The National Pathology Exchange (NPEx) is a robust digital solution that has transformed laboratory medicine across the UK and further afield. Digitising the request and referral process mirrors the high level of technology used in labs and offers something unique and integral for the future-proofing and efficiency of diagnostic healthcare. With over 80% of patient pathways relying on laboratory medicine services for a diagnosis, we understand the importance of cost-effectiveness, efficiency and productivity while prioritising patient safety. From speeding up result turnarounds; reducing administration; and accommodating a range of disciplines; to enabling national-level strategic initiatives, NPEx strives to improve care. The system was originally designed to assist the UK NHS’s labs to send and receive pathology results locally and nationally. Since its formative days, NPEx is successfully working at scale across the UK and has grown to accommodate testing outside the NHS network both internationally and privately. The LIMS interoperability enabled by NPEx has ensured hospitals, trusts and national services have benefited from the solution. It is unlike any other lab-to-lab system in the work due to its scale and success and continues to grow year on year, adding more features to improve testing practice, simplify the jobs of testers and tackle the challenges facing laboratory medicine head-on. NPEx is operated by X-Lab Ltd and the NHS’s The Health Informatics Service (THIS). This long standing commercial partnership has enabled the successful growth of NPEx and ensured that NPEx can continue to serve its users and the needs of their labs.