ACB Scottish Region, Annual Reports, 2006


Chairman


This has been another busy and successful year for the Scottish region with a series of three excellent and well attended scientific meetings.
The spring meeting was held in March at the Southern General in Glasgow, on Point of Care testing, with first class presentations from speakers from both within and outwith the region, including Dr Richard Taylor from Oxford, on the thorny topic of getting those POCT results into the patient record.
This meeting also encompassed the AGM of the Scottish Region, chaired by Dr Alan Hutchison. At the meeting he reported the recent sad death of Dr John Paterson, Consultant Biochemist at Dumfries Royal Infirmary. Following discussion, about how to mark his valuable and unique contribution to Clinical Biochemistry in Scotland, the ACB Scottish Regional committee, have proposed that a prize for a higher specialist trainee project, might be an appropriate and fitting memorial. Details of the prize will be published on the Scottish ACB website.
The John King Award, for the best presentation by a trainee biochemist during the year, was presented to Dr Colleen Ross for her paper entitled “Nutritional Support and Manganese”.
At the AGM, Dr A Hutchison (Chairman) and Dr P Stromberg (Regional Member) demitted office and were replaced by Dr J Tillman and Dr A McConnell. The committee has also welcomed, over the past year, new Trainees Representatives Mr Neil Squires (East) and Miss Sarah Jarvis (West).
The summer meeting was held in June in Melrose, a small town located in the Scottish Borders, and was devoted to members’ papers. This provided an opportunity for members, particularly the Region’s trainees, to present the results of a number of excellent projects and some fascinating and challenging clinical cases. Topics included the identification of specimens, evaluation of serum light chain measurements and synergic protection of human endothelial cells from oxidative stress by selenium and sulforaphane supplementation.
The autumn meeting, held in November at Ayr General Hospital, focussed on hypertension and renal medicine, with international and local speakers providing an overview of the investigation and management of hypertension, unusual clinical cases, and a highly topical presentation on the estimation of glomerular filtration rate from Dr Mark McGregor, a nephrologist from Ayrshire and Arran. This provided an on overview of the background and proposed recommendations for the implementation of eGFR reporting in Scotland.
The Scottish Regional website has been further developed by Joy Johnstone and now hosts information and links to Scottish biochemistry laboratories; a clinical science area, which details the results of audits performed by our Audit Group, information about tests, and other scientific information relevant to the region. Over the past year, Dr Peter Rae, Honorary Secretary, has been using the site as the main means of communicating information on future meetings, reports and minutes directly to members. However over the next year it is hoped to improve communication further within the region by expansion of this valuable resource.
The Scottish Audit Group, under the direction of Dr Anne Pollock, has again been extremely active. With the audit slot at regional meetings and completed audits now posted on the website, this should promote greater dissemination and discussion of results.
The Grade A training scheme continues to work well under the supervision of the Regional Tutor, Dr Mike Wallace. Three Grade A Trainees were appointed in 2005, with a total of eight trainees currently in post. The help and support in their training, provided by a wide variety of staff in many laboratories in Scotland, is gratefully acknowledged.
The Scottish region will host the National Training Course (6) next month in Glasgow. The organising committee, under the Chairmanship of Dr Maurizio Panarelli, have arranged a wide and comprehensive programme supported by local and national speakers and a full attendance is expected.
The Scottish Regional Committee met on three occasions, prior to the regional scientific meetings. In an attempt to improve communication between members and the regional committee, at the close of the scientific meetings, the short business meetings have continued. Members should note that all committee minutes are posted on the website.
Overall this has been a busy and productive year for the Scottish Region of the ACB. My thanks are due to all the committee members, both present and outgoing, for their hard work and dedication.

Dr Janet Tillman
Chairman, Scottish Region
20 March 2006.



