issue 495 july 2004

ACBNewsACBNewsThe Association of Clinical Biochemists • Issue 495 • 20th July 2004

Focus in

Photos

The Ethics of

Surplus Blood

Samples

HbA1c and

Haemoglobinopathies

Inside the

MRCPath . . . the

Truth at Last!

Focus in

Photos

The Ethics of

Surplus Blood

Samples

HbA1c and

Haemoglobinopathies

Inside the

MRCPath . . . the

Truth at Last!

THE

LATEST

ARRIVAL

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TM Trademarks referenced are owned by Dade Behring Inc. or its affiliated companies.

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Family values to appreciate in theclinical laboratory.

July 2004 • ACB News Issue 495 • 3

About ACB NewsThe monthly magazine for Clinical Science

The Editor is responsible for the finalcontent. Views expressed are not necessarily those of the ACB. EditorDr Jonathan BergDepartment of Clinical BiochemistryCity HospitalDudley RoadBirmingham B18 7QHTel: 07973-379050/0121-507-5353Fax: 0121-765-4224Email: [email protected]

Associate EditorsMiss Sophie BarnesDepartment of Chemical PathologySt Thomas’ HospitalLondon SE1 7EHEmail: [email protected]

Mrs Louise TilbrookDepartment of Clinical BiochemistryBroomfield HospitalChelmsfordEssex CM1 5ETEmail: [email protected]

Mr Ian HanningDepartment of Clinical BiochemistryHull Royal InfirmaryAnlaby RoadHull HU3 2JZEmail: [email protected]

Focus Handbook EditorDr Richard SpoonerDepartment of Biochemistry Gartnavel General HospitalGlasgow G12 0YNEmail: [email protected]

Situations Vacant AdvertisingPlease contact the ACB Office:Tel: 0207-403-8001 Fax: 0207-403-8006Email: [email protected]

Display Advertising & InsertsPRC AssociatesThe Annexe, Fitznells ManorChessington RoadEwell VillageSurrey KT17 1TFTel: 0208-786-7376 Fax: 0208-786-7262Email: [email protected]

ACB Administrative OfficeAssociation of Clinical Biochemists130-132 Tooley StreetLondon SE1 2TUTel: 0207-403-8001 Fax: 0207-403-8006Email: [email protected]

ACB ChairmanMiss Janet SmithDepartment of Clinical BiochemistryUniversity Hospital Birmingham NHS TrustBirmingham B29 6JDTel: 0121-627-8449 Fax: 0121-414-0078Email: [email protected]

ACB Home Pagehttp://www.acb.org.uk

Printed by Piggott Printers Ltd, CambridgeISSN 1461 0337© Association of Clinical Biochemists 2004

ACBNewsNumber 495 • July 2004

General News 4

Disposable Laboratory Tips 7

IT Links 8

MRCPath Short Questions 9

Focus 2004 in Photos 12

Focus Workshops 14

Agenda for Change 18

Meeting Report 22

Trainees Committee 25

MRCPath 27

Obituaries 29

Letters 32

Situations Vacant 34

Front cover: Members of the Nichols Institute Diagnostics team in costumes at the Focus 2004 Corporate Members Evening

4 • ACB News Issue 495 • July 2004

General News General News General News General News General News

ACB News CartoonsPeople sometimes ask if they can use ACB News cartoonsin lectures incorporated into PowerPoint presentations.The Editor is very happy that this is done. All you need todo is open the electronic version of ACB News intoAdobe Acrobat and extract the page. You can then chooseto save the page as a TIFF and crop and edit the page in aphoto-editing package before inserting it into your presentation. Please do mention ACB News when you usethe cartoon! Editions of ACB News back to July 1998 areall available from the ACB website: www.ACB.org.uk byclicking on the latest ACB News front cover icon. ■

Arnold BeckmanDr Arnold Orville Beckman,founder and chairman emeritusof Beckman Instruments diedon Tuesday 18th May 2004 atthe age of 104 years old. Bornthe son of a blacksmith inIllinois, Beckman invented thepH meter, which was the foun-dation for the company that helaunched in 1935. In addition to his considerablebusiness and scientific achievements, Dr Beckman wasrecognised as a great philanthropist. Through theArnold and Mabel Beckman Foundation, formed in1977, Beckman contributed more than $400 million tosupport scientific research and education. ■

Nichols Storm Corporate Members Night

What can we say about James Crofts and the team fromNichols at the Focus 2004 Corporate Members night?They really took the monochrome theme to theirhearts. The Nichols team were judged and awarded allfive prizes by the judges at Bobby Browns which Jamesand his team said was “well worth sweating for”. ■

Mr Henk Nijzing (NID Netherlands) emancipated as the Skeleton, Dr JuergenWilde (NID Euro-HQ) looked great as a Prisoner, Ms Leonie Hilliard (NIDUK) excelled as Morticia Addams, Mr Anthony Wilks (NID Euro-HQ) was asuperb Sister Parathyroida Bio-intacta, Mrs Christine Chesters (NID UK) wasthe ultimate Cruella De’Vil and Mr James Crofts (NID UK) was, “finer than afine thing”, as Edmund Blackadder

Royal College of Pathologists

Inaugural Annual MeetingWednesday 22 September 9.20 am – 4.45 pm

This inaugural Annual Meeting of The Royal College of Pathologists is an unrivalled opportunity to be updated aboutsome of the most urgent, challenging and vital topics in the pathology specialties. This programme of high qualitypresentations is open to members of the profession of pathology, public, media, government and health servicerepresentatives from the independent and public sectors.

• Fresh challenges for the College - Professor James Underwood• Pathology from the patients’ perspective - Dr Patricia Wilkie• Cameron Lecture: Fingerprints, tissues and Society – Professor Mark Walport• Impact of new genetics on pathology – Dr John Crolla• The Government’s vision for pathology in the NHS – Rt Hon John Hutton• Investigation of sudden infant death: can justice be done? – Baroness Helena Kennedy QC• Awaiting the next great Plague – Professor Stephen Gillespie• “It must be an allergy. . .” reactions to food – Dr Carrock Sewell

Registration: £75.00 for all bookings made before Friday 27 August. £100.00 for bookings made after the above date.For further details please contact: Michelle Casey, Academic Activities Co-ordinator Tel: 020-745-16740 Email: [email protected]

11 Total Laboratory Automation projects successfully implemented and deliveringproven work flow efficiency benefits through robotic sample handling directly connectedto analytic platforms.

Over 40 laboratories in UK and Ireland realising the benefits of full consolidation ofclinical chemistry and immunoassay testing on a single platform with installation ofMODULAR ANALYTICS SWA systems.

Over 80 installations of Roche system process manager (PSM) offering analyticalconnectivity for simplified sample tracking and archiving, workflow management, qualitycontrol, technical validation and reporting.

