May 18, 2018 - boundaries and LIMS systems. There is also the possibility of other benefits including Synoptic. Reportin
Scottish Pathology Network
Newsletter February 2018
Issue 5
Welcome to the Scottish Pathology Network winter newsletter. This edition will summarise the work that SPAN has undertaken or been involved in during late 2017-early 2018.
Digital Pathology While implementation for the pilot has been coordinated at a local level in NHS GG&C and NHS Lothian, we now have to look forward to national roll out. As some of the decisions and policies we put in place will have implications for any Board that continues with digital pathology, it is only appropriate that there is wider participation in the decision making process. This will be guided by three subgroups. The first two are more suitable to future clinical users (most likely consultant pathologists or senior medical trainees). The third would benefit from both clinical and technical/ managerial contributions.
National Data Retention Policy
NSS Excellence Awards We are so pleased to share that SPAN was shortlisted for the NSS Excellence Awards 2017, celebrated at a ceremony hosted at the Golden Jubilee National Hospital on 31st January. This award recognises the historic excellent work that SPAN has championed, including the buy-in and engagement the network has always had across all ten centres. It also acknowledges the development of the SPAN dataset and the more recent collaboration with the Information Management Service to establish the dashboard, the NHS Board reports and the all-Scotland report.
BMS Dissection The BMS Dissection Implementation Group was delighted to receive applications for the BMS Dissection Training from each of the ten pathology labs in NHS Scotland. The Implementation Group met on 2nd February and agreed places to be offered for the first programme to be delivered during 14th-18th May 2018. The programme is being finalised, a course handbook developed and a pre and post-evaluation will be issued. The BMS Dissection Business Case has been reviewed by the NHS Directors of Finance and will be presented to NHS Board Chief Executives in spring 2018.
This group will develop a common data retention policy taking into account RCPath and other guidance. This policy needs to be in place prior to business case finalisation as the amount of data storage required, and therefore cost, will be dependent on it.
National Reporting System As part of the pilot we are aiming to trial a Reporting System from SolitonIT. One possibility is that this is incorporated into the national programme. One of the key advantages of this is that it would allow seamless reporting across current Board boundaries and LIMS systems. There is also the possibility of other benefits including Synoptic Reporting, integrated voice recognition, enhanced report formats and a unified national pathology database. This group will help build the specification of what is required.
Business Case Development Team The current project team feels that the best possibility for national roll out of digital pathology will be for a coordinated approach to business case development, with the aim of securing appropriate national funding. We are looking for committed individuals to help with this process. Dr Gareth Bryson is putting together these 3 working groups, and would invite anyone willing to participate or lead a group to contact him directly on
[email protected]. The Digital Pathology symposium took place on Friday 9th March.
Shared Services
The DSM Design Group met on 23rd February.
Distributed Service Model Design Group
systems. It has been highlighted that it is unlikely that one LIMS system would be suitable for all diagnostic disciplines. The group would also make recommendations of a national rollout of National Pathology Exchange (NPEx).
Data group There was some discussion on coordination across regions/labs, with suggestion that the role of the networks and DSG should be more effectively utilised in the process. It was noted the DSM Design Group would not be reviewing the role of networks or the DSG however their role should be borne in mind as the DSM was designed. The timetable for the business case was outlined, noting that it would be submitted to Chief Executives in April. It was anticipated an update on this would be presented to DSG in March. The model going forward was then proposed as a threeregional model, with the suggestion of three regional operational boards and some overarching national oversight. Prior to deliberation on the best way forward, it was suggested there was a need to identify what was required in each location and define measures of effectiveness. There was discussion on the potential for DSG to fulfil the national oversight requirements. It was noted it was a great opportunity for the networks and DSG to be part of the design for future services. The blueprint had been refined in line with feedback from the networks and others and was available online here. It was agreed that further feedback would be sought on this to identify who might lead on the key pieces of activity outlined. The next meeting of the DSM design group would be arranged following submission of the business case. The IT group met on 8th February. The business case for
IT group NPEx was progressing and was hoped to be submitted to Chief Executives in April. The group is aiming to agree high-level national technical specifications of LIMS systems which could advise each region if they wished to procure new LIMS
