•ACB Statement •Pathology Alliance Statement · In this Issue Pathology Networks: •ACB Statement •Pathology Alliance Statement • Industry Insights Equality, Diversity and

In this Issue

PathologyNetworks:• ACB Statement

• PathologyAllianceStatement

• Industry Insights

Equality, Diversity and Inclusion

Lab Tests Online-UKWhich?Recommen-dation

FCS Briefing‘Retire andReturn’

The Association for Clinical Biochemistry & Laboratory Medicine | Issue 649 | October 2017

ACBNews

NHS Improvement: 29 PathologyNetworks in England

About ACB NewsThe Editor is responsible for the finalcontent; advertisers are responsible for thecontent of adverts. Views expressed are not necessarily those of the ACB.

Lead EditorMr Ian HanningDepartment of Clinical BiochemistryHull Royal InfirmaryAnlaby RoadHull HU3 2JZEmail: [email protected]

Associate Editors Mrs Sophie BarnesDepartment of Clinical Biochemistry12th Floor, Lab BlockCharing Cross HospitalFulham Palace RoadLondon W6 8RFEmail: [email protected]

Dr Gina Frederick Pathology Laboratory, Level 5Royal Derby HospitalUttoxeter RoadDerby DE22 3NEEmail: [email protected]

Dr Derren Ready Public Health England National Infection ServiceMicrobiology Reference Services61 Colindale AvenueLondon NW9 5EQ Email: [email protected]

Situations Vacant AdvertisingPlease contact the ACB Office:Tel: 0207-403-8001 Fax: 0207-403-8006Email: [email protected]

Display Advertising & InsertsPRC Associates Ltd1st Floor Offices115 Roebuck RoadChessingtonSurrey KT9 1JZTel: 0208-337-3749 Fax: 0208-337-7346Email: [email protected]

ACB Administrative OfficeAssociation for Clinical Biochemistry & Laboratory Medicine130-132 Tooley StreetLondon SE1 2TUTel: 0207-403-8001 Fax: 0207-403-8006Email: [email protected]

ACB PresidentProfessor Ian YoungTel: 028-9063-2743Email: [email protected]: @ACBPresident

ACB Home Pagehttp://www.acb.org.uk

Printed by Swan Print Ltd, BedfordISSN 1461 0337© Association for Clinical Biochemistry &Laboratory Medicine 2017

ACBNews

General News page 4

Microbiology News page 13

Practice FRCPath Style Calculations page 14

Federation News page 16

Current Topics page 18

Council News page 23

Focus News page 24

Meeting Reports page 26

BIVDA News page 28

ACB News Crossword page 29

Situations Vacant page 30

Issue 649 • October 2017

The monthly magazine for clinical science

Issue 649 | October 2017 | ACB News

Front cover: The latest networks proposals

#FabChangeWeek 2017Calling all Healthcare Scientists! This year, FabChangeDay has beenextended to FabChangeWeek, runningfrom 13th-17th November 2017. Getinvolved by thinking of something youwant to pledge to improve patientexperience, patient safety, leadership andstaff wellbeing, service improvements oranything else you want! Upload a photoof your pledge to the FabChange websiteand share with @WeHCScientists#FabChangeWeek. Commit to your pledgeand share your successes! �

Life Sciences IndustrialStrategy Report toGovernment PublishedThe report, written by Life Sciences’Champion, Professor Sir John Bell, provides recommendations to Governmenton the long term success of the LifeSciences sector. It was written incollaboration with industry, academia,charity, and research organisations andcontains recommendations relating toscience, data, the NHS and industry growth from global companies. Business Secretary Greg Clark has

announced that the Government is toinvest £146m in discovering newmedicines, in a bid to help the UK become a world leader in Life Sciences. A strong Life Sciences sector cansimultaneously benefit the UK’s economyand help improve the nation’s health. �

CondolencesIt is with regret that we must inform youof the sad news of the passing of ACBRetired Member, Dr Ian Hunter, who diedon 20th April. Dr Hunter joined the Association in 1966

and was based in West Lothian until 2005and then later in Boston, Lincolnshire. �

4 | General News


ACB MicrobiologyScientific Day:

Registration OpenRegistration is now open for the

ACB Microbiology Annual Meeting on 24th November 2017.For further information

and registration please visit:http://www.acb.org.uk/whatwedo/events/national_meetings.aspx �

SudokuThis month’s puzzle

Solution for August’s Sudoku

“Which? exists to make individuals aspowerful as the organisations they dealwith in their daily lives”. It is the largestindependent consumer body in the UK,with over 680,000 members subscribing totheir magazine and 330,000 membersonline. Which? aims to provide consumerswith advice to help them make informedchoices, campaigns to make people’s livesfairer, simpler and safer and puts theconsumer’s needs first to bring thembetter value. The September edition of Which?

