You got predictable answers, Wayne.
So, we have our labs regulated to the hilt internally, with nobody but us
really interested or understanding the complexities, but as a profession we
are failing to regulate, or 'build a service responsive to patients' for
POCT in our own hospitals in clinical areas, where there is far less
regulation and consistency of practice, but a clear need.
The existing lab-centred CPA system has not even been a useful lever to
influence POCT practice in our own hospitals. It could have been a useful
adjunct to the leverage available through developments in Clinical
Governance. The present CPA scheme is not specific on POCT requirements,
(with the implication that it is not important), which diminishes our
authority to change practice or argue for resources in our organisations.
In response to Jonathan's question, a separate CPA scheme for regulating
POCT on our hospital sites, community hospitals, DTCs and GP surgeries would
be valuable step forward. It may as well be separate because the
practicalities are different from procedures within a laboratory. It should
cover all POCT sites within and beyond the hospital, because the
practicalities are common between them. Maybe it should also provide for
Clinical Biochemistry to have influence over the 'POCT that isn't related to
Biochemistry'.
If we had such a CPA in operation, we would have a clear set of criteria for
acceptable standards for POCT. It would be easier to introduce and manage
better ways of doing POCT. As Jonathan points out, this would obviously
involve working in partnership with nurses and other clinicians. We would
have a higher profile, a clear, shared agenda with primary care colleagues
and hopefully some more like-minded allies in primary care. We would then be
in a better position to shape agendas for POCT in the high street.
Richard Taylor
Dr Richard Taylor
Consultant Clinical Scientist
Dept of Clinical Biochemistry
John Radcliffe Hospital
Oxford
OX3 9DU
tel 01865 220477
fax 01865 220348
> ----------
> From: Clinical biochemistry discussion list on behalf of Wayne
> Bradbury
> Reply To: Wayne Bradbury
> Sent: Thursday, September 15, 2005 15:05 PM
> To: [log in to unmask]
> Subject: Re: PoCT EQA & CPA
>
> I asked the panel at the last CPA conference this very question.
>
> At the moment PoCT is usually linked to Biochemistry accreditation
> although much
> PoCT isn't related to Biochemistry.
> I made the point that there is a no incentive to tick the box on their
> application
> form saying you are following the JWP guidelines on PoCT. If the
> inspectors find
> your PoCT is not up to scratch you could lose accreditation for the
> laboratory.
>
> At the moment CPA don't publish the number of labs which have applied
> for
> PoCT accreditation. I suspect many labs like my own don't apply.
>
> Enrolment for laboratory accreditation is mandatory; but illogically is
> not for PoCT.
>
> The CPA panel were unenthusiastic about a separate scheme - I suspect
> because
> they are struggling to cope with the workload for just the
> laboratories.
>
> Wayne Bradbury
>
>
>
> Mr. W.H. Bradbury
> Consultant Biochemist
> Cumberland Infirmary
> CARLISLE
> CA2 7HY
>
> Telephone: 01228 814521
> Facsimilie: 01228 814831
> E-mail: [log in to unmask]
>
>
> >>> Jonathan Kay <[log in to unmask]> 15/09/05 12:02:57 >>>
> What are the arguments for and against a new CPA scheme that assesses
>
> PoCT across an organisation such as a hospital or primary care
> organisation (not a laboratory)?
>
> I think it would be much better to have a specific scheme shaped that
>
> way, rather than being laboratory-based, because
> 1 So many of the issues are about operators (who are mostly nurses)
> 2 Organisational ownership is often the factor which limits quality
> 3 Many of the issues are common across PoCT, but don't match
> traditional laboratory disciplines
>
> Jonathan
>
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