A Laboratory of The Future Built on The

A Laboratory of The Future Built on The Foundations of The Past

The Leeds Teaching Hospitals Trust: The Pathology Service Leeds is one of the UK’s largest pathology providers 25 million tests carried out annually Comprehensive diagnostic support to hospitals and GPs in the Leeds and Bradford area - serving a population of around 1. 5 million Analytical services: Blood sciences and blood transfusionat three teaching hospitals Consolidated services: - Microbiology – LGI - Clinical Genetics- Chapel Allerton - Cellular Pathology and Cytopathology – SJUH - Immunology – LGI - Laboratory Genetics – SJUH - Histocompatability and Immunogenetics – SJUH - Specialist Testing - SJUH A Laboratory of The Future Built on the Foundations of the Past 2

Services Provision Overview Bradford Royal Infirmary St James University Hospital Leeds General infirmary A Laboratory of The Future Built on the Foundations of the Past 3

The Leeds Teaching Hospitals Trust Estate Leeds employs 800 staff, including pathologists and healthcare scientists, from consultant to support grade, across multiple locations. 3 major hospitals: 3 peripheral hospitals: - Leeds General Infirmary - Seacroft Hospital - St James University Hospital - Bradford Royal Infirmary - Chapel Allerton Hospital - Wharfedale General Hospital A Laboratory of The Future Built on the Foundations of the Past 4

Pathology Increasing Demand 80% of health care decisions require pathology and service requests are increasing rapidly LTHT activity is up 2%. 75, 111 requests with no corresponding increase in FCE Leeds GP activity is up 6. 8%. 162, 459 requests A Laboratory of The Future Built on the Foundations of the Past Accident and Emergency requests have been rising significantly faster than the number of A&E attendances Demand for services has risen over a 3 year period and this trend is expected to continue 5

A Requirement for Change A radical rethink was required for the service to remain relevant and viable Much of the equipment and supporting I. T. was approaching end of life with the potential to compromise service provision. The fabric of the estate is challenging as is the allocation of the space within it. A Laboratory of The Future Built on the Foundations of the Past Increasing financial challenges, significant changes in technology, training requirements and user expectations. 6

The 5 Pathology Pledges Seeing the implementation as simply refreshing equipment would limit opportunities to improve service provision. As a result, pathology outlined five key pledges: Give a better service to patients Provide a better place to work for staff Improve access to training and development Make us more financially sustainable Build a platform for expansion Right report, right person, right time Cleaner estate with improved layout Improve skills for all grades Achieve financial balance Become a centre of excellence Reliable and consistent Improved utilisation and skill mix Opportunities to develop knowledge in other areas Provide investment opportunities Develop business partnerships Improved access to information Clear definition of roles and responsibilities Career development opportunities Supporting the Trust in achieving targets Research and innovation excellence A Laboratory of The Future Built on the Foundations of the Past 7

A New Pathology Partnership Leeds Pathology entered in to a partnership arrangement with Siemens Healthineers to provide a managed pathology service contract (MPSC). The contract value is approximately £ 44 million and is over a term of 5 years with the option to extend for a further 2 years. Key benefits include: - Upgraded equipment - Significant financial savings - Opportunities to improve service efficiency and effectiveness A Laboratory of The Future Built on the Foundations of the Past 8

A Requirement for Change Rapid Comm Lab LIS A radical rethink was required for the service to remain relevant and viable DATA CENTRE Halia DMS Hospital Network TIE Much of the equipment and supporting I. T. was approaching end of life with the potential to compromise service provision. LGI VLAN SJUH VLAN Pathology IT A Laboratory of The Future Built on the Foundations of the Past

I. T. Infrastructure • Validation can be undertaken on any site with full visibility of IQC and status of any connected analyser • Validation of specialty specific tests remains with the relevant section at a local or remote location. • Future development of the system would facilitate a bi discipline/ multi discipline approach to training and education A Laboratory of The Future Built on the Foundations of the Past

Benefits realisation Blood Sciences 3 rd Party Analysers A radical rethink was required for the service to remain relevant and viable POCT and Digital Morphology • Further connectivity to third party analysers • Intelligent routing • Wider connectivity to the community A Laboratory of The Future Built on the Foundations of the Past Halia Immunology 3 rd Party Analysers Microbiology 3 rd Party Analysers

The Shifting Landscape – Leeds LGI Aptio Current State Sample Flow - Single area of loading therefore reduced movement - All tubes handled and routed automatically on the track - Tubes automatically stored, retrieved (for add-ons) and disposed A Laboratory of The Future Built on the Foundations of the Past 12

Productivity and efficiency Blood Sciences 3 rd Party Analysers POCT and Digital Morphology Halia Microbiology 3 rd Party Analysers Immunology 3 rd Party Analysers A Laboratory of The Future Built on the Foundations of the Past

The Shifting Landscape – St. James SJUH Future state Layout and Sample Flow - Single point of loading therefore reduced movement - All tubes handled and routed automatically on the track - Tubes automatically stored, retrieved (for add-ons) and disposed A Laboratory of The Future Built on the Foundations of the Past 14

Lessons Learned Both parties underestimated time and resources required for: - Training and competency based assessment - Validation and verification - New ‘untested’ IT External changes (e. g. new Trust data warehouse) can have a significant impact Commissioners need to be more involved A Laboratory of The Future Built on the Foundations of the Past Honesty and openness with users when there are problems is key to them accepting temporarily extended turnaround times Opportunities for innovation: - Long term condition panels - Responsible requesting 15

Leeds Teaching Hospitals Trust Road Map Integrated , Automated Laboratory Unified service, ‘ologists not ‘ologies. • Integrated Blood Sciences , Virology, Immunology , Combined Reception , Blood Bank. • Integrated Blood Sciences , Combined Reception , Blood Bank at both sites. A Laboratory of The Future Built on the Foundations of the Past 16

Leeds Teaching Hospitals Trust Road Map • Larger consolidated networks • Integrated Care Records • Care closer to home • Continuing access to legacy data • Large storage requirements • Keeping abreast of technology • Changing the culture of the workforce A Laboratory of The Future Built on the Foundations of the Past 17

Thank You A Laboratory of The Future Built on the Foundations of the Past 19