north of scotland laboratories programme ‘taigh solais’...‘cirdan ultra implementation...

North of Scotland Laboratories Programme

‘Taigh-solais’

Published for professionals working within or alongside North of Scotland Laboratories

Issue 2

2


Taigh-solais Issue 2


Team

Executive Sponsor

Gerry O’Brien

CEO, NHS Orkney

Regional Joint Clinical Leads

Dr Ellie Dow

[email protected]

Dr Liz Furrie

[email protected]

NoSPG Regional Laboratories

Programme Manager

Shaun Baxter

[email protected]

IT Workstream Lead

James Allison

[email protected]

POCT Workstream Lead

Dr Neil Greig

[email protected]

Quality Workstream Lead

Ryan Cooper

[email protected]

Remote and Rural

Workstream Lead

Alex Javed

[email protected]

Joint Infrastructure

Workstream Leads

Dr David Ashburn/Chris Hind

[email protected]

[email protected]

PathAlba Digital Pathology

Workstream Lead

Fiona Payne

[email protected]

In Issue 2…..

12.

Page Contents

3. Welcome!

4. The North of Scotland Laboratories Programme Update

5. Workstreams Update

11. On the Road

12. Stars in their eyes!

13. And finally...

3


Taigh-solais Issue 2 Welcome

Welcome!

Welcome once more to ‘Taigh-solais’, the second issue of our triannual newsletters from the North of Scotland Laboratories Programme, and a sincere thank you for all of the great feedback we received after publishing Issue 1! Once again we hope you find this newsletter informative, engaging and relevant to you in the North of Scotland laboratories community. In this issue you’ll find updates on the programme, further details for each of the workstreams for the North of Scotland laboratory services, and a feature from the North of Scotland laboratory community.

What’s in a name? In keeping with the newsletter name theme, in the first issue we asked if anyone knew where the two lighthouses featured in the newsletter were. Congratulations go to Ishbel Gall, Chair of the Association of Anatomical Pathology Technology and Lead Anatomical Pathology Technologist/Mortuary Manager based at Foresterhill, NHS Grampian who was the only person to correctly identify:

The lighthouse on the cover page as Corran Point Lighthouse, on the shoreline of Loch Linnhe on the Ardnamurchan Peninsula , near Fort William

and

The lighthouse on page 3 as Neist Point Lighthouse situated on the most westerly tip of Skye near the township of Glendale.

What and where is this lighthouse? This one sits at the mouth of a large tidal estuary, with ‘The Basin’ seeing over 80,000 migratory birds every year! Answers on a virtual postcard to [email protected]!

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North of Scotland Laboratories Programme: Programme Update

Work has continued with the further definition and refinement of the North of Scotland Laboratories workstreams. The Programme Board meets at various locations across the North of Scotland with the most recent being held in Perth Royal Infirmary. During this particular meeting all Workstream objectives and priorities were revisited to ensure the programme remains focussed on the main actions agreed at the ‘Developing our Workstreams and Roadmap’ workshop.

Issues being faced by the programme are that of competing priorities, not only from each Board in keeping their laboratory services running, but also of additional resourcing implications for the North of Scot land Laboratories Programme itself combined with the National Laboratories Programme deliverables. As promised in Issue 1, the following pages provide updates on the scope of the workstreams.


Taigh-solais Issue 2 Programme Update

Did you know there are approximately...

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Taigh-solais Issue 2 Workstreams Update

North of Scotland Laboratories Programme: Workstreams Update

Information Technology Workstream

Lead: James Allison

Unit Clinical Director for Laboratory Medicine, NHS Grampian

[email protected]

Based at Aberdeen Royal Infirmary, Jim is coordinating two

IT specific projects, with the primary focus being on the

‘Cirdan Ultra Implementation Feasibility Study’.

This project has the following objectives:

Understand and determine the appetite, challenges and

obstacles of implementing the Cirdan Ultra LIMS solution

across the NHS Western Isles laboratories

If deemed feasible, implement the Cirdan Ultra LIMS

solution into NHS Western Isles laboratory services

It is envisaged the following immediate and long term benefits would be realised if

implementing the Cirdan Ultra LIMS into NHS Western Isles laboratories:

• Offer additional resilience to NHS Western Isles laboratory services pending the

implementation of a National LIMS

• Resolve the NHS Western Isles issues with current LIMS support

• Provides an opportunity for provision of clinical support via Cirdan LIMS to NHS

Western Isles from NHS Highland clinical laboratory services

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Taigh-solais Issue 2 Workstreams Update


Quality Workstream

Lead: Ryan Cooper

Quality Manager, NHS Tayside

[email protected]

Based at Ninewells Hospital, Ryan is coordinating the activities in the Quality workstream which

has the following objectives:

Setup Regional Quality group to enable sharing of knowledge, experiences and practices

across the North Region

Seek to gain UKAS accreditation for the three NHS island Boards

Shared learning from Blood Transfusion service (BTS), facilitating lesson learned from the