Federation of Clinical Scientists


This is theoretically my last report to the Region as I am pleased to confirm that Jaqui Maguire from Hairmyres has agreed to take over as the Scottish Regional Representative to the FCS National Committee. However, as Jaqui is currently on maternity leave I am holding the fort. We will notify members and Local Representatives in due course of the change over date.
As for the Local Representatives the situation in Scotland mirrors that around the UK with a hard core of individuals, including 2 Clinical Microbiologists, with no obvious successors. I have 2 areas where there is no representation at present with members agreeing to act as post boxes. As with most ACB structures there is a need for new blood. The FCS can provide excellent management training by exposure and I would encourage senior colleagues to recognise the importance of these positions and encourage their junior staff to think of these positions as opportunities.
I have to pay tribute to the Local Representatives for all the work they have undertaken in relation to Agenda for Change. This workload is unlikely to diminish in the short term, as members disappointed by their banding seek redress through the review and appeals processes. The local impact of AfC is too early to call at this moment, but members will be aware of the request from the ACB Office for notification of individual gradings as they become available.
I have been disappointed at times to find that Heads of Departments sometimes view their colleagues as cost centres rather than colleagues when agreeing job descriptions.
Issues in relation to Trainees should have been resolved through the introduction of Annexe U of the Terms and Conditions Handbook. However, the associated additional cost is possibly deterring some employers from recruiting the expected complement of A Grade trainees in other parts of the UK.
The work of the Regional and Local Representatives has changed over the years from redundancy issues through AfC and the trend may well return to redundancy, particularly in England as the modernisation agenda begins to bite.
At a national level, the lack of any significant succession planning has caught up with the FCS Executive. I have spent some time on behalf of FCSE assisting the succession process and a new Executive is effectively now in place with Geoff Lester willing to step up to Chairman for a year while the new organisation shakes down.
The FCS is one of the two Staff Side organisations represented on the Scottish Forum for Healthcare Science (SFHS). The SEHD has now granted funding for an individual to work with the SFHS and the most important aspect is felt to be workforce planning. The 3 Scottish NHS Regions have now submitted interim workforce plans and Boards are now obliged to respond by April. The chances are low that Clinical Scientists have made it into these plans despite the acknowledged issues with the age profile.

Dr Richard Spooner, March 2006


Treasurer’s Report

The Association of Clinical Biochemists
Scottish Region


Receipts and Payments Account for the year ended 31 December 2005


Receipts                                                                   £                               £
                                  Sponsorship                                                              1,450.00
                                  Capitation                                                                 2,071.60
                                  Interest received                                                           131.99
                                                                                                                   3,653.59

Payments
                                 2004 expenses carried over       16.80
                                 Committee expenses                407.29
                                 Speakers expenses                  494.25
                                 Meeting facilities/catering         888.00
                                 John King Award                    200.00
                                 Bank charges                            37.65
                                                                                                                  2,043.99

Surplus for the year                                                                                 1,609.60

Reserves
Balance brought forward                                                                             8,224.41
Surplus for year                                                                                          1,609.60
Balance carried forward                                                                              9,834.01

Represented by
Bank current account                                                                                    500.00
Bank savings account                                             9,353.56
Less outstanding cheque                                              19.55
                                                                                                                  9,334.01
                                                                                                                  9,834.01
(Honorary Treasurer)

I certify that the above balance is in accordance with the records, receipts and bank
statements supplied to me.

Signed: Dr A Glen


Frank Finlay
Treasurer


Audit Report


1. Only 1 meeting of the Scottish Audit Group has been held this year.
2. Unfortunately no one was able to attend the last meeting of the ACB National Audit Group (NCBAG) in September, as it clashed with the Publications Committee and other members of the group already had too many demands on their time. The following is taken from the notes of the meeting.

There have been continuing discussions with the RCPath and the ACP. It has been agreed that representatives from the RCPath and ACP will attend the NCBAG and the group will report to both these organisations; it will be responsible to the Scientific Committee of the ACB. Terms of Reference and a constitution are to be drawn up. UKNEQAS and WEQAS will also be invited to send representatives.
Audit areas are now being set up on the regional websites and regional audit leads will have editorial control. These websites will link to a national audit page. It is intended that these will include a record of proposed, ongoing and completed audits as well as an area documenting questionnaires. It was felt that it was acceptable for there to be open access to these areas.

