SPAN May 06 Scottish Pathology Network (SPAN) The First 6 Months

SPAN May 06 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 miles Darlington Newcastle Gateshead Edinburgh London Clydebank

SPAN May 06 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

SPAN May 06 The Reception? Professional and cordial Questions about where the network was going and its function Some dismissive No Department seemed disinterested

SPAN May 06

SPAN May 06 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

SPAN May 06 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

SPAN May 06 Benchmarking Kerr and Delivering for Health All Laboratories in Scotland to Keele Benchmark by 2006 Why? How do we compare?

SPAN May 06 Histopathology Turnaround times Scotland Wide

SPAN May 06 Cytology Liquid Based Cytology Imaging HPV Vaccination HPV Testing Consultant Recruitment SCCRS Role Extension Health Improvement Public Expectation Drivers for Change

SPAN May 06 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

SPAN May 06 Herceptin

SPAN May 06 Status Nov 2005 LocationTesting November 05 West of Scotland (inc Forth Valley) All breast cancers ( backlog in testing) Dumfries & GallowayER/PR negative, recurrent and metastatic disease TaysideAll breast cancers tested ICC FISH only on relapsed patients GrampianAll breast cancers FISH only on relapsed patients HighlandOnly on relapsed patients. Lothian/Fife/BordersAll relapsed patients on request. All new grade 3s, All ER Neg, All node +

SPAN May 06 ICC/FISH LocationAntibody UsedFISH West of ScotlandHerceptestVysis CrosshouseHerceptest + CBE356N/A Dumfries & GallowayHerceptest + CBE356N/A TaysideCB11Q Biogene GrampianDako Poly A0485Vysis HighlandN/A Lothian/Fife/BordersHerceptestVysis

SPAN May 06 Questionnaire LocationCore v Resection (Majority of cases) West of ScotlandResection CrosshouseCore Dumfries & GallowayResection TaysideCore GrampianCore HighlandResection Lothian/Fife/BordersResection

SPAN May 06 Resources LocationFunding for testing at 1 st Diagnosis West of Scotland£100k (Capital & Revenue) Crosshouse£3k Dumfries & GallowayN/A Tayside£22k Grampian£31k Highland£18k Lothian/Fife/Borders£101k

SPAN May 06 Role Extension LocationICC ScoringFISH Scoring West of ScotlandConsultant onlyClinical Scientist/BMS CrosshouseConsultant only Chief BMS Staff in training N/A Dumfries & GallowayConsultant/Chief BMSN/A TaysideConsultantClinical Scientist GrampianConsultantClinical Scientist HighlandN/A Lothian/Fife/BordersConsultantConsultant/BMS

SPAN May 06 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.

SPAN May 06

SPAN May 06 Web Site Development

SPAN May 06 National Clinical Dataset Development Programme

SPAN May 06 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..."

SPAN May 06 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

SPAN May 06 Others Osteo GI Neuro Paed Possible Structure? Scottish Pathology Network Breast Pathology Departments Lymphoma Cervical Skin Head BMS Gynae SEHD Planning Groups

SPAN May 06 HDL (2006) 12 Nationally

SPAN May 06 Regionally Locally

SPAN May 06 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