The UK’s leading supplier of Laboratory Integration Solutions

Telephone: +44 (0)1273 484788 Roche Diagnostics Limited, Bell Lane, Lewes, BN7 1LG

One sample One process One set of results


General News General News General News General News General News

Paediatric metabolic biochemistry is a rapidlydeveloping sub-specialty. Important new services fornewborn screening (haemoglobinopathies, cysticfibrosis, medium chain acyl CoA dehydrogenasedeficiency, plus the potential for other metabolicdisorders) are creating increased demands for clinicalscientists for the future. In addition there is thecontinued expansion of inherited metabolic disordersand the need for the specialist laboratory to supportdiagnosis and management of patients with thesecomplex disorders. An added pressure to the demandsfor new posts is the impending retirement of severalsenior members!

In order to address these important issues, theDepartment of Health, as part of the Genetics WhitePaper, has funded a training strategy for metabolicbiochemistry; this includes the funding of trainersacross England and eight higher specialist trainee posts.These latter posts will be 5-year supernumerary postsfor Grade B Clinical Scientists who wish to train in thisspecialist area. Post-holders will be expected tocomplete training for their MRCPath and will be givensupport to attend appropriate courses/meetings,including specialist meetings, e.g. British InheritedMetabolic Disease Group, Society for the Study ofInborn Errors of Metabolism.

Dr Mick Henderson has been appointed as LeadTrainer for the Network and, subsequently, it is plannedthat trainers will be appointed across clusters in threecentres (the North – Sheffield, the Midlands –Birmingham and the South – London). Together thesewill form a co-ordinated approach to training to

support these new HST posts, and also to strengthen thecore training for paediatric biochemistry for Grade Atrainees across England. For the latter it is hoped thatthere will be some standardization of secondments andtraining programmes as a means of rectifying some ofthe deficiencies which have been identified by theTraining Committee.

These developments are clearly very exciting and theNetwork is delighted that the Department of Health hasfunded these initiatives. The timescale is for theappointment of the trainer posts within the next threemonths. All these trainer initiatives should be in placefor the appointment of the HST posts from October2004 onwards.

The HST posts are advertised in this month’s ACBNews. There are posts in the following centres:Birmingham Children’s Hospital; BristolSouthmead/Bristol Royal Infirmary; AddenbrookesHospital, Cambridge; Liverpool Children’s Hospital(Alder Hey); Great Ormond Street and Guy’s & StThomas’s, London; Manchester Children’s Hospital andSheffield Children’s Hospital

Candidates will be expected to state their preferencefor centres in priority order. If you are interested infinding out more, please do not hesitate to contact Dr Anne Green, Lead Scientist, Clinical ChemistryDepartment, Birmingham Children’s Hospital.Tel: 0121-333-9922. Email: [email protected],or the Lead Trainer, Dr Mick Henderson, St James’sUniversity Hospital, Leeds. Tel: 0113-206-6861.Email: [email protected] ■

HST Posts for Paediatric Metabolic Biochemistry

Marshall Gets a MedalThe Royal College ofPathologists have awardedWilliam Marshall a CollegeMedal for distinguished serviceto the College. Speaking of thishonour,William told ACB News“I’m not one to brag, but it is agreat honour with only sevenmedals awarded since theCollege was founded”.Interestingly, five of the medalshave been presented to ClinicalBiochemists. Hugh Platt, lately

Director of Studies at theCollege, previously LeadPostgraduate Dean forPathology and a formerChemical Pathologist atUniversity College Hospital wasawarded one at the sameceremony. William is, ofcourse, a past PublicationsCommittee chairman of theACB as well as a leading writerand editor of Clinical Chemistrytextbooks. ■

Professor James Underwood, President of the College, presentsWilliam with his medal

Tips Disposable Laboratory Tips Disposable Laboratory Tips


IT Links IT Links IT Links IT LInks IT LInks IT Links IT Links IT Links


The Trace Element andMicronutrient Unit atGlasgow Royal InfirmaryBy Dr David Halls, Glasgow Royal Infirmary

http://www.trace-elements.org.uk

Whilst this site was originally intended primarily as a handbook for users ofthe service of this Scottish Reference Laboratory, it has much tocommend it as a source of information to any biochemist wishing to find

out more about the essential trace elements, toxic elements and vitamins. Traineebiochemists will find an introductory tutorial on trace elements, written originallyby Professor Gordon Fell, one of the pioneers of trace element clinical research inthe UK. Pages on trace elements from aluminium to zinc and vitamins from A to Egive details of the biochemistry of that element, the relevance of possiblemeasurements as well as sample requirements and reference ranges. Many pagesgive links to other sites to help further research. For those involved in occupationalmonitoring, an explanation is given of the “Control of Lead at Work Regulations.2002” as they apply to biological monitoring and a converter allows conversion ofblood lead results in µmol/L to those old-fashioned µg/100 mL units that theRegulations cling to.

• Don’t forget, links to all past and present ‘Websites of the Month’ are availablefrom the ACB website (www.acb.org.uk). If you wish to suggest a site for the‘Website of the Month’, please submit a short review (150-200 words) to IanGodber at Wishaw General Hospital ([email protected]). ■

Questions MRCPath Short Questions MRCPath Short Questions


Deacon’s ChallengeNo. 40 AnswerThe SHO in ITU carried out a blood gas analysis but failed to record all of the results in the patient’s notes.The only available results are:

H+ concentration = 93 nmol/LStandard bicarbonate = 15 mmol/LActual bicarbonate = 21 mmol/L

Calculate the pH and Pco2 (in kPa). Assume the solubility coefficient of CO2 (in kPa) is 0.225.

pH = - log10 [H+]

To convert the H+ concentration from nmol/L to mol/L divide by 1,000,000,000.

[H+] = 93 = 0.000 000 093 mol/L1,000,000,000

pH = - ( log10 0.000 000 093 ) = - (-7.03) = 7.03

The Henderson-Hasselbalch equation for the bicarbonate – CO2 pair is:

pH = pKa + log10 [HCO3–]

α Pco2

substitute:pH = 7.03

pKa = 6.1[HCO3

–] = actual bicarbonate = 21 mmol/L

α = solubility coefficient for CO2 in water = 0.225

then solve for Pco2

MRCPath Short Questions MRCPath Short Questions MRCPath Short


7.03 = 6.1 + log10 21

0.225 Pco2

7.03 - 6.1 = log10 21

0.225 Pco2

0.93 = log10 21

0.225 Pco2

antilog10 0.93 = 21

0.225 Pco2

Pco2 = 21 = 21 = 21 = 10.9 kPa

0.225 antilog10 0.93 0.225 x 8.51 1.92

Exam tip: The pKa for carbonic acid-bicarbonate was not given. The examiners expect youto know important constants such as the pKa for carbonic acid, phosphate and ammonia.Knowledge of these is a requirement for an understanding of acid-base homeostasis – animportant subject that should be covered in detail.

Question 41If the half life of a radionucleotide is 20 hours, at the end of how many complete days will theactivity have fallen to less than 2% of the initial value?

ACB West Midlands Scientific Meeting

Unravelling DNA inClinical BiochemistryAustin Court, City Centre Canalside (located between the ICC and the NIA), Birmingham30th September 200412.30-17.30

Programme12.30-13.30 Registration, Lunch and DNA Equipment Demonstration

Chairman: Dr Jonathan Berg, Regional Chairman

Randox Presentations, Trainees’ Award13.30-13.50 Menkes’ Kinky Hair - Straightening the DNA

Dr Stephanie Barber13.50-14.10 Plasminogen Activators in the Thyroid

Dr Lesley Buswell14.10-14.30 Real Time PCR; Is this the Future?

