• Project led by NHS Stoke on Trent.
  • Involved 55 general practices across the primary care trust.
  • Aimed to reduce variation in requesting patterns for pathology tests in primary care.
  • Used online educational tools, face to face training and a local enhanced services agreement to help general practices to achieve greater consistency in the requesting of specific tests, along with reduced levels of inappropriate testing.

The NHS Stoke on Trent team set out to reduce variation in requesting patterns for pathology tests in primary care, with a focus on patients with cardiovascular disease, chronic kidney disease, diabetes and thyroid disease. The project aimed to use education, innovation and collaboration to achieve:

  • greater consistency and standardisation in the requesting of specific tests
  • less inappropriate testing and more use of cheaper alternatives where appropriate
  • enhanced standards of clinical practice
  • improvements in patient experience and reductions in clinical risk
  • more effective and efficient use of resources within general practice and pathology laboratories.

The project team developed:

  • a range of e-learning tools, including podcasts and PowerPoint presentations, to support practitioners to review and apply guidance
  • workshops and masterclasses to engage practice teams in a more personal and targeted way
  • best practice guidance and post-training feedback for practices
  • a local enhanced services (LES) agreement which enabled practices to nominate a clinical champion to lead on effective pathology testing, including developing action plans.

Who was involved

A total of 55 general practices took part in the project, with 28 practices signing up to the LES agreement.


The findings showed that each practice could save £1,430 per month by reducing unnecessary testing, with  predicted annual savings of around £17,000. Practices who attended the educational workshops tended to achieve greater cost savings than those that did not attend.

Feedback suggested that most patients would accept reduced testing frequency provided it was clearly explained by clinicians.

Further reading

Learning report

Shine: Improving the value of local healthcare services

February 2014
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