There were reports from the regions describing current activity.

The 5th National Audit Meeting took place in Manchester on 3rd November.

3. Our current activities

Callum Fraser has distributed a report on the audit of FOB testing.
Reports are being prepared on the progesterone audit and the interpretation of PSA results.
Results from the interferences questionnaire were presented at the meeting in Ayr and a report will be produced.
A questionnaire on measurement of glycated haemoglobin has been prepared and sent out.
A re-audit of electrophoresis practice against the guidelines is planned.

4. National Audit

A paper on the discretionary requesting of electrophoresis has been published in the Annals in July 2005. This includes a report of the questionnaire which was sent out previously.
A report of the re-audit of detection of xanthochromia in CSF that was sent out previously has been received distributed to Heads of Department and/or Audit Leads.
A report of an audit of troponin measurement in Wales and associated recommended standards was published in the Annals in September 2005.

5. Estimated GFR

I was invited to attend a meeting in February of interested biochemists and nephrologists instigated at the request of the Steering Group of the Scottish Renal Registry, regarding the introduction of eGFR. The group formulated some guidelines, which have been sent to lead biochemists and nephrologists in Scotland for comment. The new version of the Quality Outcomes Framework of the GP contract will incorporate eGFR reporting as of 1st April 2006.

6. Future meetings of Scottish Audit Group

Now that the group has become more dispersed it is more difficult to meet up and while much can be done by email there is nothing like the deadline of a meeting for concentrating the mind. The members of the group based in the West of Scotland intend to meet together but it is important that the group as a whole meet together. The possibility of the Regional Committee providing funding for travelling and associated expenses so that the Audit Group can meet together is under consideration.


7. Regretfully I am unable to continue as Chair of the Audit Group due to other pressures. I am very grateful to all the members of the group for their help and support, and also to all the colleagues in Scottish biochemistry departments who have taken the time to fill in the questionnaires and support our activities. I wish my successor very best wishes for the future.

Anne Pollock
March 2006



Trainees Report for the Scottish Region Committee Meeting/AGM


Trainees’ Committee meetings were held in September 2005 and March 2006 at Tooley St., London.
Relevant points arising from discussion were:
Agenda for Change
There are still large discrepancies between and within trusts. Annex U applies to all trainees and is 60 to 75% of the top of band 7. Most discrepancies occur between trusts or when a 3rd year trainee gains a grade B post. Here, the difference may be overcome by “marking time”: freezing wages until the bias is overcome.
Discussion regarding gender bias in the profession
Reasons for gender bias in the profession were discussed. These included lack of awareness of the profession. Suggestions included promotion of the profession to chemistry undergraduates, at postgraduate level and in university career centres. A report was presented in the ACB News.
Issues regarding fair and efficient recruitment of trainees into grade B posts
Concerns were raised advertising and recruitment of grade B posts. It was confirmed that employers have no obligation to advertise nationally. It was reported that some hospitals are withholding grade B posts in the belief no one would apply for them. Opportunities for trainees to make themselves known were discussed.
There is confusion over HST posts and their responsibilities. Many people in HST posts are not state registered and yet have posts that require state registration and pay for a state registered biochemist. There is disagreement over the definition of a trainee biochemist, resulting in people receiving varying degrees of help preparing for part 2 of the MRCPath. These issues will be raised at the next regional tutors meeting.
Other issues
-  There were problems with grade A recruitment, which was outsourced to Northgate. These have been addressed.
-  Pat Twomey’s course is not recognised by the ACB or RCPath.
-  A Trainees’ Committee induction pack is near completion.
-  Trainees’ website is being updated and improved.
-  Lecture notes are increasingly being removed from the internet but will be available on request from the ACB.
-  Numbers for the ACB training courses are not sufficient, but because they are booked 18 months in advance this will

   take time to rectify. Advice is to be aware of the dates for application and send in quickly with deposit to avoid

   disappointment.
-  The course content of all the MSc courses is being reviewed. The ACB will tailor the content of the training courses to

    fill in the gaps.


