Events on 28 September 2023

A variety of virtual ward services are delivered across Oxfordshire through collaboration of Oxford University Hospitals NHS Foundation Trust, Oxford Health NHS Foundation Trust, and Principal Medical Ltd (PML) a GP led service. They include Hospital at Home, Children’s Virtual Ward (jointly with OHFT), Acute & Community Palliative/End of Life Care (Community – Sue Ryder Care).

The Point of Care Testing (PoCT) team at Oxford University Hospitals NHS Trust has supported the development and delivery of PoCT in community and ambulatory settings over the past 10 years.

Using a model developed around the requirements of ambulatory medicine; this has been delivered with limited resource, focussing on utilising existing resources wherever possible.

Commencing with the Acute Hospital at Home, the service has been successfully expanded to support mobile PoCT across Oxfordshire.

The laboratory acts as the distributor of instruments and supplies; facilitates connectivity, and testing, and coordinates delivery of training through a combination of remote and cascade routes.

Device selection and repertoire has been standardised. Up to this point mobile services have been limited to use of the Abbott i-Stat & Alinity systems (electrolytes/metabolites/blood gas). However, Hospital at Home, and other mobile services are requesting a greater repertoire of tests, particularly CRP. The LumiraDx platform provides us with an option for CRP that is portable, easy to operate, connectable and robust.

Challenges remain around connectivity and information management. This has been exacerbated by the cross-organisational nature of these services leading to the management of patients through multiple IT systems; and led to the development of indirect routes for result entry into the patient record.

Whilst we have been able to deliver connectivity in two rapid response vehicles, this was not a scalable solution and mobile devices are docked at the base location on return from visits.

Delivery of a virtual ward in East Kent: A clinical overview

As the climate health crisis continues to escalate, governments and key NHS leaders are recognising the need for change. There is growing sector awareness of the impact of the lab on the environment and it is now time for laboratory medicine to consider the role POCT can play in achieving NHS net zero carbon targets. Centres for Sustainable Healthcare propose four principles for sustainable healthcare: prevention, patient self-care, lean service delivery and low carbon alternatives.

This presentation considers the role GIRFT and POCT can have, in supporting these principles of sustainable healthcare and promoting greener diagnostic pathways.

Getting it Right First Time

ISO15189:2012 had reached its periodic review date and there was international consensus that it needed revision. The new version was published on 6th December 2022 and there are some key changes which include an emphasis on a patient-focused approach and to promote the welfare of patients - i.e. putting the patient at the heart of the service. There is also more emphasis on a risk based approach to the Quality Management system. In addition ISO 22870 (POCT) has been incorporated into ISO 15189:2022.

This presentation will review POCT definitions, highlight key considerations for currently accredited POCT services and also for organisations considering applying for accreditation to include (or extend) POCT in their scope.

POCT is referenced implicitly throughout ISO 15189:2022 and with additional distinct requirements as an Annex A.

The presentation will discuss generic POCT services, and highlight considerations on both current POCT services and also emphasise considerations for planning new POCT services, and that overall, when compared with ISO 22870:2016, things have not changed as much as one would think. Principles are similar, and POCT could even be considered as another specialty within pathology, regardless of where it is or managed from.

High Sensitivity Troponin in the Community

To introduce a discovery community Point of Care Testing project that is working collaboratively with primary and secondary care.

By working in wider partnerships, the project aims are to scope and work towards recommendations and collaboration to deliver effective and measurable benefits for safer patient care and a governance led service, aligned to national NHS strategy plans.

National Point-of-Care Strategy

The presentation gives an overview of the NHS Patient Safety Incident Response Framework, it’s principles and requirements. There is also a brief summary of the Systems Engineering Initiative for Patient Safety (SEIPS) and how this is different to previous models of investigation. The presentation then focusses on how PSIRF has been implemented at Northumbria Healthcare, an acute and community provider in the North East of England, with a focus on the phased implementation approach used by the PSIRF leads. The speaker will also cover the challenges in the implementation to date and the successes experienced so far.

Many reports have demonstrated the correlation between good team working and better outcomes. This talk explores the value of civility and the cost to our patients of rudeness in the workplace.