Issue 494 June 2004 · of NHS commitments and targets, especially for cancer, coronary heart disease, access, waiting times and A&E. A modernised NHS depends on modernised pathology

ACBNewsACBNewsThe Association of Clinical Biochemists • Issue 494 • 20th June 2004

Pathology

Benchmarking

Not Registered -

You Must Act

Now!

Cascading

Agenda for

Change

GTT Increase . . .

WHO to Blame

Pathology

Benchmarking

Not Registered -

You Must Act

Now!

Cascading

Agenda for

Change

GTT Increase . . .

WHO to Blame

June 2004 • ACB News Issue 494 • 3

About ACB NewsThe monthly magazine for Clinical Science

The Editor is responsible for the finalcontent. Views expressed are not necessarily those of the ACB. EditorDr Jonathan BergDepartment of Clinical BiochemistryCity HospitalDudley RoadBirmingham B18 7QHTel: 07973-379050/0121-507-5353Fax: 0121-765-4224Email: [email protected]

Associate EditorsMiss Sophie BarnesDepartment of Chemical PathologySt Thomas’ HospitalLondon SE1 7EHEmail: [email protected]

Mrs Louise TilbrookDepartment of Clinical BiochemistryBroomfield HospitalChelmsfordEssex CM1 5ETEmail: [email protected]

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

Focus Handbook EditorDr Richard SpoonerDepartment of Biochemistry Gartnavel General HospitalGlasgow G12 0YNEmail: [email protected]

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

Display Advertising & InsertsPRC AssociatesThe Annexe, Fitznells ManorChessington RoadEwell VillageSurrey KT17 1TFTel: 0208-786-7376 Fax: 0208-786-7262Email: [email protected]

ACB Administrative OfficeAssociation of Clinical Biochemists130-132 Tooley StreetLondon SE1 2TUTel: 0207-403-8001 Fax: 0207-403-8006Email: [email protected]

ACB ChairmanMiss Janet SmithDepartment of Clinical BiochemistryUniversity Hospital Birmingham NHS TrustBirmingham B29 6JDTel: 0121-627-8449 Fax: 0121-414-0078Email: [email protected]

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

Printed by Piggott Printers Ltd, CambridgeISSN 1461 0337© Association of Clinical Biochemists 2004

ACBNewsNumber 494 • June 2004

General News 4

Disposable Laboratory Tips 11

MRCPath Short Questions 12

ACB Training Course 13

Current Topics 14

Training 19

Lab Test Online 21

Federation News 23

Letters 25

Situations Vacant 26

Front cover: Alan Wall, Deputy Head of Department of Clinical Biochemistry at City Hospital inBirmingham poses with Karen McLean who plays the role of GP for the Lab Tests Online website

4 • ACB News Issue 494 • June 2004

General News General News General News General News General News

National Pathology Adviser Goes to Ian Barnes

Dr Ian Barnes has been appointed as the Government’sfirst National Pathology Adviser to champion pathologymodernisation across the country. Health Minister JohnHutton said:

“I am delighted to welcome Dr Barnes to this post. Thisappointment builds on the launch, this February, of a new strategyfor modernising pathology services. Dr Barnes will now driveforward these changes and chair the new national pathologymodernisation group.

Pathology is vital for patients to get the services they need at thetime and in the place they need them. Pathology underpins deliveryof NHS commitments and targets, especially for cancer, coronaryheart disease, access, waiting times and A&E. A modernised NHSdepends on modernised pathology services.”

Dr Barnes has been Head of Pathology at LeedsTeaching Hospitals NHS Trust since 1998. In 2001, hewas seconded part-time to the Department as itsPathology Modernisation Adviser, and was chair to theworking group that helped develop ‘ModernisingPathology Services’. He is also Chair of the Associationof Clinical Scientists, a Fellow of the Royal College ofPathologists and an experienced and respectedconsultant clinical scientist.

Dr Barnes has been seconded part-time for 18months and will be responsible with the NationalPathology Modernisation group for:

• Disseminating key messages on modernisingpathology to the NHS and stakeholders.

• Advising the Department of Health on the use andallocation of funding.

• Supporting the sharing of good practice inpathology across the NHS.

• Networking with the Modernisation Agency andother key stakeholders to redesign pathologyservices.

• Working with the diagnostics industry to supportthe uptake of new technology, new ways ofworking and effective point of care testing services. ■

Grants for Research Projects Improving Patient Care

The Health Foundation is seeking to fund individualswith research projects that will make a direct differenceto the quality of patient care or the health of thepopulation with the Leading Practice Through Researchaward scheme aimed at mid-career health professionals.

Applications are sought from people wishing todevelop their leadership skills as well as pursuing theirinterest in research. Proposals should enhance youroverall professional development and help youcontribute to influencing policy and practice. Awardsare for a period of six months to a maximum of twoyears and support locum cover costs, research and travelcosts, personal development training and knowledgetransfer costs. The deadline for applications is 5thAugust 2004. Visit The Health Foundation’s website atwww.health.org.uk for more details. ■

ACP Management Course for Pathologists 20048th-10th September 2004

in conjunction with the School for Health,

University of Durham

Venue: Hardwick Hall Hotel, Sedgefield,

County Durham

This is a residential three day course which introduces awide range of management issues relevant to therunning of a modern pathology service. It is intendedfor specialist registrars in pathology, clinical scientistsand those who have held their first consultant post forless than one year.