Neil Squires,

Sarah Jarvis


Regional Tutor


The Grade A Training Scheme continues to work well and the Trainees are making good progress. The help and support provided by a wide variety of staff in many laboratories in Scotland is gratefully acknowledged.
GRADE A Trainees
The Trainees currently in post are:-
First Year
Dr Fiona Stefanowicz, Fife Area Laboratory, Kirkcady [Supervisor – Dr PR Wenham]
Dr Michael Crane, Edinburgh Royal Infirmary [Supervisor – Dr P Rae]
Dr Roy WA Peake, Wishaw General Hospital [Supervisor – Mr E Carlyle]
Second Year
Dr Jane McNeilly, Aberdeen Royal Infirmary [Supervisor - Dr B Croal]
Ms Louise Brown, Ninewells Hospital and Medical School, Dundee [Supervisor – Dr Callum Fraser]
Third Year
Ms Eleanor Oakes, Stobhill General Hospital [Supervisor –Dr A M Wallace] recently appointed to Grade B Higher Specialist training post in Ninewells
Mr Neil Squires, Western General Hospital, Edinburgh [Supervisor – Dr JP Ashby]
Sarah Jarvis, Glasgow Royal Infirmary [Supervisor –Dr A M Wallace] recently appointed to Grade B Higher Specialist training post in North Glasgow
Over the past year Sarah Jarvis, Eleanor Oakes and Neil Squires successfully completed the MSc in Clinical Biochemistry with Molecular Biology at the University of Surrey.
All trainees were appraised in October 2005 in Glasgow by the Training Scheme Co-ordinator (Dr Callum Fraser), the ACB Regional Tutor (Dr AM Wallace), and an External Assessor (Dr M Wheeler). It is pleasing to report all Trainees are making very good progress. The two Trainees who had completed Year 3 were awarded the ACB Certificate of Completion of Grade A training and have both now obtained Higher Specialist Training Grade B Clinical Biochemists posts in North Glasgow (Ms Louise Todd) and RHSC Edinburgh (Dr Leigh Campbell). Two of the third year trainees (Ms Sarah Jarvis and Eleanor Oakes) have also obtained a Higher Specialist Training Grade B posts in North Glasgow and Ninewells respectively.
It is encouraging that all have been suitably promoted before the end of their four year Grade A contract.
Recruitment
NSD are funding three new Trainees in 2006 and it is proposed that they will all be based in Glasgow ( Royal Infirmary, Gartnavel General Hospital and RHSC Yorkhill). These posts have been advertised recently in the New Scientist and the ACB Newsheet and interviews are to take place shortly. We are grateful to Dr John Fyffe (Yorkhill) and Dr Richard Spooner(Gartnavel) for taking on this new commitment.
Administration
Tayside University Hospitals NHS Trust continues to hold the contract with NSD for the Scottish Training Scheme for Grade A Clinical Biochemists and this arrangement works very well. Dr Callum Fraser is currently reponsible for the co-ordination and local administration of the scheme and the Regional Tutor is responsible for professional matters. Dr Fraser will retire in June and the current plan is that administrative matters will remain within Tayside. Dr Fraser has been responsible for the smooth administration of the scheme for over ten years and his expertise and enthusiasm will be sorely missed.


