NHS Tayside -
Biochemical Medicine
Laboratories
Ninewells Hospital, Dundee
Perth Royal Infirmary
Scottish Bowel Screening Laboratory
Biochemical Medicine in Tayside
Biochemical Medicine services are provided from two laboratory sites in
Tayside, Ninewells Hospital and Medical School, Dundee, and Perth Royal
Infirmary. Both sites have gained accreditation from Clinical Pathology
Accreditation [UK] Ltd and we were the very first pilot site for the new
ISO 15189 based standards. Following on from our pilot site assessment,
we became one of the first laboratories in the UK to achieve accreditation
from CPA (UK) Ltd under the revised standards. We have a total quality
management system in place that includes rigorous quality control and
assurance techniques and we participate in a wide variety of external
quality assessment schemes. The analytical procedures are common on both
sites where routine clinical biochemistry testing is performed. Thus,
the results obtained are transferable across geography. This also means
that a common set of reference values and other interpretative criteria
apply. Test profiles and approaches to clinical problems are also consistent
across Tayside and North East Fife. A common core set of laboratory tests
in provided on both sites and, in general, the more specialist tests are
performed in Ninewells Hospital. The laboratory in the Scottish Bowel
Screening Centre at Kings Cross undertakes the faecal testing required
for the Scottish Bowel Screening Programme, which is rolling out nationally
from March 2007.
Our Philosophy
Our mission is to “provide a prompt, quality assured and clinically
appropriate analytical and clinical service”. The motto is “Quality
Assured”. We aim to provide a first class clinically appropriate
clinical biochemistry laboratory service. We see ourselves as a group
who are unafraid of change and embrace new technology and ways of operating.
We are keen on clinical liaison and try very hard to ensure that our many
users are more than satisfied with our service. We see teaching of medical
and science undergraduates as worthwhile investments for the future; the
University of Dundee was graded as “excellent” in the recent
Teaching Assessment Exercise and we have strong links with the University
of Abertay, Dundee, and its Biomedical Sciences degree course. We have
medical, clinical scientist and BMS trainees and our record in assisting
them to pass examinations and gain promoted posts is very good. Although
there is rarely enough time for research and development at present, we
encourage our staff to undertake these and expect to see the names of
our staff in conference proceedings and in peer reviewed and other journals:
many of the University of Dundee Departments rate very highly in the Research
Assessment Exercises. We encourage our staff members to become involved
in professional affairs since this reflects well on our Department and
institution.
Our Staff
The current staff complement is as follows:
Clinical Leader
Dr. Bill Bartlett
4 Medical staff –
Dr Ellie Dow Consultant [diabetes, metabolism, clinical toxicology] and
Director of Research and Development, Tayside.
Dr Michael J Murphy Senior Lecturer and Honorary Consultant [endocrinology,
metabolism].
Dr Rajeev Srivastava Specialist Registrar.
Dr Fiona Jenkinson Specialist Registrar.
Our medical staff are involved in clinical medicine and provide sessions
for Diabetes, Endocrinology, Lipid and other Clinics and run a Clinical
Toxicology Clinic.
We have 7 Clinical Biochemist staff –
Dr. Bill Bartlett Consultant Biochemist.
Mrs Judith A
Strachan Consultant Biochemist [pregnancy and newborn screening, metabolism]/
Designated Consultant for Perth.
Professor Callum
G Fraser Designated Consultant for Scottish Bowel Screening Centre.
Dr Joy Johnstone Principal
Clinical Biochemist [endocrinology and diabetes, point of care, oncology].
Dr Sharon Jenner Senior Clinical Biochemist [drugs, toxicology].
Eleanor Oakes Senior Clinical Biochemist [proteins].
We organise the Scottish Grade A/B Training Scheme for Clinical Biochemists
and there are currently 10 Trainees in Scotland, mainly in the large teaching
hospitals.
Our BMS staff complement is currently about 50 and the senior staff members
are –
Mr Jack McIntosh Head BMS [Biochemical Medicine, Tayside]
Mr Allan Brown Senior Chief BMS [PRI – and Site Manager]]
Dr Jimmy Burns Quality Manager
Mr Graham Matthew Chief BMS [NW – special chemistry]
Mr Ken Campbell Chief BMS [PRI]
Mr Ian Kennedy Chief BMS [IT co-ordinator]
Mr Gavin Lauder Senior BMS [NW-drugs, toxicology]
Mr John Card Senior BMS [NW - automated chemistry]
Mrs Shirley McKay Senior BMS [Immunoassay]
Mrs Sharon Boyle Senior BMS [NW – NPT/POCT]
Mr Cameron Greig Senior BMS [NW- metabolism/proteins]
Ms Paula MacDonald Senior BMS [KX – SBSC]
We try to foster good staff relationships throughout Tayside. Although
the staff establishment is broken down according to traditional professional
groupings, in fact, we encourage staff to perform the functions for which
they have the talents, expertise and motivation. We have a comprehensive
communications strategy in which all staff are involved. All minutes of
all meetings are freely available to all members of staff. All staff have
e-mail and internet access.
Our Laboratories
Ninewells Hospital and Medical School.
