The future of diagnostics

Just how do the latest recommendations affect the UK’s pathology services?

The diagnostics industry has been very much in the spotlight recently and even more so since the latest independent review on the modernisation of pathology services. With its main aim to make the service more responsive to the needs of the patients, the review ascertained levels of access, convenience and choice in the light of current resource restraints. The conclusion by Lord Carter of Coles that “it is clear that NHS pathology services are currently providing an effective service” has been welcomed by the industry, in particular the British In Vitro Diagnostics Association (BIVDA).

Jag Grewal of Beckman Coulter has recently been appointed as chairman of BIVDA for the next two years. Grewal says he is privileged to become chairman of BIVDA at such a pivotal time for the in vitro diagnostics industry: “The laboratory plays a crucial role in the modernisation agenda. Over 80% of clinical decision making is based on diagnostics. Identifying disease earlier and treating disease more efficiently with the sharper tools the laboratory provides means better patient care and improved healthcare economics.

“Patient care has always been our primary focus as an industry. But the role of the laboratory has not always been fully understood or valued by our many stakeholders -whether they are patients and GPs, or hospital medical teams and managers. Promoting greater understanding of the work of our members with these key stakeholders will also be a key mission.”

Though the pathology service is certainly an effective service, the fact that Lord Carter found several different models of service delivery have evolved within pathology leading to fragmentation of services, shows there is plenty of scope for change as these services continue to grow.

Carter's 12 pilot projects have £1 million to support them as they road test the recommendations of the review and to gather improved data on activity, cost and performance. Grewal believes that, “they are a start and an essential piece of groundwork that needs to be done prior to any significant strategy change. Such a transformation always requires a period of learning and data gathering to test various scenarios.”

Unprecedented changes are now expected as the outcomes of these pilot sites will have a significant bearing on the shape of pathology services to come. According to Grewal, payment by results would have been another but this has been postponed for unbundled pathology testing. An increasing shortage of capital and the recent NHS cash crisis will continue to have a detrimental effect on the modernisation of services where procuring new technology and automation is not based on best value but cheapest price. BIVDA are actively working with the professional bodies (IBMS, RcPath, ACB) to support the pilot sites and work on ground breaking initiative such as standardisation and national service frameworks for pathology. Grewal adds that, “BIVDA together with the relevant professional bodies intend to work very closely together to promote the value of laboratory medicine. As pathology services face unprecedented change, it is crucial that BIVDA is justly recognised as a leading voice for everyone in the industry.”

Jag Grewal is the marketing manager, Northern Europe, for Beckman Coulter with responsibility for both diagnostic and biomedical research divisions. He has been with Beckman Instruments and then subsequently Beckman Coulter for 11 years. He was a clinical chemist in the NHS for five years after graduating from university.