Ms Sweta Ram14.30-14.50 Recent advances in the measurement of IGF-1

Dr Deon Grant14.50-15.20 Afternoon Tea & DNA Equipment Demonstration

Practical Approaches to DNA in the Clinical Biochemistry Laboratory15.20-16.00 Quality Issues in Establishing Molecular Genetics in Clinical Biochemistry

Dr Gill Rumsby, Clinical Biochemistry, UCL Hospitals, London16.00-1640 Practical Techniques in Molecular Genetics

Dr Tony Fryer, Central Pathology Laboratory, Stoke on Trent16.40-17.20 Clinical Applications for DNA Testing in Clinical Biochemistry

Dr Dimitris Grammatopoulos, Clinical Biochemistry, University Hospitals of Coventry and Warwickshire

17.20-17.30 Discussion

Registration: ACB/IBMS Members £15 (Grade A & BMS Trainees free), Non-members £25. To register please send your cheque payable to “ACB WestMidlands Region” to: Dr David Kennedy, ACB West Midlands Meetings’ Secretary,Department of Clinical Biochemistry, Good Hope Hospital, Rectory Road, Sutton Coldfield, B75 2RR. Email: [email protected] We will email you a map and any further details that are required.

Remember – cheap flights to Birmingham from Dublin, Cork, Belfast, Edinburgh and Glasgow!

www.acbwm.org.uk

Focus 2004 in Photos Focus 2004 in Photos Focus 2004 in Photos


Focus on Social EventsRock climbing, Chinese Banquets and walks round the cityall featured in the social programme at Focus 2004 . . .

Steve Goodall rocked on at the Corporate Members night The now traditional Focus Chinese Banquet was a great success

The Walking Tour offers some public art to the people of Birmingham

Focus 2004 in Photos Focus 2004 in Photos Focus 2004 in Photos


Fun at theExhibition

The Exhibition was packed and stands who had original ideas werevery busy. From fresh orange to spinning the wheel, there was all thefun of the fair at the Focus 2004 Exhibition

TraineesMeetAcademicHeads . . .

The Petit Blanc was a great meeting place for the trainees and theheads of academic departments. Over 100 trainees turned up and agreat time was had by all


Focus Workshops Focus Workshops Focus Workshops Focus

This popular workshop led by Professor Furness, aHistopathologist from Leicester, centred on discussion ofthe Human Tissue Bill currently going through

Parliament. Within the Bill, ‘tissue’ is defined as any materialcontaining human cells. All biochemical samples (i.e. blood,urine, faeces, fluids) are thus included.

Under the new Bill, it will become illegal to use any suchsample for research or training, which is not ‘incidental to thediagnostic process’ and without ‘appropriate’ patient consent.No distinction is made between different grades of researchactivity (ie developing a new method versus a full-scale clinicaltrial) and use for training is poorly defined. Consent must beexplicit - although there are no plans/resources for achievingthis. No distinction is made between tissue (samples) surplus todiagnostic requirements (i.e. waste) and that required as part ofthe patient clinical record (i.e. retained). Use of anonymisedsurplus samples for research projects would therefore becomeillegal. The position on laboratory addition of tests that werenot requested is also unclear.

The penalties for breaking the law would be significant finesor up to 3 years imprisonment. Enforcement would become theresponsibility of a (new) Human Tissue Authority, but it isuncertain whether there would be pathologist representationwithin this body.

In conclusion, Professor Furness stated that, although writtenprimarily in response to recent organ retention scandals involving post-mortem specimens, the proposed legislation willbe applicable to all human tissue specimens and is thereforerelevant to all pathology disciplines. He explained that there aremany anomalies within the Bill and areas that raise concern forcurrently accepted laboratory activity. He urged all ClinicalBiochemists to familiarise themselves with the contents of theBill and encouraged further discussion with local pathologystaff, Chief Executives, MPs and the DoH as a matter of urgency.

Further information, including the Royal College response,can be obtained from the following web-sites:www. pathology.plus.com/HTB andhttp:/bmj.bmjjournals.com/cgi/content/full/328/7439/553 ■

When is it Ethical touse Surplus BloodSamples?Reported by Karen Poyser, Aberystwyth

Discussion continued on the canalside on when, and if, you can usea patient sample for anything other than the requested test

Professor Furness conducts his workshop on a crowded narrowboat


Workshops Focus Workshops Focus Workshops Focus Workshops

At the outset thanks were given to the manufacturers of systems formeasurement of glycated haemoglobin, all of whom provided information forthe workshop on how results from their systems should be reported in the

presence of haemoglobin variants.Miss Janet Smith and Dr Sue Manley (Birmingham) reminded us of the current UK

guidelines for treatment of diabetes and the importance of providing accurate HbA1cresults. The treatment goals set by NICE (National Institute for Clinical Excellence) fortype 2 diabetes are HbA1c (DCCT aligned) between 6.5-7.5% for an individualpatient, depending on their risk of complications or hypoglycaemia. Measurement ofHbA1c is recommended at 2-6 monthly intervals. The new GP contract providesmaximum points (and therefore funding) if HbA1c levels are maintained below 7.5%in diabetic patients.

The validity of HbA1c results in the presence of haemoglobin variants wasdiscussed. Although some methods allow the measurement of HbA1c whenparticular variants are present, the results do not necessarily relate to DCCT values.Glycation rates may differ in the presence of variants, consequently the relationshipbetween plasma glucose concentration and HbA1c will be different in these patients.HbA1c in patients with variants should therefore not be used when treating todefined goals.

Alternative Approaches in Presence of VariantsFor patients with haemoglobinopathies it is important to determine whether HbA1ccan be reported from the particular method employed. We gave the approach of ourown laboratories to reporting HbA1c in the presence of haemoglobin variants. It isrecommended that if HPLC is employed, chromatograms must always be reviewed tolook for variants. If HbA1c cannot be reported due to the presence of a variant whichleads to a falsely elevated or decreased result for HbA1c, an alternate method formeasurement of HbA1c or glycaemic control should be employed. Most laboratoriesusing HPLC routinely use affinity chromatography, immunoassay or fructosamine asalternate methods.

We reviewed HPLC chromatograms to look for variants and some interestingexamples of interferences in HbA1c methods were presented, including the case of afalsely elevated HbA1c value obtained from a POCT system due to the presence ofpersistent HbF. This highlighted the importance of educating users in the limitationsof HbA1c POCT systems, particularly with the expanding use of these systems inPrimary Care.

Delegates were all provided with the contents of this workshop in the form of a CD,together with some recently published papers on the subject. ■

Glycated HaemoglobinAnalysis andHaemoglobinopathiesReported by Julie Day, Durham


Focus Workshops Focus Workshops Focus Workshops Focus

Several weeks before this meeting, participants received a series of cases from Dr ChrisFlorkowski (New Zealand) around which the workshop was structured.