The course includes practical team-based exercises inbusiness planning and financial management.

Excellent quality, en-suite accommodation and allmeals are included.

As the 2003 course was heavily oversubscribed, earlyapplication is encouraged.

Programme and registration details from: JacquiRush, ACP Central Office, 189 Dyke Road, Hove, East Sussex BN3 1TL. Tel: 01273 775700. Fax: 01273773303. Email: [email protected] ■

Coming Soon . . . www.LabTestsOnline.org.uk

■ Blood gas systems such as the Omni S can be totally managed from the central laboratory

allowing staff to monitor reagent levels, update user security, perform troubleshooting and

assess quality control performance of all remote analysers.

■ Professional blood glucose meters like the Accu-chek Inform can offer strip lot tracking, quality

control enforcement, user proficiency management and meter tracking.

■ The Cardiac Reader with point of care D-Dimer and Troponin T assays can be integrated into a

24 hour pathology service whilst allowing management and visibility of all results by patient.

One sample One process One set of results

Innovative IT Solutions for the integration of Roche point of care

systems into hospital and laboratory information systems allowing

the security and confidence to conform with EPR guidelines.

Tel: +44 (0)1273 484788 Bell Lane, Lewes, BN7 1LG

Innovative solutions for IT integration



Registration in PaediatricsThe Metabolic Biochemistry Network has negotiatedwith the Association of Clinical Scientists for thecreation of a new sub-modality of clinical biochemistryfor paediatric metabolic biochemistry. Competences forthe sub-modality are now available on the Associationof Clinical Scientists (ACS) website: www.assclinsci.org

This is a particularly important development forclinical biochemists working within specialist paediatricmetabolic units, who are providing specialist servicesfor inherited metabolic disorders and have not beentrained via the conventional Grade A training route forclinical biochemistry. The creation of this sub-modalitywill enable individuals to enter from other backgroundssuch as academic post-doctoral routes, or less tradi-tional routes to become registered clinical scientists within this specialist area. Please considerwhether this applies to you or anyone in your depart-ment so that appropriate steps can be made for applica-tion. If you need any help or further advice, theNational Metabolic Biochemistry Network and the ACSOffice are happy to enter into discussions. We feel thisis an important step forward and hopefully will helpaddress some of our recruitment difficulties.

For any queries please contact the Association ofClinical Scientists. Tel: 0207 940 8960. Email:[email protected] and The Metabolic BiochemistryNetwork, Tel/Fax: 0121 445 5818.Email: [email protected] ■

Alan Seeks Lifestyle Change Advice from Karen

Whitehead Wins Queen’s Award

Professor Tom Whitehead, Dr Gary Thorpe andcolleagues at the University of Birmingham arecelebrating for winning a Queen’s Awards for Enterprisefor an innovative water testing kit. This is the secondQueen’s award for their innovations inchemiluminescence technology. The test helpsdetermine within minutes whether water iscontaminated or safe to drink and the originaltechnology has been commercialized by Severn TrentServices.

At 80 years of age Tom has kept a keen interest inClinical Chemistry since retiring. He has bench space atthe University and has also made weekly trips toLondon to work in a consultant capacity and of coursehas been a regular attendee at Focus meetings. ■

Alan Wall, well known in the West Midlands,volunteered to act as the patient for the Lab Tests Onlinewebsite. Alan says that he was “ideal as I looked likelifestyle change was just what was needed”. The role ofAlan’s GP was played by Karen McLean an assistanttechnical officer in the sample reception area in ClinicalBiochemistry at City Hospital, Birmingham. Karen tookthe part very seriously and was really quite strict. Theresult has been startling with Alan shedding anundisclosed amount of weight that has been estimatedat over three stone!

The Lab Tests Online website is explained in this issue and next month we will report on the launch of the site. ■



Association of Clinical Biochemists in Ireland27th Annual ConferenceRochestown Park Hotel, Cork, Ireland24th-25th September 2004

Friday Morning - 24th September 200410:30-10:40 ACBI Chairman’s Address10:40-11:00 Opening Address

Current Hot TopicsChairman: Ms Niamh Kavanagh, Portiuncula11:00-11:45 The Role of Clinical Scientists in Modern Healthcare

Mr Mike Hallworth, Royal Shrewsbury Hospital11:45-12:30 Implications of IVD Directive for Laboratory Testing

Ms Ann O’Connor, Irish Medicines Board12:30-13:15 CE Marking an In-house Assay

Dr Jonathan Berg, Birmingham City Hospital13:15-14:30 Lunch – sponsored by Olympus

Friday Afternoon Session - 24th September 2004Communicating with Our Service UsersChairman: Dr Ned Barrett, Limerick14:30-15:15 Computerised Order Entry. A Panacea for Interactive

Decision SupportDr Clive Collins, Cork University Hospital

15:15-16:00 Influencing Test Ordering in General Practice. Who is afraid of Computer Based Decision Support?Dr M A M van Wijk, Erasmus University, Rotterdam

16:00-16:30 Coffee - Sponsored by Aalto Bio Reagents16:30-17:15 Clinical Biochemistry and General Practice.

