Changing times at Pennine

Xchange newsletter - Autumn 2006

Changing times

In 2005, the Pennine Acute Hospitals NHS Trust chose to install Abbott systems across its four biochemistry laboratories to process 7 million clinical chemistry and 650,000 immunoassay tests per annum. With the pathology service in the midst of modernisation and a new central laboratory under construction, flexibility and system streamlining were key to meeting the changing needs of the laboratories.

The Pennine Trust was formed in 2002 from four existing Trusts, all with their own pathology units and all using different analytical systems. Following a pathology service review, it was decided the north east of Greater Manchester would be best served by a central laboratory at The Royal Oldham Hospital, together with 'essential service laboratories' (ESL) at Fairfield General Hospital (Bury), Birch Hill Hospital (Rochdale) and North Manchester General Hospital. The new £18 million central laboratory will handle in-house urgent analyses and routine samples from hospitals and GPs within the north east sector of Manchester. Each hospital has an ESL for processing STAT work.

New analysers are now live at each of the sites while the central laboratory is still under construction and due for completion by 2007. Until then, routine workload is shared.

John Mansley, biochemistry service manager, explains, "Standardising pathology services across the Trust will achieve continuity of results and improve long-term patient care. Our aim is for patients to be seen at any hospital and for their test results to be comparable as well as visible from any hospital via a new IT system."

"There are many advantages to rationalising pathology services," comments Dr Kathryn Brownbill, consultant clinical scientist at Royal Oldham. "We will be offering a more efficient service overall, and especially for less frequently performed tests. Streamlined sample handling systems and combined clinical chemistry and immunoassay analysers will improve safety by reducing requirement for secondary specimen handling."

Through centralising pathology, a wider test repertoire can be achieved. "Additional tests can be brought back in-house, as consolidation will help reach the critical limit required to make testing worthwhile," remarks John.

Kathryn continues, "We wanted to use a single analytical platform and introduce unified protocols across the service plus set common reference intervals. We will be using common internal quality control limits and ideally we would like to work towards networked QC so data can be reviewed across sites."

Abbott's solution was to install ARCHITECT ci8200 combined clinical chemistry and immunoassay analysers at each of the sites, plus a Tecan FE500™ preanalytical system at the central laboratory. An important challenge was to offer a solution in which the analysers could be moved around and reconfigured as necessary to adapt to a changing workload and laboratory environment. Everyone was very aware that these 'interim solutions' would be as important as the final one.

Reactions to the installation at Birch Hill Hospital have been positive. Paul Mooney, BMS 2, says, "We first experienced the analysers at Abbott’s HQ in Maidenhead. The ARCHITECTs are pretty sturdy, robust instruments with good reliability statistics. Back in the laboratory, staff like using these systems and we have experienced minimal analyser downtime. It’s reassuring to have at least two analysers in each laboratory as they can back each other up. Also, with Abbott having several engineers located in this area, we knew we would get rapid assistance if we ever needed it."

"The analysers have demonstrated good precision and paediatric sample handling capability," adds Kathryn.

As staff will work between laboratory sites within Pennine Trust, having common analysers is very beneficial and will also streamline staff training. Prior to installation, training courses were run both at Abbott’s dedicated suite in Maidenhead and using the newly installed instruments at the North Manchester ESL, which minimised the amount of time staff had to be away from the laboratory.

"We knew that whatever solution we went with, it would need to be developed over the duration of the contract," concludes Kathryn Brownbill, "We needed a solution that would offer us analytical quality, choice, flexibility and streamlined processing. Abbott offered us this solution, with equipment that can grow with our workload and the changing demands in service delivery."

Pennine Acute Hospitals NHS Trust

• Serves 820-830,000 people
• 10,000 staff
• One of the largest non-teaching Trusts in the UK