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Imperial College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing Director

North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

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Page 1: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Imperial College Pathology Services and

North West London

Pathology Modernisation Programme

PCPH November 2015

Stephen Snewin

Interim Managing Director

Page 2: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Pathology 2015

NWL Pathology 2

Page 3: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

> 800 staff across combined

Pathology

Over 16,000 samples processed daily

Total budget > £55 million

Distributed labs with ‘Hub and Spoke’

Consistent with Lord Carter’s report (main Autolab opened by Lord Carter)

Services spread across 4 sites and locations within those sites

Contract with Chelsea & Westminster Hospital NHS Foundation Trust

ICHT Pathology Service

746 staff across combined Pathology

Over 16,000 samples processed daily

Total budget > £70 million

Distributed labs with ‘Hub and Spoke’

Consistent with Lord Carter’s report (main Autolab opened by Lord Carter)

Services spread across 4 sites and locations within those sites

Contract with Chelsea & Westminster and West Middlesex Hospitals

Page 4: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Pathology ServiceGPs represent approximately 28% of

activity

Common IT system deployed

Established transport infrastructure

Accredited labs in all specialties

MHRA compliant for Blood Transfusion

Trust NHSLA level 3 attainment included pathology risk management

Page 5: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

SMH

GPs

HH

CWH

CXH

Hub and Spoke Configuration

CXH Hub, building on Autolab

All GP and non-urgent work

Centralised Microbiology, virology Immunology, Special Chemistry

Histopathology retained on Trust sites for now

All sites have acute services with Blood Sciences (Haematology, Transfusion and Clinical Chemistry)

Some specialist services on sites to support clinical services

Page 6: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Pathology

Modernisation

• £250million to £500 million savings per

annum on a total pathology spend of £2.5

billion

• NHS London report estimated that the

reconfiguration of pathology

• services in London would to be able to deliver

an NPV of approximately £100m over 7 years

• This highlighted the need to change from 27

laboratories to approximately 5 Hub

laboratories that would carry out more than 20

million tests each. This would create between

4 and 5 pathology clusters in which Trusts

were encouraged to collaborate.

NWL Pathology 6

Page 7: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

CCG - Pathology

Transformation

• Move diagnosis closer to the patient

-Hospital service to primary care

-Primary care to high street

• Explore new ways of working

• Improve access, convenience and choice

• Deliver key national priorities

• Improve efficiency, productivity ,quality

• Empowered patient

Page 8: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

THH HH SMHCWHWMUH CXH

Geography

8NWL Pathology

Page 9: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Vision

9

Sustainable

Cost effective

Working together we can identify and deliver pathology services that are

And provide opportunity to

Pathology delivery

Single management team

NWL Pathology

Page 10: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Commercial model

• Ownership shares calculated on the basis

of activity and revenues:

• The business share represents the share

of benefits and liabilities.

Organisation Business Share

CWH 11%

ICH 67%

THH 15%

WMUH 7%

10NWL Pathology

Page 11: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Commercial & contractual• Arms length organisation (ALO)• Hosted by Imperial College Healthcare• Contracts

−Host to NWL Pathology partners−Partners to Primary Care (CCGs)−Host to 3rd parties

ICH

WMUH

THH

CWH

Hillingdon CCG

Central London CCG

H’smith & Fulham

CCG

Ealing CCG

Hounslow CCG

ICH

NW

L P

ath

olo

gy

Suppliers

Customers

West London CCG

11NWL Pathology

Page 12: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

ICHT Three main sites:

Plus integrated services and specialist outpatients operating out of each site and additional local centres

Charing Cross Hospital, Hammersmith

• Evolving to become a new type of local hospital, offering a wide range of specialist, same-day, planned care, as well as integrated care and rehabilitation services for older people and those with long-term conditions. Charing Cross Hospital will retain a 24/7 A&E appropriate to a local hospital.

• Major redevelopment costs (of £150 million before inflation uplift as part of IMBC refresh) are included in the IMBC.

Hammersmith Hospital/Queen Charlotte’s & Chelsea Hospital, Acton

• Building on their reputations as specialist hospitals, with strong research and education links. For Hammersmith Hospital, particularly with regard to renal, haematology, cancer and cardiology care, and maintaining the regional specialist heart attackcentre; and for Queen Charlotte’s & Chelsea Hospital, with regard to a wide range of maternity, women’s and neonatal care.

