Introduction In this issue ...
· Requirements for Laboratories Seeking Accreditation who use Remote Reporting Services for Routine Histopathology
· A Practical Guide to Accreditaton in Laboratory Medicine
· EQA Pilot Scheme Funding 2003/4
· Hub Vs Satellite (Spoke) Consultant Commitments in Immunology: Guidance on Professional Direction
The CPA & UKAS
Communication Statement - January 2003
Within the UK there are two laboratory accreditation bodies, operating in complementary fields, the United Kingdom Accreditation Service [UKAS] and Clinical Pathology Accreditation (UK) Ltd [CPA].
UKAS and CPA have formed a partnership. The partnership enables the two organisations to co-operate on the development of accreditation policy and facilitates the exchange of best practice. Where appropriate the activities of the two organisations will be aligned thereby benefiting dual accredited organisations.
The partnership is aimed at strengthening the authority and reputation of accreditation both in the UK and internationally by bringing together two organisations with established reputations in their respective fields. It is also a means of reducing the risk of fragmenting accreditation and avoiding proliferation of accreditation standards for laboratories.
There is an increasing demand for accreditation across a wide range of services and an associated need for the accredited services to be accepted internationally. UKAS and CPA are working together to maximise the international recognition of accreditation.
UKAS is recognised by Government as the national accreditation body and is the signatory of international mutual recognition agreements on behalf of the UK. It is intended that the partnership will in due course be incorporated into these agreements.
The partnership is the culmination of discussions, which started with a joint statement of intent in 1998 to co-operate in areas of mutual interest and benefit. It is the recently introduced international standards for laboratory accreditation [ISO 17025 & ISO 15189] however, that enables UKAS and CPA to capitalise on common criteria thereby making a partnership possible and desirable.
CPA Annual Conference
A date for the CPA Annual Conference had been agreed for 20 March. However, at the December meeting of the CPA Board of Directors, it was agreed that we would not be holding the annual conference in 2003. This decision was reached because other meetings had been arranged
for the spring of 2003 with similar topics and speakers. Also, we are committed to a heavy programme of the second phase of CPA assessor re-training during 2003.
CPA NEW Standards
The new CPA standards are scheduled for implementation from April 2003. This is an appropriate time to ask whether the current advisory committee structure meets CPA’s needs now and in the future. Following discussion, a proposal for change was put forward to the CPA shareholders for consultation and has now been agreed. We have also changed the organisation within Central Office and both changes are described below.
it has retained the
FAREWELL TO SACs
Gone with the Wind
I didn’t think I had a lot in common with the Queen but when I looked back over the past few years of the Haematology SAC I find that my memory is not what it used to be. Is Tara identical to Central Birmingham? Did the SAC talk SHOT all the time? Some people may think so but in fact much of the work of the SAC has been involved with deliberations over contentious issues where there has been a difference of opinion. The consistent interpretation of whether the CPA standards have been met during a particular inspection visit has been one of the most difficult issues for CPA in general. Sometimes inspectors have clearly got it wrong and sometimes the objections from the Department being inspected have been unreasonable. In my experience however the SAC members have always tried to be fair and consistent and if a particular grey area still remains uncertain after discussion then the host department is usually given the benefit of the doubt. Looking back over the minutes I see
that we have discussed issues such as staffing numbers, on-call rotas, transport of blood around hospitals, security of blood bank and satellite fridges, lack of air conditioning in departments, merging of laboratories (haematology and clinical chemistry) and merging of Trusts (networks). A regular and difficult agenda item has been the different interpretations of the standards by different inspectors. The SAC have long held the view that a smaller number of dedicated inspectors was required. There are clear difficulties in establishing this format and with the advent of the new standards and the likely difficulty in recruiting haematology inspectors this is clearly now a major issue for CPA.
little knowledge but Brian Warner (IBMS representative) knows a great deal about cycling in the dark and Ivor Cavill (BSH, BSCH and Plaid Cymru representative) knows how to herd sheep in the dark. But there were no sheep in the SAC. All were strong-willed individuals who expressed their views. I remember Sam Machin (Rhett Butler) crossing swords with Ivor Cavill – just because he was Welsh. I remember Brenda Gibson advising me how to preserve my hair style wearing a cycling helmet. I remember David Gorst receiving an invitation to join the SAC in the morning and receiving notification of its dissolution in the afternoon. And I remember Edwina Currie (Scarlett O’Hara) telling me that grey hair was attractive. But now my memory is playing tricks. This is all in the past. The future for haematologists and CPA beckons. For tomorrow is another day.
The main problems that the SAC had to face during the year were a reflection on the staffing issues within the Pathology Service.
CPA Genetics SAC
The SAC in Genetics was, for a long while, something of an anomaly. For historic reasons it not only encompassed Clinical Cytogenetics and Molecular Genetics, but also semenology – as a carrier of genetic information perhaps? The largest contrast however, between this SAC and the others, was its virtual nature – this SAC had not met for some very many years. The SAC business was entirely conducted by E-mail and telephone, quietly and efficiently. This mutation was very well suited to the circumstances of delivery of genetics services – regionally based with far fewer units delivering the service than the other pathology disciplines. As ex-chair I would like to thank my predecessor for developing the process and, of course, my colleagues on the SAC for their constant help and wisdom.