members’ magazine featured the article‘Help your GP to help you’ providing thereader with an insight into GPappointments. It provides pragmaticadvice on how to prepare for a GPappointment, how patients can enhanceinteractions at a GP appointment and howto get the best outcome from theperspective of the patient. The article usesvignettes and feedback from GPs andpatients alike to guide the reader throughan appointment, how the GP structuresthe appointment, what information theyneed from the patient and how best todeliver it. The article features a story froma patient at Haughton Thornley Surgery,who advocates access to full medicalrecords including test results andemphasises the importance of this servicefor developing ‘a partnership of trust’ withher GP and enabling her to monitor hercondition and find out more about it inorder to get the best health outcomes. The article features ‘Useful websites

recommended by GPs’, which includes Lab Tests Online-UK as one of only fiverecommended and trusted websites. The‘bottom line’ of the article includes advice

to ‘look at your patient records and useinformation such as test results’ in order to‘have really informed conversations withyour GP and minimise the need forappointments’. This fits seamlessly withthe objectives of Lab Tests Online-UK toprovide peer-reviewed, non-commercialinformation to patients to help themunderstand their test results and empowerthem to be involved in their ownhealthcare. The article stresses theimportance of patient preparation prior totheir GP appointment and Lab TestsOnline-UK is well placed as a free, easy toaccess resource, that provides furtherunderstanding of their test results. With the increase in GP practices

providing online access to medical recordsand positive patient stories such as thoseincluded in this article, Lab Tests Online-UKis the perfect resource to support patientsaccessing their results. This then builds onthe ‘partnership of trust’ between thepatient and the GP by providing patientswith reliable information before or afterthey have had their 10 minute interactionwith the clinician to understand theircondition better and get involved in theirown care. This is a great endorsement from a

completely independent super power inthe consumer body market and as one ofthe three stakeholders (ACB, IBMS andRCPath) for Lab Tests Online-UK, weappreciate your help in spreading theword about the website to your colleaguesand bringing this article to their attention.If you want to become a champion for

the website, or have somewhere you canprovide leaflets to patients please get intouch at [email protected] �

Lab Tests Online-UK is Recommended by GPs in Which? MagazineRebecca Powney, Lab Tests Online-UK, Marketing and Promotion Lead

6 | General News


General News | 7


Equality and HealthInequalities AnalysisCapability TrainingThe national Equality and HealthInequalities (EHI) Unit is running one-dayfree workshops across regions for all NHSEngland staff to understand their legalduties under the Equality Act 2010 and the Health and Social Care Act 2012. The training will also include advice on

completing an effective a EHI analysis. For further information and to book

your free space on 17th October 2017 inLondon follow this link:https://www.events.england.nhs.uk/events/6494/nhs-england-staff-equality-and-health-inequalities-capability-programme �

NIHR CLAHRC NorthThames Academy NewCourse: BecomingResearch ActiveIn collaboration with the Research DesignService London and Clinical ResearchNetwork North Thames, the CLAHRC NorthThames Academy is running a new shortcourse in 2017: Becoming Research Active.This one-day workshop will be held on

12th October 2017 and is designed forhealthcare and public health staff fromNHS Trusts, NHS CCGs, and LocalAuthorities who are interested inbecoming involved in research. Find out more details and how to

apply here: https://clahrc-norththames.nihr.ac.uk/event/becoming-research-active-oct-2017 �

8 | General News


On Friday 8th September the ACB Officeadvised us that NHS Improvement has justwritten to NHS Acute Trust Chief Executivesin England outlining proposals to establishand implement 29 pathology networks todeliver services for the whole of England. The objective is to establish pathology

services that deliver the highest qualityservices to patients and maximise value formoney, and to rapidly realise the clinicaland financial benefits which NHSImprovement believes will result. The letterincludes detailed proposals for each of the29 networks. It stresses that these are notintended to be definitive, and ChiefExecutives have an opportunity to proposealternatives which will achieve comparablebenefits.The ACB was made aware of the

proposals through participation in theNational Pathology Implementation Board.We were not consulted during thedevelopment of proposals, and there was

not an opportunity for them to beamended. We indicated our scepticism thatit would be possible to deliver the clinicaland financial benefits intended.

The ACB supports the overall objectiveof delivering maximum clinical benefitfrom laboratory services, and minimisingunnecessary variation. In addition servicesshould be delivered as efficiently aspossible. We recommend that heads oflaboratories engage at an early stage withChief Executives to discuss local proposalsand suggest alternatives whereappropriate.The Pathology Alliance Statement is

reproduced on page 10 and there is also an article on page 28 under BIVDA News.Further details of the proposals can be

found at https://improvement.nhs.uk/resources/pathology-networks/ (published 08/09/2017) �

ACB Statement on Proposals to Establish andImplement Pathology Networks in England

Upcoming Regional MeetingsACB Southern Region Autumn Scientific Meeting

17th October 2017Viapath, St Thomas' Hospital

ACB North West Autumn Audit Meeting6th November 2017

Wigan Hospital Education Centre

ACB Scotland Biennial Meeting9th-10th November 2017Norton House, Edinburgh

ACB Southern Region Scientific Meeting4th December 2017

Guy's Hospital

Further information and booking for all these meetings can be found here:http://www.acb.org.uk/whatwedo/events/regional_meetings.aspx

