The National Pathology Imaging Cooperative (NPIC) is delivering a nationally coordinated digital pathology infrastructure to support both clinical service transformation and data-driven research across the NHS. This talk will describe NPIC’s end-to-end digital pathology ecosystem, from large-scale slide digitisation and image management to secure data access, analysis, and governance at national scale.

The presentation will outline how NPIC’s infrastructure supports high-throughput clinical workflows while simultaneously enabling advanced research use cases, including artificial intelligence development, validation, and translational deployment. The talk will also highlight the NPIC AI FORGE, a unique multi-scanner digital pathology testbed designed to support robust, reproducible evaluation of AI tools across heterogeneous imaging platforms and real-world NHS data.

The talk will also highlight how NPIC integrates with broader national initiatives, including secure data environments to enable responsible data access while maintaining patient confidentiality and public trust.

Through practical examples, this session will demonstrate how NPIC is enabling translational research at scale.

Digital pathology (DP) is transforming histopathology by facilitating improved workflow efficiencies, flexibility in working, and facilitating the integration of artificial intelligence (AI) devices. However, successful implementation requires evidence to ensure patient safety is maintained in light of new technologies.

Clinical implementation requires a systematic risk assessment of the ‘new’ technology and its integration into the diagnostic pathway. Established NHS clinical safety standards help support hazard identification and risk evaluation, identify mitigation strategies, and recognise the importance of ongoing incident management to minimise the potential for patient harm.

Quality assurance extends beyond digital systems to encompass the entire laboratory workflow. Variability in tissue preparation, staining, scanner performance, and display technologies can affect digital image quality and diagnostic consistency, especially when considering AI. Emerging quality-control tools, including objective stain assessment and scanner calibration technologies, offer opportunities to improve standardisation and support reproducible practice.

The successful implementation of digital pathology and AI relies on embedding quality assurance, clinical safety, governance, and validation processes throughout the digital diagnostic pathway, ensuring innovation is delivered without compromising patient care.

With elbow grease, blood, sweat and tears, or perhaps just hard work, perseverance and good fortune, digital pathology was implemented in the 4 pathology laboratories in Northern Ireland between 2020/2021. This created a virtual laboratory network and saw N. Ireland become an early adopter of digital pathology in the UK, as well as one of the first regions to adopt PACS-based reporting and workflows. This is the story of the implementation journey, and will include some reflections of the entire process from a battle-hardened project team member. Along the way you will hear what pathologists in N. Ireland think of digital pathology, and get a few opinions on making the case for digital pathology in financially challenged healthcare systems - all in less than 30 minutes (somehow).