Main programme
Scientific programme sponsor
Cellular Pathology
Disease models and quantitative pathology in liver research
Disease models and quantitative pathology in liver research
Cellular Pathology
Learning outcomes
This talk will:
- Introduce exemplar translational models of chronic liver disease, primary liver cancer, and liver regeneration that are used to understand their cellular and molecular basis and develop therapeutics.
- Describe emerging quantitative pathology methods that capitalise on the availability of whole-slide imaging and open-source tools for image analysis of tissue from translational models.
- Discuss the potential application of similar digital pathology methods in both clinical trials and routine diagnostic work.
Speakers
Dr Tim Kendall
Case studies - lung carcinoma & cholangitis
Case studies - lung carcinoma & cholangitis
Cellular Pathology
Learning outcomes
Delegates attending this presentation will gain through the presentation of case studies:
- An insight into clinical context around investigative techniques.
- The challenges encountered.
- The techniques used by the department and the patient outcomes.
- Reinforcement of the concept that the patient is at the centre of everything the laboratory does.
Abstract
Lung carcinoma
Lung carcinoma is the 3rd most commonly diagnosed cancer in the UK and the 2nd most diagnosed cancer worldwide. Pathological diagnosis of non-small and small cell lung carcinoma is essential to ensure patients have access to suitable palliative care and benefit of tailored target therapy.
This presentation discusses the investigative techniques used to differentiate between non-small and small cell carcinoma and the importance of subtyping non-small in order for patients to avail of molecular testing and access the most suitable treatment pathway.
Cholangitis
Patients with autoimmune liver disease regularly display similar clinical diagnostic features for more than one condition. Primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) are two cohorts of autoimmune liver disease that rely on the collective findings from laboratory serology markers, liver histology and radiological imaging to determine a diagnosis.
In this presentation, it reports the case of a liver biopsy of a female that was suggestive for autoimmune hepatitis. However, the histological pattern was in favour for and reported as primary sclerosing cholangitis.
Speakers
Maria Cunningham
Case studies - LLETZ and gallbladder
Case studies - LLETZ and gallbladder
Cellular Pathology
Learning outcomes
Delegates attending this presentation will gain through the presentation of case studies:
- An insight into clinical context around investigative techniques.
- The challenges encountered.
- The techniques used by the department and the patient outcomes.
- Reinforcement of the concept that the patient is at the centre of everything the laboratory does.
Abstract
Case study 1
Gall bladder The patient presented to their GP with upper abdominal pain in January 2018 after presenting with pain to A&E in February 2018 a series of investigations were performed, the patient was treated for peritonitis and gall stones were identified as the source of the pain. In March 2018 the patient’s gall bladder was removed and sent to the histopathology laboratory at Calderdale Royal Hospital. It was dissected as per laboratory protocols, these were all processed in 1 cassette.
A H&E stained section/slide was produced the following day and the specimen was subsequently diagnosed by the consultant histopathologist as cholelithiasis. No further ancillary tests or immunohistochemistry were required. It was noted at dissection that there was disruption to the gall bladder wall, likely as a result of gallstones. This was not seen on CT and likely contributed to the peritonitis. The patient was discharged and no follow up was required.
Case study 2
Cervical Large Loop excision of the transformation zone (LLETZ) Patient attended a routine cervical screening procedure in March 2018, this was overdue by 3 years due to a recent pregnancy and missing a screening recall test. The cervical screening showed severe dyskaryosis. The patient attended an outpatients appointment in April 2018 at the colposcopy clinic for subsequent examination and treatment. A LLETZ was performed and the specimen was sent to the histopathology laboratory. The specimen was dissected as per laboratory protocols, and both ends of the LLETZ were placed cut side down.
A H&E stained section/slide was produced from each block the following day and the consultant histopathologist diagnosed the specimen from the H&E as high grade CIN, which extended to the margins. This diagnosis was consistent with the results of the cervical screening. The patient was discharged via a letter and the treatment complete, the patient was advised
Speakers
Jemma Morris
Best practice - andrology
Instrumentation – friend or foe?
Instrumentation – friend or foe?
Cellular Pathology
Learning outcomes
The delegates will understand:
- The history, impact and development of instrumentation in Cellular Pathology
- The part of instrumentation in pathology modernisation.
- Compliance with ISO 15189 guidance
- The impact on the knowledge and skill base.
Abstract
The session will look at the core Histology process and the instrumentation used in it its delivery, in doing so we will consider:
- The history, impact and development of instrumentation in Cellular Pathology
- The part of instrumentation in pathology modernisation.
- The effect of technological developments on quality.
- Compliance with ISO 15189 guidance
- The impact on the knowledge and skill base.
Speakers
Rob Hughes
Recent advances in immunocytochemistry for melanoma diagnosis
Recent advances in immunocytochemistry for melanoma diagnosis
Cellular Pathology
Learning outcomes
Delegates will be given an overview of:
- The growing applications of new antibodies to assist with the diagnosis of malignant melanoma.
- An appreciation of where these new antibodies are likely to be used in the developing field of patient tailored therapeutics.
- An appreciation of the complementary role of histopathology, immunocytochemistry and molecular biology in modern day cellular pathology.
Abstract
Malignant melanoma (MM) remains the deadliest form of skin cancer. It is well known that MM can be treated with surgery alone and survival rates are high, however after metastasis survival rates drop significantly. In histopathological interpretation morphological assessment of any melanocytic lesion is always key, but recent developments within the field of immunocytochemistry (IHC) have provided great support in aiding the distinction of the dysplastic verses malignant lesions. This does not just apply to the diagnosis, but also more recently in providing information regarding prognosis and determining patient therapeutics.