10 | General News


Pathology services underpin NHS care. The Pathology Alliance, which representsthe professionals developing and deliveringthese services, is committed to workingwith NHS Improvement to ensure thatpatients have access to high quality, cost-effective pathology provision whereverthey live.The Alliance endorses the optimisation

programme’s aims to reduce unwarrantedvariation and maximise benefits ofcollaborative working. Networks willreduce the impact of the staffing shortagescurrently seen in many areas, althoughinvestment in staff and their trainingremains a key component of any successfulservice. Sufficient numbers of appropriatelyskilled professionals are vital to achievingthe aims of the programme.The collection of reliable data is

particularly welcome, and provides anunparalleled opportunity to understandthe scope and scale of pathology services inEngland. Going forward, it is importantthat data are as accurate as possible so thatcomparison between networks ismeaningful and any savings recognised.Investment in pathology services must notbe cut before the benefits of a networkedapproach can be realised. Many of the mostsuccessful consolidated pathology serviceshave required significant investment in theearly stages to maximise long term savings.While some pathology services have

already undergone successfulconsolidation, it is important that thosethat have not achieved their objectives arenot forgotten. Good practice should beshared but some of the most valuable

lessons are likely to come from unsuccessfulventures, particularly those that mapclosely onto the proposed new networks.Repeating the same mistakes is likely toresult in the same outcome.It is vital that staff across the networks

are supported and engaged in the planningand transition to the new serviceconfigurations, with time provided forpathology professionals to understand andlead this unprecedented change.Although this proposal focuses on acute

trusts, pathology services are not deliveredin isolation. The needs of the whole healthsystem must be considered, includingprimary care and specialised services.The Pathology Alliance welcomes the

Optimisation Board’s assurance that theproposed networks are a starting point fordiscussion and not proscriptive. One sizenever fits all, particularly across pathology’s19 diverse disciplines, but these proposalsare an important step in assuring equitableaccess to high quality, cost-effectivepathology services for patients.

Dr Suzy LishmanChair, The Pathology Alliance:

� Association for Clinical Biochemistry and Laboratory Medicine

� Association of Clinical Pathologists � � British Division of the International

Academy of Pathology� British In Vitro Diagnostics Association� British Infection Association � � British Society of Haematology� Institute of Biomedical Science� Pathological Society� The Royal College of Pathologists �

Pathology Alliance Statement in Responseto the NHS Improvement Document onPathology Networks Published on 8thSeptember 2017

12 | General News


Last year the ACB Golf Society hosted theNVKC ‘All in One Club’ in the first British-Dutch Open at Mottram Hall nearWilmslow; we won the clog trophypresented by the All in One Captain, Hans Jensen. Well now we had to mount a defence!A select team i.e. those willing and able,

comprising: Bill Fraser (Captain), GrahamWhite, Rajeev Srivastava and yours truly,arranged to meet in Schipol with flightsarriving within an hour of each other; air-traffic control had other ideas andthree hours later we finally assembled and set off for our hotel in Zoetermeer; a hurried meal and so to bed to face thechallenges of the morrow. We hadn’trealised the main Den Haag – Goudarailway line ran, fast, directly behind thehotel, which didn’t help the slumbers!So, on to Golfbaan Bentwoud to meet

our Dutch challengers. Despite somecompetent SatNav programming by Billand Rajeev, the address for the golf clubfound us in a nature park: we weren’talone, another lost soul was one of theDutch players! Hans Jensen rescued us,took us to the club, and with minutes tospare, no practice, we had to tee-off, or as the Dutch say ‘our flight’.Golfbaan Bentwoud is a golf complex of

four 9-hole courses, we played B & C;being the Netherlands we were not toosurprised to find every hole had waterhazards of one kind or another, somemore daunting than others as well asgenerous (big!) bunkers. Although therewas rain for the first two or three ‘flights’,the weather cleared and a sunny calm dayenabled us to enjoy the company and thecompetition.Well we expected to lose a few balls and

that expectation was met, but everyonefound this a demanding course andmedian Stableford scoring was low. After our ‘flights’ had ‘landed’ we

congregated on the clubhouse veranda fordrinks and nibbles whilst the cards werecollected, checked, team scores calculatedand individual scores ranked: after dinnerthe results announced . . . We knew that inthe top four scores there was only one ofus, so our expectations were low, howeverthe aggregate team scores meant weedged it: we retained the Clog!An enjoyable and convivial time was had

by all and plans were laid for the 3rdmatch to be played somewhere in the UK,details will be posted when arranged.If you want to join us in one of our

domestic games get in touch with me [email protected] �

Defending the Clog!Ian D Watson, Honorary Secretary, ACB Golf Society

The delighted ACB teamwith the trophy; Bill isholding a big cheese hewon as the second highestscoring individual

Microbiology News | 13


The Diggle Microbiology ChallengeThese multiple-choice questions, set by Dr Mathew Diggle, are designed withTrainees in mind and will help with preparation for the Microbiology Part 1FRCPath exam.

Question 3 from AugustMany antiviral drugs act by inhibition of a viral DNA polymerase enzyme. Select thevirus for which this class of drugs would be effective:

A) Cytomegalovirus B) Influenza C) Measles D) Mumps E) Rabies

AnswerA) Cytomegalovirus (CMV) is the only DNA virus listed here, which encodes a viral DNApolymerase. The other viruses are RNA viruses and replicate via a viral RNA polymerase.

Question 4You are informed of an outbreak of diarrhoea and vomiting amongst the 100 guests ata wedding reception. About two thirds of the guests became ill between 2 and 3 daysafter the reception. You obtain a list of guests and the menu for the buffet meal. Select the most appropriate epidemiological investigation:

A) A case-control study B) A correlational study C) A cross-sectional study D) A randomized controlled trial E) A retrospective cohort study

The answer to Question 4 will appear in the next issue of ACB News – enjoy! �

14 | Practice FRCPath Style Calculations


A metabolic disease is known to result in decreased plasma activity of enzyme X. X was measured in 100 normal subjects and 100 individuals with the disease. A reasonableGaussian distribution was obtained for each population with the following statistics:

Mean (m) Standard deviation (s)Normal subjects 1025 U/L 100 U/LDiseased group 530 U/L 200 U/L

Find the decision level at which sensitivity is equal to specificity? What is the sensitivity(and hence specificity) at this decision level?

