Edition 13 - August 2010 - Keele University · Edition 13 - August 2010 Contents Pathology User Group ... Front cover illustration (“Oh No”) ... We did experience a couple of

Edition 13 - August 2010

ContentsPathology User Group MeetingPCT Project updateEvents – SBK Healthcare, Focus, Immunology Managers MeetingDispelling a MythCrystal Ball: Pathology Benchmarking in the FuturePathManager Case Study - Clinisys

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Regular Features

From the editor

Spotlight on...

Dates for your diary

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PATHOLOGY BENCHMARKING NEWS

From the EditorWelcome to the latest edition of Pathology Benchmarking News. I am writing this right in the middle of the World Cup, having seen England just progress to the knockout phases following a nervy last group match against Slovenia. Whilst it is easy to get distracted from daily life by the football... or Wimbledon, or the cricket, or one of the many sporting events taking place this summer for that matter, some things are impossible to avoid. George Osborne also announced his emergency budget earlier this week, which amongst other things came as a reminder that the economic situation is still in the balance, and it seems that Pathology really does need to save that £500m. Unfortunately, it is not like it has sometimes been in the past... you know, where we can ignore it for a bit until it goes away. No, this time it is real, and there have been meetings, letters to SHAs and Trusts, conferences and events which have all confirmed it. So, what do we do about it? Many departments have already ‘leaned’ themselves down to the Pathology equivalent of size zero, and most are already vastly overworked and so the idea of cutting further staff from the roster feels like suicide. Well, the SBK Healthcare events earlier this month helped give people the opportunity to discuss some

of the alternative options, which included things like re-profiling the workforce, joining forces to find better economies of scale, and managing workload so that the tests being done are appropriate. The latter is the one I personally find the most interesting at this moment in time, as it fits in with what we are hoping to achieve in both our PCT project and the INTERCEPT study, looking at managing the requesting of HbA1c tests for the treatment of diabetes. It is an area I believe Keele can make a huge difference in, and I do not think it will be long before the PCT project finally gets the chance to open its wings and take flight. The systems are almost ready, the outputs are ready to be discussed, and people are taking an interest in the work we are doing. So it is an exciting time, albeit a challenging and difficult one, and one where we all need to ensure we are proactively helping make the change, not have the changes made to us. I hope you enjoy reading this edition of Pathology Benchmarking news, and look forward to writing the next one.

David Holland Operations Lead, National Pathology Benchmarking Service,

Keele University

Front cover illustration (“Oh No”) by David Holland

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Participant User Group Meeting for 2009-2010 BenchmarkingAs you are aware, our user group meeting for the 2009-2010 benchmarking cycle will be hosted as one pathology-wide event. It will, again, be held in Birmingham and the date is Friday 14th January 2011.

With the date fixed, it was down to myself and Dave to find an appropriate venue that had the capacity to host a larger, multi-disciplinary meeting. After going through the University’s conference provider, we had a choice of three venues – obviously, one could not be chosen without a trip to Birmingham to view each one! So, on a dreary Friday at the end of April we hopped on a train and went on our site visits. Keeping our fingers crossed that the weather held... we were walking between each venue... we had done venues 1 and 2 by lunchtime and without getting wet I hasten to add!

After having lunch, we went on to find venue 3... which, according to our map, was not far away from the Children’s Hospital. After walking down Corporation Street for a short while... by which time the heavens had decided to open and it was raining lightly... and getting ever closer to the Children’s Hospital... Dave asks ‘What is the name of the venue we are looking for?’ I informed him that it is called ‘Maple House’, and he amusingly tells me that he had already seen a building with that name... we had only walked straight past it! Finally arriving

at venue 3, we were both immediately impressed and had a good feeling about it. Our visit over, all that was left to do was to get back to the station for our journey home – sounds easy... but oh no... the heavens had really opened now and it was pouring down with rain! With only lightweight jackets on and no umbrella, we made a dash for the station and arrived there like a pair of drowned rats for our journey home.

Back at work on the Monday, we evaluated each venue and finally came to a decision. The user group meeting for the 2009-2010 benchmarking cycle will be held at Maple House on Corporation Street in Birmingham. So, although we got caught in the rain, our visit was successful!

We look forward to seeing our participants at the meeting in January.

Written by Gill Trigg, Project Administrator, National Pathology Benchmarking Service, Keele University

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Dispelling a MythSo here is the myth: that men do not ‘do’ visits to the doctors. And in terms of relevance to us, particularly relating to HbA1c testing for the treatment of diabetes, the following question arose from a meeting we had at our INTERCEPT study steering group meeting: “Is under-testing of HbA1c more prominent in men or women?”

