Scottish Pathology Network (SPAN)

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Scottish Pathology Network(SPAN)

• May 2006
• A Route for Development in Scotland?

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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?

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The Past.formulation of strategy

• No formal NHS overview above Trust/Board level
• SMASAC
• The Professors in Glasgow and Edinburgh
• (Some well kent faces)

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Scottish Pathology in a Devolved Administration

• Recognised problems in manpower, infrastructure
• SPAG
• National Framework for Service Change (Kerr
  Report - Diagnostics subgroup)

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Managed Clinical Networks

• A Scottish concept (linked groups of health
  professionalsworking together to provide high
  quality effective services)
• Pathology Networks central to Modernising
  Pathology Services in England
• A means of service design across traditional
  boundaries

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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

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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

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NESPAN WORKING GROUPS

• Lymphoma (Dr J Goodlad)
• Cytology (Dr M McKean)
• Renal (Prof S Fleming)
• BMS 4 (Mr B France)
• Training (Dr P Johnston)

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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)

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Agreement to Proceed.

• But
• Networking to be made Scotland-wide
• Funding for Manager post
• Concerns regarding position of Edinburgh and West

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SPAN (2005)

• Now operational as a national MCN(MDN)
• Membership all Departments and staff in
  Scottish Pathology
• Internal structureto be decided at National
  Meeting

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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

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Initially proposed working structure
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Alternative Working Structure?
SEHD Planning Groups
Osteo
GI
Others
Skin
Head BMS

• Scottish Pathology Network

Neuro
Paed
Breast
Gynae
Lymphoma
Cervical

• Pathology
• Departments

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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)

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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
  pathology.service.review_at_dh.gsi.gov.uk by the end
  of January 2006.

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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.

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What Kerr saysand NHS response

• Benchmarking (2006)
• Managed Diagnostic Networksagreed
• New technology - Rapid advances in automation
  mean that consideration should be given to
  rationalisation of some non acute and screening
  functions

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Kerr.

• Regional and National overview of service
  provisionnew developments screened across
  traditional boundaries
• Molecular Pathologymodel of Molecular Genetics
  Consortium.agreed

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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

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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

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Negatives

• A threat to local autonomy?
• An unnecessary layer of administration?
• Interferes with existing structures?

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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

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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)