Two-tailed values of the normal deviate (z-score) and probability (P) are:

P(%) 10 5 2 1 0.2 0.1z 1.65 1.96 2.33 2.58 3.09 3.29

These data form two overlapping normal probability distributions in which the mean ofthe normal group (mN) is higher than the mean of the diseased group (mD). The decisionlevel (DL) divides the normal group into true negatives and false positives. The diseasedgroup is divided into true positives and false negatives:

If the sensitivity (proportion of true positives in the diseased group) equals the specificity(the proportion of true negatives in the normal group) then the proportion of each groupin the shaded area must also be equal. If the data is normalised (by subtracting the meanfrom each value and dividing the difference by the standard deviation) then the normaldeviates (z-scores) at the point of intersection with the decision level with eachdistribution must also be equal:

Deacon’s Challenge No 192 - Answer

Practice FRCPath Style Calculations | 15


Question 193A patient in A&E with suspected adrenal crisis was given an iv dose of hydrocortisone at18.00. The medical team on take wish to carry out a short synacthen test to confirm thediagnosis but there will be a significant contribution from the administered drug untilits concentration has fallen to 10% of the peak value. Assuming that hydrocortisoneelimination follows a single compartment (first order) model with a half-life of 2 h,what is the earliest time at which the test can be carried out?

DL - mD = mN - DL

sD sN

which can be re-arranged to give an expression for DL:

sN (DL - mD) = sD(mN - DL)

sN.DL - sN.mD = sD.mN - sD.DL

sN.DL + sD. DL = sD.mN + sN.mD

DL (sN + sD) = sD.mN + sN.mD

DL = sD.mN + sN.mD

sN + sD

Substitute mD = 530 U/L, sD = 200 µ/L, mN = 1025 U/L and sN = 100 U/L to evaluate DL:

DL = (200 x 1025) + (100 x 530) = 205,000 + 53,000 = 860 U/L

100 + 200 300

The sensitivity can be calculated from the z-score of the diseased group:

z = DL - mD = 860 - 530 = 330 = 1.65sD 200 200

From the table of z-scores a z of 1.65 corresponds to a probability of 0.1 (10%). Therefore10% of results will fall outside the mean±1.65s range, with half of these (5%) beingabove the mean+1.65s. Therefore 95% of results in the disease group will be below thedecision level of 860 U/L. The sensitivity (the % of diseased individuals below the DL) istherefore 95%.

Similarly the specificity can be calculated from the z-score of the normal group:

z = mN - DL = 1025 - 860 = 165 = 1.65

sN 100 100

Again 5% of results in the normal group will be less then mean-1.65s and 95% will beabove the decision level of 860 U/L so that the specificity (% of normals above the DL) isalso 95%.

FCS Briefing 14: “Retireand Return” Guidance forEmployees and EmployersGeoff Lester, NHS Staff Council and Pensions Scheme Advisory BoardRepresentative

16 | Federation News


BackgroundBack in 2015, that guardian of publicmorals, The Daily Mail, and other parts ofthe media, became agitated about NHSstaff who exercised their legitimate rightto take their NHS pension and then(request to) return to work. The criticism was based on rather

out-dated notions that “retirement”means stopping all work, coveting yourgold-watch and withdrawing to thegarden shed or rocking chair and knitting(no offence meant to gardeners orknitters!). In response to the Daily Mail’sindignation the Secretary of State, JeremyHunt, resolved to take action.

The NHS Pension Scheme Advisory Boardrecommended that the retirementflexibilities that have long been enshrinedin the 1995, 2008 and 2015 schemeregulations are in the interests of bothscheme members and NHS employersfacilitating “wind down” in either volumeor intensity of work and better work-lifebalance for those approaching retirementwhilst permitting services to retain accessto valuable knowledge and experience.Any response should therefore be in theform of guidance rather than restrictiveregulation. That guidance was released inJuly 2017 and can be downloaded fromthe link below.

Federation News | 17


Flexible RetirementEach of the NHS schemes has slightlydifferent flexible retirement regulations.The 1995 scheme, with its Normal PensionAge (NPA) of 60, is the most stringentwhilst the 2008 and 2015 schemes havemore flexibility built in.

Important Points to Note1. If you do retire with 1995 scheme

pension benefits you cannot contributefurther to that scheme after returningto work. You have to retire and resignin order to take your pension.

2. If you have a 2008 or 2015 pensionthen you can take some of yourpension, referred to as draw-down,without leaving NHS employment andyou can continue to contribute to yourpension. See the sections in the 2008and 2015 scheme guides via the linksbelow.

3. The “Retire and Return” process mainlyrefers to the 1995 scheme with itsattraction of taking a final salarypension at 60 and then returning towork.

4. Even though you may not be entitledto contribute further to a NHS pension

scheme, under the pensions auto-enrolment legislation, theemployer is legally obliged to enrol youinto some pension scheme. This willprobably be the NEST scheme. If you donot wish to make further contributionsit is then for you to opt out. Note thatyou will have a limited time windowafter returning to employment to dothat.

