Upload
vohanh
View
217
Download
0
Embed Size (px)
Citation preview
Imperial College Pathology Services and
North West London
Pathology Modernisation Programme
PCPH November 2015
Stephen Snewin
Interim Managing Director
Pathology 2015
NWL Pathology 2
> 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
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
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
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
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
THH HH SMHCWHWMUH CXH
Geography
8NWL Pathology
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
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
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
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.
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.
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
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
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
Hot work
EPR A
HOSPITAL A
ESL
Sample
Single LIMS
Results
Diagnostic Cloud
WARD A
Results
17NWL Pathology
Cold work
EPR A
GP A Sample
HUB
Single LIMS
PMIPResult
EPRResult
Diagnostic CloudHOSPITAL A
18NWL Pathology
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
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
Pathology future state
NWL Pathology 21
Tranformative infrastructure
22
Digital pathology
NWL Pathology 23
Business Intelligence
NWL Pathology 24
Patient Centred Pathways
NWL Pathology 25
POCT
NWL Pathology 26
Personalised medicine
NWL Pathology 27
Questions
NWL Pathology 28