Scottish Pathology Network(SPAN) May 2006 A Route for Development in Scotland?
Overview • Planning for Pathology in Scotland • Managed Clinical Networks • Pathology Modernisation Plan (England) • Development of Pathology Networks in Scotland • The Kerr Report • “Delivering for Change” • Where do we go from here?
The Past….formulation of strategy • No formal NHS overview above Trust/Board level • SMASAC • “The Professors in Glasgow and Edinburgh” • (Some well kent faces…)
Scottish Pathology in a Devolved Administration • Recognised problems in manpower, infrastructure • SPAG • National Framework for Service Change (Kerr Report - Diagnostics subgroup)
Managed Clinical Networks • A Scottish concept (“linked groups of health professionals…working together to provide high quality effective services”) • Pathology Networks central to “Modernising Pathology Services” in England • A means of service design across traditional boundaries
Pathology Networks in Scotland • Indirectly grown from SPAG • 2003 – Network proposals through SEAT (SE and Tayside Planning Group) and West of Scotland Regional Pathology Subgroup • Confined to Histopathology/Cytopathology
North and East • Feb 2003 meeting of clinical and BMS heads from Highland, Grampian, Tayside and Fife • Conclusion that the idea would be beneficial and in keeping with HDL (2002) 69 and MEL (1999) 10 • Subsequent meetings to draft an agreed proposal for funding
NESPAN WORKING GROUPS • Lymphoma (Dr J Goodlad) • Cytology (Dr M McKean) • Renal (Prof S Fleming) • BMS 4 (Mr B France) • Training (Dr P Johnston)
How the scheme has evolved… • Lead clinician (FAC) chosen by Steering Group • Operation based on consensus • Meetings with SEHD (Dr Keel), Scottish Cancer Group, Planning Groups and West of Scotland representative (Dr Imrie)
Agreement to Proceed…. But… • Networking to be made Scotland-wide • Funding for Manager post • Concerns regarding position of Edinburgh and West
SPAN (2005) • Now operational as a national MCN(MDN) • Membership – all Departments and staff in Scottish Pathology • Internal structure…to be decided at National Meeting
Who funds it? • Scottish Executive Health Department • Each Planning Group North, South/East and West supported by the Cancer Networks • Funded for 2 years in 1st Instance
Alternative Working Structure? Pathology Departments SEHD Planning Groups Osteo GI Others Skin Head BMS • Scottish Pathology Network Neuro Paed Breast Gynae Cervical Lymphoma
Context for development of Pathology in NHS Scotland • Kerr and NHS reply • Watching developments South of the border • Molecular pathology (HER2, HPV) • Other new technologies (HPV vaccination, improved IT links/digital pathology)
If we were in Carlisle…… Independent Review of NHS Pathology Services CALL FOR EVIDENCE Have you a view on the way that pathology services should be modernised? Do you have suggestions to make on the safety, quality or efficiency of pathology services and how they should be delivered in this country? If so, please send your comments to the independent Review of Pathology Services to email@example.com by the end of January 2006.
Modernising PathologyEngland Oct 05 • …..timeliness, reliability, capacity and efficiency benchmarked against international standards….. And the feasibility…..of wide scale reconfiguration, innovation and modernisation and involvement of the independent sector.
What Kerr says…and NHS response • Benchmarking (2006) • Managed Diagnostic Networks…agreed • New technology - ‘Rapid advances in automation mean that consideration should be given to rationalisation of some non acute and screening functions’
Kerr…. • Regional and National overview of service provision……new developments screened across traditional boundaries • Molecular Pathology…model of Molecular Genetics Consortium….agreed
Positives (1) • A rational contact point for pathology in Scotland (Pathology Modernisation) • A coherent voice at SEHD/NHS Scotland • Ability to influence reshaping of services • A formal forum for dissemination of information from the centre to departments (and vice versa) • Full time manager with a remit for facilitation of improvement in service delivery
Positives (2) • A flexible structure (adaptable to NHS changes) • Supports specialisation • Workforce overview • A Scottish “school” for trainee pathologists/BMS • Quality management support for CPA/benchmarking • Research/Tissue Banking • Scotland/Malawi partnership
Negatives • A threat to local autonomy? • An unnecessary layer of administration? • Interferes with existing structures?
Early examples…… • Pathalba (digital imaging/telepathology) • Coordinated assessment of HER-2 testing (molecular pathology paradigm) • Helping implement roll-out of colorectal cancer screening • National procurement for ICC
Key contacts • SEHD (Dr A Keel) • NSD (Dr A Bryson) • Scottish Cancer Group (Dr A Gregor, L Porterfield) • Regional Planning Groups • Framework Diagnostics Group (Prof G Needham)