contract to last until 2040. A new procurement process is due at the end of the year.
In Somerset, Southwest Pathology Services is a joint venture between Taunton and Somerset NHS Foundation Trust, Yeovil District Hospital NHS Foundation Trust and Synlab (as Integrated Pathology Partnerships). The joint venture was established in June 2012, serving a population of 500,000 and over 100 GP practices.
Synlab has done well out of the push to move to the hub-and-spoke model of pathology services. A model that has been encouraged since the mid-2000s and involves a reduction in the number of hospitals that have their own pathology services. Hospital trusts would instead share services with neighbouring trusts and could also partner with private companies.
In September 2017, NHS Improvement reiterated the development of the hub and spoke model and outlined plans to create 29 pathology networks across England in a bid to save £200 million by 2021. The NHSI plan calls for 105 individual hospital pathology services to be linked together through the hubs, to create networks which will each serve populations of between 1.5 million and 2 million. An update on how the plan is going was published in 2019, but there is no new information available from NHS England as to how these are all developing.
In February 2023 the merger of pathology into one large laboratory at four trusts in Lancashire and South Cumbria as a ‘hub and spoke’ model was abandoned due to delays in receiving £31m of capital that was allocated to the scheme in 2018 by the DHSC. For four years the trusts had worked on the plan, but work was “paused” in 2022 due to uncertainties around the capital funding. Mark Hindle, who was managing director for the project until retiring, told HSJ the plans for a central hub have effectively now been scrapped, as the system could not continue deploying resources to the project without certainty over the funding. He added: “It’s such a waste of public money to have gone five years down this line and then just have to stop. What kind of way is that to run a health service?”
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