Introduction In this issue ...

·           Call for assessors
·           Introducing new CPA regional assessors
·           Changes to PAC membership
·           CPA / UKAS Partnership joint assessment

CALL FOR ASSESSORS

Peer Assessors

Once again we are looking for peer assessors for medical laboratory and EQA assessments.  The person specification and application form can be downloaded from the CPA website www.cpa-uk.co.uk

 We have a training course booked for October and we are prepared to schedule additional training courses if we have sufficient numbers.  If you wish to discuss this before applying, please do not hesitate to contact Cheryl Blair at CPA Central Office.  We look forward to receiving your applications.  

Regional Assessors

We shall also be advertising in the professional journals during July for additional regional assessors with a view to interviewing in October.  Although this is advance notice, anyone who is interested is invited to apply to CPA Central Office now for the relevant packs.

Retiring Member                          New Member          Specialty

Mr Julian Jolly                                Mr Chris Brazier       Microbiology

Dr Ceridwen Coulson                      Dr Nigel Lawson       Clinical Chemistry

Dr  Gavin Spickett                          Dr Philip Dore           Immunology

Mr Pradeep Agrawal                       Mr Blair France         Histopathology

Dr David Goldie                              Dr Mike Wheeler       Numerate EQA

K W M Scott   
Chief Executive

EQA Assessment Manager

I join CPA as EQA Assessment Manager after working in the NHS since 1967.

I began my career as a Trainee Medical Laboratory Technician with Forth Valley Laboratory Service in 1967 and progressed to Senior MLSO after passing the IBMS Fellowship Examination in Haematology in 1976.

I moved to Raigmore Hospital, Inverness in 1983 as Chief MLSO before becoming Head Biomedical Scientist of the Haematology Department in 1993, the post that I held before joining CPA.

I have always had an interest in training and education of Biomedical Scientists and taught at the HNC and Fellowship courses at the Caledonian University, Glasgow before moving to Inverness. This interest has continued to this day and I am currently a member of the Scottish Biomedical Scientists Modernisation Board.

In 1983 my interest progressed to IBMS activities where I have been involved ever since locally, regionally and nationally.  I was elected an IBMS Council member in 1992 and am honoured to have held office of both Treasurer and President and am at present Past-President. I have been privileged to represent the IBMS on a number of national (both UK and Scottish) working groups and committees.

I have been involved with CPA for many years as an assessor and as a member of the EQA Committee, PAC and Board and many of you will know me from my time as Chairman of the EQA Committee.

In my free time I enjoy golf - which unfortunately I play rather poorly, railway photography and reading.

I look forward to a new career with CPA and meeting you in the coming months.

Regional Assessor - North Team

I was born in Nottingham but was brought up in Fife where on leaving school I began work in industry in the R&D and process control laboratories of a local manufacturer.  During this time I completed a degree in chemistry along with qualifications in management.  

In 1989 I moved to Lancashire and into the medical device industry, responsible for firstly R&D and then chemical, physical testing and micro laboratories within a company in the orthopaedic field.  From there in 1994 I joined an NHS unit manufacturing custom made devices where I had responsibilities including quality, health and safety and regulatory management.  

In 1998 I turned from poacher to gamekeeper and joined a Medical Device Notified Body as a Medical Device Assessor.  In the subsequent six years I took part in/conducted approaching 300 quality management system assessments and acquired far too many air miles than is healthy!  

Following a brief period back in the orthopaedic industry last year to recover from the jet lag, I am delighted to have joined CPA where I hope my experience as an assessor will cover for me as I learn a whole new glossary of TLA’s.

In terms of interests I enjoy skiing, golf (when my partner Amanda gives me a weekend pass), cooking and am currently breaking a new set of neighbours into my guitar collection.  On turning 40 in 2004, Amanda and I acquired a map pocket, compass and sturdy boots and can now be seen at weekends scratching our heads at crossroads and heading off in the wrong direction.

CPA TRUST EQA Pilot 
Funding and Bursaries

The CPA Trust has agreed to support the following bids for the financial year 2005/06.

EQA Pilot Schemes

1.         North West Non-Gynaecological Cytology Virtual Microscopy Pilot EQA Scheme.  
Dr Sally Hales, Chester .  £4,420.

2.         North West Regional General Histopathology EQA Scheme.  
Dr R F T McMahon, Manchester .  £5,290.  

3.         Clinical Chemistry EQA Scheme for the Measurement of Serum Creatinine and Estimate of GFR Calculation. 
Mr Finlay McKenzie, Birmingham .  £7,500.