Structure and Function
of the Professional
1 Responsibilities The Professional Advisory Committee (PAC) is responsible to the Board of CPA for the implementation of all matters relating to the laboratory accreditation section of CPA.
2 Membership The main specialties of Clinical Biochemistry, Haematology, Histopathology, Immunology and Microbiology are represented by a consultant and a biomedical scientist. At present Genetics is represented by a consultant only.
There are four nominated individuals representing Transfusion Medicine, Cytopathology, Virology and Histocompatibility and Immunogenetics, who attend when relevant matters are to be discussed, either identified by members of the PAC or these representatives themselves. They may come from any of the three professional groups within Pathology.
There is also a representative of the Independent Healthcare sector.
In addition there is a Chairman, who may come from any specialty or professional group, but does not represent any discipline of Pathology on the PAC.
The Company Officers are also members: namely the Chief Executives of the laboratory accreditation and EQA accreditation arms of CPA, the Executive Manager and the Chairman of the CPA (EQA) Committee. The total membership is therefore 21.
3 Term of Office Members serve normally for a period of three years and retire in rotation, one third being replaced each year. The two representatives from each of the five main sub-specialties should not demit office in the same year.
4 Methods of Appointment The Chairman is appointed by the Board of CPA. The consultant representatives are appointed jointly by The Royal College of Pathologists
Membership of the PAC
as at 10 January 2003
|Dr Ken Scott (Chair)||Independent Chair|
|Prof Archie Malcolm||Histopathology||RCPath/ACP|
|Mr Pradeep Agrawal||Histopathology||IBMS|
|Dr Jim Murray||Haematology||RCPath/ACP|
|Mr Brian Warner||Haematology||IBMS|
|Dr Ceridwen Dawkins||Clinical Biochemistry||RCPath/ACP/ACB|
|Mr Martin Nicholson||Clinical Biochemistry||IBMS|
|Dr Mark Hastings||Microbiology||RCPath/ACP|
|Mr Julian Jolly||Microbiology||IBMS|
|Dr Gavin Spickett||Immunology||RCPath/ACP/ACB|
|Mr Ray Russell||Immunology||IBMS|
|Dr Lorraine Gaunt||Genetics||RCPath/ACP|
|Mr John Turner||IHA|
|Mr John Revill||Blood Transfusion|
|Dr Celia Aitken||Virology|
|Dr Peter A Smith||Cytopathology|
|Dr David Briggs||H & I|
|Dr Mansel Haeney||Chief Executive|
|Dr David Goldie||Chief Executive (EQA)|
|Mr Eddie Welsh||Chairman (EQA)|
|Mrs Cheryl Blair||Executive Manager|
Vs Satellite (Spoke) Consultant
Commitments in Immunology:
Guidance on Professional Direction
as defined below; and ability to influence all necessary managerial and clinical decisions, including those regarding staffing (recruitment and rotation),
to run a safe, effective, clinically appropriate and clinically governable specialist laboratory service (management responsibility for immunology may be exercised through the Head of Multidisciplinary Laboratory if necessary, this is the usual arrangement at satellites). Executive control also incorporates full and meaningful involvement in the future development of the immunology service through the business planning process.
repertoire, the complexity of the work and workload. They will also be influenced by the inclusion of clinical scientists in the laboratory team.
CPA (UK) Ltd
REQUIREMENTS FOR LABORATORIES
SEEKING ACCREDITATION WHO
USE REMOTE REPORTING SERVICES
FOR ROUTINE HISTOPATHOLOGY
A department applying for accreditation that wishes to use a remote reporting service for routine* histopathology shall first establish a clear policy for this. This shall include details of the referring and receiving laboratories, the nature and amount of work to be sent and the duration of the use of the service.
In order to carry out this policy the referring laboratory will require a set of procedures (New CPA Standards in brackets).
These shall include a procedure(s) for:
· establishing the needs and requirements of the users (A2)
· selection of the work to be sent away, with a clear distinction between wet tissue and prepared slides (E6)
· maintaining a record of all specimens referred (E6)
· ensuring the safe and secure transport of the material (E3, E4)
· tracking of the material at all times (E6)
· monitoring the return of reports from the receiving department (E6)
· monitoring the return of clinical material (slides and/or tissue) from the receiving department (E6)
· auditing the reports returned, in conjunction with those of the referring department (H4)
A Practical Guide to Accreditation in Laboratory Medicine
This book has been written by David Burnett, OBE PhD FRCPath, author of “Understanding Accreditation in the Laboratory”. David is Chairman of the CPA (UK) Ltd Standards Revision Group and is also a respected member of the British Standards Institute.
EQA PILOT SCHEME FUNDING 2003/4