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This is an exciting project looking at the way that new technologies can be used to improve the way that Cellular Pathology services are delivered.

Technological advances have made it possible to efficiently digitalise (scan) glass microscope slide preparations to a high level of quality, so that cellular pathology slides can be viewed and reported more efficiently using digital images.

A digital service has the benefits to eliminate many of the physical and time consuming steps involved in transporting microscope slides to consultant Cellular pathologists and multi-disciplinary team review. 

In addition, case review and external expert opinion can be undertaken electronically in real-time, which would provide additional diagnostic expertise and precision, supporting the potential for greater sub-specialisation and shared working across NHS Wales.

The project has been split into the following 3 phases, 2 of which have already been successfully completed:

Phase 1

A rapid evaluation and national verification of the quality of digital pathology. Results of the verification showed above 95% concordance between reporting from glass slides and reporting from digital images.

Phase 2

Procuring and implementing limited digital scanning capability in each health board in Wales; configuring scanners in a hub and spoke formation to enable national image sharing, as a proof of concept, to support remote reporting and shared specialisms.

Phase 3

The intention is for this phase of work to be the national scale-up of end-to-end digital enablement.

Progress is also being made of making use of the latest AI technology in Cellular Pathology.  During a visit to Betsi Cadwaladr University Health Board, the Minister for Health and Social Services, Eluned Morgan said “By embracing new technologies we can transform how we interact with the NHS, find new ways to save lives and increase performance across health and social care.  Innovative and effective use of data-driven technology, moving to digital heath care and exploiting new technology is vital if we are to meet the soaring demand and increasing  pressures on our NHS.”

The All Wales Pathology Quality and Regulatory Compliance Group will support the NHS Wales pathology community in discharging its responsibilities through the development of consistent approaches to regulatory compliance; supporting and sharing best practice amongst Pathology leads in quality and health and safety and working collaboratively across NHS Wales to deliver specific projects and pieces of work.

NHS Wales will develop a networked quality management system, maintained at a national level to work towards standardisation of practice. The Pathology Quality and Regulatory Compliance Group will seek to improve opportunities for training and qualifications in Quality Management.

The main aims and objectives of the Pathology Quality and Regulatory Compliance Group will be:

  • The introduction of a Governed National Quality Framework, supported by Welsh Government and NHS Wales, to ensure:
    • A fully accredited pathology service for NHS Wales, with quality and regulatory requirements met
    • Patient safety and the delivery of timely, accurate and informative results that reduce the risk of harm and contribute to direct patient care will remain a priority
    • Evidence based, standardised practices and approaches are adopted by NHS Wales
    • Unwarranted variation evidenced and acted upon
    • Feedback mechanisms on services (patients and referrer facing) are further developed
    • Errors, specimen losses, waste and incidents are minimised.

Recognising that emerging trends and technologies provide exciting opportunities for the pathology community to rethink approaches to the development and delivery of services in the future, the National Point of Care Testing Strategy Group is working to identify and establish a formal structured arrangement to deliver Point of Care Testing services in NHS Wales.

Point of Care Testing (POCT) relates to any medical diagnostic testing at the time and place of patient care. 

It is an area of healthcare that is developing rapidly, with increased and improved connectivity and technological innovation. These advancements make ‘near patient’ results possible, with the potential to improve assessment and care management for the patient.

Having diagnosis closer to the patient can help manage life-threatening conditions, such as sepsis and infection control.  It also helps patients to self-monitor chronic conditions, such as diabetes, without having to visit hospitals and GP surgeries.

Working with health board point of care testing services, the POCT Strategy Group will also oversee other areas of work, such as:

  • Improvements in the infrastructure to support national POCT systems
  • The development of POCT training and competencies for both laboratory and non-laboratory based staff
  • Promoting and championing the role and value of POCT, which will improve the consistency of the service throughout Wales, and help share best practice and the benefits of research.

The Communication and Engagement workstream has been developed to improve and strengthen the profile of Pathology across NHS services in Wales. We aim to raise awareness about the importance of Pathology services, improve public perception, enhance internal communication within the Pathology departments and strengthen the educational awareness of careers in Pathology.

We aim to strengthen communication of Pathology services in Wales to healthcare professionals, patients, stakeholders, and the general public. Collaboration with stakeholders, such as medical practitioners, hospital administrators, policymakers, educational professionals, and patient advocacy groups, is essential for successful implementation. By involving all relevant parties in the decision-making process, their perspectives and expertise can be harnessed to create comprehensive and effective strategies for improvement.

Strengthening communication of Pathology services in Wales to various stakeholders is a crucial step in ensuring better understanding, cooperation, and trust.

Key messages will be tailored to specific groups but will encompass the following:

  • The population of Wales deserve Pathology services that support quicker diagnoses and better patient outcomes
  • Pathology Boards and Groups will work together to ensure that patients are at the heart of service development and provision.

