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Proposal for Regional Diagnostic Service Integration at Southmead Hospital

Centralized regional diagnostic service integration at Southmead Hospital featuring Genomic Lab Hub, Flow Cytometry, and Histological Reporting by Haematopathologists. Service includes single request form, integrated report, and IT system for systematic testing and standardized reporting terminology. Service metrics include quick report turnaround times and same-day urgent services. Future directions involve NHSI projects for centralizing diagnostic services nationally.

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Proposal for Regional Diagnostic Service Integration at Southmead Hospital

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  1. Regional SIHMDS Update Paul Virgo NBT SIHMDS Manager Southmead Hospital

  2. Proposal for Regional SIHMDS • Centralised service for Region Based at NBT Incorporating • Genomic Lab Hub (GLH) • Centralised Flow Cytometry • Histological Reporting by trained Haematopathologists • Aspirate Reporting at local centre • Difficult cases reviewed at weekly diagnostic meeting

  3. Service Configuration • Networked SIHMDS service • Single request form • Integrated report • IT system to link diagnostic sections and integrate reports (HILIS) to allow: • Systematic testing - defining order and choice of tests • Standardised reporting terminology (WHO 2017) • Extensive data extract/analysis functions

  4. Service Structure • Recognised service within NBT • Service Director – Alastair Whiteway • Service Manager/Flow Lead – Paul Virgo • Genomics Lead – Chris Wragg • Histopathology - Lead Joya Pawade

  5. Service Metrics • 6,000 request per year received (2018) • Integrated BM report in <7 days • Integrated Tissue report in <10 days • Same day urgent flow cytometry • Urgent FISH service (APML etc.)

  6. Current Service Participants - SSG • NBT – All Haematopathology Samples • Paediatrics - All Haematopathology Samples • Bath – Bone marrow and molecular diagnostics

  7. Drivers for Change • SSG has not defined a Regional SIHMDS Centre • GLH Project has defined NBT as local provider of genomics testing • NHSI Pathology Consolidation defines NBT as Hub lab for South 3 Network

  8. NHSI Proposed Pathology Network

  9. Current Discussions - SIHMDS • Taunton – Proposal to provide SIHMDS review for Lymphoma – awaiting consideration • UHB – Proposals regarding centralisation of Bristol SIHMDS functions– awaiting consideration

  10. Future Directions • Potential that NHSI project will deliver centralised SIHMDS • The NHSI agenda is large and progress to date is slow • Recent IOG 47 update 2016 considered: • Slow national implementation of SIHMDS • Recognised network and co-located models • Provided an economic assessment of SIHMDS

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