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Pathology

Clinical Director: Jon Hughes

Associate Clinical Director: Dr Wynne Williams

Pathology is responsible for the provision of clinically led diagnostic services to Swansea, Neath Port Talbot and Bridgend. In recognition of the scope of expertise available, second opinion and tertiary services are also provided to clinicians from further afield.
 
There are four disciplines in Pathology; Clinical Biochemistry, Laboratory Haematology, Blood Transfusion Science and Histopathology\Cytology. The Department also hosts Microbiology Services on behalf of the National Public Health Services. Microbiology transferred to PHSW in 2008.
 
The Pathology directorate also manages Phlebotomy Services in Swansea as well as Health Board wide Mortuary Services.  These also host the coroner post mortem services for Swansea, Neath Port Talbot and Bridgend.
 

Achievements

 
The directorate has successfully merged two previously independent Pathology Departments into a single department in order to work as one organisation across the Health Board.  This allows for standardisation of working practices and tests to support clinicians and patients in terms of quality, speed and consistency.
 
The directorate has met all its targets for service delivery, quality improvement, financial management, staff sickness and training. The Directorate was assessed in February 2011 by the Internal audit Department as providing full assurance regarding Corporate and Financial Governance
 
Singleton Hospital Blood Bank achieved Medicines and Healthcare products Regulatory Agency (MHRA) accreditation in March 2010
 
The directorate has achieved Clinical Pathology Accreditation (CPA) for its services and in September 2010 was accredited on the basis of an organisation wide provision of service in Clinical Biochemistry.
 
The Human Tissue Authority (HTA) provided a very positive report regarding the Health Board contribution to the post mortem service following a review of Bridgend Mortuary in October 2010.
 
The opportunity gained from merger into the larger departments has increased the range of skills and equipment. This means departmental tests previously sent away for diagnostic review are now undertaken within the Health Board e.g. specific tumour marker tests. The speed of turn around of the results for these tests to ABM clinicians and patients has improved.
 
The Directorate commenced a Health Board wide Pathology Modernisation Programme in 2008\9, and this continues in achieving milestones to improve the efficiency of working practices; ensure the delivery of a high quality service is maintained, and greater responsiveness to service users.
 
In September 2008, the project to reorganise the sample reception in Bridgend was completed. By January 2010 this had extended to all 4 acute site sample receptions. The redesigned streamline sample receptions are in place and this has promoted the development of a multi-skilled workforce able to work flexibly and in an ergonomic area to decrease sample handling times.
 
The Bridgend sample reception laboratory layout improved the speed of sample turnaround by 2 hours. This project  was a shortlisted entry for the NHS Awards Ceremony in June 2009.
 
In September 2009 a standardised blood form was rolled out across ABMU for ease of all clinicians across ABMU. This assisted the efficiency of work in the sample receptions, and required the agreed standardisation of the range of tests, result parameters and the presentation of results. This was the culmination of work over 1 year, and was in line with improvement in management of risk as well as improved efficiencies 
 
In April 2010 a single laboratory information system was rolled out to Haematology, Biochemistry and Microbiology Services. This has enabled samples taken on one site to be analysed and reported on different sites, with the result accessible to the clinician on any site ABMU. This has improved accessibility for clinicians to their patient results across the health board, and enabled the pathology department to maximise the flexibility of its laboratory facilities.
 
In February 2012, ABMU Pathology will become the third health board to implement the All Wales Laboratory Information Management System to support efficiencies of testing and accessibility of results across Wales.
 
The directorate continues to support the work of the Department of Health in staff skills development as part of a multidisciplinary team working across traditional discipline boundaries.  
 
The directorate is creating a single Laboratory Medicine Department as one merged laboratory function in place of laboratory Haematology and Clinical Biochemistry to progress the Multidisciplinary staffing model in all laboratories. It is anticipated this will be operational from Autumn 2011.
 
Phlebotomy services in Swansea have completed a skill mix review and through flexible allocation of the workforce determined by the particular skills needed by specialist clinical departments, successfully sustained the service despite significant increase in demand for the services.
 
Working with companies to provide laboratory equipment has reduced the cost of delivering the pathology services across ABM. Haematology and Biochemistry have transferred provision of the laboratory equipment, consumables and service contracts to single providers. This has delivered improved state of the art equipment for the services across ABMU pathology departments. A major analyser procurement programme commenced in December 2010 with plan for upgrade of all laboratory analysers over the next 2 years across all Disciplines. This will improve the ease of working in multidisciplinary way on 24 hour basis and reduce the costs of delivering services.
 
Government guidelines recommend all patient results should be entered into a single electronic patient record. ABM Health Board is at the forefront in the UK in achieving this with Point of Care Testing (POCT) results.
 
All POCT results from blood gas, glucose, urinalysis and pregnancy testing are now captured via a middleware piece of software called POCcelerator. This software has the capability to allow review POCT results alongside Laboratory and X-Ray results on a single platform.
 
ABM is leading the way in the UK regarding the capture of POCT data. The aim is to extend this capability across the Health Board.  
 
POCT meters purchased by Pathology, on behalf of the clinical departments has enabled the standardisation of POCT automated equipment across ABM to progress.
 
The Directorate has developed competency assessments for the accredited training for Laboratory Support Workers linked to National Occupational Standards and Key Standards Framework.
Research Grants have been awarded to the departments to work with the University and with the Welsh Office for Research and Development.
 
The directorate continues to achieve international recognition in the publication of research papers, and the work being cited by the World Health Organisation.
 
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Last updated: 20 January 2014