5. When you retire you do not have aright to return. Employers must be ableto justify re-employing you publically if called upon. This is partly because the practice could be viewed asreducing career advancementopportunities for others and may notbe the most efficient use of publicmoney. The Retire and Return Guidance(Annex B) includes an employer’schecklist.

6. If you take your pension before theNPA for your scheme and then returnyour pension benefit will be subject toreduction (abatement). See therelevant sections in the guides below.

7. You should consider all flexibleretirement options available to youbefore making any decisions. �

Further Information1. DH Guidance: Re-employment of staff in receipt of NHS Pension Scheme benefits,

Guidance for employers and staff: https://www.gov.uk/government/publications/re-employing-staff-who-receive-an-nhs-pension

2. NHS Pensions Retirement Guide (Information for those about to retire with a section on “What if I want to work after I retire”): https://www.nhsbsa.nhs.uk/sites/default/files/2017-06/ Retirement%20Guide%20%28V23%29%20-%2006.2017%20.pdf

3. The pension scheme guides contain sections about the retirement flexibilities availablein each scheme: 1995/2008: https://www.nhsbsa.nhs.uk/sites/default/files/2017-05/1995-2008%20 Members%20Guide%20%28V19%29%2005.2017.pdf

2015: https://www.nhsbsa.nhs.uk/sites/default/files/2017-06/2015%20Members%20Guide%20%28V8%29%2006.2017_0.pdf

4. Links to NHS Employers resources on flexible retirement: http://www.nhsemployers.org/your-workforce/pay-and-reward/pensions/pension-scheme-flexibilities

18 | Current Topics


The Science and Engineering sector hasbeen attempting to address lack ofdiversity for decades. WISE (Women inScience and Engineering), for example,was started in 1984 (seewww.wisecampaign.org.uk); Ethnicity inSTEM (Science, Technology, Engineeringand Mathematics) is one of the main areasof focus for race.bitc.org.uk. The sectorrecognises that if it fails to attract morewomen or people of a black and minorityethnic (BAME) background and hold on tothem as they hit each educational orcareer hurdle, the skills shortage alreadyapparent will continue to grow. TheBiomedical Sciences do better at gettingwomen into relevant degrees – over 50%of medical students are now female andrecruitment into the Life Sciences STPprogramme is approximately 75% female;there remains a question though – is oursan area in which women thrive, survive orstall? Healthcare is seen as an area of goodrecruitment for BAME. However, whilst ourhospitals and even our laboratoryworkforce may be becoming moreethnically diverse, Clinical Science stillseems to struggle either to attract oremploy people from outside a whitedemographic (The Workforce Survey, as reported by Jonathan Scargill in June’sACB News, shows us to be over 90% white).In 2016 the ACB signed up to the

Science Council’s Declaration on Diversity,Equality and Inclusion: http://www.sciencecouncil.org/web/wp-content/uploads/2016/01/Science-Council-Declaration-on-Diversity-Equality-and-Inclusion.pdf As part of that agreement I wasapproached to act as the ACB’s firstDiversity Champion.

Initially I, possibly like you, asked myselfwhy would the ACB need such aChampion? After all it is largely the NHSthat hires, fires and promotes us, the GMCor HCPC that determines if we are fit andproper people for our role and the RoyalCollege of Pathologists that assesses ourability. The ACB just Champions theScience, right?Firstly, we should acknowledge that it is

ACB members who are at the business endof most of those decisions. Secondly, theACB is a leading voice for LaboratoryMedicine, it speaks for us across manyplatforms, scientific, educational andpolitical; in doing so it should be reflectiveof all its members. In Focus and FiLM wehave two of the most important UKmeetings for presenting, celebrating andleading the debate about Pathology. It isvital we ensure equality of opportunity forall our members to participate and attend;similarly with our prizes, awards andgrants. The FCS represents the interests ofour Clinical Scientists and needs to beaware of issues that might be impactingon some sectors of our membership morethan others.Equality projects are generally regarded

positively because “it is the right thing todo” and it is only fair and proper to ensurepeople are not discriminated against onthe basis of their gender, race, sexualorientation or religious belief. But EDIinitiatives do not just benefit those of uswith a protected characteristic; Diversitybrings major benefits to organisationsthemselves. The first Women Matterreport from management consultancyMcKinsey in 20071 concluded thatcorporations with women on their boards

Equality, Diversity andInclusion in the ACBRachel Wilmot (Hull), ACB Diversity Champion

Figure 1: Gender Distribution by Age of Active ACB Members

Current Topics | 19


perform better than those without acrossboth financial performance andorganisational excellence. Significantperformance improvement is seen when acritical mass of female representation –30% – is reached.2 In the NHS we work in aparticularly rapidly changing environment,the ability to leverage a diversity ofperspectives facilitates innovation andagility which can only improve ourinteractions and decision making. So, where to start in this new role?