Unfortunately, at present these therapeutic regimes are often short term. As a result, new biomarkers and drug targets are constantly needed in order to develop and improve the accuracy of diagnosis and treatment.
In this presentation we will review the popularly used diagnostic markers (eg MelanA/Mart-1, HMB 45, MITFP, Tyrosinase), as well as also focus on the new markers employed (eg Sox10, PRAME, P16, Ki67) and include options for double labelling techniques too. We will consider the new wave of biomarkers employed to assess therapeutic target treatment regimens (eg BRAF and PD-1) and see how these new approaches are paving the way for new strategies in order to develop a more tailored approach to treatment modalities.
We are beginning to understand the underlying mechanisms of the disease, including melanogenesis, and also how melanomas evade the immune system. IHC continues to play its part in the field; although both useful in diagnosis and prognosis, there is a need to standardise the subjectivity of interpretation of IHC to ensure reproducibility and consistency between laboratories and also between pathologists. This becomes increasingly important as new biomarkers are found and assessed employing the evolution of digital technology.
Speakers
Dr Guy Orchard
Advanced Specialist Diploma in Breast Dissection
Advanced Specialist Diploma in Breast Dissection
Cellular Pathology
Learning outcomes
Following the presentation delegates will learn:
- Ideas on how to overcome barriers in training.
- Guidelines on producing a professional portfolio – what to include in the portfolio, what to audit, selecting case studies.
- Preparing for the exam and viva.
Speakers
Chris Ward
The benefits of including pathology in multidisciplinary training days for forensic paediatric post–mortems
UK NEQAS Tissue EQA Scheme
UK NEQAS Tissue EQA Scheme
Cellular Pathology
Learning outcomes
Delegates will:
- Understands the background to new Tissue EQA Scheme
- Be able to appreciate the benefits of the new scheme
- Learn about the progress so far
Abstract
The original slide-based External Quality Assurance (EQA) scheme for routine histopathology was devised 30 years ago. From this, a comprehensive portfolio of testing programmes covering a broad range of histopathology services has been developed. The original ‘General’ scheme assessed archival haematoxylin and eosin (H&E) stained slides, and special staining of slides distributed by the scheme. This assessment model stood the test of time and provided participants with an independent quality assurance and proficiency testing service for laboratory core work.
However, following a change in accreditation, the demonstration of compliance with ISO 15189:2012 standards through data analysis, validation and participation in inter-laboratory EQA schemes became a more pressing requirement. The change prompted UK NEQAS Cellular Pathology Technique, as it is known today, to review the ‘General’ scheme design.
The concept was to increase quality initiatives by the assessment of not only the H&E stained slide, but also the quality of its associated paraffin wax processed tissue block. The proposal was expanded further to examine quality output from individual tissue processors, thus providing a more representative assessment of processing, by introducing asset specific participation.
Following a successful pilot, the review led to the implementation, in May 2021, of the new ‘Tissue Diagnostics’ scheme and for assessment of special stains, the separate ‘Specialist’ scheme. For the Tissue Diagnostics scheme, mandatory online data entry at registration has allowed us to gather and present information about methodology, equipment and reagents in use. Data analysis is proving to be very useful to participants in a number of ways.
An example is a new option for participants to re-evaluate the way Tissue Diagnostics scheme results are reviewed, enabling the monitoring of variations between processing machines. In this presentation, we will look at the impact of the Tissue Diagnostics scheme, results so far and trends observed through assessment.
Speakers
Jane Woods
Clinical Chemistry
Monitoring asparaginase activity to inform treatment of acute lymphoblastic leukaemia
How will the challenges of the pandemic impact how we offer future Clinical Biochemistry services?
How will the challenges of the pandemic impact how we offer future Clinical Biochemistry services?
Clinical Chemistry
Learning outcomes
The COVID pandemic has caused massive global challenges logistically, emotionally and even personally to most of the world’s population. This added to the complexity of Brexit has resulted in challenges in keeping a biochemistry service running. Lean and just in time processes came under significant strain due to global shortages and blocks in the logistical chain, be it through lack of consumables, customs blocks and people not being available to provide services.
The pandemic also forced any businesses into a new way of working, healthcare included. This impacted how people interacted with accessing healthcare, staff availability and staff skill sets as departments managed new infection control requirements whilst maintaining the service. This now is an opportunity to build on these lessons and use these to remodel the service to align with the changes in the way healthcare is delivered.
Sponsored by
Speakers
Dr David Ricketts DBMS CSci FIBMS
Harveys Gang: From the lab to the ward
Harveys Gang: From the lab to the ward
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will be able to:
- Describe Harvey’s Gang project and its applications.
- Understand how laboratory chemistry can be incorporated into Harvey’s Gang project.
- Understand how laboratory methods demonstrated are used in the care of Harvey’s Gang patients.
- Explain examples of where laboratory chemistry has been demonstrated to Harvey’s Gang.
Abstract
In this presentation, Sophie will demonstrate how the charity has helped translate the work performed in the labs to the those most vulnerable, to improve their experience in the hospital, and get both patients, carers and parents involved with each step of the care pathway.