Dr AM Wallace
Regional Tutor
March 2006



ACB Clinical Practice Section Steering Committee:

Meeting 15th November 2005
Unapproved Report (Minutes not yet Available)


Since spring 2004 planning has been underway to set up the ACB Clinical Practice Section, which aims to better represent Clinical interests and better serve medical membership within the ACB. This was the first meeting of the ACB CPS Committee. The ACB CPS Committee is made up of the Steering Committee, which includes representatives nominated by each ACB region, plus the Executive Committee, which includes the chair- and vice-chairpersons, director of communications and heads of the three operational sections (see below). Appointments, which have been on a temporary basis up to now, were made formal. Elected officers will serve for 3 years with the possibility of 2nd terms. Length of office may need to be more flexible for SpR’s.
As part of the Steering Committee, roles of the regional representatives (eg. for Scotland) will include electing the executive committee members, serving on the Steering Committee, promoting awareness of the ACB CPS and of Clinical Biochemistry as a Clinical Speciality, promoting a sense of belonging for medical graduates, providing a mechanism for feedback to the group, ensuring good response levels to questionnaires etc. and other more specific roles as the ACB CPS develops.
Operational Sections: The areas of interest have been divided into 3 sections, each with Team Leaders. Sections have an open membership, and services provided by and membership of the Sections will be open to all ACB members. These 3 sections will be responsible for delivering services to members. Although there will be overlap with existing ACB committees, these sections will endeavour to provide new services and avoid duplication of effort.
(i) Clinical Specialities Section
Aims of this section include creating a discussion and meeting forum for members with specialist clinical interests, providing clinical input for future Focus meetings, contributing to clinical guidelines etc. Specialist Clinical Interest groups already being formed include Cardiac, IEM, Endocrine, Nutrition, Bone Metabolism and Best Practice groups. Contribution to best practice guidelines is seen as a good opportunity for trainee involvement.
(ii) Professional Affairs Section
No report received for this section. Initial areas of interest include consultant contracts and job planning, nominations for Clinical Excellence Awards, leadership training and consultant appraisal and assessment.
(iii) Training, Education and Academic Development Section
Areas of interest include Modernising Medical Careers, medical undergraduate education, recruitment into and profile of the speciality. The lack of teaching of Biochemistry to undergraduates was highlighted. A response to this will need to be broad based. This group felt that the ACB could make a contribution as follows: an analysis of undergraduate curricula to highlight lack of Biochemistry; a survey of students to assess ability at data handling etc
Strategic Direction:
Initial goals determined at the meeting include the following:
- Increasing ACB membership and involvement (on review of ACB membership numbers, it would appear that around 80% of consultants and SpR’s are indeed members and that increasing involvement of existing members should be the primary goal)
- Looking at undergraduate and postgraduate training requirements to see what contributions can be made. Improve understanding of the specific needs of trainees in the speciality and assess whether these are being met.
- Improving links to other organisations, for example the ACP
- Developing and advertising clinical sessions for Focus 2006 and 2007
Next Meeting
21st March 2005 at ACB Offices, Tooley Street, London
Current activities
The ACB CPS has not met since 15 November 2005 (summarised notes above) and there is little to report at present. Recent activities have included development of a number of Best Practice Guidelines. There has also been much debate regarding Lord Carter’s review of Pathology Services & the ACB CPS’s response to this. Although this is a debate for the health service of England, it retains importance for Scotland. A webpage for the ACB CPS has also been added to the ACB website: http://www.acb.org.uk/site/clinprac.asp .
We are trying to set up a database with details of all trainees. New trainees should then be able to be provided with important details shortly after getting SpR posts (namely SpR club meetings, relevant meetings, contact details of SpR’s close by etc), something which has not happened up to now.
The ACB CPS has a meeting on 21 March 2006 which I can report back on at Livingston. Issues on the agenda include:
1) Chairman’s report on National Executive issues
a. Carter review
b. Science Council report on diagnostic testing
c. National Electronic handbook
d. Parliamentary affairs officer
e. KSF and extended role of clinical scientists and BMS

2) Section reports
a. Clinical specialties
b. Professional affairs
c. Excellence awards
d. Education
e. Communications
3) Undergraduate education
4) Focus 2006 and 2007 planning

David Preiss
ACB CPS Regional Representative for Scotland
davidpreiss@doctors.org.uk