Case 1

34 year old female presents acutely psychotic. Free thyroxine index (FTI) 220 (55-160), TSH 20.4mU/L (0.4-4 mU/L).This case illustrated interference: TSH was suppressed using an alternative assay.Strategies for investigating interference were discussed and it was felt that an expedient approach wasto use an alternative assay. Binding protein abnormalities were discussed, but the use of free hormoneassays largely overcomes such problems in these cases.

Case 2

84 year old male. No clinical details. Total T4<10 nmol/L (55-140 nmol/L), FTI 9 (55-160), TotalT3 4.14 nmol/L (1.2-2.8 nmol/L), TSH 2.82 mU/L. A confusing set of results, but the interpretationis simple given that patient is taking T3. The lesson being to have all the relevant information to hand.

Case 3

31 year old male, presenting thyrotoxic. Raised Total T4 166 nmol/L and FTI 382 with a raised TSHof 8.8 mU/L. Imaging studies revealed a pituitary adenoma (TSH-oma). A TRH test was performed,which gave a flat response as would be expected in this situation. The value of measuring alphasubunits in such cases was mentioned.

Case 4

Generalised resistance to thyroid hormone (GRTH). In such cases T4 and T3 are elevated with anormal or increased TSH. Family studies are important, and some genetic testing is available. There isa dominant inheritance pattern and prevalence is approximately 1:50,000. Clinically, expression isvariable and patients can be asymptomatic. An important consideration when faced with such resultsis distinguishing from a TSH-oma.

Case 5

This involved a baby born to a thyrotoxic mother (thyroid stimulating antibodies) who throughoutpregnancy was treated with propylthiouracil (PTU). TFTs on the cord blood indicatedhypothyroidism – a transient effect due to trans-placental PTU. The infant then became transientlythyrotoxic, due to the persistence of maternal antibodies. Despite biochemical abnormalitiestreatment was appropriately withheld.

Apparent resistance to thyroxine and carbimazole was discussed. Possible causes of a persistenthyperthyroid state despite treatment with carbimazole were ectopic thyroid tissue or factitioushyperthyroxinaemia.

Other topics included the effects of amiodarone, and non-thyroidal illness (NTI). Data were showndemonstrating that total T4 was most likely to fall within the euthyroid range in patients with NTI. ■

Difficult ThyroidCasesReported by John Shepherd, Hull Royal Infirmary


Workshops Focus Workshops Focus Workshops Focus Workshops

This was a well attended workshop, held on a narrowboat on asunny Wednesday morning. Dr Steve George from the RegionalToxicology Laboratory, in Birmingham wasted no time and we set

sail for a whirlwind tour.The use of saliva was discussed. Benefits included watching the

sample being taken, but many disadvantages were also highlighted suchas the issue of residual effects, needing assays specific for the parentdrug rather than metabolites and low concentrations of drug (all withcost implications). Sweat analysis is falling out of favour due to thepotential of adulteration of the collection patches and hair analysis wasdeemed to be unsatisfactory due to external contamination, difficultextraction procedures and, again, low concentrations. This brought usback to the use of blood and urine for routine DOA investigations withnew techniques such as GC/MS and LC/MS/MS to combat cross-reactivity issues.

The potential of POCT devices for DOA screening is well recognised,but the same issues of quality control, operator training andunderstanding of assay limitations such as sensitivity and specificitywere again raised. This is especially relevant considering their useoutside the hospital setting at job interviews and schools etc. ManyPOCT users were reported to have little interest in quality assurance andthe question was raised as to whether the MHRA should impose QCprocedures and education and pressurise manufacturers to support thecosts.

As the narrowboat was pulling into dock, medico-legal issues werediscussed, with the awareness that more litigation was arising fromDOA screening. We were reminded of the importance of keeping welldocumented files for up to 2 years, which in itself brings up the furtherissue of space in our already cramped laboratories. Finally, theimportance of chain of custody was stressed. ■

Drugs of AbuseScreening Reported by Sarah Knowles, Derby

Agenda for Change Agenda for Change Agenda for Change Agenda for


The lunchtime sessions held at Focus 2004 were a valuable opportunity for delegatesto meet with officers from the Federation of Clinical Scientists; Geoff Lester, AlanPenny and Tim Saben (local representative at Guy’s and St Thomas’). The aim was to

provide an up to date briefing on progress with Agenda for Change and to answer as manyquestions as possible in the limited time frame.

It was standing room only at the Tuesday session I attended – reflecting the high level ofinterest from Focus delegates. The principles of the NHS Job Evaluation Scheme werereviewed and the process by which existing posts will be matched to the 8 bands of thenew system. The early implementer sites have not yet reported, but some general pointsabout the process are becoming evident. The FCS opinion was that the amount of time andresources required by each Trust should not be underestimated. Trusts will be askingpeople to form working parties within each organisation, some Trusts have asked for vol-unteers, others have asked that each department allocate a given number of staff to theproject. However the team is formed, it is not expected that staff from a given departmentwould be involved in job matching colleagues within the same department. Each SHA hasan AFC Lead and they would be the initial contact for people keen to be involved in theprocess at a local level.

The FCS Officers were keen to emphasise the practical aspects of undertaking the jobmatching process. In particular their recommendation was that the job matching teamshould be allocated dedicated office space during the process. This would enable allrelevant documents to be readily accessible with quiet space available for private consulta-tion with staff members etc. Ready access to a range of documents is likely to be requiredduring the job matching process – easy availability of telephones, a PC and internet accesscan all help to make the process run as smoothly as possible.

Many questions were asked by delegates, below are a summary of the main subjects covered. More details can be found on the FCS websitehttp://www.acb.org.uk/federation

Job BandingsThe evidence for your current role should be presented in the job description and a scoreassigned for each of the 16 factors outlined in the NHS Job Evaluation scheme profiles.This is then matched to a ‘job family’ - it is expected that clinical scientists would bematched against other scientific disciplines (rather than allied health professionals, forexample). It was stressed that jobs which exist now do not map directly to the new bands,nor do titles define a role. It is recognised that the profession is effectively being com-pressed from the current system - due to the nature of the profession Grade As shouldstart at no lower than band 5. However, the new system could lead to significant opportu-nities for certain areas for the profession, in particular high grade Bs who are currentlydoing the work of a Grade C. The job matching process provides an opportunity for thisrole to be recognised and matched to the job evaluation scheme accordingly.

At present there is not a full set of published job profiles to cover the whole range ofpost-registration clinical scientists, up to and including clinical director level. This is being

Focus BriefingSessionReported by Louise Tilbrook, Associate Editor

Change Agenda for Change Agenda for Change Agenda for Change


addressed and members are advised to watch the FCS website closely for further information.

Generic person specifications for different grades are being developed and these shouldbe used by Heads of Departments to inform the job matching process. Again it was emphasised that skills are matched to the job, not the person. If a person has PhD, forexample, but is employed in a post where a PhD is not required, then this cannot be takeninto account for grading purposes.

Those who haven’t yet seen a copy of the 71 page FCS Guidance on job descriptions areadvised to visit their web site where a pdf file can be downloaded or viewed electronically(to save trees!). There are also a number of informative Q&A articles which aim to addressspecific questions of members.