I looked first at the data the ACB holds onits membership. In terms of protectedcharacteristics this is limited to gender, so with apologies, the rest of this articlehas a gender bias. With a further apology

to our Overseas Members I concentratedon UK based members, as these aregenerally most available to take on ACBroles and responsibilities. Table 1 showsour UK membership by category.It has long been said that we are an

organisation of old men and youngwomen and that the ACB Leadershipwould be less male and pale once thatdemographic matured. If we concentrateon the active UK membership thatstatement merits further scrutiny.Sixty-one percent of our active members

are women with a pronounced bias to theyounger end. The old men peak howeveris not so obvious (see Figure 1). If we lookat members over 40 (at this age we are

Table 1: Background Data Category

20 | Current Topics


Figure 2: Gender Distribution by Age Contrasting Scientists and Medics.Please note the difference in scale

generally considered senior members ofthe profession in terms of either timeserved or position), women make up 52%.Figure 2 contrasts the demographics of ourScientists and Medics. For Scientists atolder age groups the gender breakdown ispretty even; at the younger end it islargely female and indeed we are startingto ask why we are not attracting youngmen into our profession. For our medicsthe older male peak is clear, there is also ademographic time bomb apparent. In theover 55s the Scientist to medic ratio is 2:1,in the under 55s it is 6:1. We need toconsider how we remain inclusive of ourmedical members as this demographicchange actualises. Do the higher echelons of the ACB

reflect its demographic? The currentExecutive has three female members outof nine, ACB Council fares better at 40%female, largely due to the good number offemale regional representatives. All threecurrent National Members (considered a

route to higher office) are male. Table 2shows the breakdown by gender of thehigh offices of the ACB over the last 30years. Also included are the data onmembers who have been recognised fortheir contributions to the ACB.Looking at Chairs and deputies of

various ACB Committees over the sametime frame (Table 3), it is a very mixed bag with Education and Publicationsfaring well whilst the Federation andparticularly the Scientific Committee aremore of a concern. Over the same 30 yearperiod our Trainees Committee has largelyreflected the makeup of our Trainees. The data raise interesting questions: arethere roles that are not attractive to ourwomen members? Or does our difficulty in attracting volunteers mean bias (conscious or unconscious) comes into playwhen people are being persuaded to takeup roles? Ending the data trawl on a more positive

note Figure 3 looks at regional Chairs and

Current Topics | 21


Table 2: Does the ACB Reflect its Membership? 30 Year Review: Higher Office and Contribution Recognition

Table 3: Does the ACB Reflect its Membership? 30 Year Review: Selected Committee Chairs

Secretaries over the last 12 years.Future articles will look more closely at

scientific contributions and recognition,describe how we benchmark against othermember organisations of the ScienceCouncil and introduce the team pulling

together an action plan for our next steps.(You will have already noted a few moreEDI questions on this year’s workforcesurvey). Meantime if you want to getinvolved or have issues you wish to raise,please contact me.

22 | Current Topics


Figure 3: Regional Chairs and Secretaries 2005-2017

Finally, in Ian Young’s Meet the Presidentpiece in the last issue, you will see that wehave buy-in to EDI at our highest level.Interestingly he put this alongside hisdesire to maximise Membership of theAssociation in all branches of LaboratoryMedicine. I would suggest being aninclusive organisation open to diverseperspectives can only help the voices andinterests of all these disciplines to be heard.

References

1. McKinsey & Co (2007). Women matter:gender diversity, a corporateperformance driver.

2. Konrad A, Kramer V, Erkut S Criticalmass: The impact of three or morewomen on corporate boards.Organisational dynamics (2008); 32:145-164 �

Council News | 23


As usual we had the topics of the day. It is at this time each year that our newmembers to Council get some insight intowhat being a Director (as a CouncilMember) means. As a brief introductionfor anyone considering engaging in ACBactivities, I will give the readership someinsight, although it is all very muchcommon sense. The role involvespromoting the success of the company,ensuring the best interests are maintained, maintaining companystandards and ensuring fairness betweenall members. keychainA brief and to the point fact sheet is

available on www.gov.uk/BEISGiven one of the roles of the Directors is

to ensure that there is equity within themembership, it is no surprise that we areengaged in work looking at how we canensure equality, diversity and inclusivity(EDI). I did write about this a few monthsago and informed the membership thatwe had embarked on a programme ofwork with the support of the ScienceCouncil. Rachel Wilmot has kindly taken alead on this work and presented asignificant number of facts about the ACBand how we as an organisation stack upagainst the standards of EDI. It makesinteresting reading. Rachel will publishsome of her findings in the ACB News, soplease read what will be an interestingarticle.The third topic discussed was the

Membership, and the potential pressuresthat exist going forward as membernumbers potentially decline as colleaguesretire, with reduced new members joining.Our President, Ian Young, has pledged toensure that the ACB Executive and Councilwork to rectify the current trend, ensuring

we understand our current position andhow can we make the ACB for everyonewho is involved in Laboratory Medicine.Food for thought. Do you know apracticing Laboratory Scientist who is not amember of the ACB? Would you supportan initiative to proactively recruit some ofour colleagues? Do you actively encouragenew members to the profession to join, if not, why not? I guess what I am saying isthat we are aware of a problem comingour way, so what are we all going to doabout it?The final item I would like to mention

was our Members’ Award ceremony heldat lunchtime during this Council meeting.It was great to see some old and some notso old faces being recognised for theircontributions to the aims of theAssociation. The awardees received theirAwards from Gwyn McCreanor, our Past President. Congratulations go to you all. �

Council Meeting: 6th July 2017Paul Newland, Director for Publications and Communications

From left to right: Edmund Lamb received thePresident’s Shield, David Vallance, Fellow of theACB, Philip Wenham as Emeritus Member andDavid Bullock as Fellow of the ACB

As a proud Mancunian, I’m delighted toinvite you to Manchester for Focus 2018.We hope that as many of you as possiblewill join us for the ACB’s National Meeting,where we will Focus on Value. The conference will be held in the

modern and environmentally-friendlyBrooks Building, part of ManchesterMetropolitan University, from 6th-8thJune, 2018.Manchester is the original modern city.

