Those who attended the launch of the Welsh POCT policy
in Newport earlier this year may remember Rhodri
Morgan, First minister for Wales, being quoted as
saying that "in order to improve the health service
for patients, better and more rapid access is needed
to diagnostic services. If that necessitates an
increase in the use of Point of Care investigations,
then so be it". A later quote advised that "these
investigations did not need to be to laboratory
standard, but good enough."
So if CPA is not going to say what is good enough,
then who is?
Jan
--- IAN WATSON <[log in to unmask]> wrote:
> Don't agree that CPA has not influenced hospital
> based POCT, in my
> experience it has along with the MRHA guidance.
>
> To cover POCT outwith the central lab, we need to
> accept that networks
> should include the disseminated aspect of analysis
> and interpretation
> and that we as professionals in this area are best
> place to deliver
> this. There is no logical reason why patients should
> be exposed to more
> risk by ineptitude [a common POCT problem], but
> unless we push our
> case............
>
> Ian Watson
>
> >>> "Taylor, Richard" <[log in to unmask]>
> 09/16/05 2:09 pm >>>
> 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
> >
> > ------ACB discussion List Information--------
> > This is an open discussion list for the academic
> and clinical
>
=== message truncated ===
Mrs. J. Still,
POCT Manager,
Biochemistry Dept,
Watford General Hospital. 01923-217998.
The views expressed in this message are personal and do not reflect West Herts NHS Hospitals Trust policy.
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