Sponsored by
Speakers
Sophie Ward
Spectrum of conditions associated with paraproteins - From laboratory to the clinic
Spectrum of conditions associated with paraproteins - From laboratory to the clinic
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will be able to :
- Identify the clinical features of plasma cell disorders, including myeloma, plasmacytoma, plasma cell leukaemia, and lymphoplasmacytic disorders such as Waldenstrom’s macroglobulinaemia.
- Explain how laboratory investigations, such as protein electrophoresis and serum free light chains, are translated into the clinical picture and patient management.
- Learn how plasma cell disorders are monitored.
Abstract
A paraprotein is an abnormal protein produced by plasma cells in the bone marrow. These Plasma cell dyscrasias (PCD) are a heterogeneous group of conditions the most common of which is Monoclonal Gammopathy of Undetermined Significance (MGUS).
This premalignant PCD consistently precedes multiple myeloma (MM) and lymphomas depending on the paraprotein subtype with a 1% risk of progression per year. Paraprotein as a biomarker of disease has withstood the test of time. The quantification and identification is of crucial importance in the diagnosis, monitoring and treatment of patients with PCD.
Sponsored by
Speakers
Dr Aaron Niblock MB Bch BAO MRCP FRCPath MSC
Cerebrospinal fluid (CSF) biomarkers in the investigation of patients with dementia
Cerebrospinal fluid (CSF) biomarkers in the investigation of patients with dementia
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will:
Understand how CSF biomarkers may help in the differential diagnosis of patients with dementia
Abstract
Dementia is a major public health concern that will increase in the next decade due to the ageing population. This means that there is increasing need for the development of sensitive and disease-specific diagnostic tests. These tests will enable earlier and more accurate diagnosis to be made and ensure that therapeutic interventions and active support for both the patient and their families are given as soon as possible. There has been extensive research into the use of cerebrospinal fluid (CSF) biomarkers for the diagnosis of Alzheimer's Disease (AD).
Reduced concentrations of β-amyloid in conjunction with elevated tau protein and/or hyper-phosphorylated tau protein have been proposed biomarkers of AD. The recent development of Real-time Quaking induced Conversion (RT-QuIC), a highy sensitive technique for detecting misfolded proteins associated with Creutzfeldt-Jakob disease and Lewy body dementia, has enabled the accurate diagnosis of these rre forms of dementia. The impact of recent analytical advances on the future of dementia diagnosis will be discussed.
Sponsored by
Demand optimisation in a post-COVID world
Tumour markers for today and tomorrow
Tumour markers for today and tomorrow
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will be able to :
- Summarize the current state and clinical applications of tumour markers.
- Understand the limitation and benefits of PSA in screening for prostate cancer.
- Discuss the merits and problems in using tumour markers (e.g., CEA, CA 125) in post-operative surveillance and monitoring therapy.
- Gain an insight as to the future use of tumour markers, including the potential transformative use of circulating tumour DNA (ctDNA).
Sponsored by
Speakers
Professor Joe Duffy
Essential contribution of laboratory diagnostics in COVID-19
Essential contribution of laboratory diagnostics in COVID-19
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will have an understanding of:
- How COVID-19 can be diagnosed with molecular and antigen testing
- The role of serology in monitoring immune response after COVID-19 and vaccination
- The role of laboratory tests for predicting unfavourable outcomes in patients with SARS-CoV-2 infection
Abstract
The global coronavirus disease 2019 (COVID-19) has presented major challenges for clinical laboratories, from initial diagnosis to patient monitoring and treatment. Initial response to this pandemic involved the development, production, and distribution of diagnostic molecular assays at an unprecedented rate, leading to minimal validation requirements and concerns regarding their diagnostic accuracy in clinical settings. In addition to molecular testing, serological assays to detect antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are now becoming available from numerous diagnostic manufacturers.
In both cases, the lack of peer-reviewed data and regulatory oversight, combined with general misconceptions regarding their appropriate use, have highlighted the importance of laboratory professionals in robustly validating and evaluating these assays for appropriate clinical use. The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 has been established to synthesize up-to-date information on the epidemiology, pathogenesis, and laboratory diagnosis and monitoring of COVID-19, as well as to develop practical recommendations on the use of molecular, serological, and biochemical tests in disease diagnosis and management.
This lecture summarizes the latest evidence and status of molecular, serological, and biochemical testing in COVID-19 and highlights some key considerations for clinical laboratories operating to support the global fight against this ongoing pandemic. Confidently this consolidated information provides a useful resource to laboratories and a reminder of the laboratory's critical role as the world battles this unprecedented crisis.
Sponsored by
Speakers
Professor Giuseppe Lippi
Biomarkers in the diagnosis of sepsis
Urgent Biochemistry – impact of the 1 hour TAT in the ED, does it benefit patients?
Urgent Biochemistry – impact of the 1 hour TAT in the ED, does it benefit patients?
Clinical Chemistry
Learning outcomes
This presentation will discuss:
- Which tests are of importance in the context of a 1-hour TAT and why?
- How does the 1-hour TAT matter to the patient and patient outcomes?
- Operational and workflow impact in a busy emergency department.
- Point of care versus laboratory based tests - advantages & disadvantages.
Sponsored by
COVID-19: Cross skilling of healthcare workers
Clinical Scientist Experiential Route and Process and Q&A with the Clinical Chemistry Higher Specialist Diploma (HSD) Examiners
Clinical Scientist Experiential Route and Process and Q&A with the Clinical Chemistry Higher Specialist Diploma (HSD) Examiners
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will:
- Learn about the process of applying for HCPC registration as a Clinical Scientist via the IBMS Experiential Route.