Well, not ones to disappoint, we had a play with our data and have produced an answer... though admittedly, not really a definitive one! The quick and simple answer is: “Yes, under-testing of HbA1c for the treatment of diabetes, using national guidance as an indicator, is more prominent in males than it is in females”.

But the variation between them is not as pronounced as you might have thought. As you will see from

the chart, around 52% of under-tests are on male patients, and you can see for yourself the trend over the past 7 years. So whilst we have partially proved the myth, the situation is not perhaps as ‘bad’ as our steering group feared it might be!

PCT Project UpdateThe first discussions with Les Martin and Jane Pattinson at Cumbria and Lancashire Pathology Network have taken place, and we are pleased with the data that have come through the system. We did experience a couple of technical issues in extracting the data, but these now appear to have been overcome, and the mapping has continued at a cracking pace since then. The first outputs are now ready for formal presentation and we are very nearly ready to show the results of this pilot to the rest of the world. The PCT project will hopefully soon be available for use as a tool for PCTs, commissioners, GPs and Pathology departments to help manage their workload and ensure that the tests they are doing are appropriate.

If you would like further information about the project, please visit the website at www.ychi.leeds.ac.uk/benchmarking/

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CUSTOMERS & PARTNERS

Pennine Acute trust imProves PAthology PerformAnce“clinisys Pathmanager with sAP Businessobjects Xi enables Pennine Acute trust Pathology Directorate to respond rapidly to changing demands for information resources across the nhs.” gary Walton, Pathology it systems & Project manager, Pennine Acute Pathology Directorate

Industrynhs

Business PlanTo respond to growing demands for information across the NHS, including detailed analysis to support continual improvements to the Pathology service.

Why PathManagerThe ability to provide rapid access to information within the Laboratory Information System is enabling the Pathology Directorate to provide scheduled and ad hoc reporting to stakeholders across the NHS.

SAP BusinessObjects Products & Services sAP Businessobjects Xi

Partner clinisys

CHALLENGEBusiness Focused NHS Pennine Acute Pathology Directorate provides comprehensive pathology services to a population of over 800,000, four hospitals and over 180 gP practices. the laboratory services comprise one ‘central laboratory’ at the Royal Oldham Hospital and three essential services laboratories at Fairfield General Hospital, North Manchester General Hospital and Rochdale Infirmary. in recent years Pennine Acute hospitals nhs trust has invested over £17 million in state of the art pathology laboratory services to ensure the safe, fast and effective processing of samples and subsequent reporting in haematology and blood transfusion, clinical biochemistry, microbiology and cellular pathology.gary Walton, Pathology it systems & Project manager, Pennine Acute Pathology Directorate, explains, “the nature of the nhs has changed, it is now very much more business focused. in order to plan and manage the business, operations, investments and staff and to meet the demands of the client base, the nhs needs to analyse activity in every conceivable manner.”he continues, “this fundamental change, combined with an increasing demand for our pathology services, highlighted the need for greater reporting abilities.”

APPROACHEnhance Reporting having already implemented the clinisys labcentre laboratory information system to improve the efficiency and accuracy of sample processing, after review, Pennine Acute decided to extend the solution with the tailored Pathmanager data warehouse and reporting system, developed using sAP Businessobjects Xi™. “the clinisys Pathmanager Data Warehouse is providing rapid access to information not previously readily accessible,” explains gary. “the functionality of Pathmanager enables scheduled reports to be automatically sent to recipients; provides the functionality to drill down to detailed levels of summary reports; and delivers much easier access to copious amounts of activity information required to refine Pennine Acute’s pathology services as the need arises.”staff across pathology have been trained to develop their own reports, creating a dynamic environment that can respond to the changing demands placed on the department. Gary Walton continues, “Each Pathology discipline has specific requirements, with an IT Lead Technical manager in charge of extracting and presenting data to match those needs. each discipline extracts its own reports using the Pathmanager universe to support invoicing, reporting activity or provide activity summaries for the Pathology Dashboard.”

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RESULTS

Transforming Service Delivery Pathmanager is providing Pennine Acute with the enhanced reporting features and functionality required to meet the fast growing demands for information from across the nhs – from the Department of health (Doh), to strategic health Authority (shA) and Primary care trust (Pct) to local clinics and gP services.

the Pathology Directorate processes 15 million tests per annum, ranging from simple blood tests to complex microbiology and cellular pathology. speed of information provision is key, especially in areas such as cancer diagnosis where a clear care pathway has been created by the Pct to ensure patients begin treatment within a tight timeframe.

The adoption of PathManager has enabled Pennine Acute to significantly reduce its workload. Gary Walton says, “the ability to set up standard reports at scheduled intervals and to automatically send these reports to the specified recipients has been invaluable.”

