The Pathology Partnership (’the Partnership’) – update 7
To: All GPs in East and North Hertfordshire, via Practice Managers
29July 2015
Dear colleague,
This is the seventh regular update report, to keep you informed of the CCG’s actions and the Partnership’s progress towards delivering a high quality pathology service to GP practices.
East and North Hertfordshire CCG representatives continue to meet with the Partnership and Cambridge and Peterborough CCG on a weekly basis to review the Remedial Action Plan.
Key progress made this week includes:
- Delayed test reports
I am pleased to report that the national issue with delayed test reports has now been resolved. The Partnership is working through the backlog of results from the last 24 hours. Abnormal results will continue to be telephoned through to practices in line with procedures. In the meantime, if you have clinical concerns about particular patients you can all the Partnership’s helpline on 0333 103 2220 and press 1 for GP practice queries.
- First clinical forum meeting
Thursday 23rd July 2015 saw the first CCG and Pathology Partnership Clinical Forum. The meeting was well represented by CCG Directors and GP leads, the Partnership and Public Health England (PHE). The following key items were discussed:
- Chris Nolan has been appointed as the new Interim Chief Executive of the Partnership and has started in post.
- Batch reports:From, the 18th September, GPs will be able to view results from a batch of tests ordered for a patient at the same time. To make this happen, the Partnershipis implementing an interim IT solution, prior toEpic, the software manufacturer of the Electronic Patient Record System used at Cambridge University Hospitals (which includes the pathology IT system) makes longer term changes to the underlying software. This isin-line with the delivery date agreed within the remedial action plan. Epic is currently estimating the delivery date for changes to the underlying system to be in place by the end of December 2015.
- Change control process: The Partnership has developed a collaborative ‘change control process’which was discussed at the Forum. This is an important document which ensures that approval from commissioners is sought before any non-contractual changes are made which impact upon GPs and patients. Before changes are introduced, the Partnershipwilloutline the reasons for the requested change and demonstrate that it has considered the impact on practices.
A draft of this document has also now been shared with all CCGs and we will let you know when a final version is in place. - Date and time sample taken:GPs have reported that they are unable to see the time and date the sample has been taken. This data is being captured but there are problems with this information feeding into GPs’ clinical systems. The Partnershipis working with clinical system providers tofind a resolution.
- Communication of severely abnormal results: We are aware that some practices have not been notified of severely abnormal results. The Partnershiphas stated that it works to the Royal College of Pathology guidelines, but it has become apparent that not all calls are being logged. The CCG has asked the Partnership to be more rigorous in its call logging and undertake an audit to provide assurance that standards are being met.
- Delays in Microbiology: the Partnership informs us that laboratory turn-around times for microbiology tests are now being achieved. Please let us know via the contract hotlineif you are experiencing delays in microbiology.
- Duplicate Results: The CCG has provided the Partnership with a list of specific cases raised through the hotline and has asked the Partnership to review and provide feedback for each case.
- Delays in HBA1C results – the Partnership has confirmed that results for a HBA1C test should be reported back to practices within two days. If you find that results are taking longer, please report via the contract hotline to enable us to review on a case by case basis.
- Falsely elevated potassium levels – We have been told by one practice of a number of results with falsely raised potassium levels. The Partnership is reviewing these cases and the CCG is looking into whether there is any link between the incorrect results and the pick-up schedule for samples. The Partnership has audited this issue and don’t believe it to be indicative of a wider problem but the CCG will continue to keep an eye on the issue.
- Introduction of new ‘Starstedt monovettes’ urine pots–The CCG has agreed with the Partnership that these new urine sample collection pots will not be introduced until a full impact assessment is undertaken, the CCG has been provided with evidence to support the change and the LMC has been briefed on the implications. This is a good example of how the new ‘change control’ process should be used to introduce new ways of working and minimise the impact on practices.
- Recall of patients– It has now been agreed that the recall service for East and North HertfordshireCCG patients, which is currently delivered from the pathology laboratory at the Lister will move to Cambridge, because this is where the pathology service for GPs is now provided. The date for implementation is to be confirmed and we will let you know through this bulletin once it has been agreed.
- Response to hotline queries– As set out in the action plan, the Partnershipis on track to respond to all queries raised through the hotlinewithin 21 days.
- Pathology user guide handbook – the Partnershipis revising the current handbookand producing an at-a-glance guide to turnaround times for results. Both of these documents will be available via East and North Hertfordshire NHS Trust’s website shortly.
- The Clinical Forum is next due to meet later in August. A final date has yet to be confirmed but it is expected to be on 20 August. If you have items you would like to be addressed at the forum, or would like to comment or share your experiences, please email them to Paula Simms no later than close of play on the 20 July 2015:
- Educational Topics
The Partnership’s team of specialist clinicianshasoffered to provideeducational sessions to practices at TARGET days to share their knowledge and experience. Suggested topics so far include the diagnosis of infections; diagnostics to rule out infection and appropriate treatment or point of care testing for C-reactive protein (CRP).
If practices have a specific topic they would like the Partnership to cover in one of these sessions, please contact your locality manager.
Reporting concerns
If your practice continues to have problems with the service provided by the Partnership, please use the contract hotline webformto refer specific concerns to the Quality Team as they arise.
Alternatively you can email or ring the hotline co-ordinator on 07786 625 043. All of the issues that you raise are investigated, passed to the Partnership for resolution, and will be reported back to the practices that raised them.
Thank you for your patience during this difficult period. Please be assured that all available contractual levers are being used to resolve outstanding issues as soon as possible.
With regards,
Sheilagh Reavey
Director of Nursing and Quality
East and North Hertfordshire CCG