4.         UKNEQAS Point of Care Testing Glucose EQA Scheme.  
Ms Jane French and Mr Finlay McKenzie, Birmingham .  £7,500.

Bursaries  

1.         Error Management in Clinical Laboratories.  
Mrs Glynis Kane, Birmingham .  £3,197.

2.         Evaluation of CGH Microarray Analysis Software.  
Mr R Palmer, London .  £4,500.

3.         QF-PCR Rapid Aneuploidy Screening Mail Group.  
Dr S Hamilton, Manchester .  £2,500.

4.         Audit of Blood Transfusion Triggers in Post-operative Patients.  
Ms Maria Summerfield, Sunderland .  £1,000.

The 2006 Conference was held on the 14 March at a new venue for CPA, the Royal Society of Medicine in Wimpole Street , London .  278 delegates attended and most enjoyed the comfort of the leather covered lecture theatre seats although some found the temperature too bracing!

The morning session, chaired by Dr Ken Scott and Sir Duncan Nichol, was devoted to a series of presentations on the changes and challenges facing Pathology in the light of modernisation, structural changes, competition and regulatory developments.

 The first talk was by Ms Tania Clarke, a member of the Review Co-ordination Team of the Healthcare Commission, on the subject of the Healthcare Concordat.  The purpose of the Concordat, co-ordinated by the Cabinet Office and the Department of Health, is to foster greater co-operation and co-ordination between bodies auditing, inspecting and regulating healthcare in England.  This should lead to less duplication of effort, leading in turn to better assessments and more value for money.  The original signatories to the Concordat and the new signatories in 2006 were identified and the objectives defined. It was apparent that this initiative is still in its infancy with little tangible achieved thus far.  From a CPA perspective it was galling that, although reference was made to using the outcome of CPA assessments, CPA has yet to be invited to join the Concordat. 

The next presentation was on Pathology Service Improvement, given by Ms Ann Eason, National Pathology Manager, Pathology Service Improvement Team of the NHS Modernisation Agency.  Ms Eason identified the drivers for change and outlined the Modernisation Strategy with Improving the Patient experience at its core; this is to be achieved by using new technology, service redesign, introducing new patterns of service delivery and workforce redesign.  The needs of patients were confidently identified although no explanation was given as to how these had been determined.

Different patterns of service provision were described and problems identified.  Suggestions for ways of improving the service were discussed, which seemed to rely heavily on the provision of more Point of Care Testing (POCT).  In the discussion following the presentation it was apparent that many in the audience were sceptical about of the cost effectiveness of new patterns of service provision and concerned about what was seen as a conflict between the staffing needs of a redesigned service and the Department of Health commitment to provide staff with family friendly working conditions.

We then moved on to a presentation on the activities of the private, South African based, PathCare Group given by Dr Willie van Rijswijk, a Director of the Group.

PathCare has a long history of private sector provision in South Africa and some other countries in Africa and the Middle East and operates via a chain of over 60 laboratories.  The company set up its first laboratory in the UK in 1999 and now operates five laboratories (in Kingston , Ilkeston, Balborough Links, Plymouth and Ashburton) in the UK .  The services provided, predominately Clinical Biochemistry and Haematology, rely heavily on robotics and automation and the advantages of this approach were described.  The laboratory services provided by PathCare are currently accredited by the South African National Accreditation System (SANAS) but discussions are on the way for the CPA/UKAS partnership to conduct assessments of the PathCare UK based laboratories in the future.

The final talk of the morning session was on the subject of Titles, Qualifications and Competences and was given by Professor Sue Hill, Chief Scientific Officer at the Department of Health.  Professor Hill presented a mass of information – 53 “busy” slides in 30 minutes – but her presentation was undoubtedly the most important of the day in terms of its messages for the future of Pathology.

Change must and will happen; “more of the same” will not work.  The future will be based on a flexible workforce centred around patient needs delivered by teams based on competence to deliver not job title or route of entry.   Professional barriers will be dismantled allowing progression through a Healthcare Scientist Career Pathway based on skills and competences and Benchmarked against National Occupational Standards and Agenda for Change.  This has profound implications for all the professional organisations in Pathology and for CPA will necessitate a review of Standard B1.