And whilst it is difficult to quantify the return on investment, Gary maintains, “The achievements made are of such a magnitude that management have no doubt that the system will pay for itself over and again. This is not only in time savings, but in hard cash terms such as cash flow and income preservation. there is also the constant redevelopment of services based upon the detailed activity summaries to reflect the needs and requirements of our clients.”

The benefits of the adoption include:

Improved cash flow: supporting documentation for invoicing is easier and faster to generate which has enabled the Pathology Directorate to move from a quarterly to monthly invoice generation process, significantly improving cash flow.

Greater Efficiency: Automated scheduling of standard periodic reports about activity across each pathology discipline ensures senior staff are now far more efficient. Rapid response is ensuring that key targets for care provision are met, examples include the provision of information to the cancer networks to ensure care protocols are urgently initiated; providing key information for the Department of health on important infections such as mrsA and swine flu; and the monitoring of turnaround times for laboratory tests required in A&e to ensure emergency access targets are met.

On demand information: the development of ad hoc reports is completed in a timely manner and in a format to meet the needs of each pathology discipline. for example, workload analysis aids decision making regarding outsourcing tests or setting up a third party contract.

Strategic Drive: the Pathology Directorate now has a basis upon which the Pathology Services can be redefined to reflect the changing needs of its service users. Furthermore, analysis of demand patterns is enabling the Directorate to redesign staff shifts in order to maximise efficiency and improve response times.

Statutory Reporting: Pennine Acute has significantly reduced the overhead associated with statutory reporting by using sAP Businessobjects Xi to automatically schedule and run reports.

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Spotlight on....This section is open to panel members and participants to volunteer information about themselves. This edition features Stephen Snewin and John Smith (overleaf):-

Divisional Manager for Division of Clinical Biochemistry and Investigative Medicine which is part of Imperial College Healthcare, the countries first Academic Healthcare Centre. Stephen was formally Head Biomedical Scientist and Laboratory Manager in Chemical Pathology and Immunology at St. Mary’s Hospital Paddington.

He has always had special interests in automation, process management and method development. The department offer Beta site testing facilities to a

number of instrument manufacturers.

He has had a long term interest in training both internally and externally and has been involved in a number of initiatives with the local Workforce Development Council and Pathology Modernisation.

Long suffering supporter of West Ham United and Essex Cricket Club which may explain a lot!

Stephen John Snewin

Clinical Biochemistry and Investigative MedicineImperial College Healthcare NHS Trust

London

ABOUT CliniSys

the clinisys group has been successfully developing and delivering laboratory it systems for over 20 years. The company is an SAP BusinessObjects partner with offices across the UK and Europe.

www.clinisys.co.uk © 2007 Business objects. All rights reserved. Part # Ws000-X

Written by Matthew Fouracre, Clinisys

Looking for an opportunity to showcase your pathology-related business in the newsletter? Please contact Gill Trigg on [email protected]

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Spotlight on....

I was born and educated in Wiltshire, where I acquired a lifelong passion for flyfishing (of which more later), and proceeded to the Middlesex Hospital Medical School, London where I was first inspired to pursue a career in pathology. So after qualification and house jobs I started training in pathology, and cellular pathology in particular, at St Bartholomew’s Hospital. Three thoroughly enjoyable years later, with Part 1 MRCPath under my belt and after a brief excursion into comparative animal histopathology and toxicology, I was appointed Senior Registrar in Bristol based at Southmead Hospital with rotation to the Bristol Royal Infirmary, Frenchay Hospital and Bristol Children’s Hospital. At Southmead I developed a particular interest in cervical cytology and, having obtained the MRCPath, I was appointed Consultant Histopathologist & Cytopathologist at the Northern General Hospital, Sheffield in 19�7, with a remit to develop the cervical screening and gynaecological histopathology services, the latter to establish Sheffield as one of the emerging gynaecological cancer centres under the Calman-Hine Reforms. In 2001 the cervical cytology service relocated with the obstetrics and gynaecology clinical services for Sheffield to the Royal Hallamshire Hospital.

In 1990 I founded the Sheffield Cytology Training Centre (SCTC) to support the increasing demand for comprehensive training of cytology laboratory staff following the re-organisation of the NHS Cervical Screening Programme (NHSCSP) in 19��. SCTC recently amalgamated with a similar facility in Leeds to become the East Pennine Cytology Training

Centre, which is principally responsible for training laboratory and clinical staff working in the NHSCSP, but also facilitates training for staff working in the other Cancer Screening Programmes. We also have a growing international portfolio of training activity.

My cytology training activities have led to national recognition and I have served at various times on working parties and advisory committees of the General Medical Council, RCPath, BSCC, Clinical Pathology Accreditation (UK) Ltd and the NHSCSP. I am currently President of the British Society for Clinical Cytology; Chair of the RCPath Cytopathology Sub-Committee; and the immediate past Chairman of the RCPath Panel of Examiners in Cytology.