The Shared Services labs programme hosted a data workshop on 31st January. SPAN, SCBMDN, SMVN and the Information Management Service (IMS) were all represented. The aim of the day was to begin to develop a datamart for labs, in order to provide real-time information to manage a distributed services model. The day started with an overview of progress within the programme, highlighting that a Business Case, including the data needs, was to be submitted to NHS Board Chief Executives in April, identifying what was needed to deliver a distributed service model. There were three breakout sessions to capture the needs of developing the datamart: The first focused on data requirements; asking what we wanted to do with the datamart and what data we needed to do this. The second asked if this data existed. In the third, we looked at priorities around standardisation. The need to explore how data definitions could be standardised was seen as a key issue; with the role of the networks explored. Steering Groups will be asked to take this onto their workplans for the coming year and a clear plan will be developed. As well as the interactive sessions, there were presentations from NHS Lothian and the IMS, on current developments within existing work programmes. It was clear that the standardisation already achieved in Lothian should be further explored. The visualisation in the IMS dashboards was praised with attendees keen to see this further progressed. Further workshops to define the data set will commence in April. It is anticipated that this work will be taken forward in collaboration with the Demand Optimisation data workstream A flash report on the day is also available. Laboratories shared service programme updates along with papers and team details can be found here
Demand Optimisation
Following collaboration across diagnostic services and Scottish Government’s publication of “Demand Optimisation in Diagnostics”, a second phase of work was planned to build on ongoing work and embed the recommendations of the report into operational practice thereby improving quality. A kick-off workshop took place on 15th February, with 3 members of the Pathology community attending. Chief Medical Officer, Dr Catherine Calderwood, has put a new team together to progress the Realistic Medicine agenda, which aims to deliver personcentred care, targeted to the interventions and treatments that patients would value most. The link with demand optimisation is the strand in Realistic Medicine to tackle unwarranted variation. Tackling Allocative, one of the published deliverables of the programme is to produce a Scottish Atlas of Variation. A training programme for clinicians to support them to understand the variation would be commissioned alongside this. The next stage of the programme would be to look at a programme of care that impacted on several areas. This work would commence with frailty, linked to the other strands of work.
• Communications and Engagement: Ensuring appropriate engagement with diagnostic staff and with referring clinicians; working in partnership to realise improvement in the patient pathway. • Data: Linking with the development of the datamart being designed for the Distributed Services Model; further development of the atlas to include data from all NHS Boards; extension of current data collection and visualisation beyond biochemistry. • National Alignment: Developing a shared vision across laboratory centres and nurturing synergies with realistic medicine and the distributed services model. • Biochemistry: A targeted quality improvement programme, across four specific test, (FSH, Vit D, Thyriod, U+Es) • Pathology: Exploring optimised demand in appendix biopsies; mega block requesting and molecular requesting. • Microbiology and Virology: Quality improvement projects to tackle variation in TB testing; leg ulcer testing and high-vaginal swabs. • Imaging: Learning lessons from work underway in the imaging network on referring in primary care, decision support tools and DNA coding.
Workshops took place involving representation across diagnostics in NHSScotland The first session allowed participants to vision the future, in the context of the report recommendation and subsequent work. The second workshop session then planned activity for the next twelve months to support the realisation of this vision, in the following key areas:-
ICC Survey The ICC Requesting Patterns survey has been re-circulated (closing 9th February) and results will be collated by Jackie Walker.
SPAN workstreams
Next SPAN Event
Horizon scanning The Horizon-Scanning Group meeting was held on 14th December with three invited speakers from NHS Grampian who presented on IT/eHealth (addressing challenges with voice recognition technology) and developments in genetics. Participation in this group to be welcomed from labs across Scotland, which may be testing new ideas or technology
Mortuary Group The mortuary group met on 23rd February to review the outcome of the survey, which was issued in January. This will provide baseline data for the current mortuary provision and issues facing services in Scotland.
Data group The Information Management Service led the first SPAN Data Group meeting on 11th January. The group discussed the data set requirements for 20172018, including a baseline measure for complexity.
SPAN Data deadline The SPAN Data collection round begins again soon. Questionnaires will be issued on 3rd April, with a deadline of 1st June. The Information Management Service will present the data in Individual Health Board Reports to the SPAN steering group on 11th September.
Communication We have found Twitter to be a flexible and innovative way to communicate directly with the Pathology community and engage with key stakeholders across Scotland and the UK. Key partners such as the Royal College of Pathologists and Institute of Biomedical Science track our Network’s progress and retweet our posts. We are followed by the Pathological Society Undergraduate Network – attracting interest from the Pathology community essential for the future. To date @NMDNScot has 394 followers
Our next SPAN event will take place on 2nd November, the same month as National Pathology Week, in a central location in Scotland. Please save the date in your diaries! If you have any suggestions for topics please let us know!
Quality Improvement support If you would like any support with Quality Improvement projects please contact us! We are happy to provide Quality Improvement tools and methodologies.
Get involved
Upcoming surveys SPAN will be issuing the following surveys soon!: Block & slide storage questionnaire
Further details can be found on the SPAN website:
www.pathology.scot.nhs.uk Or, contact us at
[email protected]
The National Managed Diagnostic Networks are on Twitter at @NMDNScot
