Management & Operations

Laboratories in British Isles Face Many Challenges-Major Lab Consolidation Proposed for Ireland!

How about consolidating all laboratory testing services in a nation down to two central core laboratory sites and converting most hospital labs into rapid response testing sites? That's what might be in Ireland's future, based on recommendations in a draft report circulated by a laboratory services study team commissioned by Irish health officials.

Such radical laboratory consolidation in Ireland is just one example of the serious challenges facing laboratory leaders in the British Isles. Some of these challenges are familiar to lab executives in North America, others are unique to the national healthcare systems they serve. These were among the findings from the Sixth Annual Frontiers in Laboratory Medicine(FiLM) conference last week. It took place in Manchester, England and was co-produced by The Dark Report  and the Association for Clinical Biochemistry  (ACB).

FiLM concluded last Thursday and your Dark Daily editor is writing this e-briefing while en route back to the United States. At this year's FiLM, a record crowd of pathologists and clinical laboratory leaders came together to share laboratory best practices, discuss new threats to laboratory medicine, and craft effective strategies to sustain the financial and clinical viability of laboratory organizations. Speakers from the United Kingdom, Ireland, Australia, and the United States made it truly an international event in laboratory and pathology management.

Some key insights for Dark Daily readers include:

1)      When it comes to the regional consolidation and standardization of laboratory testing services, the British Isles continue to lag behind Canada, the United States, and Australia. As noted above, Ireland seems poised to possibly undertake a far-reaching rationalization of laboratory and pathology services. By contrast, in the United Kingdom (England, Scotland, Wales, and Northern Ireland), laboratory regionalization is happening in selected areas, but in a limited and incremental fashion.

2)      In the United Kingdom, laboratories are struggling to find the most effective response to unfolding reforms within the National Health Service (NHS). Primary care trusts are being asked to improve prevention, early detection, and active intervention in management of patients with chronic conditions. Primary care trusts are getting additional funding to support these priorities. However, NHS hospital laboratories-which provide the increased number of tests requested by their local primary care clinics-are not receiving proportional increases in their operating budgets. Further, it is unclear that reforms to pathology service funding will resolve this issue, particularly in the short term.

3)      Quality management methods are working their way into pathology laboratories in the United Kingdom. Interest in using Lean, Six Sigma, and ISO-15189 quality systems is increasing at a steady pace. FiLM's satellite conference, "Essentials of Lean-Six Sigma in Laboratory Management" was well-attended and participants revealed that they are using Lean and Six Sigma methods across the spectrum of laboratory operations, ranging from specimen collection and transport to work flow redesign in chemistry, hematology, microbiology, and histopathology.

FiLM 2008 validated another trend frequently discussed in The Dark Report: the global convergence of laboratory operations. Upcoming Dark Daily e-briefings will feature commentary and analysis about this and other revelations that emerged during the conference, along with information about the site visit to a hospital laboratory in Manchester.

Your Dark Daily editor,

Robert Michel

Related Articles:

• Complete Agenda for the 2008 Frontiers in Laboratory Medicine Program, conducted in Manchester, England on January 29-30-31, 2008
• FiLM 2007: Change and deliver
• FiLM 2005: Lean and mean