Essential information which the job matching panel will need includes:• person specification – details skills required• job description – outlines roles and responsibilities• organisational chart – outlines accountabilities and line management• supplementary documentation – details conditions of work etc.

What is the Timescale for Implementation?Foundation Hospitals wanted to implement AFC in October, but currently there is not fullunion agreement to the proposals. Early implementers have had the go-ahead to start thepilot but the process is unlikely to get underway before December 2004.

Specialist PostsThe generic person specifications will not cover specialist areas such as paediatrics. Specificroles and responsibilities for those positions will need to be added to the appropriateperson specification.

What about Clinical Scientists who also hold

posts as Clinical Directors?Issues around the role of Clinical Director still need to be resolved. Many unions want tosee introduction of a band 9 although the Department of Health is strongly resistant to this.Roles which are graded as 8D or above will need to be referred for evaluation.

Out of Hours WorkingThe position on this is clearly stated in the agreement. It is likely to be more of an issue forBMS colleagues. The AFC is essentially a drive towards a flatter, 24/7 form of servicedelivery. Other professions such as radiographers also have similar concerns.

In conclusion, the Agenda for Change seems to have been the subject of much discussionfor several years. We are now entering the ‘action’ phase of the process, where things arelikely to progress much more rapidly, particularly as the early implementer sites make theirreports public. ■

Manage the Process - Control the Flow


Meeting Reports Meeting Reports Meeting Reports Meeting Reports

The scientific session, chaired by Dr Damian Griffin, took thetheme of the assessment of cardiac risk factors. It openedwith Dr Nuha Haboubi of the West Wales General Hospital

updating the audience on developments in lipid management.Nuha concentrated on new therapies such as ezetimibe and newformulations of more established products, particularly nicotinicacid.

Dr Lena Izzat, an Associate Specialist in Cardiology at the PrincePhilip Hospital, continued with an overview of the assessment ofrisk in a Chest Pain Assessment Clinic and emphasised the use ofPOCT assays of troponin in this environment. Although thenumber of occasions where a POCT troponin was actually used wascomparatively small, she emphasised the clinical usefulness, evenin this small number of cases where the wait for a laboratory assaywould not have been practical.

After coffee, Dr Mike Penney gave a brief review of thephysiology and clinical utility of natriuretic peptides and thenfocussed on the potential cost to laboratories of implementing thetest according to NSF guidelines. At current market rates, the costof introducing BNP into his repertoire could cost his department inexcess of £1 million per year. Dr Penney compared the cost ofscreening patients with BNP to reduce the number of referrals forechocardiography and concluded that the cost of BNP assays mustcome down considerably to make this cost effective.

Dr Paul Collinson managed to negotiate the rail networksuccessfully and delivered a talk on ischaemia modified albumin,presenting data so new that it had not yet been reported elsewhere.Dr Collinson outlined the current theory of disordered cobaltbinding to the N-terminal of human serum albumin and itspotential use as an intermediary marker in the assessment ofcardiac risk.

Wales AuditFollowing straight on from the scientific meeting, the All WalesClinical Biochemistry Audit Group held their meeting. Chairman,Dr Keith Griffiths of Bangor presented an overview of the activitiesof the group emphasising its multidisciplinary constitution. Thegroup has currently audited practice within Wales of 18 or so areasof activity within clinical biochemistry and these reports can befound at HYPERLINK http://www.acb.org/welshauditwww.acb.org/welshaudit. Mrs Annette Thomas, WEQAS Director,presented the results of a survey of POCT support provided by

Science and Auditin WalesReported by Gareth Davies, Wrexham

The Spring Meetingof the Wales Region

followed its usualformat of combiningscience with auditat the Prince PhilipHospital, Llanelli on

23rd June

Peter Thompson

AINTREE HOSPITAL’S

BIOCHEMISTRY LABORATORY,

which handles some 1800 requestsevery day, seized the opportunity andinvited Olympus to conduct a full‘process management’ study. The evaluation identified sample handling as an area where major benefits would be gained by improved efficiency.

Typical of most pathology labs throughout the country, manual sortingof samples and transfer to the appropriate analyser or storage areaare tasks requiring valuable time.Inevitably, each is open to a degree ofhuman error, estimated at between 1and 3%. Since the installation of anOlympus OLA 2500, PeterThompson,General Manager of the lab commented,“The new Olympus systems have gone

a long way to solving the problem.”

The system provides automated sample handling, both pre and postanalytical, with minimum hands-ontime. The high throughput bringsconsiderable savings in terms of bothtime and money to the typical path lab.“Where samples were previously sortedmanually, automated handling frees uphighly trained personnel for moreimportant tasks. Pressure is eased onboth the lab and the staff,” said Peter.

Apart from saving the valuable timeof highly qualified staff, automatedarchiving provides efficient sampleretrieval in addition to full sample audit. The next part of the processmanagement procedure addressed the bottleneck encountered at the earlier stage of sample reception.

A familiar problem for this kind of lab is the sudden deluge of samples arriving in early to mid afternoonrequiring manual data entry of requests prior to processing.

Olympus PathRequest system hasalready been installed on two wards.This notifies the lab LIS system of allpatient and test request details so thatwhen the sample arrives in the lab asimple bar code scan is all that isrequired prior to sample processing.This improves patient safety andremoves the possibility of transcriptionerrors. Peter added, “This has provedto save valuable time at data entry andwill soon be extended to other wards.”

For further information: email [email protected]

NEARING THE END OF A CURRENT CONTRACT IS AN IDEAL TIME TO EXAMINE WORKFLOW

“The Olympus process managementstudy identified areas where

the introduction of new systems hasgreatly improved overall efficiency.”

AND REASSESS THE ENTIRE DEPARTMENT ...


Meeting Reports Meeting Reports Meeting Reports Meeting Reports

laboratories within Wales. The results of this survey would beconsidered and draft standards for practice will be presented at thenext meeting in November. Mr Mike McGrane of the RoyalGlamorgan Hospital presented draft standards for the operation ofmultiple blood gas analysers within the same Trust and Mr GarethDavies of the Wrexham Maelor Hospital presented draft standardsfor the investigation of suspected phaeochromocytoma. Draftstandards are circulated to heads of service at all Welsh clinicalbiochemistry laboratories for comment before a final standard isadopted for application within the Principality.

The day was closed following the Annual General Meeting of theWales Region. ■

ACB Southern Region Autumn Scientific Meeting

New Insights intoBiochemical DiseaseFriday 1st October 2004Alice Fisher Lecture Theatre, Cambridge

09.30 Coffee and registration10.25 Welcome and Introduction

Dr G A MaguireMorning Session Chairman: Dr G A Maguire10.30 New Advances in the Genetics of Obesity

Professor S O’Rahilly11.10 Recent Advances in Inherited Hormone Resistance

Professor K Chatterjee11.50 The Modern Management of Diabetes: DAFNE (dose adjustment for normal eating)

Dr S Dinneen12.30 Lunch

Afternoon Session Chairman: Dr A Norden13.30 The Epidemiology of Hyperglycaemia

Professor K-T Khaw14.10 Enzyme Replacement Therapy for Lysosomal Storage Disorders

Professor T Cox 14.50 Tea15.10 MRI: A Measurement Bridge between the Clinic and the Laboratory

Professor L Hall 15.50 Alpha 1 Antitrypsin Deficiency and the Serpinopathies

Professor D Lomas16.10 End

Cost of Meeting: £15 (free to Grade A Trainees)Further Information: Mrs Vanessa Palmer, Dept Secretary,

Department of Clinical Biochemistry and Immunology, Box 232, Addenbrooke’s Hospital, Cambridge, CB2 2QR.

