span may 06 scottish pathology network (span) the first 6 months
TRANSCRIPT
May 06SPAN
Scottish Pathology Network (SPAN)
The First 6 Months
May 06 SPAN
Where?• Lothian - WGH and NRIE• Glasgow North – WIG and GRI• Glasgow South• Yorkhill• Neuropathology SGH• Inverclyde• Royal Alexandra Paisley• Crosshouse• Stirling• Raigmore• Dumfries & Galloway• Aberdeen• Fife• Lanarkshire – Monklands, Wishaw & Hairmyres
•Travelled 15000 miles
•Darlington
•Newcastle
•Gateshead
•Edinburgh
•London
•Clydebank
May 06 SPAN
Why?
• Scoping Pathalba
• Scoping the quality of the pathology infrastructure
• Communication
• Gaining perspectives and viewpoints from Herceptin to colorectal screening from specialist reporting to accreditation
May 06 SPAN
The Reception?
• Professional and cordial
• Questions about where the network was going and its function
• Some dismissive
• No Department seemed disinterested
May 06 SPAN
May 06 SPAN
Overview
• The majority of departments seemed to have secured significant investment in laboratory upgrade and new technology
• Vacancies anecdotally did not seems as bad as 3 years ago
• CPA status varied although 2 Departments had significant long standing problems.
• No evidence of significant backlogs of work.
• Evidence of pressure to deliver under a significant backdrop of change
May 06 SPAN
What?
• Cervical cytology- Briefing paper• Herceptin – Questionnaire, S. Exec Briefing paper and status report• Pathalba – Scoped need, Board decision paper and tender• Colorectal screening roll out• Launch meeting• Web site• Developed communication strategy• Developed a framework and initial workplan for SPAN• Facilitated plans for movement of work• Consulted on National Clinical Datasets• Scotland/Malawi partnership• In conjunction with National Procurement negotiated additional discount of
£40k with Dako• Provided advice to organisations and management on pathology issues
May 06 SPAN
Benchmarking
• Kerr and Delivering for Health
• All Laboratories in Scotland to Keele Benchmark by 2006
• Why?
• How do we compare?
May 06 SPAN
Histopathology Turnaround times Scotland Wide
% Breast Diagnosis/MDT Meeting
0
20
40
60
80
100
Lab1
Lab2
Lab3
Lab4
Lab5
Lab6
Lab7
Lab8
Lab9
Lab10
Lab11
Lab12
Lab13
Lab14
May 06 SPAN
Cytology
SCCRS
Consultant
Recruitment
HPV Testing
HPV Vaccination
Imaging
Liquid
Based CytologyRole Extension
Health Improvement
Public Expectation
Drivers for Change
May 06 SPAN
Pathalba Project Plan
• Scoping exercise Oct/Nov 05
• Paper agreed at Pathalba Board Jan 06
• Tender for Phase 1 Issued Mar 06
• Tender Closing Date 08 May 06
• Delivery of systems by Summer 06
• Phase 2 delivery by Late 2007
May 06 SPAN
Herceptin
May 06 SPAN
Status Nov 2005
Location Testing November 05
West of Scotland (inc Forth Valley)
All breast cancers ( backlog in testing)
Dumfries & Galloway ER/PR negative, recurrent and metastatic disease
Tayside All breast cancers tested ICCFISH only on relapsed patients
Grampian All breast cancersFISH only on relapsed patients
Highland Only on relapsed patients.
Lothian/Fife/Borders All relapsed patients on request. All new grade 3s, All ER Neg, All node +
May 06 SPAN
ICC/FISHLocation Antibody Used FISH
West of Scotland Herceptest Vysis
Crosshouse Herceptest + CBE356 N/A
Dumfries & Galloway Herceptest + CBE356 N/A
Tayside CB11 Q Biogene
Grampian Dako Poly A0485 Vysis
Highland N/A N/A
Lothian/Fife/Borders Herceptest Vysis
May 06 SPAN
Questionnaire
Location Core v Resection (Majority of cases)
West of Scotland Resection
Crosshouse Core
Dumfries & Galloway Resection
Tayside Core
Grampian Core
Highland Resection
Lothian/Fife/Borders Resection
May 06 SPAN
Resources
Location Funding for testing at 1st Diagnosis
West of Scotland £100k (Capital & Revenue)
Crosshouse £3k
Dumfries & Galloway N/A
Tayside £22k
Grampian £31k
Highland £18k
Lothian/Fife/Borders £101k
May 06 SPAN
Role Extension Location ICC Scoring FISH Scoring
West of Scotland Consultant only Clinical Scientist/BMS
Crosshouse Consultant onlyChief BMS Staff in training
N/A
Dumfries & Galloway Consultant/Chief BMS N/A
Tayside Consultant Clinical Scientist
Grampian Consultant Clinical Scientist
Highland N/A N/A
Lothian/Fife/Borders Consultant Consultant/BMS
May 06 SPAN
Conclusions from Dec SPAN Paper
• Any site must meet the published guidelines and EQA requirements
• In line with ‘Delivering for Health’ FISH to be provided on 3 or 4 centre model
• Pathology testing is unlikely to be a constraint to timely treatment (Funding Dependant)
• Testing where regionalised needs to provide a standardised timely service to meet local MDT needs.
May 06 SPAN
NHS Tayside Pecos Spend Analysis
0
500
1000
1500
2000
2500
Apr-05
May-05
Jun-05
Jul-05 Aug-05
Sep-05
Oct-05
Nov-05
Dec-05
Jan-06
Feb-06
Mar-06
Sp
en
d (
in £
'00
0)
May 06 SPAN
Web Site Development
May 06 SPAN
National Clinical Dataset Development Programme
Breast Cancer Data Standards
for healthcare information in NHS Scotland
Post - consultation document
March 2006
National Clinical Dataset Development Programme (NCDDP) Support Team Information Services Area 54E Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB Tel: 0131 275 7053 Email to: [email protected] Website: www.show.scot.nhs.uk/clinicaldatasets/
May 06 SPAN
Major Incident Recovery Plan
• Backup computer systems• Retain partial functionality on site where possible• Labs in other centres/regions• Plans for staff movement
• "sift carefully through rubble; reassemble specimens and staff; process as normal..."
May 06 SPAN
What next?
• Steering Group
• Scoping major areas of development
• Prioritising the development through workplan
• Encouragement of current advisory structures/committees to feed through SPAN
• New groups where appropriate
• Develop further initiatives in histopathology, cervical cytology and molecular pathology
May 06 SPAN
Others
Osteo
GI
Neuro
Paed
Possible Structure?
•Scottish Pathology Network
Breast
Pathology Departments
Lym
phoma
Cervical
Skin
Head
BM
S
Gynae
SEHD
Planning Groups
May 06 SPAN
HDL (2006) 12
Nationally
May 06 SPAN
Regionally
Locally
May 06 SPAN
The Final Slide
• ‘Roll-out of successful initiatives and the sharing of best practice remains piecemeal’ Scottish Parliament Audit Committee May 2005
• ‘Rapid advances in automation mean that consideration should be given to rationalisation of some non acute and screening functions’ Kerr Report May 2005