Throughout my career my research has been clinically directed including audit of cellular pathology laboratory practice and methodology i.e., cytological-histological correlation in cervical screening, specimen fixation, applicability of terminology in cervical smear reporting, and more recently application of human papilloma virus and other molecular marker testing in cervical screening and automation in cervical screening. This is the reason for my enthusiasm to be involved in NPBS.

Outside work and my family I am a fanatical fly fisherman and have fished on every continent for both fresh and saltwater species. I am Secretary of the Cressbrook & Litton Flyfishers Club in Derbyshire; an elected member of the Flyfishers’ Club, London; and an active member of the Salmon & Trout Association and the Wild Trout Trust.

John H F Smith

Consultant Histopathologist & Cytopathologist, Royal Hallamshire Hospital, Sheffield Director,

East Pennine Cytology Training Centre Director, South Yorkshire & Bassetlaw Cervical

Cytology Service

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EventsfeedbackSBK Healthcare: Achieving Cutting Edge Point of Care Testing, Jurys Inn, Birmingham, Wednesday 2�th April 2010

The Siemens sponsored SBK Healthcare event held in April, entitled “Achieving Cutting Edge Point of Care Testing”, marked a change in focus towards a more practical/workshop feel to the day. Whilst the events are always informative and enjoyable, this particular event proved to be a refreshing change from the norm, and as a result prompted a huge amount of audience participation and involvement.

The event began with an introduction from Dr Joan Pearson, the Clinical Lead for Point of Care Testing at Leeds Teaching Hospitals NHS Trust, who set the scene with the following pretext: “The current financial year, 2010-2011, is the last year in which NHS funding will increase (by 5.5%). The NHS must subsequently save some billions of pounds before 2014, while caring for an ageing population and managing increasing levels of chronic disease such as diabetes. NHS staff will have to face major changes, with healthcare in the community promoted at the expense of acute secondary and tertiary care.”

“POCT will continue to grow, as it has much to offer in the planned increases in community healthcare provision. However, many in laboratory medicine have expressed concern about the risks of uncontrolled implementation of

POCT, where there is a poor understanding of the risks and the costs of inappropriate or poor quality management and conduct of POCT. Most hospital laboratories are now accredited by CPA Ltd, to standards which are now aligned with ISO 151�9, and their staff are highly qualified, trained and state registered. POCT, on the other hand, is entirely unregulated.”

The use of e-Learning as a tool to help educate POCT professionals was a key theme emerging from a number of the presentations. Kenneth Hardy-Smith, Project Manager for POCT at e-Learning for Healthcare, delivered a presentation entitled “Achieve POCT Accreditation: Implementing an e-Learning Solution For Your Trust”, which was then followed by a practical exercise led by Angela Parnham and Catherine Spurgeon, Consultant Clinical Biochemist at Northumbria Healthcare NHS Foundation Trust and Project Manager of Urinalysis at Siemens Healthcare Diagnostic Services Ltd respectively. These highlighted the points raised by Dr Pearson in her previous talk, in which the following words struck a chord with the delegates:

“The role of POCT Managers is likely to be increasingly important in advising PCTs and Commissioners on the

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SBK Healthcare: ‘How To Deliver True Costing for Pathology’ and ‘Delivering Your 20% Efficiency Savings in Pathology’, City Inn, Manchester, Tuesday �th June 2010 and Wednesday 9th June 2010.

effective use of POCT, as well as managing new patterns of POCT provision across traditional boundaries and ensuring that POCT users are trained. They will need to have a wide range of clinical, scientific, educational and management skills so that they can work with different professional groups. Commissioners’ understanding of POCT will be crucial in specifying quality standards when commissioning patient services which are increasingly likely to include POCT.”

Communications and technology formed the basis of the two case studies which were delivered either side of the lunch break by Dr David Kennedy, Consultant Clinical Scientist at the Heart of England NHS Foundation Trust (“Delivering The Vision: Building Effective Communications Networks”) and David Harrison, Customer Education Specialist at Siemens (“Utilising Technology to Meet

Quality Control and Quality Assurance Requirements in POCT”). The well-rounded content was then completed with two practical exercises: “Your Guide to Developing Your POCT Business Case”, and “You Have the Green Light – Now What? Step-by-Step Guide to Making POCT Work in Practice”, both led by Phillip Hurley, Head BMS in Biochemistry at the Heart of England NHS Foundation Trust.

The event was highly informative and offered practical advice on how to achieve a successful POCT solution in your Trust, using the wide variety of experiences from the speakers to draw on workable examples.

We very much look forward to attending the next SBK Healthcare events, details of which can be found later in the newsletter.

The timing of the two SBK Healthcare events in Manchester on �th and 9th June 2010 could not have been any better. No, not because they took place just before the start of the World Cup, but rather that they hit the current ‘hot’ subject at exactly the right time.