Tel: 01223 586820. E- mail: [email protected]


Trainees Committee Trainees Committee Trainees Committee

In keeping with tradition, the Monday evening of the ACB NationalTraining course in Guildford was devoted to the trainees. The TraineesCommittee excelled themselves in providing two high quality speakers –

David Cassidy, Chair of the ACB Education Committee and the ACB’sEuropean Officer Mike Hallworth.

The Education Committee ExplainedDavid Cassidy began the evening by giving the trainees a valuable insight intowork of the Education and the Regional Tutors Committees. He also flatteredthe trainees by noting that the competition for places in grade A schemes wasas high as ever and that the high calibre of recruits could only be a goodthing for the future of the profession.

Future ACB National Training CoursesIt is a great belief of the Education Committee that trainees should play amajor role in the shaping of their training. This opportunity was sought toobtain ideas and feedback from the trainees about the organisation of thecourses, update sessions and training days.

Trainees felt that the numbers on the course and the overall level ofteaching was appropriate. Planned expansion of the number of placesavailable on future courses was thought to be an excellent idea- as long assupply met demand! This expansion may make workshops difficult toorganise, but these should still be possible.

There were mixed views on the suitability of the course for first year GradeA trainees. Some felt that that the level was too high and these trainees wereperhaps blocking the access to the course of those about to take the MRCPathPart 1 exam. Others, however, thought that if funding was available then itshould be used. In addition, as the courses are on a 3-year cycle, traineesshould start early if they plan to take the exam at the end of Grade A training.

Paediatric TrainingSome trainees felt that there should be more dedicated paediatric trainingdays. The Education Committee is working with the new National MetabolicBiochemistry Network to provide specific training for paediatric trainees.Everyone agreed that while it would be good to include more specialist areasin the National Training Courses there is a huge amount of information to becovered in only six courses!

Developments in EuropeAfter displaying an encyclopaedic knowledge of the member states of the EU,Mike Hallworth dispelled the myth that Europe was all about “Drains inSweden” by explaining EC4!

Training Coursesand Swedish Drains! Reported by Stephanie Barber, Sandwell General Hospital, West Midlands


Trainees Committee Trainees Committee Trainees Committee

The European Communities Confederation of Clinical Chemistry andLaboratory Medicine (EC4) was founded in 1993. Its main goal is toimprove the quality in clinical chemistry laboratories across Europe.This is mainly achieved through the harmonization of clinical chemistryin the EU and Europe – and as Mike pointed out, since May 1st thesetwo are now virtually the same!

The activities of EC4 are mainly split into two – the training andregistration of professionals and the accreditation of laboratories. EC4has produced a common syllabus across Europe for the training ofclinical chemistry staff. Although personal EC4 registration is voluntary,the trainees present were interested to hear how they could get involved.As Mike explained, it takes a minimum of 8 years from entry touniversity to become eligible for EC4 registration, but once gained itallows you to work in any EU country.

At the end of a long day Mike gave such a great explanation of recentdevelopments in Europe that the trainees for once were silenced butthen again, as Mike said, “Europe always silences everyone!” ■


MRCPath MRCPath MRCPath MRCPath MRCPath MRCPath MRCPath

With all due respect to William Marshall’s excellent series ofarticles on how to prepare for, and succeed in, the MRCPathexams I felt that there was something missing, namely a true

sense of what it is like to prepare for and sit these exams. This perspective can only be given by somebody who has recently gonethrough the experience of the MRCPath exams. So, to this end, I havewritten my own survival guide to MRCPath Part 1. I hope that it mightbe of some small help to those poor souls who can no longer put offhaving to face the exams, and at least give them an idea of what toexpect, or at the very least provide them with an excuse to stop revisingand read something else for a few minutes.

The opinions expressed are of course my own…

Expect a Severe ReactionLet’s not mince words, the Part 1 exams are going to be one of theworst experiences of your life. It is likely that you have never beforehad to revise so much material in such detail. You continue working fulltime and still have to find time to feed yourself and keep the houseclean. If you have a spouse and/or children you are really in trouble. Butit has to be done and no amount of procrastinating will change that.However, there are several essential psychological phases that you mustgo through first, before you can hope to do anything constructive.

Phase 1 . . . ExasperationThe standard advice is to start planning and preparing as soon aspossible. Read past papers, search out useful review papers, get a feel forthe size of the task and how you are going to go about it. You cannotdo this too early because, frankly, you are going to need time to get overthe reaction this process will provoke in you. Most will experiencesevere exasperation when they realise the huge range of subjects candidates are expected to know about in detail. This is made worsesince much of it is, in your opinion, irrelevant to your everyday work.This especially applies if you work in a children’s hospital. At this pointyou feel the urge to rant and rave about this to anybody who will listen,or can’t escape. Yes, you need to get it out of your system before youcan move on to the next stage.

From Despair to MotivationDespair sets in when you realise that ranting and raving isn’t going tochange anything. At this point you may find yourself contemplating achange of career, something with a few less exams perhaps and I seriously considered opening a bookshop at this point. Bear with it

MRCPath Exams . . .Let the Truth Be Told!By Claire Hart, Senior Clinical Biochemist, Sheffield Children’s Hospital

MRCPath Part 1:What they didn’ttell you. A seriesof two articlesby Claire Hart


MRCPath MRCPath MRCPath MRCPath MRCPath MRCPath MRCPath

though, you will eventually realise that having come this far it’s a bit latenow to start again. Anybody who has survived three terms in a studenthall-of-residence with a bunch of noisy undergraduates whilst on theGuildford MSc course will have the added incentive of not wanting tohave gone through all that for nothing.

If you are lucky, you will now find some motivation. However, motivation is fragile and needs to be nurtured. Try thinking about theconsequences of not doing the exam and being stuck in a career deadend, or worse still, of sitting the exam, failing and having to do thatrevision all over again. This should encourage you to do some properrevision, rather than just going through the motions.

Getting StartedHere are a few tips for getting started:

• Accept now that you will partially lose your sanity for the duration.Don’t fight it, it’s a waste of energy. If you aren’t talking to yourselfby the time you actually get to the big day itself then you eitheraren’t human or you haven’t been working hard enough.

• Say goodbye to family and friends, you won’t be seeing them for awhile.

• Explain patiently to your loved ones that them telling you not toworry too much because you have never failed an exam before isnot helpful. Your response to this is to say that while it is true thatyou have never failed an exam before you have never sat theMRCPath Part 1 before either. I also found it helpful at this point topoint out that I did actually fail my driving test the first time round.