- Be able to meet and discuss areas of HSD examination with an examiner and HSD candidate including learning about the benefits of undertaking this qualification.
Sponsored by
Speakers
Future of Clinical Biochemistry – health informatics and bioinformatics
Future of Clinical Biochemistry – health informatics and bioinformatics
Clinical Chemistry
Learning outcomes
Delegates will:
- Understand what big data & machine learning has got to do with the laboratory
- Learn how laboratory data can add value to diagnosis and prognosis
- Be given real world examples of how health informatics & bioinformatics are being used
- Learn about future developments.
Sponsored by
A case of pseudohyperkalaemia and pseudo-hypercalcaemia in a patient with acute myeloid leukaemia with thrombocytosis
A case of pseudohyperkalaemia and pseudo-hypercalcaemia in a patient with acute myeloid leukaemia with thrombocytosis
Clinical Chemistry
Learning outcomes
Through the discussion of a case study delegates will learn that:
- Awareness of pseudo elevations of biochemical analytes not just commonly seen ones such as Potassium
- Importance of ensuring biochemical parameters are assessed in conjunction with FBC parameters
- Lithium heparin or anticoagulated samples rather than serum can be helpful in these cases.
Abstract
An unusual biochemical presentation in a patient with acute myeloid leukaemia. The patient was a generally unwell GP patient with the highest platelet count we have seen to date. The patient had such extreme platelet counts it caused significant changes to the routine biochemistry monitoring while the patient was at our hospital.
Pseudo hyperkalaemia is a regular problem and widely reported phenomenon in the biochemistry laboratory particularly with regards to myelproliferative disorders. This particular case had the much more uncommon issue of causing possible pseudo hypercalcaemia also, as well as affecting other parameters such as phosphate. In order to obtain useable accurate potassium levels for this patient we recommended the use of lithium heparin plasma samples, however we would routinely only receive serum samples; this gave an alternating serum, plasma pattern and a quite dramatic yoyo situation for the biochemical parameters despite the patient being stable.
During the clotting of the serum sample in the tube the cellular contents of the vast quantity of platelets are released into the serum prior to centrifugation. The anticoagulant in the lithium heparin sample tube has protected and maintained the platelet integrity until centrifugation has effectively removed them from the plasma and prevented the contents from being shed causing the pseudo artifacts.
We lost track of this patient after they were transferred from our district general hospital to a specialist centre more suitable for their needs. I am sure the pathology service there had very similar issues…
Sponsored by
A case of myeloma diagnosed from a random urine protein
A case of myeloma diagnosed from a random urine protein
Clinical Chemistry
Learning outcomes
Through the discussion of a case study delegates will:
- Be able to describe the types of proteinuria (glomerular, tubular, overload and postrenal).
- Understand the analytical steps taken following discovery of an elevated random urine protein result.
- Be able to link the clinical presentation and test results to myeloma diagnosis.
Abstract
In this case study submitted as a piece of coursework towards the IBMS Higher Specialist Diploma in Clinical Chemistry we will discuss the case of an 83-year-old male who presented with an elevated random urine protein. Microalbumin levels contributed to less than 5% of the total urine protein and therefore further investigations were requested.
Repeat sample collection confirmed the initial results and urine electrophoresis revealed the presence of an abnormal band which was characterised as free lambda light chains by immunofixation. Clinical symptoms which indicated myeloma included bone pain, anaemia, and renal dysfunction.
This case study will explore the causes of proteinuria, laboratory diagnosis, and clinical presentation of myeloma.
Sponsored by
Speakers
Charlotte Atkin
A biochemistry Biomedical Scientist – roles and career development beyond the laboratory
A biochemistry Biomedical Scientist – roles and career development beyond the laboratory
Clinical Chemistry
Learning outcomes
Through attending this presentation delegates will:
- Gain knowledge in the development opportunities post-registration.
- Gain an awareness of skill development beyond the laboratory environment.
- Gain an insight into professional registration and where it can lead you.
- Learn how to access the different development opportunities.
Sponsored by
Speakers
Sheri Scott
Identifying patients with advanced liver fibrosis: Utility of the enhanced liver fibrosis test
Identifying patients with advanced liver fibrosis: Utility of the enhanced liver fibrosis test
Clinical Chemistry
Learning outcomes
Delegates will learn:
- Why is liver disease a growing issue?
- Why is identifying liver fibrosis important?
- What are the challenges in identifying patients with liver fibrosis, and what can the laboratory offer?
- The use of the Enhanced Liver Fibrosis (ELF) in routine practice
Sponsored by
Biochemical screening for phaeochromocytoma and paraganglioma (PPGL)
Maternal serum screening, what is the chance?
Maternal serum screening, what is the chance?
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will be able to :
- Understand the development of maternal serum screening.
- Explain how different factors influence the chance result.
- Describe the benefits and pitfalls of the screening programme.
Sponsored by
Pre-eclampsia markers: Current status in clinical practice
Pre-eclampsia markers: Current status in clinical practice
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will:
- Understand the physiological changes associated with angiogenic markers in pregnancy and how these can be disturbed in pre-eclampsia
- Understand the diagnostic benefits of providing these tests in clinical practice including the high negative predictive value
- Understand the available methods for these markers used in practice
- Be able to access NICE guidance (currently being updated) on their use.