MHRA regulation processes that can be utilised within non-BTS North Region laboratories

Develop Regional Continuity Plans to enhance resilience of the analytical services, during

periods of downtime, staff shortages, and equipment or reagents shortages

Shared Quality Management Systems Feasibility Study to ascertain how much duplication

occurs across the North Region laboratories, increasing the support to rural laboratories

It is envisaged the following immediate and long term benefits would be realised from this

workstream:

Increased compliance to Quality standards for all North of Scotland laboratories

Greater confidence from users of the analytical services

Can promote recruitment and retention with IBMS training status

Greater confidence from MHRA regulation of Blood banks

Mitigate workload of gaining and maintaining accreditation by sharing practice and

experiences

Aid service resilience

Support smaller remote and rural labs

Support consistency in the quality of care

Encourages the sharing of best practice

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Workstreams Update

Point of Care Testing (POCT) Workstream

Lead: Dr Neil Greig

Consult. Clinical Scientist and Clinical Lead (Biochemical Medicine ), NHS Tayside

[email protected]

Based at Ninewells Hospital, Neil is coordinating the activities in the POCT

workstream which has the following objectives:

Standardise guidance for POCT across the North of Scotland Laboratories

Commonality of POCT governance approach across the North of Scotland

Laboratories

Determine how POCT solutions can supplement laboratory service provision in

remote and rural locations

Investigate and prioritise use of IT transference of POCT results

Provide framework to share educational, learning materials and experience for

POCT across the North of Scotland Laboratories

It is envisaged the following immediate and long term benefits would be realised

from this workstream:

Improved governance oversight of POCT commissioning

Improvement of Clinical Governance thereby reducing

patient risk

Facilitate shared learning and experience

Supplement and support service provision in remote and

rural locations

Reduce potential inequities of service provision

Build commissioning, governance and support structures

with ISO standard 22870 in mind

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Workstreams Update

Infrastructure Workstream

Joint Leads: Dr David Ashburn/Chris Hind

Dr David Ashburn, Microbiology Department Manager, NHS Highland

[email protected]

Chris Hind, Clinical Laboratory Manager, NHS Tayside

[email protected]

Based at Raigmore and Ninewells Hospitals, David and

Chris are jointly coordinating the activities in the

Infrastructure workstream which has the following

objectives:

• Review service distribution at each site and for each

discipline to ensure appropriate delivery for the needs

of the hospitals

• Develop a weighted ‘regional currency’ to

demonstrate equivalent costs irrespective of location

• For ‘cold’ tests identify possible economy of scale through consolidation (taking account of

contingency)

• Map logistics across the region and identify possibility of a relay service using existing transport

• Establish a regional equipment list for possible standardisation of platforms

• Establish a regional supplies and suppliers list for regional price list from common suppliers

• Investigate alternative models for specimen (and supplies) transport

Identify innovative and collaborative ways of working

Create an Options Appraisal based on the above findings for the North of Scotland laboratories

community


workstream:

• Appropriate levels of service taking into account local needs, critical mass of staffing to

maintain 24/7 (if this is indeed deemed to be required), and geography

• Standardisation of platforms/ processes (where appropriate)

• Opportunity to divert spending for equality and equity of service

• Effective re-distribution of work

• Improve resilience of remote and rural laboratories

9




Workstreams Update

Remote and Rural Workstream

Lead: Alex Javed

Service Manager - Laboratories, NHS Highland

[email protected]

Based at Raigmore Hospital, Alex is coordinating the activities in the Remote and Rural

workstream which has the following objectives:

Identify representatives from each of the 6 North of Scotland Boards to participate in a

Remote & Rural (R&R) group across the North of Scotland

Gap analysis to provide improved understanding of risks and opportunities, and

financial implications, associated with current model(s) across the North of Scotland

Defined requirements for an appropriate level of service taking into account local needs

and geography, staffing to maintain 24/7 service

Conduct an options appraisal in conjunction with SNBTS to identify opportunities for

enhancing governance, resilience and sustainability of Transfusion Services

Ensure a link from the Remote & Rural Group exists back to the North of Scotland

Programme Board to develop any proposals arising from the above objectives


workstream:

Standardisation of approach to Transfusion Service provision within Remote & Rural

Boards

Improved governance and resilience of Transfusion Services within Remote & Rural

Boards

10




Workstreams Update

PathAlba Digital Pathology Workstream

Lead: Fiona Payne

Service Clinical Director, Pathology, NHS Grampian

[email protected]

Based in Aberdeen Royal Infirmary, Fiona is leading on an exciting addition to the NoSLabs

Programme!

Diagnostic histopathology departments throughout Scotland are experiencing significant

economic and service pressures, and many health boards are now considering digital pathology

as part of the solution.

Digital pathology has the potential to revolutionize the way in which pathology services are

delivered, offering a flexible platform for safety, quality and, potentially, efficiency improvements in

diagnostic pathology, while contributing to the future-proofing of an increasingly pressured

medical specialty.