• Costs for small expansion and improvement (of £10 million before inflation uplift as part of IMBC refresh) are included in the IMBC. Additional work to be undertaken to explore options for additional redevelopment to improve facilities, enable possibleexpansion and tackle backlog maintenance.

St Mary’s Hospital/Western Eye Hospital, Paddington

• Developing as the major acute hospital for the region, covering a wide range of specialties. Co-location of hyperacute stroke unit with 24/7 A&E and major trauma centre. Relocation of Western Eye Hospital to the Paddington site. Continuing to provide maternity, neonatology and paediatric services.

• Costs for partial redevelopment to be included in the IMBC, with costs for a full redevelopment of the site to be included in the IMBC addendum, with that investment case to be led by the Trust.

Page 13: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Other two main sites:

Plus integrated services and specialist outpatients operating out of each site and additional local centres

The Hillingdon Hospital

a major hospital with all the services of a local hospital plus a 24/7 A&E and associated emergency surgery. It will also deliver complex medicine and surgery and have Intensive Care beds. It will have inpatient paediatric services and consultant-led and midwife-led maternity units, as well as a 24/7 Urgent Care Centre and outpatient and diagnostic services.

• .

The West Middlesex Hospitalremain a major hospital with all the services of a local hospital plus a 24/7 A&E and associated emergency surgery. It will also deliver complex medicine and surgery and have Intensive Care beds. It will have inpatient paediatric services and consultant-led and midwife-led maternity units, as well as a 24/7 Urgent Care Centre and outpatient and diagnostic services.

Page 14: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Institute of Precision Medicine

To develop investigation based disease

stratifies to enable construction of decision

trees for precise and personalised clinical

management.

• Cancer

• Non neoplastic haematological disease

• Infection and molecular pathology

• Immunology

• Renal disease

• Metabolic Medicine

• Rare diseases

NWL Pathology 14

Page 15: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Imperial West

• Imperial College is currently developing the Imperial West Site in White City.

Discussions are currently underway with Imperial College to understand the

opportunities and synergies that both NWL Pathology and Imperial College

could benefit from if the pathology hub were located in the Imperial West

science park.

NWL Pathology 15

Page 16: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Proposed configuration

Speciality Category Local Hub

Blood Sciences

Inpatient 100%

Out patient 10% 90%

GP 100%

Specialist tests 100%

Transfusion All work 100%

Immunology

Serology virologyAll work 100%

Microbiology All work 100%

HistopathologyFrozen sections 100%

Routine 100%

Cytology All work 100%

NWL Pathology 16

Page 19: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Services

NWL Pathology 19

CX

Hub

THH

HH

SMHCWH

WMH

Charing Cross HubMulti disciplinary automated

laboratory

Chemistry, Haematology (incl

specialist services)

Cellular pathology / Electron

microscopy

Microbiology

Immunology/Virology/Serology

Chemistry (+andrology)

Haematology

Blood transfusion

Chemistry

Haematology

Blood transfusion

Chemistry

Haematology

Blood transfusion

Chemistry

Haematology

Blood transfusion

Cytopathology

Chemistry (+andrology)

Haematology

Blood transfusion

MVH

Page 20: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Benefits

Improved access to specialist testsImproved experience for patients across the sectorCloud technology - sharing results sector-wide including community & GPs

Improved experience for learning – training and development

Improved resilience - Rationalisation of equipment, LIMS, structures

Savings and re-investment in services

Sharing clinical models of service delivery

NWL Pathology 20

Operations

Patients

Financial

Page 21: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Pathology future state

NWL Pathology 21

Page 22: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Tranformative infrastructure

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Page 23: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Digital pathology

NWL Pathology 23

Page 24: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Business Intelligence

NWL Pathology 24

Page 25: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Patient Centred Pathways

NWL Pathology 25

Page 26: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

POCT

NWL Pathology 26

Page 27: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Personalised medicine

NWL Pathology 27

Page 28: North West London Pathology Modernisation … College Pathology Services and North West London Pathology Modernisation Programme PCPH November 2015 Stephen Snewin Interim Managing

Questions

NWL Pathology 28