A very acceptable lunch was followed by the afternoon session chaired by Dr Ken Scott.  This was more “hands on” than the morning session and centred around the introduction of a cadre of paid assessors by CPA and consideration of the practicalities of extending Point of Care Testing.

The first session was shared by the three recently appointed CPA Regional Assessment Managers, Mr Phil Shread, Mrs Gwen Guthrie and Mr Ken Rae.  The background to the appointment of Regional Assessment Managers and Regional Assessors was explained as was their role, responsibilities and training. The new Regional structure and the new assessment programme and processes were also described.  This was a lively and informative joint presentation which gave delegates the chance to meet and question the new team.

The final two presentations were on POCT.  In the first “Point of Care Testing: How should it be Regulated?”, Mr Gilbert Wieringa, Consultant Clinical Scientist, Greater Manchester NHS Trust, gave an overview of the present position, particularly as it exists in Manchester, and shared his thoughts about possible future developments. 

He envisaged POCT developing in High Street Pharmacies and identified measurements of glucose, glycated haemoglobin, cholesterol and INR as the most likely areas for expansion of demand.  Mr Wieringa pointed out the substantial governance issues involved in such a development and discussed possible solutions emphasising local laboratory involvement and identifying the need for accreditation of services possibly by CPA and UKAS.

Ms Annette Thomas, the Director of the Cardiff based WEQAS, gave the final talk on EQA of Point of Care Testing.  She talked about the need for Accreditation of POCT sites in partnership with accredited laboratories and the need for clear governance arrangements; perhaps best facilitated by having a robust Quality System overseen by a local POCT Management Group.  She emphasised the need for operator training and quality assurance procedures including EQA.  She went on to describe the Welsh POCT EQA Schemes for glucose, urinalysis, lipids, blood gases and cardiac markers.

It was interesting to note that both speakers on POCT had very similar ideas about the governance issues raised by the development of POCT and provided a glimpse of a framework that could be developed at a national level.

Overall this was an interesting, informative and thought-provoking day which I believe made a useful contribution to the debate about future directions for Pathology.

David Goldie

After a ground-breaking assessment carried out last year by a multidisciplinary team of assessors, on 17 January this year Laboratorios Dr Moreira in Mexico became the first medical laboratory to be accredited by UKAS through its partnership with Clinical Pathology Accreditation (CPA). 

This first accreditation to the international standard ISO 15189, which was included in UKAS’ Memorandum of Understanding (MoU) with Department of Trade and Industry in 2004, heralds the start of what is expected to be a long and fruitful cooperation between UKAS and CPA for the assessment and accreditation of medical laboratories for this standard.

The assessment team consisted of two assessors from UKAS, two assessors from CPA and an assessor from the New Zealand laboratory accreditation body, IANZ. Two representatives from the national accreditation body in Mexico (ema) also attended as observers of the 

assessment.  Staff from both CPA and UKAS liaised very closely on all aspects of the planning and delivery of the assessment and, prior to the decision on accreditation being made, valuable advice was provided by the CPA Professional Advisory Committee. 

The laboratory was accredited for sample collection and site testing, covering a wide range of services in the following disciplines: biochemistry, endocrinology, microbiology, parasitology, serology, histopathology, cytology, immunology, haematology, and urinalysis.

Senior management and staff of the laboratory said that they were very satisfied with the approach used and felt that the assessment had provided added-value.  Julie Eccles, the UKAS Assessment Manager who led the assessment commented:

“The assessment proved to be a success for all involved and the team worked extremely well together to provide the laboratory with an effective and highly competent assessment to the new medical laboratory standard.  

The partnership between UKAS and CPA was formally established in 2002 to enable the two organisations to co-operate on the development of accreditation policy and to facilitate the exchange of best practice.  It 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. 

All applications for accreditation to ISO 15189 will be managed through the partnership and we will continue to refine our approach to assessing medical laboratories against this standard in the light of experience and developments taking place in European and international arenas.

Jane Beaumont

Accreditation Director
jane.beaumont@ukas.com

There are new additions to the CPA support website:

·         Human Tissue Authority

·         Human Fertilisation and Embryology Authority

·         References for use with CPA Standards

DIARY DATES

CPA Peer Assessor Training Course

Tuesday-Thursday 3-5 October 2006 – Beeches Management Centre, Birmingham

Christmas closing

The CPA Office will be closed over the Christmas/New Year period from Monday 25 December opening again on Tuesday 2 January 2007.