directorate of laboratory medicine central manchester and
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Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory MedicineCorporate BriefCorporate BriefAgendaAgenda
Clinical GovernanceClinical Governance
& Developments & Developments (Keith Hyde)(Keith Hyde) People People (Pat Zukowskyj)(Pat Zukowskyj) PFI and Facilities PFI and Facilities (Pat Zukowskyj)(Pat Zukowskyj) Finance Finance (Pat Zukowskyj)(Pat Zukowskyj) CPA Accreditation CPA Accreditation (Malcolm Dunlop)(Malcolm Dunlop) Fire Lecture Fire Lecture (Malcolm Dunlop)(Malcolm Dunlop)
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
PATHOLOGY NETWORKSPATHOLOGY NETWORKS
REPORT DUE SOONREPORT DUE SOON
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
Clinical DiagnosticsClinical Diagnostics
Capacity ProjectCapacity Project
PROJECT DIRECTORPROJECT DIRECTORGILBERT WIERINGAGILBERT WIERINGA
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
DOH Diagnostics AgendaDOH Diagnostics Agenda
Drivers:Drivers:
- Better chronic disease management- Better chronic disease management
- Reduced hospital - Reduced hospital admission/attendanceadmission/attendance
- Improved services- Improved services
- Patient choice and demand- Patient choice and demand
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
Capacity planning: 2003-2008Capacity planning: 2003-2008
Two phases:Two phases:1)1) To determine To determine current capacitycurrent capacity in in
staffing, facilities and technology at staffing, facilities and technology at primary and secondary careprimary and secondary care
2)2) To determine To determine capacity needs in 2008capacity needs in 2008
Phases led by healthcare professionals drawn from GMSHA secondary care geographical sectors
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
Initial findings: Initial findings: Lab. medicineLab. medicine
Services have Services have little impact on waiting little impact on waiting listslists, access targets, access targets
Secondary care capacity Secondary care capacity well organisedwell organised GP referred workloads GP referred workloads rising rapidlyrising rapidly Point of Care testing in the communityPoint of Care testing in the community
needs to be developedneeds to be developed Where should Where should future work be locatedfuture work be located??
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
GP GP phlebotomy phlebotomy demandsdemands
2000 2001 2002 2003
70000
55000
40000
Nos. of samples
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory MedicineGP GP glucoseglucose & & HbA1CHbA1C requestingrequesting
2000 2001 2002 2003
Nos. of tests
15000
24000
33000
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory MedicineDOH supported DOH supported developmentsdevelopments
Development of Development of Withington DTCWithington DTC/ / establishing new models of access to MR establishing new models of access to MR capacitycapacity
Proviision of Proviision of DIAGAMDIAGAM – mobile diagnostics – mobile diagnostics
Introducing clinical/diagnostic services at Introducing clinical/diagnostic services at the point of care in the point of care in Pharmacy outletsPharmacy outlets
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory MedicineDrivers for Drivers for clinical/diagnostic services clinical/diagnostic services
at the point-of-careat the point-of-care Diagnostics agenda, Diagnostics agenda, new pharmacy contractnew pharmacy contract Advances in Point-of-Care Advances in Point-of-Care technologytechnology Increased Increased workloadsworkloads from NSFs, from NSFs, NICE NICE
guidelines implementationguidelines implementation Increase in Increase in OTC prescribingOTC prescribing Patient Patient choicechoice GMS contractGMS contract
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory MedicineApplications of Pharmacy-Applications of Pharmacy-basedbased
point-of-care testingpoint-of-care testing
Condition/disease POCT Patient supportDiabetes Glucose Detection
Anticoagulation INR Manage/prescribewarfarin
Hyperlipidaemia Cholesterol Manage/prescribelipid lowering
Diabetes HbA1C Monitoring,repeat prescribing
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
What is What is DIAGAMDIAGAM ? ?
Taking Diagnostics closer to patients Taking Diagnostics closer to patients ….….