Communication is key to supporting the developments within the Training and Education Group for building a sustainable Pathology workforce (of medical, scientific, nursing and support staff) over the next five years. Relationship building with external educational professionals will be key to distributing relevant resources to support staff to promote training routes and careers within NHS Wales.

Pathology services are key to the efficient and effective delivery of many patient care and management pathways.  They are integral in delivering timely clinical services across NHS Wales that have a beneficial impact on the health and well-being of the population.  Pathology services are provided by a workforce made up of different professions, including  scientific, medical, nursing and support workers.  

The National Pathology Programme is developing an all-Wales strategic vision and action plan for Pathology training and education, in collaboration with Health Education and Improvement Wales (HEIW).  The Programme recognises the importance of investing in training and education to develop a well-trained and motivated workforce,  that can adapt to the changing demands on services.  

A key ambition for the scientific workforce is to provide the right support and infrastructure for every member of staff to reach their full potential, with a career pathway in all disciplines that extends from Band 2 support worker through to Band 9 consultant scientist (biomedical and clinical).

The Progamme has set up the Pathology Workforce and Education Group (PWEG) to take forward the workforce elements of the Pathology Statement of Intent and the Welsh Government Diagnostics Recovery and Transformation Strategy for Wales (2022 – 2025). 

The PWEG will have oversight of the delivery of the Programme’s workforce, training and education strategy.  It also ensures that any developments for the scientific workforce is aligned to the work of the National School of Healthcare Sciences (NSHCS), Modernising Scientific Careers (MSC) pathway and the Academy of Health Care Science (AHCS).

The PWEG is a well-established and active group.  The membership includes Pathology Training Leads in each health board/trust and representatives for:

  • Specialist areas such as Genomics, and Anatomical Pathology Technologists (APTs)
  • Health Education and Improvement Wales (HEIW) 
  • Higher Education Institutions (HEIs)
  • The National Pathology Programme Welsh Government
  • Scientific and medical professional organisations - the Institute of Biomedical Science (IBMS), the Royal College of Pathologists (RCPath) and the Association for Clinical Biochemistry and Laboratory Medicine (ACB).

The Pathology Operational Managers Group will co-ordinate the developing Regional Joint Committees and enable health boards to collaborate more effectively on service redesign and change with three regional footprints covering North, South-west and South-east Wales.

The main aims and objectives of the Pathology Operational Managers Group will be:

  • To consider how best, in the context of limited funding, Pathology in NHS Wales can help realise its vision for:
    • Better health for everyone
    • Better access and experience for the patient
    • Improved health outcomes by better service safety and quality
  • To support health boards and trusts in the planning and delivery of efficient / effective Pathology services that fit with the priority areas outlined in the Pathology Statement of Intent 2019 and the planning and delivery of the objectives in the subsequent Implementation Plan
  • To provide an environment which supports clinicians and managers in collaborating together to deliver the Pathology Statement of Intent 2019
  • To maintain a general overview of Pathology services across Wales
  • To champion and promote the role and value of Pathology service

The anticipated outcomes / benefits that will be realised by the Pathology Operational Managers Group include:

  1. The creation of an environment that supports collaboration resulting in:
    • Reduced duplication of effort
    • Access to expertise across organisations throughout Wales
  2. Increased rationalisation of services to reduce variation, waste, harm and cost through:
    • Implementation of the recommendations contained in the Pathology Statement of Intent 2019
    • Health board redesign plans; regional and national collaboration to configure services at a level where most beneficial.

The Anatomical Pathology Compliance and Workforce Group (APCWG) aims to enhance compliance with regulatory standards, promote workforce development, and facilitate the implementation of best practices across the sector. Collaborating with NHS Wales health boards and stakeholders, the APCWG is committed to fostering a culture of continuous improvement, knowledge sharing, and professional development. 

Key objectives

The group will work closely to disseminate knowledge and promote adherence to the standards outlined by the Human Tissue Authority (HTA) codes of practice. By facilitating the sharing of experiences and best practices, the group seeks to elevate the overall quality and conformity within the sector.

The APCWG is dedicated to recognising the pivotal role of the mortuary-based workforce. The group aims to empower individuals within the workforce, to recognise, develop and promote the mortuary-based workforce.

The APCWG advocates for the adoption of evidenced-based best practices across anatomical pathology establishments. By encouraging standardisation of workforce roles and practices where feasible, the group aims to enhance efficiency, effectiveness, and consistency within the sector, ultimately contributing to improved patient care and outcomes.

Ensuring timely decision-making and the successful implementation of the National Pathology Strategic Plan is a priority for the APCWG. By providing expertise, insights, and actionable plans, the group will be contributing to the advancement of the pathology field on a national scale.