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This presentation will examine a specific case study submitted as part of the 'Advanced Specialist Diploma in Breast Pathology'. The case in question was a mastectomy sample for the treatment of diffuse multifocal invasive ductal carcinoma.

Within the presentation I intend to highlight the importance of pre-analysis and emphasise its correlation with macroscopic examination and block sampling. I will also highlight the importance of post analysis and the understanding of how the role of the Advanced Practitioner can directly impact patient treatment.

Delegates attending this presentation will:

Receive an overview of the clinical history of MMR/Lynch Syndrome, EQA and data from UK NEQAS ICC & ISH
Gain a better understanding of the importance of MMR testing and the UK NEQAS ICC & ISH assessment process.
The presentation will also focus on acceptable and not acceptable tests, and the importance of ideal controls.

NGS for molecular profiling of cancer in routine practice.

There is legitimate expectation that molecular profiling of cancers can bring precious information to guide the treatment.

The clinically relevant alterations are of varied types: gene mutations, copy numbers, rearrangements, but also protein levels of expression. Profiling of tumours in routine practice is complex logistically, due to the high number of patients and targets, the small size of the samples and the quick turn around time required. An exhaustive assessment requires a variety of platforms.

Furthermore, it becomes relevant to repeat profiling on tissue and on blood during the patient’s treatment.

Next Generation Sequencing (NGS) offers the possibility of multiplex testing, with high sensitivity and specificity. There are multiple approaches: whole genome sequencing, whole exome sequencing and panels of varied sizes.

In practice, the focus is to concentrate on providing an exhaustive clinically relevant assessment for all patients, which is guided, for each type of tumour, by WHO and NICE or equivalent guidelines.

There has been initially an excess of enthusiasm about what NGS could offer in routine practice; the technology had yet not reached the stage of being implementable within clinical practice without significantly destabilising the management.

However, thanks to significant improvement, including automation of the process, efficient IT and Bioinformatics, NGS is now safely implementable.

Pending a coherent political and funding approach, molecular diagnostic laboratories are able to provide high throughout sequencing of tumours on real life tissue samples and on blood.

It is important to mention that the molecular diagnostic laboratories also need to maintain single gene testing, immunohistochemistry, FISH and to implement artificial intelligence based assays on tissue, which will be essential and complementary to NGS testing.

The results of the molecular profiling will need to be transcribed in a comprehensive, integrated and clinically relevant report.

The undeniable growth of molecular pathology in biomedical science continues and is now an established discipline in its own right. At present, the IBMS offers a 'Certificate of Expert Practice', and to this will be added a 'Specialist Diploma', the latter consisting of a number of independent but linked modules.

Andrew's talk will be providing an overview of these two qualifications, and where they sit in the IBMS's qualifications structure.

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

NHS Long Term Workforce Plan

NHSE Diagnostic Transformation - progress to date and future ambition

Pathology Network Maturity - meeting the NHS Long Term Plan objective

Pathology Services in the Northern Ireland Health and Social Care (HSC) system face a range of challenges including increasing demand, recruitment and retention, aging information systems, rapidly evolving technology and changing quality requirements. The Northern Ireland Department of Health’s vision is for the delivery of modern, sustainable, world-class Pathology services through a single, regional HSC Pathology Services delivery vehicle capable of supporting safe, effective delivery of Clinical Services into the future for HSC Patients.

Stakeholder engagement and participation is viewed as critical for successful delivery of the Department’s vision. This presentation will describe how the Northern Ireland Health and Social Care (HSC) system is enabling Pathology stakeholders to design a preferred operating model for a regional Pathology Management Structure that will deliver key benefits for HSC Patients and Service Users, the Pathology Workforce, Pathology Managers and the wider HSC system. It will briefly describe complimentary programmes to implement new regional Pathology Information Management Systems, and implement a regional Workforce and Training Plan.

The role of the pathology practice educator (PE) was funded and implemented as part of the Covid response. When these roles were recruited to we were well in to the national Covid response, and the vast majority of the pathology laboratories were up and running for Covid testing and so the role of the pathology PE became so much more than Covid. Most pathology PEs no longer have this title and are all working with networks on the recruitment, retention and education of the pathology workforce from support workers to clinical roles, admin staff and biomedical scientists of all levels across all disciplines.

Since their implementation they have worked on numerous projects including a workforce gap analysis; registration portfolio training; specialist portfolio training; apprenticeships; outreach; undergraduate placements and training; continuing professional development and leadership.

There has been improved engagement with the IBMS; Universities; Further Education providers and even schools to ensure that all of the establishments involved within pathology are working together to ensure a brighter future for our pathology workforce.

In this session you will hear how these roles, as individuals and as a network have impacted the pathology workforce and how they can continue to do so as we move to mature pathology networks..