• If you can draw up a revision timetable without freaking yourselfout too much then it’s quite a good idea to come up with one. Butdon’t worry about this too much, it is far more important at thispoint to just get started, worry about the details later. But not toomuch later!

RevisingHopefully you are now in a position and frame of mind to get down tosome serious revision. To be honest there isn’t much I can say at thispoint that will be of any help, or that hasn’t already been covered inWilliam Marshall’s articles. One thing that I would say is that you shoulddefinitely take any opportunity to practice past practical and writtenexam questions or any offers of tutorials and the like. However, in theend nothing can change the fact that you will have to put in hours andhours of frequently mind numbing revision. There is no real short cutor trick.

Next month Claire has exam day blues! ■

Obituary Obituary Obituary Obituary Obituary Obituary Obituary


Alex started his career in Edinburgh, working in the ClinicalChemistry Laboratory at the Western General Hospital. After sixyears at the hospital bench Alex moved on to develop a successful

commercial career with Boehringer Mannheim and subsequently becameManaging Director of Roche in 1995.

Alex had a commitment to life-long learning and completed an MBA atRoffey Park in 1994. He advocated continuing professional education andfully supported many of his colleagues in their professional development.In his 25 years with Boehringer/Roche Alex worked in the UK, Germanyand in the US spending time in each of the business divisions – LaboratoryDiagnostics, Near Patient Testing, Diabetes Care and MolecularBiochemicals.

Alex was first and foremost a people person. He cared passionatelyabout everyone and always put them first. He always treated people withrespect and in the way he would wish to be treated. He was always down to earth, open and honest and wanted to make work a fun place foreveryone. He was extremely proud of the achievements of the Rocheorganisation in the UK and all those who worked with him.

Work With the ACBAlex was a passionate campaigner for the value of diagnostics in healthcare,encouraging industry to work together with charities, professional bodiesand government to achieve the recognition that we know it so richlydeserves. In the early 1990’s he worked closely with colleagues in the ACBto develop guidelines for Near Patient Testing.

Helping people with diabetes became the major focus of Alex’sprofessional life, constantly working to achieve greater understanding andawareness of best practice for both professionals and patients alike.

He always sought to give praise where it was due. He was highlyenergised, passionate about success and also about giving peopleopportunities. His support and frank and honest feedback helped manypeople develop in their careers. He had a huge influence on all who methim as a truly inspirational leader and role model. Those of us who knewhim will miss his professionalism, irrepressible sense of fun and wickedsense of humour. Diagnostics in the UK and Ireland has lost a greatambassador. Our thoughts are with his beloved wife Kath and son Jordan.

C.B.

Passionate AboutDiagnosticsAlex Grant, 1955-2004 Managing Director of Roche Diagnostics UK and Ireland

Alex Grant at Focus 2001



Arthur Walker was one of the brightest clinical biochemists of hisgeneration. Born in July 1940, the son of a local solicitor, Arthurwrote his PhD on acid-base metabolism at Aberdeen University

where, on its completion, he was immediately appointed to an assistantlectureship. He came south in 1966 to a job at Charing Cross HospitalMedical School where, working with John Daly and Tony Pollard, hedeveloped an interest in clinical enzymology. He soon attracted theattention of the then leaders of the profession because of his ability andpersonality. Shortly after taking up a senior post in Norwich, Ron Nunnpersuaded him to apply for the newly established top-grade biochemistpost in Guildford where I had recently become Professor. Despite being by far the most junior of all the applicants the appointments board had nodifficulty in electing him to become, at 32, the youngest holder of thegrade anywhere in the country. He was immediately accepted by thehospital’s Medical Advisory Committee as a full member - unusual inBritain for a Clinical Scientist at that time - and thereafter played an activepart in the management of the hospital as well as of the laboratory until hisretirement almost 30 years later.

Trace Metals LaboratoryUnder Arthur’s guidance the Guildford laboratory went from strength tostrength and was one of only two in the country to house three SASlaboratories one of which, the trace metals laboratory, he headed from thetime of its inception until he retired.

Besides playing a leading professional role within South West ThamesNHS Region, Arthur served the ACB well. He was an examiner for the MCBand later for the MRCPath. He served as Treasurer of the Southern Regionfor a time and chaired the Scientific Committee for one of the early Focusmeetings in Brighton.

Arthur was an Honorary Senior Lecturer in the Biochemistry Departmentat the University of Surrey and played an active part in the organisation andteaching of the department. Amongst his many protégés are some of thecurrent leaders of our profession, including Janet Smith, Andrew Taylor,Stephen Halloran, Sue Martin, and others, both medical and non-medical,too numerous to mention.

Stressful Role as Clinical DirectorArthur became Head of the Clinical Biochemistry Department at St Luke’s,later the Royal Surrey County Hospital, after I retired and subsequently

Proud . . . But NeverBoastfulArthur Wellesley Walker BSc, PhD, MCB, FRCPath



became Clinical Director when this post was instituted under one of the NHS re-organisations. Under his guidance the two laboratories inGuildford and in Frimley were merged and he became its first ClinicalDirector until he retired in 1999. This was an extremely stressful periodfor him and unquestionably put a strain on his health.

Arthur was an excellent conversationalist, very perceptive, a goodraconteur and only slightly more intolerant of stupidity in others thansome of us. Although always innovative in his own right he was theideal person off whom to bounce radical proposals as you couldguarantee that he would give a carefully considered and rationalresponse – but not always the one you wanted to hear. He was wellinformed about all manner of things and a most convivial colleaguewith whom I and others spent many a pleasant hour putting the worldto rights over a pint of beer at the Sandford Arms before going homeafter work.

Friends in and outside the laboratory held Arthur in high regard, andwith affection, and after a committee meeting you always knew whichpapers were his; they would be covered with sketches of aircraft whichhe was adept at drawing and were a life-long interest. More athletic thansome of us, he took up jogging, cycling, squash and swimming in hisearly 50s and on his retirement threw himself wholeheartedly into hispassion for engineering, especially of model railways. He soon becameinternational editor of its leading journal – and loved it.

Arthur died peacefully in his sleep the day after he had returned froma four-day conference on model railways in the Netherlands. It was aprivilege to have known him and enjoyed his friendship. His manyfriends both inside and outside the profession will miss his wisecounsel. Their hearts go out to his wife Jennifer and his two sons, Benand Andrew, of whom he was justifiably extremely proud but, inkeeping with his personality, never boastful.

V.M.

Letters Letters Letters Letters Letters Letters Letters Letters


LettersReaders speak out

?

Challenging Errors and

Editors to the Power of TwoDeacon’s challenge No 34 answer published inACB News January 2004I thank David Lyon for pointing out the two errorsunder the square root sign in the solution to thequadratic equation (line 9 page 12):

I did supply the editor with (1 x 10–8) raised to thepower of 2. The error presumably occurred duringediting (I never see the proofs!).

Since (1 x 10–14) is negative, the minus sign shouldbe positive (multiplication of two minuses gives aplus) which gives a final answer of 6.98. Alas, thiserror was all mine!

