The HSE has announced that it is launching a programme to modernise its Medical Laboratory Services, as part of its ongoing transformation of services,
The Medical Laboratory Service currently incorporates 46 laboratories with approximately 3,000 staff and operating costs of €328 million per year.
Approximately 58 million tests are processed on an annual basis by these laboratories which are based on hospital sites. These laboratories process not just the workload generated by patients in hospital, but also the significant volume of work generated by hospital outpatient clinics, General Practitioners and community services.
The HSE now plans to implement a unified, co-ordinated service which will dramatically improve quality and turnaround times in these essential diagnostic services. Changes proposed will involve:
Processing the large volumes of routine patient tests generated from the community care system, outside the hospital, in dedicated ‘cold labs’. A Cold Lab is a facility that is centralised and custom designed to process routine ‘cold’ samples, typically from community based services or primary care. Cold labs would include automated and non-automated sections, would be supported by dedicated logistics solutions and IT, may be standalone or co-located with a hospital and would have a fast turnaround time.
Processing tests from patients in regional hospitals receiving acute ’round-the-clock’ care through dedicated ‘hot labs’. This will provide more access to clinical laboratory medicine advice and more direct care of the complex patient. A Hot Lab is a facility located within emergency and complex acute hospital services, and is responsible for processing all urgent ‘hot’ samples with an extremely fast turnaround time.
Increasing ‘point of care’ testing – where tests are carried out immediately: in acute hospitals, in local healthcare settings or in the patient’s home – wherever it is clinically appropriate and cost effective. Point of Care involves tests performed by non-laboratory staff at or near the site of patient care, e.g. GP surgeries, community clinics or at home.
The decision to modernise the way lab services are organised has been prompted by an external review of existing services. The review provides a valuable analysis of the existing laboratory system, identifies the issues that should be addressed and many of the improvements required to achieve a first class service. The review report, “Implementing a new system of service delivery for Laboratory Medicine Services” is available for download from this website.
The HSE will now commence implementation and dialogue with all groups affected by these modernisation measures, and welcomes the agreement of a number of key stakeholders – the Faculty of Pathology, Royal College of Physicians, the Medical Laboratory Scientists Association as well as a number of others – to become involved in the process. A number of groups, membership of which includes these key stakeholders, has been established to manage the next steps and will begin their work immediately.
Prof. Brendan Drumm, CEO of the HSE, welcomed the developments and said “this is a great opportunity for staff to drive efficiency and create a first class medical laboratory service to benefit our patients and clients. In addition, this will also bring us a more efficient, cost-effective, quality laboratory service.’
About Gary Culliton