Carter report 2006

King’s clinical
biochemistry
SWOT analysis
Strengths, weakness, opportunities,
threats
 Management
Strength Weakness
Strong Clinically led
Decision making Executive Slow to implement
Communication Minutes ? More needed
Tuesday brief

Demand management Some pathnet rules Much more needed

Disseminate information website ?GPs

Business Minded Pathology specialist Full financial

Test group (PSTG) Information not available

Biochemistry specialist
Test group(BSTG)
 End –to-end Pathology Service
Strength Weakness

Sample collection
Phlebotomy Not under Pathology
GP practice control

Transport
Hospital Vacuum Not under Pathology
Maudsley Porter
GP Collection Control
Client Post Delays

CSR EPR and Cumbersome

Bar codes Serious Delays

? New computer system will

simplify
 End-to-end Pathology Service 2
Strength Weakness
End-to-end IT
Hospital EPR Not end-to-end
Maudsley For all our users
Pathnet ?new computer
GPs
Clients Website Will address
GP Access

Blood Sciences Lab

Front and back Some problems with
yes
End automation Incomplete test and
specials

18 hour real time No Training Issues

working ?lack of staff
?staff anxiety
Standard : No sample should
Waite more than 2 hours
 End-to-end Pathology service 3

Strength Weakness
Specials
SAS
Steroids PSTG Not end-to-end
Trace Metals PSTG Turnaround times
Porphyrin PSTG ?lack of staff
EPO PSTG
New equipment
GI PSTG Not end-to-end
Turnaround times
PSTG ? Automation needed
CDT

Catecholamines New Equipment Not fully functional

?business case needed
?front end automation
 End-to-end Pathology Service 4
Strength Weakness
Endocrine
Tumour markers
Bone Markers New Equipment Not yet developed
?business case
Tumour markers Good repertoire Turnaround times
Unusual:S100, Marketing
M2PK Business case
Endocrine Good repertoire Turnaround times
TG, ACTH, Renin Business case
Aldosterone, Very slow progress of
Obesity hormones Implementation
Being developed

Molecular New Laboratory ?training issues

?business case
TDM/Toxicology 3rd floor development
R&D New staff structure
 Staff 1
Strength Weakness

Medics Good Mix Are we value for money?

Clinical Scientists Is professional demarcation
Medical laboratory scientists Defined?
Medical laboratory assistants
SATO
Administrators
Medics
Strong clinically led Yes ? Interaction with lab
service
Take part in patient’s Yes More contact with GPs
Journey
Demand management Meeting with Much more needed
Clinicians
Teaching Talks to GPs Much more needed

Training MRCPath Meet the needs of

patients
 Staff 2
strength weakness
Clinical scientists
Roles Section scientists ?value for money
Involved in routine
Income generation
And R&D
Training MSc Need for further focus
MRCPath On individual needs and
Training officer Structured training
Biomedical scientists
Roles Section managers ?more scientific involvement
Day to day operation
Training Offered ? More training
Training officer
MALAs, SATOs
Administrators
Roles Defined More training and allow
Training Local promotion
 Opportunities Threats

Core laboratory for Too expensive

Pathology network Poor turnaround times
Commissioner pressure

Core laboratory for Competition from NHS and

Referrals and SAS Independent sector

Unable to deliver
Income generation Poor customer care
 Problem Solving

Identify and define problem

Identify the people who need to be involved
Review the evidence
Decide with the standard to be adopted
Implement the standard
Audit the effectiveness of the standard
Disseminate the result
Evaluation
Periodic review & quality management
 A Vision of Future
STAFF
Academic
Flexible entry
Strong academic
Medics
Interest
Scientists
Clinically led Evidence based
SATO
Clear lines of accountability Research
Clerical
R&D section
Escalator of Managed Pathology
Promotion Network

Flexible work staff

IT, New Technology,
And work pattern
Point of care
Demand management
Shift or Extended
Continuous audit
Hours
24/7 laboratory
Outcomes

Improved Value for Improved

Clinical outcomes money quality