There is a third error which he failed to spot. 10–6

in the final line should read 106!Working out the terms under the square root sign

gives the awkward number 4.01 x 10-14, which mostcalculators cannot handle. The trick is to do this intwo parts. Using a calculator the square root of 4.01is 2.002. The square root of 10-14 is 10-7 (since –7 isthe logarithm to the base 10 and the square root of anumber is obtained by dividing its logarithm by 2).Combining these two values gives 2.002 x 10-7 forthe square root of 4.01 x 10-14.

Allan DeaconConsultant ScientistBedford HospitalKempston RoadBedfordMK42 9DJ


Topics will include:

• Renal Function

Nephron, renal failure, renal osteodystrophy, diabetes and the kidney, renal tubular disorders, proteinuria

• Fluid, Electrolytes, Hydrogen Ion

SIADH, potassium, acid-base status• Respiration, Trauma

Respiratory function, mechanical ventilation, respiratory chain disorders,metabolic response to trauma

• Screening

Principles, newborn screening, Downs and NTD

• Analytical

DNA analysis, mass spectrometry, reference values

• Quality, Standards, Risk

QA, accreditation, health and safety,risk assessment, ethics and patientconsent

ACB Training CourseUniversity of Birmingham

12th-17th September 2004

The scientific programme will comprise a mixture of lectures, workshops, and clinical case presentations, and there will also be

a mock ‘spot test’ practical.

A full social programme is being planned.

Full details and application forms are available from the ACB Office: Tel: 020-7403-8001. Fax: 020-7403-8006. Email: [email protected]

For additional preliminary information, contact: Dr David Andrews, Clinical BiochemistryDepartment, University Hospital Birmingham NHS Trust, Selly Oak Hospital, Birmingham

B29 6JD. Tel: 0121-627-1627 ext 52271. Email: [email protected]

Situations Vacant Situations Vacant Situations Vacant Situations


Vacant Situations Vacant Situations Vacant Situations Vacant


National Metabolic Biochemistry Network

Clinical Scientist Training Posts(Grade B, 8-16)

Higher Specialist TraineesPAEDIATRIC METABOLIC BIOCHEMISTRY

(Inherited Metabolic Disorders and Newborn Screening)

These posts provide an opportunity to train in paediatric metabolic biochemistry as a supernumerarygrade B clinical scientist in specialist centres across England. This is an excellent opportunity if you arewishing to gain experience in this exciting specialist area.

The Department of Health are funding eight new grade B higher specialist training posts for clinicalscientists wishing to train in paediatric metabolic biochemistry. These are five year posts and thesuccessful candidates will be appointed to one of the following centres, and will be requested to state apreference in their application:

Birmingham Children’s Hospital; Bristol Southmead Hospital/Bristol Royal Infirmary; Cambridge (Addenbrookes Hospital); Liverpool Children’s Hospital (Alder Hey); London (Great Ormond Street and Guy’s & St. Thomas’s) (2 posts); Manchester Children’s Hospital;Sheffield Children’s Hospital.

Training will include the following specialist areas: Amino Acid & Urea Cycle Disorders; Organic and Fatty Acid Oxidation Disorders; Lysosomal Storage Disorders; Peroxisomal Disorders; Newborn Screening for Metabolic Disorders.

All posts will be based in centres which will also provide training in more general biochemistry withlinks to molecular genetic laboratories and will provide an ideal opportunity for individuals working tocomplete Part II of the MRCPath.

Applicants who have completed a grade A training scheme in clinical biochemistry (or equivalent) andmay also have completed some more general clinical biochemistry training at grade B level will be ideallysuited for these posts. However, completion of Grade A training is not essential, and applicants who havenot undertaken this route but who can demonstrate interest and commitment to this area will beconsidered.

Successful candidates will be appointed at grade B, starting points 8-16 depending upon previousexperience.

The post holders will be supported by specialist trainers across the metabolic biochemistry networkwith opportunities for secondment to other specialist centres.

For a copy of the job description, personal specification and application form, please contact Mrs MaryDowling, Administrative Support for Metabolic Biochemistry Network. Tel: 0121-333-9916 or [email protected]

For further details or opportunities to discuss these posts please contact the Network Lead Scientist, Dr Anne Green. Tel: 0121-333-9922 or e-mail [email protected] or the Lead Trainer, Mick Henderson. Tel: 0113-206-6861 or e-email [email protected]

Closing date August 13th 2004



The Trust is committed to Equal Opportunities in Employment, operates a no smoking policy and is working towards a smoke free environment.

We are proud to be a 3 Star Trust.

Birmingham Heartlands & SolihullNHS Trust (Teaching)

www.heartsol.wmids.nhs.uk

THE FOREFRONT OFHEALTHCARE SERVICES

Department of Clinical Biochemistryand Immunology

Grade B/CClinical Scientist (17-31)

£31,514 - £54,572 p.a.Applications are invited for the above post fromregistered Clinical Scientists. The appointee will take alead in further developing the delivery of the service.The successful applicant will be employed at HeartlandsHospital, Birmingham and an honorary senior lecturerpost will be offered to an appropriate candidate.You will have successfully completed the MRCPath or beready to take the Part 2. As well as contributing to theservice commitment of the department, you will beinvolved in development and research, clinical liaison,teaching and audit. The salary is dependent onexperience and qualifications. The department offers a comprehensive service to alocal population of approximateley 500,000 and carriesout 2 million tests /year. We also provide regionalservices for selected specialist assays. You will play a keyrole in the service provision and development of thelaboratory. The department has research interests inhypertension, lipids and diabetes. We have recentlytaken delivery of a major laboratory analytical systemand the directorate was the recent recipient of a millionpounds from the Government’s pathologymodernisation programme. The post is an opportunity to further develop yourcareer within a dynamic and supportive environment.The departmental team has close links with the hospitaland the University of Birmingham and actively carriesout collaborative research audit and servicedevelopment.For a job description and further information, or toarrange a visit, please contact Dr. W. A. Bartlett,Department of Clinical Biochemistry and Immunology,Heartlands Hospital, Birmingham on (0121) 424 0199or (0121) 424 3228. Alternatively E-mail:[email protected] date for applications: 30th August 2004.

Vacant Situations Vacant Situations Vacant Situations Vacant




To advertise your vacancy contact:ACB Administrative Office, 130-132 Tooley Street, London SE1 2TU

Tel: 0207-403-8001 Fax: 0207-403-8006 Email: [email protected]

Deadline: 26th of the month prior to the month of publication

Training Posts: When applying for such posts you should ensure that appropriate supervision and training support will be available to enable youto proceed towards state registration and the MRCPath examinations. For advice, contact your Regional Tutor. The editor reserves the right to

amend or reject advertisements deemed unacceptable to the Association. Advertising rates are available on request

Smart SupportVisit www.dpcweb.com or call 01286 871872 for more details.

Diagnostic Products Corporation - UK, Glyn Rhonwy, Llanberis, Gwynedd, LL55 4EL

How can I provide a better service to ourdoctors and patients?

the answer is

Ortho-Clinical Diagnostics,Johnson & Johnson, 50-100 Holmers Farm Way, High Wycombe,Bucks HP12 4DP

Tel: + 44 (0)1494 658600 Fax: + 44 (0)1494 658604

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issue 495 july 2004

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