This is achieved by scanning and digitizing the glass slides used in pathology to present tissue to

Pathologists. Traditionally, these slides are reviewed by a pathologist using a microscope. With

digital pathology, the microscope is replaced by very high resolution monitors and sophisticated

image analysis software. This increases pathologist efficiency and allows for data to be shared

across any site or board with compatible digital pathology implementation; thus it will allow

networking of expertise in making complex diagnoses and speed up diagnostic second opinions,

especially important for cancer patients. The development of a digital diagnostic library is

envisaged, providing an improved and accessible training tool for pathologists of the future.

In its early stages, the PathAlba Digital Pathology pilot will explore the feasibility of cross board

working across the North Region, using LIMS connectivity between NHS Highland and NHS

Tayside Cytogenetics, which could then be expanded to explore direct image transfer between

LIMS in cellular pathology.

The installation of a trial ‘shadow’ LIMS in Grampian would maximise the North’s ability to

investigate the opportunities provided by digital pathology and shared regional Cellular Pathology

working practice.

Exciting times ahead!

11


Taigh-solais Issue 2 On the Road

On the Road

Since the last newsletter members of the Programme Board have been on the road again with a visit to NHS Western Isles Hospital, where they met with Joel Briggs and his team based in the laboratory services in Stornoway. This was another very worthwhile meeting discussing the issues facing NHS Western Isles laboratory services, and how we as the North of Scotland laboratories community can work collaboratively to help redress some of those local issues. On the agenda was: Feasibility of implementing the Cirdan Ultra LIMS into NHS Western Isles laboratories

General and clinical support for NHS Western Isles

Training opportunities for NHS Western Isles laboratory staff

UKAS accreditation for the three NHS island Boards

Point of Care Testing approach in NHS Western Isles

Transfusion Service in NHS Western Isles

The Journey

Focus on value: Triple Aim

12

Stars in their eyes!


Taigh-solais Issue 2 Cover Story

Colleagues in NHS Tayside have rightly received, not only NHS Tayside Board, but international

recognition for the fantastic work they have undertaken with their ‘Intelligent Liver Function

Testing’ (iLFT).

In collaboration with Dundee University, the team developed the new testing process using the

automated Blood Sciences laboratory infrastructure at Ninewells Hospital, which can now also detect

liver disease at an early stage, potentially saving thousands of lives.

Liver disease, which is often asymptomatic, has become the second most common cause of death in

under 65-year-olds across the UK, however initial results from these new iLFT tests showed a 44%

increase in liver disease diagnosis, allowing that oftentimes all important earlier access to treatment.

One of the iLFT project leads, Professor John Dillon stated ‘liver disease is a silent killer, it creeps up

on you, so it is crucial that we find a way to detect it earlier and switch of this ticking time bomb.’

Professor Dillon goes on to say ‘by working with the existing IT analytical systems in the lab, we were

able to develop a system that detects the early warning signs of liver disease and which can then give

GPs the tools they need to make solid diagnosis and begin treatment plans.’

This is not the only recognition the team have won; in total:

Winner Innovation Award of Royal College of Physicians' Excellence in Patient Care Awards 2019

Winner of the new international award, 2019 UNIVANTS of Healthcare Excellence Award in global recognition of the integrated clinical care project entitled: Intelligent Liver Function Testing (iLFT):

Winner for “Intelligent liver function testing (iLFT) in action” of the Frontline Gastroenterology Prize for the ‘Best patient benefit in gastroenterology and hepatology’ 2019

Winner of the Innovation Award of the Royal College of Pathology Excellence awards 2019

Highly commended in the Digital Innovation category of the “BMJ Awards” 2019

I’m sure you’ll all agree, recognition well deserved!

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And finally...

We would love to hear from you! The North of Scotland Laboratories Programme of activities affects us all, and we aim to make the programme as inclusive as possible, where all thoughts and feedback are welcomed. You may have worked on a similar activity in the past and have some fantastic learning from that to share, you may wish to add a perspective from the ‘shop floor’, or simply have a question to ask. Whatever it is, we’d love to hear from you. If you feel you can contribute to any of the workstreams or have a question, please contact us at [email protected], or by contacting the appropriate workstream lead directly.

Taigh-solais Issue Dates If you have anything you’d like us to cover in the next or future issues, here are the dates you need to be aware of: Issue 3: January 2020 — submissions by end of December 2019 Issue 4: May 2020 — submissions by end of April 2020 Issue 5: September 2020 — submissions by end of August 2020 Issue 6: January 2021 — submissions by end of December 2020 Issue 7: May 2021 — submissions by end of April 2021 Issue 8: September 2021 — submissions by end of August 2021


Taigh-solais Issue 2 And finally...

Don’t forget!

The National Laboratories Programmes has a large number of activities being undertaken also. To keep up to date with that programme visit: https://www.labs.scot.nhs.uk/

https://www.labs.scot.nhs.uk/

north of scotland laboratories programme ‘taigh solais’...‘cirdan ultra implementation...

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