Bridging the GapDr Bill Bartlett, Birmingham Heartlands and Solihull Trust

17:30 ACBI Annual General Meeting

Saturday Morning Session – 25th September 2004Clinical Biochemistry and the Liver Chairman: Ms Ellie Duly, Ulster Hospital10:00-10:45 Clinical and Sub- Clinical Liver Disease

Dr Orla Crosbie, Cork University Hospital10:45-11:30 Clinical Utility of Liver Function Tests

Dr Roy Sherwood, Kings College Hospital11:30-12:00 Coffee12:00-12:45 Herbal Medicines

Mrs Cathryn Corns, Southend Hospital12:45-14:15 Lunch – Sponsored by DPC/Cruinn



Saturday Afternoon Session - 25th September 2004New DevelopmentsChairman: Ms Paula O’Shea, Beaumont Hospital14:15-15:00 Obesity and Type 2 Diabetes

Dr Vivion Crowley, St James’s Hospital15:00 - 15:45 Stem Cell Research

Dr Frank Barry, UCG15:45-16:30 Probiotics

Professor Gerald Fitzgerald, UCC16:30 Close of Conference

Information for Poster Submission available at www.acbi.ie

Poster Abstract Deadline: June 25th 2004 Early Registration Deadline: July 23rd 2004

Booking forms may be downloaded from the ACBI website: www.acbi.ie

‘Early Bird’ Conference Package Register and pay in full before July 23rd 2004

Includes: Registration for Friday & Saturday, Lunches, Coffee, Annual Dinner & Greyhound Track

ACBI Member €220 Non-Member €280

‘Late Registration’ Conference PackageIncludes Lectures, Lunch, Coffee & Handbook

ACBI Member €265 Non-Member €320

Day RegistrationIncludes Lectures, Lunch, Coffee & Handbook

Friday €90 Saturday €90

Single Session RateIncludes Lectures, Coffee & Handbook

€50

Student Session Rate Student ID Required)

Includes Lectures, Coffee & Handbook Friday €25 Saturday €25

(Booking after 23/07/04) Friday €30 Saturday €30

Annual Dinner (Friday) €70 Greyhound Track (Saturday) €65

Room Rate per night Thursday, Friday, Saturday

Single €125 Sharing (Twin) €82 Double €164



In June, members of the association will receive a copyof Diabetes and Laboratory Medicine. This is the latestbook in the Laboratory Medicine Series from ACBVenture Publications and is jointly written by Ms JanetSmith and Dr Malcolm Nattrass from UniversityHospital NHS Trust, Birmingham.

It can be argued that diabetes mellitus is the diseasethat best demonstrates the inter-relationship between biochemistry and metabolic medicine. Theconsequences of an absolute or relative deficiency ofinsulin profoundly affect intermediary metabolism,leading to acute metabolic crises and long-term medicalcomplications. The aim of this book is to explore therole of the laboratory in the diagnosis and managementof diabetes and its complications, as well as to explainthe fundamental changes to the biochemical pathways

and their clinical sequelae. Actual clinical cases areincorporated to illustrate this. There are chapters on theaetiology, diagnosis and management of diabetes as wellas hyperglycaemic comas, hypoglycaemia and diabetesin pregnancy. The book is timely with the recent releaseof the United Kingdom National Service Frameworksfor diabetes.

Additional copies can be obtained either from theACB office (see contact details on page 3 of ACB News)at a price of £30 and £2.10 p&p (p&p £4.50 outsidethe UK). Alternatively, orders can be placed online with10% discount at www.acbstore.org.uk

Diabetes and Laboratory MedicineAuthors: J Smith and M NattrassISBN 0-902429-31-0 £30 ■

Janet Smith, author, and Mike Hallworth, Chairman of Venture Publications

Diabetes and Laboratory Medicine

Tips Disposable Laboratory Tips Disposable Laboratory Tips


MRCPath Short Questions MRCPath Short Questions MRCPath Short


Deacon’s ChallengeNo. 39 AnswerA 33 year old woman investigated for subfertility had a mildly elevated serum prolactin level varying between800 and 1400 mIU/L on three occasions over three months. The next specimen received in the laboratory ayear later gave a prolactin result of 1900 mIU/L (Bayer Centaur ref range 59-619). The possibility ofmacrolprolactin was considered.

250 µL of serum was mixed with 250 µL polyethylene glycol (PEG 6000), centrifuged at 3000 rpmfor 30 min and the supernatant re-analysed, the result being compared to a 1:1 dilution in Centaur diluent.

The result following PEG treatment was 354 mIU/L. The result of the diluted specimen was 948 mIU/L.

Calculate the recovery of prolactin in the presence of PEG and comment on the result.MRCPath, May 2003

Recovery (%) = Result for supernatant following PEG precipitation x 100Result for similar dilution with diluent

= 354 x 100 = 37%948

This low recovery indicates that macroprolactin is a major component of the serumprolactin. The non-precipitated result (354 mIU/L) can be multiplied by 2 to give the monomeric form (2 x 354 = 708 mIU/L) but this is likely to be an under-estimate. There are concerns that some monomeric prolactin precipitates with PEGgiving artefactually low recoveries; gel filtration chromatography is the preferredtechnique. The concentration of the monomeric form can be estimated from theknown relationship between PEG precipitation and gel filtration chromatography. ■

Question 40The SHO in ITU carried out a blood gas analysis but failed to record all of the results in thepatient’s notes. The only available results are:

H+ concentration = 93 nmol/LStandard bicarbonate = 15 mmol/L Actual bicarbonate = 21 mmol/L

Calculate the pH and PCO2 (in kPa). Assume the solubility coefficient of CO2 (in kPa) is0.225.

