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To: All Microbiology and Virology Peer Assessors

       Regional Assessment Managers

       Regional Assessors

Within Microbiology and Virology departments the re-processing of samples has become part of routine laboratory activities.  This is generally termed IQA (Internal Quality Assurance) and is part of the laboratory Internal Quality Control procedures (IQC). Laboratories can assess the two results from the same sample and if discrepancies or significant differences exist, take corrective action to improve the consistency of that particular laboratory test.  The concept originated in a PHLS publication on Quality Assurance and continues in the current Health Protection Agency National Standard SOP (QSOP 27).  This QSOP is directed particularly at virology and serology departments and encourages laboratories to try and re-process 0.5%-1% of the samples received in to the laboratory.

Recently a series of assessment visits raised non-compliances related to deficiencies in the IQA programme of the respective laboratories and these were discussed at the CPA PAC

(Professional Advisory Committee).  Following discussion it was concluded that IQA (as defined above) can only be considered as part of an overall IQC programme of a laboratory. Standard F3 only asks that procedures are in place to verify that the intended quality is achieved and IQA is one activity that can contribute to this aim.  It therefore follows that non-compliances cannot be raised against the F3 standard if laboratories either have no IQA programme or a selective IQA programme (ie only covering certain sample types or a limited number of samples) providing other procedures are in place to check the quality of the process.

This may seem a radical change from current assessment practice, but hopefully it will correct overemphasis on one aspect of IQC, and everyone will appreciate clarification from the PAC. There is no standard referring directly to IQA.  IQA is part of the IQC procedures of most Microbiology and Virology departments and in addition it can help in assessing staff competency where quality control samples are unavailable eg assessment of urine microscopy. It is for individual laboratories to assess the effectiveness of their IQA programme within the context of their overall IQC procedures.

Dr Philip T Mannion                                                              Dr John Goepel

Consultant Medical Microbiologist                                     Consultant Medical Histopathologist

CPA PAC Member, Microbiology                                      CPA PAC Chairman