Sponsored by
Speakers
Professor Tim James
COVID-19: Clinical Chemistry lessons learned
COVID-19: Clinical Chemistry lessons learned
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will be able to:
- Understand the impact of a global pandemic on the provision of local Blood Science laboratory services
- Explore the ways in which laboratory services and their staff can adapted to rapidly changing clinical requirements.
- Review how the laboratory is supporting a return to (the new) normal service, including the provision of serology testing.
- Assess the impact that the demands SARS-CoV2 has placed on laboratory staff and what ongoing support is required to ensure their future well-being.
Abstract
The SARS COV-2 pandemic has presented unprecedented demands on healthcare services across the world, none of us will ever forget the television reports showing the desperate conditions in which patients and staff found themselves. Laboratory services were crucial to the healthcare response, however, our role was most often behind the scenes supporting clinical services.
In this session I will review the impact of a global pandemic on the provision of local Blood Science laboratory services, we will explore the ways in which laboratory services and their staff adapted to rapidly changing clinical requirements and appraise our achievements. We will review the laboratory response to the pandemic and consider how our role will change as we face new challenges when we move towards a recovery phase. Finally, we will assess the impact that the demands SARS-CoV2 has placed on laboratory staff and what ongoing support is required to ensure their future well-being.
Sponsored by
COVID-19 antibody testing: A cross-discipline approach
COVID-19 antibody testing: A cross-discipline approach
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will be able to :
- Understand the processes behind COVID antibody testing.
- Evaluate of the different techniques involved with COVID antibody testing.
- Recognise the need for cross-discipline working during a pandemic.
Sponsored by
Speakers
James Murphy
Paula Griffiths
Pathology in a pandemic. Establishing pathology provision at the UK's first NHS Nightingale Hospital
Pathology in a pandemic. Establishing pathology provision at the UK's first NHS Nightingale Hospital
Clinical Chemistry
Learning outcomes
Delegates attending this presentation will understand:
- The clinical requirements of the service
- How Pathology Services at the Nightingale London were established
- Challenges of providing pathology services at the nightingale
- Lessons learnt.
Abstract
In order to provide extra critical care capacity at the start of the COVID-19 pandemic, plans were made by the government and NHS England to open new field hospitals across the country, the first being in London where the number of COVID-19 cases was highest. Within two weeks, the Excel centre was converted from an exhibition space to a field hospital. This required establishing new clinical teams and processes, installing IT and communication systems, building wards, sourcing equipment and supplies and providing pathology, pharmacy and imaging services among others.
As there were no existing pathology services on site, decisions had to be made as to what services were required on- and off-site to meet the clinical needs of the hospital, and how these could be provided within such a short timeframe. A project team consisting of NHS staff from across organisations, management consultants and military personnel was assembled and tasked with establishing these core services.
In this talk we will give an overview of pathology services at NHS Nightingale London and how they were established. We will also discuss the challenges faced along the way, how these were tackled and the lessons learnt.
Sponsored by
UK NEQAS Clinical Chemistry: More than a tick-box exercise
UK NEQAS Clinical Chemistry: More than a tick-box exercise
Clinical Chemistry
Learning outcomes
Through an interactive session delegates will:
- Understand the role of EQA within a Quality Management System EQA is not simply a secondary IQC or calibration tool
- Be able to get the most out of your UK NEQAS Clinical Chemistry EQA to support troubleshooting and ongoing assay verification
- Be aware of recent innovations within UK NEQAS Clinical Chemistry.
Abstract
EQA (External Quality Assessment) is sometimes seen as a 'chore' or 'just a UKAS requirement'. EQA is not just about detecting poor performance. In the majority of cases EQA should be reassuring you and your laboratory that you are providing an overall good quality of service. This lecture will show you that EQA is integral within your Quality Management System (QMS) and is beneficial not only for the routine and ongoing monitoring of your assay performance, but also for improved understanding of assays which may assist interpretation of 'odd results' or further Quality Improvement within your laboratory. Education is core to the services that we provide. This interactive session will explore some case examples and provide you with the tools to troubleshoot and get the most out of your EQA not only from an analytical perspective but also from personnel resource management.
It is the responsibility of the wider laboratory community to continuously assess whether the assays they are using are fit for purpose and whether the limits used in guidelines are valid and achievable to ensure we can all provide the best service possible for patients. EQA data contains information about the current state of the art performance of assays and is often an under used resource. This session will show you some of the questions you should be asking and where to look for information in EQA reports.
EQA services, like clinical laboratories, are continually improving. The final part will discuss recent innovations within UK NEQAS Clinical Chemistry from the Birmingham Quality perspective, including new Schemes, education and changes to reports and the website.
Sponsored by
The screening and quantification of gabapentin and pregabalin in post-mortem samplers using high performance liquid chromatographyhigh resolution mass spectrometry (HPLCHRMS)
The screening and quantification of gabapentin and pregabalin in post-mortem samplers using high performance liquid chromatographyhigh resolution mass spectrometry (HPLCHRMS)
Clinical Chemistry
Learning outcomes
Delegates will:
- Gain knowledge of Gabapentin and Pregabalin and how they are used in the treatment of epilepsy and neuropathic pain.
- Understand the use and misuse of these drugs and the role of the biochemistry department in their monitoring.
- Gain insight and knowledge of the screening methods currently used and the new methods being developed.