Topics will include:

• Renal Function

Nephron, renal failure, renal osteodystrophy, diabetes and the kidney, renal tubular disorders, proteinuria

• Fluid, Electrolytes, Hydrogen Ion

SIADH, potassium, acid-base status• Respiration, Trauma

Respiratory function, mechanical ventilation, respiratory chain disorders,metabolic response to trauma

• Screening

Principles, newborn screening, Downs and NTD

• Analytical

DNA analysis, mass spectrometry, reference values

• Quality, Standards, Risk

QA, accreditation, health and safety,risk assessment, ethics and patientconsent

ACB Training CourseUniversity of Birmingham

12th-17th September 2004

The scientific programme will comprise a mixture of lectures, workshops, and clinical case presentations, and there will also be

a mock ‘spot test’ practical.

A full social programme is being planned. Full details and application forms are available from the ACB Office: Tel: 020-7403-8001. Fax: 020-7403-8006. Email: [email protected]

For additional preliminary information contact: Dr David Andrews, Department of Clinical Biochemistry,

University Hospital Birmingham NHS Trust, Selly Oak Hospital, Birmingham B29 6JDTel: 0121-627-1627 ext 52271. Email: [email protected]

Deadline: 16th August 2004



Current Topics Current Topics Current Topics Current Topics Current

The National Pathology Alliance Benchmarking Service(NPABS) is a valuable management tool that helps pathologydepartments review their practice and improve the quality

and efficiency of their service. The service is backed by theAssociation of Clinical Scientists, the Institute of BiomedicalScientists and the Royal College of Pathologists and is now in itstenth year.

Justifying Additional FundingThe benchmarking service is more than just a paper exercise. Itenables Trusts to review key aspects of departmental activity at theend of each financial year, including:

• Workload• Staffing• Productivity• Finance

Many laboratories are using this information to bid successfully for additional members of staff and equipment. It also providesdepartments with key information, in a format presentable tomanagement teams and other members of the department, tosummarise and justify departmental activity.

Comparisons Internally and Externally are PossibleLaboratories have found that by participating in the benchmarkingscheme, they can review their activity relative to other comparabledepartments. Comparison with the best performers highlights andquantifies areas of concern within a department. This enablesrealistic and effective strategies to be developed in order tooptimise departmental efficiency and quality, both key goals of thePathology Modernisation programme.

Pathology departments also use benchmarking to monitorchange ‘in house’. This can indicate whether new strategies

The NationalPathology AllianceBenchmarkingServiceBy Maggie Throup, NPABS

Lynn Rushworth and Jane Osgerby at Focus 2004 with their poster


Topics Current Topics Current Topics Current Topics Current Topics

implemented by the laboratory are working and are worth continuing.Also, it is particularly useful for monitoring areas of interest to the AuditCommission.

The benefits of inter- and intra-departmental benchmarking are wideand varied. They can be used to support the departmentalrecommendations described in the Modernising Pathology guidelines;namely in meeting key targets and in ‘audit of delivery and continuousquality improvement’ to improve patholoogy services. The AuditCommission also monitors whether departments are participating in abenchmarking scheme, such as the National Pathology AllianceBenchmarking Service (NPABS).

Simpler Questionnaires for 2004To ensure the quality of the benchmarking service, the process isconstantly being reviewed and refined. This year, the electronicquestionnaires have been simplified to make sure that data collection is aseasy as possible for all participants. To avoid repetition and easecollection, many questions are comparable with those used by the AuditCommission, as a result of the Commission’s quantitative audit of2003/2004 being based on NPABS definitions. Also new for this year isthe simultaneous distribution of the questionnaires across all specialtiesduring May and June. This is intended to minimise departmentaldisruption, and at the same time allow the reports to be delivered in atimely fashion for budget setting.

Contacting UsAll areas of pathology are reviewed including Clinical Biochemistry,Haematology and Blood Transfusion, Immunology, Histopathology/Cytology and Microbiology/Virology so why not sign up and reviewyour departmental activity relative to other comparable departments? Ifyou would like to discuss how your Trust can benefit by participating inthe National Pathology Alliance Benchmarking Service, or, if you have anyother queries about the process, please do not hesitate to contact eitherJane Osgerby ([email protected]) or Lynne Rushworth ([email protected]) or telephone 01782 583 755. NPABS is basedat the Clinical Management Unit, Keele University.

Further Reading

1 Galloway M & Rushworth L. Red Cell or Serum Folate? Results from the National Pathology Alliance Benchmarking Review. J Clin Pathol 2003: 56: 924-926

2 Galloway M & Nadin L. Benchmarking and the Laboratory. J Clin Pathol 2000; 54: 590-597

3 Rushworth L. National Pathology Alliance Benchmarking ReviewSpring 2003 Update. Biomedical Scientist May 2003: 478-479

4 Seneviratne C J. Benchmarking Pathology. Hospital 2003; 5: L36-40

5 Modernising Pathology Services. London. Department of Health,London 2004; 1-49 ■



The Health Professions Council (HPC) came into being in 2003 to provide stateregistration for many types of health workers. This new entity must work to PrivyCouncil (i.e. government) guidelines and laws and as such is more tied in its actions

than the Council for Professions Supplementary to Medicine (CPSM) and the RegistrationCouncil for Scientists in Health Care (RCSHC), which preceded it.

