In my capacity as President of UK NEQAS and Director for UK NEQAS for Leucocyte Immunophenotyping, I was present for discussions regarding the ongoing provision of EQA during the COVID pandemic at the March 13th Haematology NQAAP meeting. It was agreed by those present that the continued provision of a service by EQA providers is a key function and that absence of EQA could well be a patient safety issue. So, I would agree with you that the maintenance of regular EQA is vital.
However, I am also aware of the challenges that EQA centres worldwide are experiencing (in parallel to those seen by diagnostic laboratories) in continuing to provide their routine level of service. Whilst some EQA providers have maintained services others have had no choice but to adjust their working practices. We should also remember that an alteration of services provided (on a diagnostic laboratory level) is the approach in the RCPath and Professional body notification for prioritization/deferral of laboratory work.
When discussing such differences in EQA provision it should be noted that whilst comparing EQA providers or even different UK NEQAS centres may appear easy from the outside it does not take into consideration any local operational complexities, for example, sample availability, that differ on a centre to centre and indeed on a programme to programme basis. Additionally, many expert EQA staff at several centres have been redeployed at this time by their host organisation and this directly affects their ability to deliver the core EQA services.
These factors and many others have directly and indirectly impacted on EQA services and thus affected decisions regarding the level of ongoing service provision.
In terms of your rhetorical question this is a very interesting point, but one that I fundamentally disagree with.
This is a challenging time for all in healthcare with numerous works and projects temporarily delayed, for example, the UK National Colon and Breast screening programmes have been suspended – would you also ask the question for these programmes of “after COVID why do we need to continue?”. I would sincerely hope not as these programmes have repeatedly been shown to save lives.
The same is true of EQA programmes and the data they produce. There is a wealth of peer-reviewed data showing time and time again that robust EQA has identified technical, methodological and interpretational issues that have not been detected by even the most robust internal procedures. These issues if not identified by EQA would then have adversely affected patient care on local, national and international levels.
I would suggest that a better question, is “what can we learn from this situation?”. Both in terms of contingency planning for provision of services (both diagnostic, EQA and accreditation) and development of new working methodologies to better support the core aim we all share: delivering the right result for the right patient.
LW
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