Abstract
The use of gabapentin and pregabalin has considerably increased in the UK since their introduction. These drugs have not only gained popularity in the UK, but across Europe and the USA, with studies showing increased use for illicit purposes. As a result, it has been decided that Sheffield Teaching Hospitals needs a robust method for the screening and quantitation of gabapentin and pregabalin in post-mortem blood.
Currently, Sheffield Teaching Hospitals employs a qualitative GC-MS screening of post-mortem samples after a ‘Basic’ extraction procedure. However, due to the lack of sensitivity of the GCMS assay as well as its inability to quantitate drug concentrations, a fully validated assay was developed for the screening and quantification of gabapentin and pregabalin in post-mortem (PM) blood. A simple protein precipitation extraction, using the deuterated analogues of the gabapentinoids as internal standards, was performed prior to analysis by HPLC-HRMS.
Analysis showed a linear calibration curve for both gabapentin and pregabalin with R2 values above 0.999 for each run. Intra-assay imprecision was assessed giving %CVs of <10%. Inter-assay imprecision was determined using one-way ANOVA. There was no clinically significant variation between QC analysed over 5 days. The average recovery for gabapentin and pregabalin was evaluated using EQA and gave a recovery value 97%.
The limits of detection and quantification were determined for both gabapentininoids. No carry over was observed in post-mortem analysis. Ion suppression tests showed there is no ion suppression or enhancement. Although a screening and quantitative method was developed, PM sample analysis and comparison are yet to be performed.
Sponsored by
Dinitrophenol – more than an explosive
Dinitrophenol – more than an explosive
Clinical Chemistry
Learning outcomes
Delegates will:
- Gain knowledge on the ilicit use of dinitrophenol
- Learn about the mode of action
- Gain insight of its involvement in fatalities.
Abstract
Dinitrophenol has a chequered history and is used in the manufacture of explosives, dyes and can be used as a wood preservative, herbicide and insecticide. It was used to treat obesity, but was found to cause cataract formation as well as fever, shortness of breath and sweating. Vast quantities were used in the first world war in the manufacture of munitions with at least one case of liver cancer being attributed to occupational exposure to the drug. It is now being marketed (illicitly) as a weight loss aid for body builders.
This talk will briefly discuss the history of its use as a drug and weight loss aid, review its mechanism of action and outline the clinical features associated with its use.
Sponsored by
Laboratory based drug adherence testing
Laboratory based drug adherence testing
Clinical Chemistry
Learning outcomes
This presentation will cover:
- Anti-hypertensive drug screening
- Hypertension
- Patient compliance with treatment
Abstract
Nonadherence to antihypertensive medication is common, especially in those with apparent treatment-resistant hypertension and its routine detection is supported by clinical guidelines. Chemical adherence testing is a reliable and valid method to detect adherence, yet methods are unstandardised and are not ubiquitous.
In this talk Dr Lawson will outline some of the techniques used for laboratory-based drug adherence testing in hypertension and in other conditions. He will also highlight issues related to ethics, sample collection, transport, stability, sample type, pharmacokinetics, instrumentation, and gaps in knowledge.
Sponsored by
How low are some people prepared to go? Hypoglycaemia and murder
Cytopathology
HPV Screening – Four Nations update
HPV Screening – Four Nations update
Cytopathology
Wales: Louise Dunk, Public Health WalesScotland: Gillian Collins, NHS Greater Glasgow & Clyde, Queen Elizabeth University Hospital
Northern Ireland: Jackie Jamieson, Northern Health and Social Care Trust
England: Dr Karin Denton, Severn Pathology, North Bristol NHS Trust
Speakers
Dr Karin Denton
Louise Dunk
Gillian Collins
Jackie Jamieson
Liquid Based Cytology - Rapid molecular testing using the Biocartis Idylla Platform
Liquid Based Cytology - Rapid molecular testing using the Biocartis Idylla Platform
Cytopathology
Learning outcomes
Delegates attending this presentation will understand:
- Utilisation of liquid-based cytology samples for molecular testing
- The role of ROSE in molecular testing
- Importance of rapid turnaround times in cancer pathways.
Abstract
Technical medical advancements have moved to minimally invasive procedures for patients resulting in smaller diagnostic samples. In contrast pharmaceutical developments have lead to the requirement for more information to be extracted from these smaller samples. Cytology services can effectively and rapidly provide essential information to support diagnostic requirements by identifying targeted and highly specialised prognostic and therapeutic biomarkers leading to personalised treatments for patients.
This presentation introduces the KEBI-CYTO trial which focused on validating optimally preserved residual liquid based cytology samples and blood plasma samples for the detection of driver mutaions in non small cell lung carcinoma and pancreatic adenocarcinoma.
Speakers
Leonie Wheeldon
Enduring impact of HPV vaccination on infection and disease: 10 years and counting
Enduring impact of HPV vaccination on infection and disease: 10 years and counting
Cytopathology
Abstract
Prophylactic HPV immunisation has been live in UK for over 10 years and we are seeing the consequences on infection and disease increasingly. The talk will cover uptake and impact of the vaccine when delivered as a single-gender and gender neutral strategy and also consider the implications of vaccinating other groups, outside the routine programme.
Considerations for future primary and secondary disease prevention in an era of vaccination will be discussed as well as new vaccine technologies and approaches to administration
Speakers
Dr Kate Cuschieri FRCPath
Education and Training
Degree laboratory placement, the success of the symbiotic relationship
Degree laboratory placement, the success of the symbiotic relationship
Education and Training
Abstract
My presentation on degree laboratory placements, the success of the symbiotic relationship will cover my approach that has been developed over time to establishing and maintaining effective relationships with practitioners in local NHS laboratories.