We have spent considerable resources over the past few years converting
this not very old building [1974] into a very modern air-conditioned laboratory.
We are rolling out a clinically orientated electronic test requesting
across the region: more than 70% of hospital requests are requested electronically
at present although a multi-disciplinary request form is still used in
some situations. We have a common sample reception area [with vacuum tube
from critical care and outpatient areas], which is next to the data input
office. We have two large main laboratories. One is the automated chemistry
laboratory, which is shared with Haematology [which is co-located]. This
contains 2 Serum Work Areas each comprising 2 ISE units, 2 P units and
1 E 170 unit with both SWA being linked through an MPA. The automated
laboratory also has the “fast track” section which is as seamless
as possible with the routine working. The other laboratory is the specialist
chemistry section, which performs assays of proteins, metabolites, vitamins,
drugs of abuse, therapeutic drugs, catecholamines and certain hormones
and we have a Roche Integra 800, GC/MS, GC, amino acid analyser, HPLC,
a DPC Immulite 2000 and other analytical tools. Our third area contains
our quality management, laboratory administration, offices and some teaching/training/research
space. We have a modern seminar room and a coffee/staff room – again
shared with Haematology and Immunology. We also have a laboratory in the
Diabetes Centre and support blood gas, glucose and HbA1c Point of Care
testing. Currently we use the LabCentre multi-disciplinary laboratory
information management system throughout Tayside. Users have access to
laboratory data, handbooks and bulletins through the novel electronic
Central Vision System and the NHS net. We run an out of hours rather than
an on-call system. On Saturdays and Sundays, we currently run a comprehensive
service and prepare and print reports. Reports of all laboratory and imaging
procedures are available electronically throughout Tayside and adjacent
areas. Certain senior staff carry a long range BT page and mobile telephone
on a rotational basis as an integral part of the 24/7 consultative and
analytical services we provide.
Perth Royal Infirmary.
The laboratories are in a separate block some distance from the main clinical
activity. The laboratory has 2 Hitachi modular analysers each comprised
of ISE, P and E units, and a range of other equipment required to provide
the core service necessary for a medium district general hospital. Most
of the special chemistry tests are sent to Dundee although the repertoire
at Perth is expanding. We have installed a vacuum tube system. The laboratory
shares the LabCentre multi-disciplinary laboratory information management
system. Users have access to laboratory data, handbooks and bulletins
through Central Vision. We run a multi-disciplinary on-call system. The
clinical services available in Perth are currently being expanded and
the commitment is to build a new laboratory close to patient care in 2009/10.
Scottish Bowel Screening Laboratory
The Centre laboratory currently tests faecal occult blood for participants
aged 50-69 in Tayside, Grampian and Fife. A second screening round is
now in progress using guaiac based collection cards and is involved in
research and development of new screening algorithms. The Centre will
undertake testing for the whole of Scotland when roll out of the Screening
Programme is completed by 2011 [see: www.show.scot.nhs.uk/sehd/mels/HDL2006_03.pdf].
Our Repertoires
We perform over 4 million tests per annum and examine about 100000 FOBT.
The laboratories in Scotland have always had good close co-operation and
we do not do every possible assay ourselves but send a number of endocrine
assays, metabolite assays required for investigation of inborn errors,
calculi and trace metals to our colleagues elsewhere. We are keen to disinvest
obsolete procedures and have established newer tests such as tacrolimus
and a wide range of tumour markers. We would like to expand the repertoire
further when finances permit. In Dundee, we perform tests for all hospitals
and general practitioners in Dundee and North East Fife and currently
perform the majority of the specialist assays for Perth and Kinross and
Angus. Perth Royal Infirmary provides a core service for patients in hospitals
in Perthshire and Kinross and for general practitioners in North West
Fife as well as Perth and Kinross.
Our Organisation
Biochemical Medicine, Haematology, Immunology, Radiology and Medical Physics
form a group known as Clinical Support Services. Each discipline has a
Clinical Leader [professional Head of Service] and a Clinical Team Manager
who meet with the Group Director, Group Manager and senior staff from
Human Resources and Finance once per month to encourage co-operation and
collaboration. Our interaction with very senior management is usually
through the Clinical Group Director. Our discipline has an extensive communications
network.
Our Teaching and Training
Like most medical schools, our curriculum has undergone much recent change.
Senior staff have input into all years of the medical course mainly through
small case discussion sessions but also through formal lectures in a variety
of systems courses. There are also opportunities to become involved in
the organisation and execution of special study modules. Staff who participate
in teaching may be awarded honorary academic status in the fullness of
time. We also participate in the teaching of biomedical science students
in the University of Abertay, Dundee, and discussions on new academic
activities are ongoing. We have medical, clinical scientist and biomedical
scientists in basic and higher specialist training and a regular journal
club. A very good library is only metres away.
Our Research and Development
We have undertaken much restructuring over the past few years and we have
published rather less recently than in previous times. However, both individual
and collaborative research and development are definitely encouraged.
Currently our main interests are molecular biology, diabetes and metabolic
disease in children, and a number of aspects of bowel screening.
Updated September 2006
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