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The CPA conference took place on 15 March 2000 in London. As
usual, the lecture theatre was virtually full for most sessions.
The morning was divided into two sessions. The first, chaired by
Mansel Haeney, Chief Executive of CPA (Accreditation), opened with a talk on the
modernisation of pathology by Dr Dennis Wright from Northwick Park Hospital.
His talk dealt with the "Pathology Modernisation Programme" introduced
last year by the Department of Health. Dr Wright, being a member of the
steering group that decides on the allocation of the available funds was able to
summarise the way in which these decisions were made in 1999-2000. The £10
million initially allocated, was subsequently reduced to £5 million. The
process was inevitably rushed, as the Health Service Circular announcing the
fund was not issued until 6 August. Dr Wright emphasised that a successful bid
needed to be "played by the rules" - rules that are not always
apparent to those making bids. He gave helpful suggestions on those areas
likely to be selected. For the coming year the details are available on the
Internet (HTTP://www.doh.gov.uk/
pathologymodernisation).
The second lecture was given by a member of the Institute of
Employment Research at Warwick University on "The Report of the Manpower
Research Study Commissioned by CPA". In fact, as this study has yet to
begin, the report was limited to the aims and intentions of the study and the
way in which it would be carried out. The study will concentrate initially on
staffing problems that are currently being experienced in histopathology and
cytopathology departments. Later it is hoped that it will extend to other areas
of the pathology services. The report should be completed by August 2000.
The second session, chaired by David Goldie, Chief Executive of
CPA(EQA), consisted of two presentations on interpretative EQA schemes. The
first by Dr Gordon Challand from Reading concerned the scheme on the Internet
that he has established in which typical sets of biochemistry results are
presented to participants who are then invited to respond with short
interpretative comments that might be helpful to the requesting clinician. Dr
Challand indicated that participants come from across the United Kingdom and
also from several overseas countries. The interpretative comments received are
passed to a selected body of assessors. Their views and the summary of
interpretations given are then circulated to participants via the Internet,
together with marks, either positive or negative, associated with particular
comments. One major problem identified in the early stages of this scheme is
that there is a very wide range of interpretations made upon a single set of
relatively straightforward biochemistry results. |
It is hoped that in due course the scheme itself will,
through its educational processes, reduce the wide spread to give a more precise
set of interpretations. Should this scheme prove as valuable in the long-term
as it appears to have been in the short-term, then it may well become an
integral part of the continuing professional development programme for senior
staff in the clinical biochemistry departments.
The second talk was
by Dr Archie Prentice, Consultant Haematologist at Derriford Hospital, Plymouth.
Dr Prentice drew the attention of the meeting to the fact that the current
training programme for haematologists means that morphological haematology is
dealt with at a very early stage of the course and is not repeated later. He
had therefore felt it necessary to organise a quality assessment programme in
his region to cover this aspect of the consultant haematologist's professional
role. His haematology EQA programme is currently limited to haematologists in
the South West of the country. He described the ways in which slides are
submitted, selected and distributed. As with histopathology EQA schemes the
nature of the circulated material limits the number of active participants. The
comments made by the participants are then assessed and circulated to all
participants. When cases of poor performance are identified the individual
participant is notified anonymously; none of the organisers are aware of the
identity. But should persistent poor performance be identified then it may be
necessary to take more decisive action. Dr Prentice hopes that the scheme may
be taken up nationwide either by similar regional schemes being organised
throughout the country or by distribution of slide images on CD-rom. Both
schemes are being supported by pilot funding from CPA.
The afternoon session was chaired by the Chairman of the Board of CPA,
Professor Brian Edwards. It was entirely devoted to presentation of and
discussion about the new CPA standards. Dr David Burnett, the Chairman of the
Standards Review Committee, introduced the concept of the new standard and
stated that this was an important change in CPA's practices in order to bring
the standards into line with European and International thinking. In addition,
the structure of the standards had been improved over those in the current
accreditation handbook. Dr Burnett indicated that the two major changes and
development that will now be incorporated in CPA standards are part of the
general concept of quality management of the laboratories. In particular a
quality manual will be a central document around which the organisation and
management of the laboratory will revolve. A Quality Manager will also have to
be appointed whose primary role is to see that the quality manual and all the
management functions associated with it are kept up to date and any actions that
result are fulfilled.
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Members of the Standards Review Committee then summarised
some of the more significant changes:
· Dr Stephen Jeffcoate considered the quality manual in more
detail and described the constituent parts of the manual and how they should be
used to ensure that the management processes are kept in control so that the
quality of the laboratory can be improved.
· Neil Porter discussed the documentation of a laboratory, its
policy, procedures, forms and records. He described the importance of the
Standard Operating Procedures and indicated how they should be drawn up.
· Dr Tim Wallington then discussed the role of the Quality
Manager. He indicated that such a person might be based in a single discipline
responsible purely for that discipline, or might be the Quality Control Manager
for the whole laboratory. In the latter instance it was likely that this would
be a full-time post but in the former a part-time one. There were however
difficulties in this part-time approach in that the Quality Manager might be
expected to be responsible for activities that he or she may be performing in
the time that they were not Quality Manager.
· The final presentation was a brief overview by Cheryl Blair,
Executive Manager of CPA, on the proposed implementation programme for the new
standards. She indicated that the standards, having been produced to the final
draft stage, had now been circulated to the CPA's supporting organisations and
would subsequently be distributed on a wider basis so that individuals could
make their comments. At the end of this consultation period the Standards
Review Committee would meet as necessary to agree and make any changes to the
standards before it was presented in the Autumn of 2000 to the CPA Board.
Cheryl Blair then discussed the implementation programme; this has subsequently
been published in the CPA Newsletter.
At particular intervals during the course of these presentations and
for a period following them the Chairman asked for comments and questions.
There was a lively discussion but conclusions about the response of the
audience, and indeed about the response of professionals who did not attend the
conference, cannot be assessed until the consultation period has closed.
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