I am, of course, referring to the ‘small’ matter of the £500m savings which need to be made from the Pathology budget over the coming years, and the fact that it is understandably the most popular topic of conversation in Pathology at the moment... And with good reason.

I get the impression that in some corners of Pathology there was a sense that this ‘would not really happen’, and that the usual 10% increase in workload whilst keeping costs consistent would suffice whilst the wind died down and things returned back to normal. But apparently not – communication from the Department of Health have asked SHAs to submit their plans for making the savings, and words such as ‘consolidation’ have been very bluntly used.

Yes, this is serious folks, and it seems as though this is starting to dawn on those corners of Pathology.

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It was therefore no coincidence to see the two SBK Healthcare events in Manchester, in particular ‘Delivering Your 20% Efficiency Savings in Pathology’, very well subscribed to. Of course, both of the events are very much linked to making efficiency savings; it is very difficult to save money, or certainly to prove that you have saved any money, if you do not even know what your service is costing you.

Those who have a good handle on their costing information may not realise this, but there are still many labs who find accessing data from their finance departments to be akin to discovering the secrets of Pandora’s magic box. The ‘True Costing for Pathology’ event aimed to help in this respect, and covered a range of related issues including QIPP, identifying ‘What is a cost and what is a price?’, and looked at utilising Service Line Reporting.

‘Delivering Your 20% Efficiency Savings in Pathology’ explored a number of ways in which the subject matter could be achieved, which included consolidation, but also looked at a range of topics including rationalising workload to remove unnecessary tests, managing demand, and re-profiling staff.

The consensus seems to be that a combination of many things will be necessary in order for Pathology to save £500m, but concerns remain that Pathology could realistically be used to save massive amounts of cash elsewhere in the NHS, without necessarily hitting its own

target. We have certainly seen some indications of this from our own work (the INTERCEPT data used from the University Hospital of North Staffs, see our May 2010 newsletter for more information), where we have shown that if laboratories were to undertake all HbA1c tests from GPs in accordance to NICE guidelines for diabetes (i.e. removal of all over-tests but inclusion of all missed tests) then workload would actually go UP, meaning an increase in Pathology work (and spend). With better testing you would expect to gain better diabetes control, and would therefore expect less complications further down the line, such as hospital stays, an increasing drugs bill and so on. An interesting case, which could be applied to the wider Pathology workload profile, and only adds weight to the concerns about the savings being imposed on the Pathology budget.

The SBK Healthcare events addressed many of the efficiency savings issues of concern to laboratory managers at the moment, but the key take-home message seemed to be ‘It is happening whether you like it or not, but you have the chance to help shape the future. If you do not do it, somebody will do it for you’. Not the most uplifting message admittedly, but in the reality of this harsh new landscape we all need to do our bit to make sure that Pathology continues to function as an essential part of the patient pathway, and continues to provide a world class service despite a 20% cut in its budget.

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PATHOLOGY BENCHMARKING NEWSPATHOLOGY BENCHMARKING NEWS

ACB Focus, Scottish Exhibition and Conference Centre, Glasgow, Tuesday 11th May 2010

The Scottish Exhibition and Conference Centre in Glasgow played host to this year’s ACB Focus annual meeting during the week commencing 10th May 2010. With the theme ‘Focus on Translation’ playing a central role, Focus 2010 organising committee chair, Richard Spooner, said the following in his pre-event welcome notes: “The strapline - Focus on Translation possibly generates a double take, but this year we want to take you through the process from policy into practice and many sessions will tell that story. Change is often bogged down by financial pressures, silo budgeting and conservative managements who so often do not subscribe to the concept of “Invest to Save” and some of this will be explored through examples.”

Focus is a huge event attracting a wide variety of speakers, delegates and exhibitors from all over the pathology world. With FiLM appearing at Focus this year, to help demonstrate best practice modernisation examples from the UK and the rest of Europe, and with the attendance of many pathologists (and companies) from around the globe,

you could easily justify removing the word ‘pathology’ from the end of the previous sentence.

With so much going on and so many presentations and workshops taking place through each day, it is impossible to see it all... though I gave it a good go during my visit on the Tuesday. With a date in my diary to speak at the Immunology Managers Meeting in Birmingham the following day, I wanted to make sure I packed in as many sessions as possible in Glasgow to the extent that I missed both breaks AND lunch, with my green lunch ticket still sitting in an envelope in my Focus delegate bag. And yes, I did sneak into a well known fast food outlet on my way back to Glasgow Central station later that evening to catch up on some missing calories.

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After the opening ceremony delivered by Dr Julian Barth, President of the ACB, and Ms Jacqui Lunday, Chief Health Professions Officer of the Scottish Government had taken place, the Roche Diagnostics Award Lecture, which centred around the subject title “Adding Value to Clinical Biochemistry” was then given by Dr Graham Beastall.

