Merging pathology laboratories Flashcards
What review gave recommendations about modernising pathology services?
Carter report of NHS pathology services in 2006 initially
2018 NHS Improvement report - provide template structure for Essentials Services Laboratories (ESLs)
What were the main findings of the Carter report?
Increasing number of requests
wide variation in tests offered and costs in different areas of country
lack of IT connectivity
complex workforce with poor planning
DGH cannot provide full range of services, as it is unsustainable, and not cost effective
Consolidation pathology services into cluster or hub and spoke model
What are the benefits of a cluster model of labs
consolidate services to create 2-3 main labs in an area, that all collaborate, and focus on their own specific role
e.g one hospital has biochemistry, the other has microbiology
allows specialisation in one lab
good for staff training
singluar IT system
transport of specimens should be easier
issue arises if labs do not work together, and do their own thing
What are the benefits of a hub and spoke lab model?
Single central hub for specialist work, expertise centred in one team
e.g central lab does CSF testing, but basic biochem can be done at spokes
this model is favoured as maximum value for money
better use of workforce - specialist trained people in central hub
more consistency in lab reporting
cost saving “economies of scale” - can buy reagents/ equipment in bulk
Consistent clinical governance between sites in the network
What are problems with changing your laboratory network model?
cross-over period - significant disruption
organisation costs
personnel - redeploying/ re-training/ recruiting. Staff may not want to transfer to the hub. Additionally commuting might not be an option if there is poor public transport or parking
physical space - hub may not be able to accommodate increased workload
IT connectivity - different labs may use different LIMS systems. This may have a significant cost
transport samples -
- turnaround time of results - samples need to be sent to the hub, which can then take longer to process
- cost of transport can off-set costs saved by using hub
governance / quality control - may be difference in management between sites
Business continuity/resilience - e.g if hub has a fire or IT issues, there is no backup lab
Teaching - medical students rotating at spokes will get no pathology training or experience
What is meant by Essential Services Laboratory?
NHS Improvement identified 29 potential pathology networks in England to deliver more efficient, high value, pathology services.
Each has a hub.
And the hub has several spokes, known as Essential Services Laboratories (ESLs). They will provide essential services only
ESLs should be accredited
What standard is used for accreditation?
ISO:15189