What Athens was to Ancient Greece, andFlorence was to the Italian Renaissance,Manchester is to the modern scientific andindustrial age. It remains a powerhouse ofscience and the arts, sport and music, and is home to the University ofManchester, the second-largest universityin the UK and the largest single-siteuniversity, Manchester MetropolitanUniversity and the University of Salford.

Following the hugely successful Focus inLeeds last year, we have kept to the two-day format for the meeting, and Chris Chaloner and the ScientificProgramme Committee have put togethera dazzling programme with something for everyone, encompassing currentresearch, horizon-scanning, clinical skillsenhancement and the realities ofdelivering value-added services to today’s healthcare providers.Focus 2018 will be packed with value –

in the lectures, in the networking withcolleagues and commercial partners, and in the opportunities to broaden yourhorizons scientifically, socially andculturally. We’ve worked hard to make this a

successful meeting on every level. We’d love to welcome you as a partner inthat success. �

24 | Focus News


A Message from the Focus 2018 OrganisingCommittee ChairMike Hallworth

Heart UK, one of the UK’s leadingcholesterol charities, hosts an annualconference on topics relating tocardiovascular risk. The 31st Annual HeartUK conference focussed on cholesterolincluding both clinical and laboratorycomponents. Set in the beautiful locationof Warwick University during the July heatwave, this conference offered a perfectcombination of professional developmentand networking opportunities in a relaxedand friendly atmosphere.The conference began with a free

educational study day open to alldelegates. This comprised a series ofmorning tutorials on hyperlipidaemiaincluding subjects such as lipoproteinapheresis and non-alcoholic fatty liverdisease. In the afternoon we had aworkshop on behavioural change led by Dr Tim Anstiss, founder of the Academy ofHealth Coaching. For many of theattendees who are involved in lipid orcardiovascular risk clinics, this was afantastic opportunity to practice a

motivational interviewing approach toconsultations.The following two conference days were

packed full of equally interesting andentertaining sessions covering all aspectsof lipidology, with presentations fromleading experts in the field. Highlightsincluded a presentation on the evidencefor childhood screening for familial hypercholesterolaemia by Professor DavidWald from Barts School of Medicine, an update on the significance of a highlipoprotein(a) by Professor Erik Stroes from

Heart UK: 31st AnnualMedical and ScientificConferenceDr Helen Cordy, University Hospital of Wales

26 | Meeting Reports


Meeting Reports | 27


Amsterdam and the keynote Myant lectureon diet, lipids and cardiovascular riskdelivered by Professor Tom Sanders fromKing’s College London.There were also more interactive sessions

including “Clinical Lipidology Live” wherepatient cases from lipid clinics werediscussed by a panel of experts; and acourtroom-style debate on the case forcurrent LDL-cholesterol treatment having solved the problem of hypercholesterolaemia. This allowed foropen discussion, and at times heateddebate, surrounding hot topics in lipidmanagement with frequent audienceparticipation.As well as the multiple sessions delivered

by expert speakers, there was also ampleopportunity for trainee involvement.Abstract submissions for poster and oralpresentations were encouraged from alldelegates. All accepted abstracts will bepublished in Atherosclerosis Supplementson line, and every presentation waseligible for receiving a prize during theevent. Travel grants were also available tohelp junior clinical and scientific staffattend the conference.It wouldn’t be right to report on a

conference without mentioning the socialaspect and Heart UK was no exception.Situated on campus, en-suite

accommodation was available to alldelegates in newly built flats. There wereplenty of opportunities for networkingwith a welcome reception plus aconference dinner, as well as manyrefreshment breaks during the conferenceand a guided campus walk. I would recommend the Heart UK

Annual Conference to anyone involved inlipid, diabetes or obesity clinics and toboth trainee Chemical Pathologists andClinical Scientists as it offers acomprehensive update on topics relevantto the FRCPath examination.The next annual conference “Hot topics

in atherosclerosis and cardiovasculardisease” takes place 4th-6th July 2018 atWarwick University. Information can befound on the Heart UK website:heartuk.org.uk �

28 | BIVDA News


The Pathology community was sent reelingin September by the NHS Improvementannouncement to establish and implement29 pathology networks across England. At BIVDA we had an amazing insight atour Point of Care Working Party meetingon the machinations of NHS Improvementbehind the scenes which I thought wouldbe worth sharing and hope you will findthis helpful and perhaps disturbingreading, but with a light at the end of thetunnel.

