Pathologists and medical laboratory managers will take up these issues at the upcoming Frontiers in Laboratory Medicine Conference in Birmingham, England on January 29-30, 2013
Medical laboratory testing in the United Kingdom is experiencing change at an accelerating rate. These changes reflect ongoing reforms within the National Health System (NHS), which is itself dealing with increased demand for healthcare services in the face of limited budgets.
That means providers in the United Kingdom—including pathology laboratories—are being asked to deliver more clinical services even as budgets are held constant or even reduced. There are also calls for all providers of clinical services to become more innovative in ways that improve the quality of patient services while reducing the overall cost of care.
Pathology Labs in UK to Be Paid Differently
Another big trend in medical laboratory testing is a fundamental change in how pathology labs in the United Kingdom are paid. The NHS is implementing a new model of reimbursement for pathology testing services. Certain providers, particularly general practitioners, are putting pathology testing services out to bid in a request-for-proposal (RFP) process called “commissioning.”
“Probably the most significant event of last year in healthcare in the UK was the passage into law of the highly controversial Health and Social Care Act 2012,” stated Dr. Michael Thomas, Department of Clinical Biochemistry at the Royal Free Hospital in London, England. “This Act announces sweeping changes in the landscape of service commission, including the commissioning of pathology testing services.
“As of April 1, 2013, the new NHS Commissioning Board takes up its full duties,” continued Thomas. “It has already authorized commissioning groups to be the drivers of the new clinically-led commissioning system envisaged by the new Act.
Greater Transparency and Patient Choice Are New Goals
“In its guidance on planning, the board identified goals which include moving toward a seven-day work week for routine NHS services, greater transparency and choice for patients, and better data to support the drive to improve services,” noted Dr. Thomas.
Just as value-based reimbursement is poised to change the fee-for-service payment status quo in the United States, commissioning promises to be an equally potent transformation for pathology labs in the United Kingdom. It means that hospital-based pathology laboratories will need to respond to tenders and offer a package of medical laboratory tests and services at a competitive price that is low enough to be awarded the commission.
Understanding Commissioning Process for Medical Lab Testing
“For these reasons, pathology labs have a keen interest in how commissioning will be conducted,” observed Dr. Christopher Price, a visiting Professor of Clinical Biochemistry in the Department of Primary Care Health Sciences at the University of Oxford. “For that reason, the upcoming 10th Annual Frontiers in Laboratory Medicine (FiLM) conference will feature several sessions and speakers on this subject.
The Frontiers in Laboratory Medicine (FiLM) conference will take place on January 29-30, 2013, in Birmingham, England. Speakers who will discuss the new commissioning arrangements and provide insight to pathology laboratory administrators include:
- Graham Atkinson, Transitional Director, North of England CCG Development Lead, NHS Commissioning Board and Commissioning at NHS North West, UK, will speak about how the new commissioning arrangements will impact pathology services;
- Professor Sir John Burn, Professor of Clinical Genetics, Institute of Genetic Medicine, Newcastle University, UK, will discuss the role of other bodies, particularly clinical senates and commissioning networks, in improved service quality; and,
- Dr. Mark Newbold, Chief Executive at Heart of England NHS Foundation Trust, UK, will address the role of innovation in pathology as a tool to meet future challenges.
Goal of Greater Innovation by UK Providers, Including Pathology Labs
Another force for change within the National Health Service is the call for greater innovation by providers, including pathology laboratories. “In its report titled Innovation, Health and Wealth, the NHS has called for innovation that is patient-centered,” noted Dr. Thomas. “This complements the new healthcare legislation which contains a focus on patient pathways, integrated care and outcomes. Pathologists and clinical biochemists will need to help their pathology labs improve in these areas.”
Pathology laboratories have existing capabilities to be more innovative, but in an unexpected way. “Laboratory services and medical laboratory tests are, of themselves, not innovative,” noted Dr. Thomas. “The innovation comes when pathology tests are used in effective ways that help physicians achieve better patient outcomes.
“However, to tap this potential, pathologists and clinical biochemists must engage with physicians in ways that are non-traditional,” he continued. “For example, it is essential to order the right test at the right time to achieve a more accurate diagnosis. Another issue is that the benefits of this type of innovation are not seen in the pathology laboratory, but rather elsewhere in the health system and more broadly by the patient and society.”
Speakers at Frontiers in Laboratory Medicine
FiLM has speakers and sessions that address how pathology laboratories in both the United Kingdom and North America are fostering innovation. This often comes through closer collaboration between laboratory scientists and the physicians who order the pathology tests, then make therapeutic decisions based on the medical laboratory test results. Sessions at FiLM that will provide these insights include:
- Dr. Ian Barnes, National Clinical Director of Pathology, on the newly-announced NHS arrangements for the oversight and safeguards of pathology laboratory testing.
- Leo Serrano, Laboratory Director, Corporate at Broward Health Medical Center, Fort Lauderdale, United States, will share lessons learned in how pathology leaders can gain advantage through continuous improvement, and ensure the workforce remains committed to corporate objectives.
- Richard J. Zarbo, M.D., D.M.D., Chairman of Pathology and Laboratory Medicine at Henry Ford Medical Centre, Detroit, United States, on how use of Lean, continuous improvement, and a culture of innovation can reduce errors in histopathology, decrease average pathology lab test turnaround times, and improve the quality and accuracy of histopathology testing.
For medical laboratory professionals interested in attending the Frontiers in Laboratory Medicine Conference, there is still space available. The full agenda, including topics and speakers, can be viewed here http://www.acb.org.uk/docs/FiLM-2013-ITP.pdf. To register, visit www.acb.org.uk.
“Two things make FiLM unique,” stated Dr. Thomas. “First, it is the largest pathology meeting in Europe organized around best practices and innovations in the management and operation of pathology laboratories. Since its founding in 2002, FiLM has achieved recognition as a conference that brings together senior leaders in pathology and medical laboratory testing.
“Second, FiLM always adds an international perspective,” he continued. “On subjects of major interest here in the United Kingdom, FiLM will invite speakers from the United States, Canada, and other countries who have been successful and innovative to share their experience in the same session as speakers from the United Kingdom. FiLM delegates essentially get a side-by-side perspective that allows them to compare the successes of these lab innovators from within and without the United Kingdom.
—By Patricia Kirk