The ACB Office acts to administrate the Association of Clinical Scientists (ACS) which isresponsible for certification prior to registration – the ACS is NOT a registration body and iscompletely separate to the HPC but we frequently get common enquiries which we try to dealwith various problems and anomalies have arisen which HPC could no longer address and itcan create major problems for any staff who have not monitored their registration status. Ascertain time constraints approach, it is essential that every one of you check and verify thatyou are correctly registered – and we strongly advise you to do it NOW before it is too late.As administrators of the ACS, and former administrators of the RCSHC, we get many questionsfrom applicants and scientists who believed they were registered but apparently are NOT nowon the HPC register.

There are two basic problems that have arisen which I will deal with separately.

RCSHC Registrants Transferred to CPSM/HPC

RegisterIn August 2000, all those clinical scientists who had been accepted on the RCSHC register andmaintained their payments to that date, were automatically transferred to the CPSM register.CPSM wrote to each of those scientists at the address on the register, for them to confirm theirdetails and status – a memorable bright green form was used which could hardly be mislaid.Only those who returned these forms together with the correct payment thereafter were kepton the register. If you failed to return the form, failed to update your work address or did notmake regular annual payments by direct debit or cheque, CPSM suspended your registration.A number of people discovered that they had overlooked these forms or payments and in 2001and 2002 sought reinstatement – which the CPSM would do if supported by our RCSHCrecords and once overdue payments were made. With the new legal status of HPC, thisreinstatement is no longer possible. You will have to apply to HPC for reinstatement andcomply with their current requirements. This is much more expensive and time consuming.Do not assume that you are registered with HPC unless your number appears on the registerwhich can be checked on the HPC website – http://register.hpc-uk.org/lisa/RegistrantSearchInitial.jsp

As a service to its members the ACB Office is checking the present registration status of allactive members on the database over the coming few months and adding your CS number toour database; but the onus is on YOU to ensure that you are correctly registered and maintainyour payments to stay so. If we find members who are not on the HPC register but appear tobe above training status, we will notify you during the summer to remind you to check thisyourself. We cannot take responsibility for errors or omissions – or for the futuremaintenance of your registration. We would encourage other associations to take thisinitiative to assist its members and avert potential problems – but the onus rests with you.

State Registration . . .Unregistered Staff Act NowReported by Graham Groom, Senior Administrator, ACB and ACS



In many laboratories, this overlooked registration may only come to light prior to aCPA inspection. We would strongly advise all heads of departments to instigate aregular annual review of registration documents for all appropriate staff to avoidproblems when CPA call.

Unregistered Staff Who Should be OnGrandparenting through HPC

“Clinical Scientist” became a legally defined entity and a “Protected Title” in July2003 and only those on the HPC register can call themselves, and act unsupervised inthe role of, clinical scientists since that date. Everyone acting in an unsupervisedclinical scientist role MUST be registered with HPC by July 8 2005.

HPC have a “grandparenting” route to accept long-standing scientists who havebeen in this role but never joined RCSHC – but this ceases to be available on July 82005. To allow for processing HPC may be unable to accept applications after Spring2005. To qualify for this approach you must meet their requirements (see website)which include acting in the role of clinical scientist for a minimum of three years inthe five years preceding July 2003 – see their website for full details. The 2003 and2005 time constraints were imposed by the Privy Council and cannot be changed. Istrongly advise those who are not yet registered but qualify for this route to apply toHPC as soon as possible to avoid future delays as the deadline approaches.

Route 2 Applicants through ACS

Those who do not qualify for grandparenting directly with HPC have to apply for aCertificate of Competence from the ACS – through their six-year route (Route 2). Asthe ACS administrators, we have been disturbed that we have not had moreapplications from this group of people already and we are concerned that they areleaving it until 2005 before applying. Normal processing of ACS applications, fromreceipt of application and portfolio to interview and certification normally takesbetween 14 to 18 weeks. In anticipation of a possible rush of applications in thespring of 2005, the ACS board have therefore stated that they will not guarantee toprocess any such applications received after December 31 this year that could havebeen submitted earlier.

Priority will be given during 2005 to applications received at the ACS Office fromGrade A (Route 1) applicants and from those Route 2 applicants who could not applyany earlier. These will be processed within the usual timeframe. All otherapplications will be given lower priority, due to the pressure of work for theAssessors, and they will only be processed after the other applications for eachmodality.

If you are in this category and able to submit for certification now, you are stronglyurged to produce your portfolio and submit it as soon as possible. The ACS will notlook kindly on any applicants who could have applied this year but left it until the lastminute, since it would disadvantage those who have to wait until next year tocomplete their time requirements. All details for certification through the ACS can befound and downloaded from the website www.assclinsci.org

Don’t be caught out and don’t leave it too late – act now please, for your sake. ■

Training Training Training Training Training Training Training Training


Grade A and B Clinical Biochemists, specialist registrarsand others arrived from across the UK and Ireland totake part in the ACB training course at Surrey University.