NHS Improvement have a clear butintimidating position – NHS England needsto stay in budget and keep publicconfidence and so has to control supplyand demand. Only marginal fundingincreases are available from taxation. A small percentage of the population,probably about 5%, use about 50% of theNHS budget (and a slightly skewed 80:20rule applies for the rest; 15% using 85%).The NHS has partially been a victim of itsown success – 70 years ago we had aproblem for most of the population withpoor access to acute care but the reality isthat by increasing the survival rate byalmost 20 years with better care and newdrugs, diagnostics and other medicaltechnology, we have an increasing burdenof elderly people with co-morbidities tolook after. This is leading to some dramatic changes

by NHS Improvement with its ChiefExecutive Jim Mackey leading withDarwinian management – success breedssuccess and failure will be penalised. The hard fact is that while most hospitalactivity earns income, it does not make apositive margin; hospitals lose moneycaring for patients. Drivers for hospitals are changing so that

a hospital or secondary care provider willchange from our current understanding.New business models are emerging such as Queen Elizabeth Facilities in Gateshead – an organisation with NHSemployees but which exists to provideservices outside the NHS to generate profitwhich is then ploughed back intosupporting the local NHS Trust (Googlethem!). There will be consolidation, chains,‘buddies’ and franchising.It is now mandated for all Trusts and

Foundations Trusts in England to use Patient Level Information Costing Systems(PLICs) which underpins service linereporting and is more accurate thanreference costing. It is PLICs that willinform strategic and operational businessdecisions. Primary Care will also be changing so

hospitals, Primary Care and community willbe redefined to become a connectedsystem working at scale and – this is thegood bit – they will need input fromPathology to make all this happen! It willneed new thinking and processes andperhaps some change in the way we workbut supporting patient pathways andambulatory care in the community, asPathology do from Oxford UniversitiesNHS Trust for the EmergencyMultidisciplinary Units. This could radicallychange the way laboratory medicine isperceived, taking it away from being seenas a back room service using consumablesto the enabling specialty delivering patientsolutions and leading the way forprevention and better health outcomes.All seems a long way from the immediateimperative to network and consolidate butthis could actually be a huge opportunityhidden in the apparent chaos. �

Industry Insights: Darwinian ManagementDoris-Ann Williams, Chief Executive, BIVDA

Crossword | 29


Solution for August’s Crossword

Across 1 Flavour enhancing salt causes nervous

excitement (9)6 Resident doctor on call, name is missing (5)9 Openings of most iambic verse (5)10 Act faster fabricating man-made objects (9)11 Try, hope, rue presentation about idea

lacking evidence (4,6)12 Sounds around Skye (4)14 Resolutely wily, rings solicitor (7)15 Scoundrel having nothing to say about one

toxic metal (7)17 Allocates allotments (7)19 If process pasteurises, not true pathogens

completely absent (7)20 Constituent of complex ampicillin

susceptibility test (4)22 Mislay tool used for measurement of particles

in solution (10)25 Mother's replacement therapy surprisingly

brief (5-4)26 Built single unit for indigenous North

Canadian (5)27 Polish female, short, former Level Two

Nurse (5)28 Settles as migrant, not being a citizen (9)

Down1 Not into uprooting unsettled class (5)2 Declare the majority is extreme (9)3 Adjustment of inapt job centre data (10)4 Institute irons out aerodynamics

difficulty (7)5 About the gut secretions problem,

no sign of distress? (7)6 Pick up car ride (4)7 Hiding place, store for quick retrieval (5)8 ‘Digestive structures’ review essay looms

but no article (9)13 Learned in a fashion about a

neurotransmitter (10)14 Stops preparation of user’s case (9)16 Found seminary, for example (9)18 Charge nurses resist endless change (7)19 A ‘senseless’ disturbance in Samoa (7)21 A rejection of French conducting contact (5)23 Last May turned up site of mythical

humanoids (5)24 Without ado, astound! (4)

ACB News CrosswordSet by Rugosa

30 | Situations Vacant


As one of the world's leading specialisedmedical diagnostic companies, Binding Siteprovides an ideal environment to meet a widerange of career aspirations. Leading the way indelivering innovation to the market ouremployees meet some of the industry's biggestchallenges and opportunities head on. Oursupport of industry research and developmentensures you can have the opportunity to drive innovation and improve patient lives worldwide.

Working at Binding Site means being part of a globalcommunity, encompassing a wide range of skills andknowledge. Our diverse workforce enables us to delivernew and innovative solutions to the market with sharedideas and a collective dedication to our mission, vision andvalues.

CLINICAL CHEMISTRY MANAGERWe have a fantastic new opportunity working in theClinical Chemistry Department. The successful candidatewill manage a team of lab staff in running samples forclinical studies and sourcing residual clinical samples for in-house assay development. As part of the role you will beexpected to provide scientific support to the company withrespect to the diagnostic utility of present and futureassays. The successful candidate will have a broader labexperience, preferably at manager level, be HCPCregistered as a Clinical Scientist or Biomedical Scientist andhave a detailed knowledge of methods commonlyemployed in the special proteins field (SPE, CZE, IFE, MassSpectrometry). Experience in working with automatednephelometric/turbitimetric analysers would be anadvantage.

To apply for the role please visit thewww.bindingsite.com/en/careers

To advertise your vacancy contact:ACB Administrative Office,

130-132 Tooley Street, London SE1 2TUTel: 0207 403 8001 Fax: 0207 403 8006 Email: [email protected]

Deadline: 26th of the month prior to the month of publicationTraining Posts: When applying for such posts you should ensure that appropriate supervision and training support will be

available to enable you to proceed towards HCPC registration and the FRCPath examinations. For advice, contact your Regional Tutor. The Editor reserves the right to amend or reject advertisements deemed unacceptable to the Association.

Advertising rates are available on request.

Documents

•ACB Statement •Pathology Alliance Statement · In this Issue Pathology Networks: •ACB Statement •Pathology Alliance Statement • Industry Insights Equality, Diversity and