Electing to pass up the opportunity to indulge in refreshments and visit the exhibitor stands, I instead attended the Immunodiagnostic Systems (IDS) Limited sponsored workshop on “Truth, Uncertainty and Standardisation of Hormone Assays”. Chaired by Mr Gilbert Wieringa of Royal Bolton Hospital, and featuring a presentation by Dr Martin Myers from the Royal Preston Hospital, the session created a fascinating discussion and feedback from the group.

The parallel session held in the Lomond Auditorium to highlight the UK-wide perspective in pathology was of particular interest to me. With a representative from Scotland, Northern Ireland, Wales and England (Dr Bernie Croal, Dr Michael Ryan, Dr Keith Griffiths, and Dr Ian Barnes respectively) it was enlightening to hear of the difference between the way pathology services are delivered across the four different regions, and of the different challenges that are presented by issues such as geographical settings and the variation in government management of NHS services in each country.

Although at the time I thought I was insane for missing out on a free lunch, attending “The Green Session” in the Morar room was probably the highlight of the day for me. Chaired by Dr Rick Jones from the Yorkshire Centre for Healthcare Informatics, and featuring presentations by three key speakers to deliver environmental case studies from NHS and industry (Siemens in this case) relating to the laboratory, the session (officially entitled “Sustainable Laboratories Workshop” was excellent. Laboratories face a huge challenge as they try to ‘go green’. An example was given that a ‘typical’ laboratory emits around 200 times more CO2 than a ‘typical’ household, and that the NHS is one of the biggest contributors towards pollution in the world. A key take-home message to emerge from the session was that, as the NHS looks to meet its target cost savings of £20bn, it might want to consider the fact that investing into renewable energy sources, and cutting down on power usage (for example by switching off unused PCs at night or ensuring lights are switched off when they are unused) can all help to save money. It is not just good for the environment, but good for the budget too!

The day’s other sessions continued to be interesting, enlightening and enjoyable in equal measure, and for me this was the best Focus event I have been to... though the other two were also good!

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PATHOLOGY BENCHMARKING NEWSPATHOLOGY BENCHMARKING NEWS

I was delighted to speak at the Immunology Managers meeting at the Arden Hotel in Birmingham on 12th May, after an invitation from Paul Virgo, to speak about “How to Get More from your Benchmarking Data”. Although I took the opportunity to present some more updated data from the work we have been doing on the appropriateness of HbA1c testing for the treatment of diabetes, the main focus of my presentation was on a case study I had prepared using our 2009 data.

The case study centred around Laboratory X, which, whilst sounding like a wing of Dr Evil’s empire, was a fictional large teaching/hub laboratory based on a real Trust. In the case study they had one of the highest costs per test of all participants, and I began by saying that the cost per test chart is the first one most people look at... and certainly the first that the chief exec sees. Whether or not our colleagues in chief exec positions would be thrilled at the thought of being compared to Darth Vader, in a slide I included showing the Star Wars villain reading a copy of our report, is debateable . . . though I am sure that even chief execs have a sense of humour too!

But the presentation was designed to show that there is far more to benchmarking data than the cost per test chart. The

case study showed how the report and analysis tools could be used to investigate the reasons behind the high cost per test, and discovered that this was a laboratory employing band � staff, where many of their large numbers of band � staff are employed as band 5 elsewhere. Furthermore, and more importantly, this was a laboratory offering high numbers of Cellular Immunology tests and virtually no Immunochemistry – this focus on highly complex work at the expense of the simpler and more automated, high volume work, was a major factor in driving up the cost per test.

Presenting benchmarking data in dashboards and shifting emphasis away from pure cost per test to providing a more complete picture of the service, is something we are revamping for this year. The article Crystal Ball: Pathology Benchmarking In The Future in this newsletter contains more information about these ideas.

I would like to thank Paul Virgo and the Immunology Managers present at the meeting for their invitation and warm welcome, and hope they got some valuable information from my talk.

Immunology Managers Meeting, Arden Hotel, Birmingham, Wednesday 12th May 2010

“Whether or not our colleagues in chief exec positions would be thrilled at the thought of being compared to Darth

Vader ... is debateable . . . though I am sure that even chief execs have a sense

of humour too!”

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As the pathology landscape constantly shifts and changes, it is impossible to know exactly where benchmarking will be in the future. But using our crystal ball (and by that you can read: looking at our plans for the future) we can see some of the possibilities and opportunities that may present themselves.

Those who have taken part in our scheme for a number of years will know that the reporting tools and mechanisms have changed fairly radically over time. Recalling the ‘good’ old days of paper questionnaires and manual entry of data into the computers at Keele, it is a far shout from the electronic collection and reporting we do now – which will be particularly emphasised by the launch of our online analysis tools later this year.