A vision for a mobile A vision for a mobile
DIAGDIAGnostic nostic AMAMbulance servicebulance service
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
DIAGAMDIAGAM : the opportunities : the opportunities
RadiologyRadiology X-rayX-ray MRIMRI UltrasoundUltrasound
Physiological Physiological measuresmeasures DVTDVT ECGECG Exercise toleranceExercise tolerance
Laboratory medicineLaboratory medicine DiabetesDiabetes AnticoagulationAnticoagulation LipidsLipids PhlebotomyPhlebotomy
EndoscopyEndoscopy GastroscopyGastroscopy
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
Issues for discussion:-Issues for discussion:-
Role of the Role of the independent sectorindependent sector in in capacity provisioncapacity provision
Role of the Role of the professions professions in new service in new service developmentdevelopment
Overlap of Overlap of pathology modernisationpathology modernisation programme with diagnostics agendaprogramme with diagnostics agenda
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
ACKOWLEDGEMENTACKOWLEDGEMENT
PROJECT DIRECTORPROJECT DIRECTOR
GILBERT WIERINGAGILBERT WIERINGA
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
Pat ZukowskyjPat Zukowskyj
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
PeoplePeople
Agenda for ChangeAgenda for Change
Format of Lab Managers meetingsFormat of Lab Managers meetings
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Division of Clinical Scientific ServicesDivision of Clinical Scientific Services
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
DLM IM&T
StrategicGroup
Estates DLM
QuarterlyReview(3/12)
DLMExecutive
SIRT
DLM BOARD
STRATEGIC
DLMVFM
Group(2/12)
Pathology Modernisation
StrategicSteeringGroup
(2-2/12)
Simon WalshPathologyStrategic
CRESMeeting inc.Children’s
(1/12)
DLMAfC
Steering Group
Lab Managers WEEK 4
Finance in attendanceCRESProcurement
Lab Managers WEEK 3
PlanningITCPABenchmarkingKPIsIT Manager in attendance
Lab Managers Week 2
FacilitiesPFI
Lab Managers WEEK 5
Adhoc
Lab Managers WEEK 1
HR in attendanceAfCH & SEducationQuality
OPERATIONAL
Departmental Meeting }Team Brief Meeting }“Chiefs” Meetings } through Lab Managers Departmental Senior Staff Meetings }DLM Safety Committee → through MSD → Lab ManagersDLM Quality Board → through MSD → Lab Managers = Terms of ReferenceMortuary Working Group → through CH & A D-G → DLM Executive (Mortuary) SIRT (½) documentedDLM Joint Consultative Committee → through PZ → Lab ManagersDLM Education and Training Group → through BW → Lab ManagersMMMPTM → through RM → Lab Managers
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
FacilitiesFacilities
PFI – CSB III Plans and PFI – CSB III Plans and DevelopmentDevelopment
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
Finance UpdateFinance Update
Clinical & Scientific Support Services Division Clinical & Scientific Support Services Division overspent by £270k to July 04overspent by £270k to July 04
Laboratory Medicine underspent by £179.8kLaboratory Medicine underspent by £179.8k Variance due to payVariance due to pay
Directorate initial share of Divisional CRES target for Directorate initial share of Divisional CRES target for the year (£80k) has been implementedthe year (£80k) has been implemented
Finance to be focus of the final Lab Managers Finance to be focus of the final Lab Managers meeting each monthmeeting each month
New Directorate Accountant to be announcedNew Directorate Accountant to be announced
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
Malcolm DunlopMalcolm Dunlop
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
Accreditation statusAccreditation status
Biochemistry – fullBiochemistry – full Cytology – fullCytology – full Haematology – fullHaematology – full Histology – (conditional)Histology – (conditional) Immunology – fullImmunology – full Bacteriology – conditionalBacteriology – conditional Virology – conditionalVirology – conditional HPA – conditionalHPA – conditional
In communication
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
ProgressProgress
Audit training completedAudit training completed Standardised document templatesStandardised document templates Departments updating documentsDepartments updating documents Document control roll out startedDocument control roll out started Quality Policy publishedQuality Policy published Management procedures being preparedManagement procedures being prepared Management review plannedManagement review planned User Survey Completed and ReportedUser Survey Completed and Reported
Directorate of Laboratory Directorate of Laboratory MedicineMedicine
Central Manchester and Manchester Children’s University Hospital Central Manchester and Manchester Children’s University Hospital NHS TrustNHS Trust
Directorate of Laboratory MedicineDirectorate of Laboratory Medicine
What’s happeningWhat’s happening
Departments have formed quality Departments have formed quality groups to prepare for CPAgroups to prepare for CPA
Vertical audits startedVertical audits started Witness audits to be plannedWitness audits to be planned Baseline audit to establish Baseline audit to establish
compliance with the new standards compliance with the new standards ongoingongoing
Series of DLM audits plannedSeries of DLM audits planned Step wise approach to standardsStep wise approach to standards
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