A close relationship with local practitioners and laboratory managers is key to developing and delivering Biomedical Science degree programmes that are fit for purpose and contain relevant and current pathology content, in addition to supporting placement provision for our students. I have organised and chaired regular Employer Liaison Group meetings since 2005 as a key component of our ongoing programme development and enhancement. A close working relationship with local laboratories underpins the curriculum design and delivery of taught sessions that include current working practices and information. We regularly have colleagues from Pathology disciples delivering taught content in modules and producing case studies / data analysis tasks for students. Practitioners also help us to prepare our students for NHS placements by providing short visits to each laboratory in year 1, being on the interview panel to select students prior to their placement and facilitating peer mentoring from returning placement students about their experiences in the laboratory. We have been commended by sequential IBMS accreditation panels for our close relationship with employers.
Further, we provide regular Training for Trainers events at the university for practitioners who supervise placement students completing their IBMS registration training portfolio. Our Placement Tutor meets with all placement students and their trainers and is available for discussions and advice before, during and after the placement. We also provide mentor training for workplace supervisors / mentors of Healthcare Science Practitioner degree apprentices, alongside regular tri-partite meetings with the apprentice, trainer and work-based learning tutor from the university.
Sponsored by
Speakers
Dr Sue Jones PFHEA, FIMBS, MRSB
Supporting learning using a virtual environment
Recognising and supporting the role of the laboratory trainers
Too busy to train?
Too busy to train?
Education and Training
Abstract
Are you responsible for laboratory training? Do you struggle to find time to fit training in around other duties and responsibilities?
This session will look at some hints and tips from experienced training officers as to how they have approached this in their own laboratories.
Sponsored by
Speakers
Victoria Moyse
Spotting qualification fraud
Spotting qualification fraud
Education and Training
Abstract
Qualification fraud is a global problem, and the UK is a high-profile target for the fraudsters. Although most recruiters will ask to see the academic qualifications of their hires, only a minority check the data with the awarding body. This creates an opportunity gap which is filled by fake certificates, inflated grades and bogus universities and institutes. The consequences of not making the proper checks can be significant, and not just financially – major employers have suffered reputational damage when it becomes known that they have hired senior staff who used false credentials.
Qualification fraud takes ingenious forms, with the fraudsters often keeping step with the latest developments in security technology. But there are also straightforward ways to spot qualification fraud that can be folded into a best practice policy that protects both the recruiter and the honest applicant.
Sponsored by
Speakers
Adam Crosbie
Qualification choices: HSD v MSc
Opening HSST to biomedical scientists
New HCPC Standards of Proficiency: Changes, emphasis and impact
CPD – what can we learn from other professions?
CPD – what can we learn from other professions?
Education and Training
Abstract
Continuing Professional Development and Lifelong Learning are the lifeblood of professional practice. CPD can take many forms. 'Good' CPD brings benefits to our individual personal and professional life as well as to our service users. CPD requires the engagement of the individual, the support of the employer and the commitment of wider systems and policy makers.
This presentation will describe how 20 different professional bodies and trade unions came together to produce Principles for Continuing Professional Development and Lifelong Learning in Health and Social Care. It will also offer some tips on how to enjoy and get the most from your CPD.
Sponsored by
Speakers
Gary Strong
Band 6 – finding, keeping, developing
Challenges of delivering training with a limited scope service
Embedding leadership – training people to lead?
Haematology
Morphology quiz
Morphology quiz
Haematology
Abstract
A selection of varied morphology cases, showing the fascinating world of the Biomedical Scientist reporting morphology and lessons for improving our decision making.
Focusing on blasts cells and those cells that can cause confusion in. No penalty, on-line quiz open to all with discussion and explanation of cases. A mixture of the common and the rare for all levels of experience. All you need is an interest in morphology.
Sponsored by
Speakers
Dr Michelle Brereton
The Integration of Morphology with Immunophenotyping and other modalities in haematological neoplasms
The Integration of Morphology with Immunophenotyping and other modalities in haematological neoplasms
Haematology
Learning outcomes
Delegates attending this presentation will be able to:
- Recognise a possible haematological emergency from the morphology and to explain what other diagnostic modalities should be employed to achieve a rapid diagnosis.
- Integrate morphology and immunophenotyping to reach a diagnosis
- Integrate morphology with information from cytogenetic, FISH and molecular analysis to reach a diagnosis.
Sponsored by
Immunodulatory drug resistance in myeloma
Immunodulatory drug resistance in myeloma
Haematology
Learning outcomes
Delegates attending this presentation will understand:
- The mechanisms of action of immunomodulatory drugs in myeloma including laboratory aspects of disease monitoring
- The mechanisms of resistance to immunomodulatory drugs in myeloma nosis.
Sponsored by
Next-generation sequencing in myeloid neoplasms
Next-generation sequencing in myeloid neoplasms
Haematology
Learning outcomes
Delegates will understand:
- How next generation sequencing is used in the diagnosis of myeloid neoplasms.
- How NGS is used for prognosis of myeloid neoplasms.
Abstract
Molecular tests for the detection of human papillomavirus (HPV) infection in humans have evolved dramatically over the last decades. Initial low-throughput hybridization/blotting techniques have been replaced by rapid high-throughput target-amplification assays. These tests can detect individual HPV genotypes and have become the mainstay of HPV-based screening and clinical testing.