However, our long term participants may also think that the content does not change to the same extent – rather, it adapts and is fine-tuned year-on-year. We still collect test numbers, we still collect staffing numbers (albeit now in an Agenda for Change compatible format and taking into account the evolution of different job roles), and we still collect finance data. Partially, this is to preserve historical comparison data: the more you change definitions, the less you can compare any meaningful changes. It also means that we are not confusing participants by constantly changing the definitions they have become accustomed to.

But the pathology world is changing... again... only this time there really could be a call for a fairly significant change in the way we do things. With the PCT Pilot in full swing, and the emphasis of that project looking at appropriateness of testing, combined with the ever-growing roles of commissioners in pathology testing work done for primary care, there is a very significant push to capture data in this area. With pathology also tasked to make savings of £500m by 2014, pathology – and indeed the wider NHS and Department of Health – will be particularly interested to monitor progress made in this respect, and this is an area that the NPBS will be involved.

Of course we will not be forgetting about the data we collect in the current scheme, and in fact this is receiving some love this year too. As well as the introduction of online analysis tools, we are also looking to provide participants with more immediate access to data – weeks before the reports are officially published – through a new dashboard tool. This piece of software will show a list of KPIs and allow quick comparison between your department and either another department of your choice or a sample mean/median, and allow you to produce a chart to show each participant’s response for any of these KPIs. Think of it as an easy access analysis tool which puts all the key information into one place, and does not require any extensive knowledge of excel – just a couple of drop down menus. This will be introduced early to allow participants to amend any errors prior to official publication, in addition to giving them access to the data for their own use at an early stage of the process.

So here at the NPBS we have plenty to look forward to, and plenty to keep us occupied. We will keep you updated with all developments in our newsletter and on our website – www.keele.ac.uk/benchmarking

Crystal Ball: Pathology Benchmarking In The Future

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Pathology Change Summer SchoolThink outside the box: investigate the models and opportunities

to transform your service and achieve real change

If you want to take your pathology department forward and reconfigure your service, this event will help you to: • Analyse where you are in the market: recognise the

value of pathology and respond to change• Evaluate service configuration models: learn about

which options are viable in the new pathology landscape

• Develop your viable business plan: build your strategic vision and identify how to differentiate your service

• Gain stakeholder commitment: respond effectively to the changing needs and adapt your service accordingly

• Overcome obstacles: step forward to achieve change and deliver your plan

• Embrace key enablers for change: shape your pathology service and new organisational design through demand management and technological solutions

• Change your workforce: ‘QIPP’ your workforce and motivate your staff through Lean

• Sustain your change: standardise quality, deliver cost improvements and move towards commercial success

Work together with your expert faculty to develop your survival plan:Dr Ian Fry, Director of Pathology, Partnership Pathology ServicesDai Davis, General Manager, Pathology and Head of Patient Access Services, East Kent Hospitals University NHS Foundation TrustPhil Hudson, Managing Director, Collinson Grant HealthcarePeter Huntley, Network Director, Kent & Medway Pathology NetworkRobin Stern, Managing Director, Medical Mosaic David Hamer, Blood Sciences Service Manager, Royal Bolton Hospital NHS Foundation TrustDavid Clarke, Director, Path LinksDave Bottoms, Pathology Network Manager, North East Pathology NetworkDavid Ricketts, Pathology Manager, North Middlesex University Hospital NHS TrustJohn Stevens, General Manager, Royal Bournemouth and Christchurch Hospitals NHS Foundation TrustMartin Myers, Lead Pathologist, Lancashire Teaching Hospitals NHS Foundation Trust

Tel: 01732 373 073 | Fax: 01732 448 047

[email protected] | www.sbk-healthcare.com

The complete guide to drivingyour organisation forward andrevitalising your service

2 DAY CO N F E R E N C E

£599 NHSFULL PRICE

For further information and to book your place visit www.sbk-healthcare.com

Tuesday 28th to Wednesday 29th September 2010 | Murray Edwards College, Cambridge

17


Point of Care Testing for Co-ordinators

Ensuring Quality Standards are met: Delivering Good Quality Training and Competency Monitoring

Gain a foundation in best practice for POCT: • Optimising your role to achieve

compliance: developing and valuing POCT co-ordinators to ensure a holistic approach to saving money, achieving consistency and implementing a robust quality management system

• Delivering new training solutions: key ingredients for a successful training programme, and utilising a combination of training tools to deliver the most appropriate training package for your trust

• Enhancing competencies: practical guide to designing protocols and guidelines for monitoring and revalidating competencies

• Connecting into the community: assessing the practicalities of setting up POCT services in the community and implementing connectivity