Initial tentative moments on collecting keys to find if you hadwon the “lucky dip” for en-suite accommodation were soonfollowed by anticipation of finding if the shower worked or ifthe water was hot…..hooray it was, things were looking up!

Dinner provided on campus was concluded quickly in order toget to the bar. Entertainment was provided by a quiz and withthe winning teams claiming bottles of wine it was back to thebar to conclude the evening.

Following a few teething troubles with the AV the first day oflectures proceeded with various aspects of liver and gut bio-chemistry concluded by an entertaining lecture on the finerpoints of presentation skills by Mike Hallworth. In the eveningthe trainees meeting provided a forum for discussion of thetraining courses, training overseas and registration with inputfrom Dr David Cassidy and Mr Mike Hallworth.

Trip to the Dogs . . .The second day concentrated on aspects of nutrition and traceelement analysis with the focus on spectrometry techniques.Poster prize for the day was awarded to Deon Grant fromShrewsbury. The social event for the evening was a trip to “thedogs” in Wimbledon where the opportunity was provided towin your drinking money for the week.

Wednesday morning covered aspects of the MRC Path practicalexam with the familiar but still daunting “Deacon’s Challenge”session on calculations. An oral presentation master class easedthe tensions by teaching the value of your vocal chords. So ifyou see someone before a presentation doing Tai-Chi breathing,making noises like a tube train and humming, you can restassured they haven’t gone mad they’ve just been to Guildford.The afternoon introduced practical approaches to NHS finance,should this be renamed ‘cooking the books…a master class’ wewondered?

Poster prize for the day was awarded to Sarah Jarvis fromGlasgow then following dinner provided on campus, coachesdeparted to Guildford Spectrum for an evening of ice-skatingand ten-pin bowling.

Thursday was dedicated to many aspects of Immunologywhere speaker introductions were provided by Pam ‘natural

National TrainingInvades GuildfordReported by Clare Jeffray, City Hospital, Birmingham

Torrential rain didn’tbode well

for those attendingthe 2nd ACB National

Training Course inGuildford from the18th to 23rd April,was this an omen?

Deon Grant from Shrewsbury receives the poster prizefrom Stephen Halloran


Training Training Training Training Training Training Training

killer cell’ Riches and initial overview given by Jo ‘B cell’ Sheldonleaving us to question what cell type would you be?

The traditional course dinner and disco was held in the LakesideRestaurant on campus where Sweta Ram from Wolverhampton collectedthe poster prize for the day and Deon Grant won the overall prize forbest poster of the week.

For those weary souls who survived the disco dancing to see the finalday, Friday morning was an insight into the areas of histopathology andcytology.

Move Over BoysThe overall view of the course was of good food and accommodationwith a varied program of both clinical and managerial lectures. Therewas emphasis on the value of support services and successful presenta-tion. The social program was good and the proximity of the venue tothe city centre provided a convenient alternative to anyone wanting tofind their own evening entertainment and for transport.

Thanks go to Stephen Halloran and the committee for organising thecourse, to the speakers for sharing their knowledge and expertise and toRoche and Bayer for sponsoring the event. The training course shows aninteresting statistic; the ladies are on their way up with about 80% ofattendees being female, perhaps all those men in more senior postsshould be looking over their shoulder?

Hopefully the 3rd ACB training course in Birmingham in Septemberwill be as successful – looking forward to seeing you there! ■


Lab Tests Online Lab Tests Online Lab Tests Online Lab Tests Online

Hopefully you will already know something of the work of Lab Tests Online. Now as the website is launched here is somebackground to this new ACB innovation.

The editorial team comprises Joe Begley, Fergus Jack, Brian Payne,Shona Twaddle, Kay Walker and Stephen Halloran, and we have beenworking behind the scenes on Lab Tests Online UK for 15 months following the decision to develop a UK version of the award winningAACC website. The financial support of the Health Foundation has madeit possible to gain the necessary software licences and website supportto make the project technically possible with Ian Godber and JamesMcGuire playing prominent roles in this area.

Over to Local LaboratoriesThe success of the project in the UK now depends as much on supportfrom individual laboratories as on the ACB and the project team. Thewebsite will initially be promoted to the public using local and nationalpress, TV and radio. If you can offer local publicity please let us know.Posters and information leaflets will provide the main mechanism forpublicising the site and they will be displayed in GP surgeries andphlebotomy areas. We would like ACB members help with distributionto GP practices and clinics who send you work. As Project Chairman,Mike Hallworth wrote to all heads of department earlier in the yearasking for local contacts to help liaise with GPs and aid the distributionof literature.

So what is Lab Tests Online? The original American site was launched in the US in August 2001 bythe AACC with financial support from the diagnostics industry andaimed to meet the needs of the public. The language, content and layoutreflected the needs of a population that was already searching theinternet to find information about ‘those blood tests’ which we knoware key to modern health care. The site proved an instant success withthe content of the site clearly meeting the needs of the US population.The web statistics speak for themselves; after the first year Lab TestsOnline had received over 1 million visits and by March 2004 the sitewas receiving over 360,000 hits a month. Since the launch three yearsago the total number of hits has passed the 5 million mark.

