Quite right, Gary!
I have only just returned from leave, so didn't participate in this
discussion before now.

Everyone can do something about raising the profile of the scientific
professions locally in the Critical Care Programme - the national Critical
Care Programme managed by the Modernisation Agency in any case
indicates that it expects the programme to be driven forward by local
systems - Trust Critical Care Delivery Groups and Local Networks.
Rightly or wrongly, we are out of sight, out of mind to too many of our
clinical and management colleagues, and it is up to us to change that.

The details of the local networks are on the Critical Care website
http://www.modern.nhs.uk/scripts/default.asp?site_id=20&id=6511
and all should have at least one AHP/HCS representative.  Find out
who that is, try to attend meetings and make sure that scientists are
involved.  All acute Trusts should have a Critical Care Delivery Group,
and all should have a Pathology representative.  Find out who yours is -
I know Doug is on the Bradford RI one, and I have got myself on the
Leeds TH one.

I posted information about the Critical Care Programme on the general
ACB mailbase (since it is relevant to all Clinical Biochemistry
contributions to Critical Care, not just POCT) on 25 April, then on 3 May
to remind people about the AHP/HCS meeting on 11 June.  The Critical
Care Programme secretary had asked me for details of professional
journals for advertising this event, but I understand that only the IBMS
Gazette got one in the end, hence my posting on the mailbase.  These
emails are there in the archives, but I will also forward the first of them
to this list since that contained most information.

Briefly, the history is that I had been asked by the ACB to attend a
meeting of the AHPs Advisory Group about this in late November and I
was later asked by Fran Woodard, who chairs the AHP Advisory Group,
to join as one of the HCS representatives - there were none before the
beginning of 2002.  The others are Alan Wainwright, Training Officer of
the IBMS, and Dominic Cox, Clinical Physiologist at the Royal Free.
Mike Hallworth asked me to keep the Scientific Committee of the ACB
informed, via Nigel Lawson, which I have done.

The original Report, as I noted in the email, did not take much account
of any professions involved in Critical Care apart from medicine and
nursing - AHPs and scientists were barely mentioned, and no
representatives of these professions were on the original working party
(medical and nursing professions only, plus managers).  For this
reason, Fran Woodard set up the Advisory Group (with the
Modernisation Agency's support) in early 2001.  During 2001, the Group
prepared a paper on the contributions of AHPs to critical care.  This was
"frozen" in December 2002, too late for scientists to be included.  I tried
hard to get a delay on the publication so that something could be
included but Fran felt that the process of getting all the scientific
professional bodies to agreeon one (a prerequisite of inclusion) would
take far too long.  A contribution will be posted on the website and
included in the next edition.   I explained this in my posting of 25 April
and it was also made very clear at the 11 June event.

It is, of course, quite astonishing and also appalling that clinical and
biomedical scientists were so comprehensively left out of the whole
process, from the original working party through all the implementation
processes until relatively recently.  Non-AHPs who were included, such
as Critical Care technicians (and Dominic), tended to be aware of the
programme via the Intensive Care Society, which pathology professions
are generally not involved with.  It is certainly true that the number of
Critical Care Technicians is small, compared with pathology professions
and other HCSs;  systematic approaches to the scientific professional
groups were not made until late 2001.  It's clear that the very large
number of these was confusing.

A great deal is happening at the Advisory Group level.  I have been in
touch with the central team about POCT and training, as this is a major
area of cross-professional working, which they are encouraging as part
of the programme.  The other progress is that it is possible that some
sort of scientists' subgroup of the Advisory Group will soon be formed;
Fran and I have had discussions with the physicists, who, with the
clinical engineers are very numerous and widely involved in critical
care.  It has been clear all along that HCSs have little in common with
the AHPs other than a joint concern about having been omitted from
the original report;  many AHPs are unaware of our contributions to
Critical Care, not interested in it anyway, and feel that our involvement
is irrelevant to them.

An article will shortly appear in the ACB News about all this.  As
indicated before, anyone wanting to discuss any of it is welcome to
contact me, although Biomedical Scientists might also like to talk to
Alan Wainwright at the IBMS for further info relevant to their profession.
Look also for local activity, as this is where it is the intended that
progress is made, and ensure that the profile of our professions is
raised there.

> It sounds to me that we should all make to effort to get involved with our
> critical care colleagues by actually going to where they are, rather than
> staying in the lab and moaning about lack of contact or consultation. There
> are critical care networks in most trusts, so it shouldn't be too difficult
> to find out who is already part of it. How many of us are actively involved
> with our critical care colleagues?
________________________________________________

Dr MJ Pearson
Department of Clinical Biochemistry & Immunology
Old Medical School
Leeds General Infirmary (Leeds Teaching Hospitals NHS Trust)
LEEDS LS1 3EX

Tel 0113 392 3945
Fax 0113 233 5672

http://www.leedsteachinghospitals.com