1. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Corporate Brief Agenda Clinical Governance Clinical Governance & Developments (Keith Hyde) & Developments (Keith Hyde) People (Pat Zukowskyj) People (Pat Zukowskyj) PFI and Facilities (Pat Zukowskyj) PFI and Facilities (Pat Zukowskyj) Finance (Pat Zukowskyj) Finance (Pat Zukowskyj) CPA Accreditation (Malcolm Dunlop) CPA Accreditation (Malcolm Dunlop) Fire Lecture (Malcolm Dunlop) Fire Lecture (Malcolm Dunlop)

2. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine PATHOLOGY NETWORKS REPORT DUE SOON

3. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Clinical Diagnostics Capacity Project PROJECT DIRECTOR GILBERT WIERINGA

4. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine DOH Diagnostics Agenda Drivers: Drivers: - Better chronic disease management - Reduced hospital admission/attendance - Improved services - Patient choice and demand

5. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Capacity planning: 2003-2008 Two phases: Two phases: 1) To determine current capacity in staffing, facilities and technology at primary and secondary care 2) To determine capacity needs in 2008 Phases led by healthcare professionals drawn from GMSHA secondary care geographical sectors

6. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Initial findings: Lab. medicine  Services have little impact on waiting lists, access targets Secondary care capacity well organised Secondary care capacity well organised GP referred workloads rising rapidly GP referred workloads rising rapidly Point of Care testing in the community Point of Care testing in the community needs to be developed Where should future work be located? Where should future work be located?

7. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine GP phlebotomy demands 2000 2001 2002 2003 70000 55000 40000 Nos. of samples

8. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine GP glucose & HbA1C requesting 2000 2001 2002 2003 Nos. of tests 15000 24000 33000

9. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine DOH supported developments Development of Withington DTC/ establishing new models of access to MR capacity Development of Withington DTC/ establishing new models of access to MR capacity Proviision of DIAGAM – mobile diagnostics Proviision of DIAGAM – mobile diagnostics Introducing clinical/diagnostic services at the point of care in Pharmacy outlets Introducing clinical/diagnostic services at the point of care in Pharmacy outlets

10. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Drivers for clinical/diagnostic services at the point-of-care  Diagnostics agenda, new pharmacy contract  Advances in Point-of-Care technology  Increased workloads from NSFs,NICE guidelines implementation  Increase in OTC prescribing  Patient choice  GMS contract

11. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Applications of Pharmacy-based point-of-care testing Condition/diseasePOCTPatient support DiabetesGlucoseDetection AnticoagulationINRManage/prescribe warfarin HyperlipidaemiaCholesterol Manage/prescribe lipid lowering DiabetesHbA1CMonitoring, repeat prescribing

12. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine What is DIAGAM ? Taking Diagnostics closer to patients …. A vision for a mobile A vision for a mobile DIAGnostic AMbulance service

13. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine DIAGAM : the opportunities Radiology Radiology X-ray X-ray MRI MRI Ultrasound Ultrasound Physiological measures Physiological measures DVT DVT ECG ECG Exercise tolerance Exercise tolerance Laboratory medicine Laboratory medicine Diabetes Diabetes Anticoagulation Anticoagulation Lipids Lipids Phlebotomy Phlebotomy Endoscopy Endoscopy Gastroscopy Gastroscopy

14. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Issues for discussion:- Role of the independent sector in capacity provision Role of the independent sector in capacity provision Role of the professions in new service development Role of the professions in new service development Overlap of pathology modernisation programme with diagnostics agenda Overlap of pathology modernisation programme with diagnostics agenda

15. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine ACKOWLEDGEMENT PROJECT DIRECTOR GILBERT WIERINGA

16. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Pat Zukowskyj

17. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine People Agenda for Change Agenda for Change Format of Lab Managers meetings Format of Lab Managers meetings

18. Central Manchester and Manchester Children’s University Hospital NHS Trust Division of Clinical Scientific Services Directorate of Laboratory Medicine DLM IM&T Strategic Group Estates DLM Quarterly Review (3/12) DLM Executive SIRT DLM BOARD STRATEGIC DLM VFM Group (2/12) Pathology Modernisation Strategic Steering Group (2-2/12) Simon Walsh Pathology Strategic CRES Meeting inc. Children’s (1/12) DLM AfC Steering Group Lab Managers WEEK 4  Finance in attendance  CRES  Procurement Lab Managers WEEK 3  Planning  IT  CPA  Benchmarking  KPIs  IT Manager in attendance Lab Managers Week 2  Facilities  PFI Lab Managers WEEK 5  Adhoc Lab Managers WEEK 1  HR in attendance  AfC  H & S  Education  Quality OPERATIONAL Departmental Meeting } Team Brief Meeting } “Chiefs” Meetings } through Lab Managers Departmental Senior Staff Meetings } DLM Safety Committee → through MSD → Lab Managers DLM Quality Board → through MSD → Lab Managers = Terms of Reference Mortuary Working Group → through CH & A D-G → DLM Executive (Mortuary) SIRT (½) documented DLM Joint Consultative Committee → through PZ → Lab Managers DLM Education and Training Group → through BW → Lab Managers MMMPTM → through RM → Lab Managers

19. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Facilities PFI – CSB III Plans and Development PFI – CSB III Plans and Development

20. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Finance Update Clinical & Scientific Support Services Division overspent by £270k to July 04 Clinical & Scientific Support Services Division overspent by £270k to July 04 Laboratory Medicine underspent by £179.8k Laboratory Medicine underspent by £179.8k Variance due to pay Variance due to pay Directorate initial share of Divisional CRES target for the year (£80k) has been implemented Directorate initial share of Divisional CRES target for the year (£80k) has been implemented Finance to be focus of the final Lab Managers meeting each month Finance to be focus of the final Lab Managers meeting each month New Directorate Accountant to be announced New Directorate Accountant to be announced

21. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Malcolm Dunlop

22. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Accreditation status Biochemistry – full Biochemistry – full Cytology – full Cytology – full Haematology – full Haematology – full Histology – (conditional) Histology – (conditional) Immunology – full Immunology – full Bacteriology – conditional Bacteriology – conditional Virology – conditional Virology – conditional HPA – conditional HPA – conditional In communication

23. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine Progress Audit training completed Audit training completed Standardised document templates Standardised document templates Departments updating documents Departments updating documents Document control roll out started Document control roll out started Quality Policy published Quality Policy published Management procedures being prepared Management procedures being prepared Management review planned Management review planned User Survey Completed and Reported User Survey Completed and Reported

24. Directorate of Laboratory Medicine Central Manchester and Manchester Children’s University Hospital NHS Trust Directorate of Laboratory Medicine What’s happening Departments have formed quality groups to prepare for CPA Departments have formed quality groups to prepare for CPA Vertical audits started Vertical audits started Witness audits to be planned Witness audits to be planned Baseline audit to establish compliance with the new standards ongoing Baseline audit to establish compliance with the new standards ongoing Series of DLM audits planned Series of DLM audits planned Step wise approach to standards Step wise approach to standards