UK Lab Tests Online The US site already gets substantial numbers of visitors from the UKeven without publicity. We have some excellent UK health informationsites such as BBCi, NHS Direct and NeLH, but nothing providinginformation to the public about those all important laboratory tests. Acomparison of the Lab Tests Online sites will quickly demonstrate notonly the quality of the site, but also the differences between US and UK

What’s it all About?By Stephen Halloran, Lead Editor, Lab Tests Online UK


Lab Tests Online Lab Tests Online Lab Tests Online Lab Tests Online

practice. For example if you look at PSA screening the US site is one ofpatients managing their own health, with doctors ‘ordering’ tests underthe appeal and perhaps direction of their patients. Perhaps this will bethe flavour of things to come in the UK but it is currently not UKpractice and our site reflects this.

So, Lab Tests Online UK reflects current UK practice; it takes heed ofNICE Guidelines and National Service Frameworks and is written with astamp of authority from UK professional bodies. That is not to say that itis complete and comprehensive or that you will not take issue withsome of the content. Like the US site it continues to grow with newtests and revised text. The record of our profession is one of productivecritical debate. I hope that following the launch of Lab Tests Online UKin May you will work with us in extending and refining a websitewhich will be the authoritative source of laboratory test information forthe UK public. ■

Federation News Federation News Federation News Federation News


Getting information out is going to be very important over the next few months.Unfortunately in some areas of the country the communication networks have failedover the years as new regional representatives have been elected and lists of local

representatives not transferred nor kept up to date.It is essential that each regional representative is aware of all local representatives in the

region to ensure that information and advice is cascaded effectively.If you are an accredited representative for your organisation, please contact your FCS

Regional representative with your name, contact details and details of involvement locally.If you know that your organisation does not have an accredited representative, nominate

someone as a contact point and inform your FCS Regional representative.Cytogenetics and Genetics department members should have a local FCS representative and

a National representative contact. If you are not in regular contact please [email protected]

Microbiology members; if you do not know who your local accredited representative isplease contact your Regional representative.

FCS Regional representatives are listed in your ACB members handbook.

Job Descriptions & Person SpecificationsWe have produced an advisory document which is now available on the FCS Website.

It is essential for all members to read this in advance of preparing and agreeing their ownjob description.

The starting point is to keep a detailed work diary for a few weeks to help identify anyduties or responsibilities not covered in current job descriptions. This takes time and requiresself-discipline but is a very valuable exercise.

The FCS Chair together with the ACB Chair and National Assessors Chair will be jointlycompiling national person specifications for all Clinical Biochemist grades to put to the chairsof ACM and ACC for consideration and amendment.

We advocate that these be adopted locally to minimise variation in scoring betweenorganisations. They will cover all of the knowledge and skill factors which do not sitcomfortably within job descriptions.

It is important to note that one of the rules of job matching is that only the knowledge,skills and qualifications which are demonstrably required for a job (i.e. essential in the personspecification) will be scored. If the person specification states PhD or MRCPath desirable youmay not be scored for having attained one.

Access to Individual AdviceThe FCS Regional Representatives have been trained in the process of job evaluation and jobmatching. Several FCS Officers including the Secretary and Chairman have been trained moreextensively as JE and Matching Trainers. If you require individual advice over any particularproblems contact your Regional Representative. Please do not ask how to prepare your jobdescription, read the guidance document and other supporting information on the FCSwebsite. ■

Cascading Agenda forChange InformationBy Alan Penny, Federation Chairman

Federation News Federation News Federation News Federation News


SpinePoint £ pa £ pa £ pa £ pa

01 16,828 G 16,82802 17,500 R 17,50003 18,197 A 18,19704 18,925 D 18,92505 19,684 E 19,68406 20,474 20,47407 21,287 A 21,28708 22,143 G 22,14309 23,026 R 23,02610 23,947 A 23,94711 24,906 D 24,90612 25,901 E 25,90113 26,939 26,93914 28,016 B 28,016 Individual posts in Grade B15 29,134 29,134 will be assigned a personal16 30,302 30,302 payscale of three consecutive17 31,514 31,514 points within the range 08 to18 32,772 32,772 24 on the spine19 34,086 34,08620 35,449 35,44921 36,867 36,86722 38,340 38,34023 39,874 39,874 G 39,87424 41,470 41,470 R 41,47025 43,128 A 43,12826 44,854 D 44,85427 46,649 E 46,64928 48,515 48,51529 50,452 C 50,45230 52,473 52,47331 54,572 54,57232 56,756 *56,75633 59,027 *59,02734 61,387 *61,38735 63,845 *63,84536 66,396 *66,396

Spine points marked * are for use only when salary scales have been advanced in accordance with paragraph 9.3 inAppendix B of Advance Letter (SP) 1/90. Pay rates should be applied pro rata to sessional staff under Appendix D toAdvance Letter (SP) 2/84.

Appendix C: London Allowances with effect from 1 April 2004Zone £paInner London 2,762Outer London 1,643Extra-Territorially Managed 923Fringe 259Resident Staff 578 (Inner and Outer London)

256 (Extra-Territorially Managed)66 (Fringe)

Details of each zone and the provisions governing payment of these allowances are set out in Section 56 of the GeneralWhitley Council Handbook.

Clinical ScientistsSalaries with effect from 1 April 2004


Letters Letters Letters Letters Letters Letters Letters Letters

LettersReaders speak out

?

