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Revised Bowel Cancer Screening Programme SOP

Revised Bowel Cancer Screening Programme SOP
15 October 2019
The NHS Bowel Cancer Screening Programme now recognises scientists with the Advanced Specialist Diploma in Histopathology Reporting

The NHS Bowel Cancer Screening Programme now recognises scientists who are qualified with the IBMS/RCPath Advanced Specialist Diploma in Histopathology Reporting and who are employed as advanced practitioners or consultants to report bowel screening histopathology samples. 

IBMS Deputy Chief Executive Sarah May said:

We are very pleased to see the revised Standard Operating Procedure expanding the workforce for who can report histopathology samples as part of the Bowel Cancer Screening Programme. This represents an extremely significant step forward in recognising the consultant level role of scientists who have successfully passed the IBMS/RCPath Advanced Specialist Diploma in Histopathology Reporting and will be important in helping to maintain turnaround times for biopsy results for patients referred for colonoscopy under the Bowel Cancer Screening Programme.

The new version of the Standard Operating Procedure referencing advanced practitioners can be found in full below:


BOWEL CANCER SCREENING PROGRAMME (BCSP)
Introduction of new staff to the BCSP pathology reporting team
Standard Operating Procedure
General principles – derived in part from the updated (2018) Pathology Reporting in Bowel Cancer Screening document
  1. A pathologist who wishes to commence reporting BCSP (including Bowel Scope) cases should typically be in a substantive consultant post. However, the following individuals may also be considered for this role: consultant pathologists in long-term locum posts, pathologists in non-consultant career grade posts, pathologists in stage D of training and advanced practitioners holding the Advanced Specialist Diploma in Histopathology Reporting – Gastrointestinal Tract Pathology. Inclusion within the local BCSP pathology reporting team is subject to agreement with the local cellular pathology department and the local lead BCSP pathologist
  2. The new pathologist must notify the Clinical Director and Programme Manager of the local screening programme and the regional screening quality assurance team (SQAS)
  3. The pathologist or advanced practitioner must register for participation in the national BCSP diagnostic external quality assurance (EQA) scheme. It is not required that pathologists or advanced practitioners new to BCSP reporting demonstrate satisfactory performance in this scheme before they begin reporting BCSP-derived specimens
  4. The pathologist or advanced practitioner must agree to attend at least one approved BCSP educational event during each three-year period
  5. The pathologist or advanced practitioner must be aware of national guidance on BCSP pathology reporting. The most up to date version of this document is available at:
    https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/694063/bowel_cancer_screening_programme_guidance_on_reporting_lesions.pdf
  6. The pathologist or advanced practitioner should be aware of the required quality standards for BCSP pathology reporting, including the required turnaround times
  7. The pathologist or advanced practitioner must double-report all cases of pT1 cancer with a second BCSP-accredited pathologist, who should be in a substantive consultant position
  8. Whilst the local BCSP pathology lead will routinely audit the reporting of the whole team, they should be careful to ensure that the reporting practice of new individuals falls within guidelines. They must be willing to mentor new members of the BSCP pathology reporting team if this is required 
Additional advice for new pathologists
  1. The pathologist or advanced practitioner should make sure that they become known to other key members of the local BCSP team, within and beyond the pathology department such as the Clinical Director, Programme Manager and Lead Specialist Screening Practitioner (LSSP)
  2. The pathologist or advanced practitioner must be familiar with the local mechanisms for generating BCSP-related pathology reports, which for polyps will usually be in a proforma style
  3. The pathologist or advanced practitioner must be aware of local SOPs related to the BCSP e.g. managing difficult cases, changing a diagnosis after review
  4. There is no current specific requirement within the Pathology Reporting in Bowel Cancer Screening document, for double-reporting all cases of high-grade dysplasia. However, as is the situation with all unusual and difficult cases within and beyond the BCSP, consideration should be given to discussing cases with a second BCSP-accredited pathologist, who should be in a substantive consultant post, where the grade of dysplasia is uncertain. It would be wise for pathologists and advanced practitioners new to BCSP pathology reporting to lower the threshold for case discussion with a colleague while they gain experience in this area. As a guide, a designation of high-grade dysplasia should be applied to less than 10% of adenomas identified within the BCSP
  5. The pathologist or advanced practitioner should become involved with audit projects related to BCSP activity, including audits of local BCSP pathology reporting.
  6. There is no current specified minimum number of BCSP-derived cases that a pathologist or advanced practitioner new to BCSP pathology work must report before being accepted by the local lead Pathologist to report cases independently
BCSP Pathology Clinical Professional Group
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