Events in 2023

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.

Role of MDT – Clinical Perspective; Colposcopy for patients with learning difficulties

Development of a new EQA programme

Meet the Examiner Session

Validation and Verification Workshop

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.

Mark Lundy was convicted of killing his wife and daughter in 2002 and again in 2015 after a retrial ordered by the Privy Council. His conviction continues to divide public opinion in New Zealand. A key piece of evidence was the presence of small smears on a shirt which prosecution experts identified as central nervous system tissue relying on immunohistochemistry.

The successful challenge to his original conviction was part motivated by arguments challenging the reliability of the latter in forensic practice. This has again come under scrutiny following a 2016 report by the US President’s Council of Advisors on Science and Technology. The PCAST concluded that there were two important deficiencies in ensuring scientific validity of so-called ‘feature-comparison methods’. These are procedures by which an examiner seeks to determine whether an evidentiary sample is or is not associated with a source sample based on similar features. Proponents of Lundy’s innocence argue that the application of immunohistochemistry must be regarded as a subjective feature-comparison method.

There was a need for (1) clarity about the scientific standards for the validity and reliability of forensic methods and (2) the need to evaluate specific forensic methods to determine whether they have been scientifically established to be valid and reliable. The report emphasized 2 key elements that are required to meet the scientific criteria of foundation validity; (1) a reproducible and consistent procedure and (2) empirical measurements from multiple independent studies of a method’s false positive rate and sensitivity.

It is this author’s position that the manner in which the immunohistochemistry was applied in the Lundy case to identify central nervous system tissue was sufficiently robust in terms of rigor and reproducibility and that to insist otherwise would be tantamount to believing in biological alchemy.

The session will provide an overview of the Histopathology Reporting qualifications outlining the success so far and then will focus on the two new limited scope Reporting qualifications. It will provide guidance on the eligibility criteria for these qualifications, the portfolio requirements and the support needed by candidates from colleagues in order to undertake the qualification.

Getting it Right First Time

Benign glandular histology as potential for BLEC