Huge Rise in GTT following

WHO Criteria

Our experience is rather different from that of DrMedbak (ACB News, April 2004) with regards to thenumber of oral glucose tolerance tests (OGTT) thatwe perform. The WHO criteria for diagnosis ofdiabetes introduced the new category of impairedfasting glycaemia (IFG) (fasting venous plasmaglucose between 6.1 mmol/L and <7.0 mmol/L)with the recommendation that all individuals withIFG should have an OGTT to exclude diabetesmellitus. These recommendations were endorsed byDiabetes UK in 2000. We have followed these rec-ommendations with the consequence that our OGTTworkload has increased from approximately 100 peryear to more than 500, excluding OGGTs done forantenatal patients.

Is this unique to our hospital or have other peopleseen similar increases in OGTT? Where Dr Medbakrefers to a reliance on fasting glucose to make a diag-nosis of diabetes is he perhaps talking of the ADArecommendations rather than those of the WHO?

The above number of OGTTs compare with about170 short Synacthen tests (SST) per year in ourhospital. If one is to base the amount of knowledgeMRCPath candidates have on the relative numbers oftests done then, in our hospital at least, I wouldcontend that they should be more familiar with theOGTT. Of course this argument is fallacious and Ibelieve that candidates should be equally knowledge-able about both tests.

Steve DavisPrincipal BiochemistDepartment of Clinical BiochemistryRoyal Glamorgan HospitalYnysmaerdyPontyclunCF72 8XR

Deacon Challenged . . .There are a series of errors in the solution given inDeacon's Challenge No. 34 answer published in ACBNews January 2004. The expression given for thesolution of the quadratic equation (line 9 page 12)contains two errors, both in the terms under thesquare root sign:

1) the term(1x10^-8) should be raised to thepower 2, not multiplied by 2.

2) the minus sign should be positive by virtue ofthe quantity (1x10^ -14) being negative.

Also, I find the subsequent arithmetic gives a pH of6.98 (rounded to two dec. places). A good teasingquestion though.

David LyonPrincipal ScientistDepartment of of Clinical BiochemistryMacewen BuildingRoyal InfirmaryGlasgowG4 0SF


Situations Vacant Situations Vacant Situations Vacant Situations


Vacant Situations Vacant Situations Vacant Situations Vacant




Vacant Situations Vacant Situations Vacant Situations Vacant



To advertise your vacancy contact:ACB Administrative Office, 130-132 Tooley Street, London SE1 2TU

Tel: 0207-403-8001 Fax: 0207-403-8006 Email: [email protected]

Deadline: 26th of the month prior to the month of publication

Training Posts: When applying for such posts you should ensure that appropriate supervision and training support will be available to enable you to proceedtowards state registration and the MRCPath 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

Department of ChemicalPathology

Quality and Risk ManagerBMS 3** or Clinical Scientist B points 15-17£32,117 - £34,509 p.a. inc. (subject to review underAgenda for Change)You will take the lead in operational risk and quality management.You will also manage, operate and develop systems, which willprovide efficient quality and risk management within thedepartment, ensuring compliance with Clinical PathologyAccreditation (CPA) and other relevant standards.

You will be active in adverse incident and complaint investigationwithin the department, participating in the implementation ofchanges as a result of lessons learned. You will be responsiblefor organising and managing the laboratories participation inexternal quality assurance schemes and for reviewing QualityControl performance within the department.

You will have either existing expertise in Quality and RiskManagement or a strong desire and drive to work in this field. Youwill demonstrate an in-depth knowledge of laboratory processes,strong organisational skills and have a proven ability to work withstaff at all levels of the organisation.

We offer an exciting opportunity for those who wish to broaden theirexperience. As part of one of the country’s largest NHS Trusts, thedepartment is fully computerised with a robotic sample handlingsystem. We provide a wide range of services for the Trust, GeneralPractices and other users around the country from our laboratorieslocated at both the Guy’s and St Thomas’ hospital sites.

You will be expected and encouraged to participate inprofessional development.

For further details or to arrange an informal visit, please contactMr Robert Simpson, Laboratory Manager on 020 7188 1260 oremail: [email protected]

For an application pack, please contact the Recruitment andMedical Personnel Centre, 1st Floor, Counting House, Guy’sHospital, St Thomas Street, London SE1 9RT. Tel: 020 7188 0044(answerphone) or email: [email protected] reference C106.

Closing date: 30th June 2004.

For further information about the Trust, please visit ourwebsite at www.guysandstthomas.nhs.uk

Guy’s and St Thomas’ is an early implementer ofAgenda for Change. The Trust is committed to

fair pay for all its staff.

Benefits include:Swimming Pool and Fitness Centres, Knowledge & Information Centre,Social Clubs, On-site Nursery (limited places).The Trust aims to help staff balance work and home life.Equality of opportunity is our policy.

Total SupportVisit www.dpcweb.com or call 01286 871872 for more details.

Diagnostic Products Corporation - UK, Glyn Rhonwy, Llanberis, Gwynedd, LL55 4EL

01628 784041

THE NEW ABBOTT ARCHITECT® RANGE

CHEMISTRY AND IMMUNOASSAY

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Documents

Issue 494 June 2004 · of NHS commitments and targets, especially for cancer, coronary heart disease, access, waiting times and A&E. A modernised NHS depends on modernised pathology