Entrench the basics and establish best practice with:

Dr David Kennedy, Consultant Clinical Scientist, Heart of England NHS Foundation Trust

Madeline Wheeler, POCT Supervisor, Dudley Group of Hospitals NHS Foundation Trust

Emma James, POCT Co-ordinator, Central Manchester University Hospitals NHS Foundation Trust

Barbara Bewley, Operations Manager, Pathology Clinical Services, Cambridge University Hospitals NHS Foundation Trust

Joan Pearson, Lead Module Editor, E-Learning for Healthcare, ePOCT Programme

Nicky Hollowood, Community Point of Care Manager, Harrogate and District NHS Foundation Trust

Tel: 01732 373 073 | Fax: 01732 448 047


Getting the best fromPOCT in your trust

N H S S p e c i a l Pa c k a g e

ONLY £299 eachwhen 2 places booked

For further information and to bookyour place visit www.sbk-healthcare.com

Tuesday 19th October 2010 | City Inn, Manchester

1�


Achieving Quality POCTLaboratory POCT Manager: Your Practical

Guide to Meeting Quality Requirements andMaximising Value from your POCT Investment

Calling all POCT Laboratory Professionals – Learn how you can make Quality Work for you: • De�ning true POCT quality: identify the key

ingredients for a quality POCT service and discover what CPA are looking for when assessing your service

• Transferring good quality outside trust boundaries: engage better with commissioners on quality for community POCT and investigate how connectivity can deliver long term rewards

• Maximising quality: learn how pursuing quality can have the added benefit of releasing cash savings and discover how to better manage relationships to help you meet your quality aims

• Meeting quality requirements: share how others have developed optimum management structures, achieved robust quality management systems and implemented quality assurance processes

Ensure you are prepared to turn regulatory requirements into tangible bene�ts for your patient safety and your cost improvement programme with:Barbara Bewley, Operations Manager, Pathology Clinical Services, Cambridge University Hospitals NHS Foundation TrustAnnette Thomas, Consultant Clinical Biochemist, Wales External Quality Assurance SchemePhil Hurley, Head BMS, Biochemistry, Heart of England NHS Foundation TrustPatricia Johnson, BMS 2 POCT Lead, Gateshead Health NHS Foundation TrustNatalie Smith, Senior Biochemist and POCT Manager, Luton and Dunstable Hospital NHS Foundation TrustTim Hogan, Chemistry Lab Manager, Basildon and Thurrock University Hospitals NHS Foundation TrustSheena Hennell, Programme Manager, NHS WirralBrent Varley, National Pathology IT Programme Lead, Informing Healthcare, NHS Wales Informatics Service

Tel: 01732 373 073 | Fax: 01732 448 047


Your practical guide tomeeting your POCTquality requirements

N H S S p e c i a l Pa c k a g e

ONLY £299 eachwhen 2 places booked

For further information and to book your place visit www.sbk-healthcare.com

Wednesday 20th October 2010 | City Inn, Manchester

19


Diary Dates/Events for 2010SBK Healthcare Pathology Events

Pathology Change Summer School, Tuesday 2�th to Wednesday 29th September 2010, Murray Edwards College, CambridgePoint of Care Testing for Co-ordinators, Tuesday 19th October 2010, City Inn, ManchesterAchieving Quality POCT, Wednesday 20th October 2010, City Inn, Manchester

see www.sbk-healthcare.com

Keele Participant User Group MeetingsMulti-discipline – Friday 14th January 2011, Maple House Conference & Events Centre, Birmingham

* Participants will receive a formal invitation to attend this meeting by the end of September *

IBMS Events

• For information see www.ibms.org/index.cfm?method=events.home

RCPath Events

• For information see www.nationalpathologyweek.org

ACB Events

• For information see www.acb.org.uk

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Contact usNational Pathology Benchmarking ServiceDepartment of Medicines ManagementRoom 3.0� Hornbeam BuildingKeele UniversitySTAFFS, ST5 5BGTelephone: +44 (0)17�2 733755/ [email protected] Web: www.keele.ac.uk/benchmarking/

Diagnostic Intelligence Advanced Management Reporting

Adapting to the growing demands in ad hoc management reporting adopting a Business Objects front end

Simplifying the delivery of Benchmarking performance reports (Keele)

Meeting the demand for high quality service reporting through flexible presentation of data

Managing the need for performance and service level management reporting (PbR)

Supporting the commercialisation of the service and meeting the demand in performance based reporting

For further information please contact Sales Enquiries on

Tel: +44 (0)1932 581200Email: [email protected]

www.CliniSys.co.uk

Documents

Edition 13 - August 2010 - Keele University · Edition 13 - August 2010 Contents Pathology User Group ... Front cover illustration (“Oh No”) ... We did experience a couple of