The next “age” of HPV testing should involve going beyond simply detecting the presence or absence of HPV but rather, provide more detailed insight into the likely course and clinical consequences of HPV infection.
Next generation sequencing (NGS) can be used as a highly sensitive method for HPV detection due to its ability to detect types at low copy numbers (even within multiple infections), novel types, and/or known types that are distantly related to primers/probes which may escape detection using standard molecular approaches.
Sponsored by
Speakers
Daniel Guerendiain
Gene therapy: Curing the incurable!
Anticoagulation in COVID-19: What does not kill
Lupus anticoagulant in COVID-19 patients
Lupus anticoagulant in COVID-19 patients
Haematology
Learning outcomes
Delegates attending this presentation will learn:
- Whether COV-SARS2 induces lupus anticoagulant formation.
- How is this relevant clinically relating to survival.
- Will this produce long term side effects post infection.
Sponsored by
Q&A. What we learnt from COVID-19
Q&A. What we learnt from COVID-19
Haematology
Learning outcomes
Through the discussion of questions submitted delegates attending this presentation will learn about:
- Changes in knowledge of the haemostatic system after the pandemic
- How the virus interferes with haemostasis
- What did we learn from the virus and its effects.
Delegates are asked to submit questions to [email protected] by Monday 31st January 2022.
Sponsored by
Speakers
Haemoglobinopathy conundrums - small details, big difference!
Haemoglobinopathy conundrums - small details, big difference!
Haematology
Learning outcomes
Through an interactive presentation based on case studies found in the Trust delegates will:
- Be made aware that since there are more than 1200 haemoglobin variants described and many other causing thalassaemia, the importance to acknowledge the complexity of HPLC interpretation.
- Understand the methods that are at their disposal to confirm the diagnosis.
- Be able to consider when it is necessary to request further testing in an environment of increasing financial pressures.
Abstract
Haemoglobinopathy screening and diagnosis is a very heterogeneous but fascinating specialist area to be working on. Specially with emerging new therapies, such as gene therapy, to treat or maybe even cure Sickle Cell Anaemia or Beta Thalassaemia Major. However, in an area where there are more than 1500 haemoglobin variants and thalassaemias described is easy to feel overwhelmed with the possibilities of diagnosis. Therefore, it’s very important to understand the basic principles of haemoglobinopathy diagnosis to be able to find the right and cost-effective solution for complicated cases.
High performance chromatography (HPLC) is one of the most used methods to separate haemoglobins in a reliable way. In this interactive presentation we will explore the diagnostic possibilities of several HPLC case studies, from the most commonly found in all laboratories to the more complex cases referred to us for investigation.
- How to ascertain if the patient has a haemoglobin variant with concomitant alpha or beta thalassaemia?
- How to ascertain if the variant is an alpha or beta chain variant or even both?
- Is the analyser, always right?
These are some of the questions we will answer together, and alongside a comprehensive explanation we will access the clinical significance, pitfalls and common errors in HPLC interpretation.
Sponsored by
Speakers
Daniel Monteiro
Standardised testing for Paroxysmal Haemoglobinuria (PNH)
Standardised testing for Paroxysmal Haemoglobinuria (PNH)
Haematology
Learning outcomes
Delegates attending this presentation will learn that:
- PNH is a rare disease, consequently diagnosis can be delayed or completely missed.
- Laboratory testing plays a critical in role in the diagnosis of the disease, for which there is a highly effective treatment. Without therapy, morbidity and mortality can be significant.
- Previous studies have demonstrated the inconsistency of laboratory testing for PNH.
- We have developed international guidelines to assist with improving testing and therefore diagnosis of this rare disease.
Abstract
Paroxysmal Nocturnal Haemoglobinuria (PNH) is a rare disease. Clinical presentation is varied and diagnosis can be missed or delayed, potentially leading to patient mortality. Flow cytometry is the gold standard method and accurate testing is essential for diagnosis of PNH.
Studies have demonstrated significant issues with inter-laboratory accuracy and precision of this test, with false positive and negative results and high coefficient of variation. Improved standardisation has been shown to improve analytical performance of flow cytometry assays.
PNH guidelines have been developed and also demonstrate improved performance of PNH flow cytometry. The talk will include details of the international PNH guidelines and the steps taken to validate this assay in a multi-centre consensus group.
Sponsored by
Gene therapy and bone marrow transplant treatment in beta thalassaemia patients
Gene therapy and bone marrow transplant treatment in beta thalassaemia patients
Haematology
Learning outcomes
Delegates will learn about
- The clinical and presentation of Beta Thalassaemia patients
- The diagnosis and categorisation of Beta Thalassaemia
- The current choices in gene therapy relevant to beta thalassaemia treatment
- How bone marrow transplant is used to introduce replacement genes in the patient.
Sponsored by
Impact of COVID-19 on the haemostasis lab testing
British Society for Haematology Guidelines – platelet function testing
British Society for Haematology Guidelines – platelet function testing
Haematology
Learning outcomes
Delegates attending this presentation will gain knowledge on the recommendations from the BSH guideline writing group on various aspects including:
- Clinical evaluation and the utility of bleeding assessment tools
- Sample collection and preparation requirements
- Recommendations on phenotypic tests for investigation of platelet function
- Quality assurance measures available for platelet function testing
- Use of genetic or genomic testing in investigation of platelet disorders.
Abstract
This guideline replaces the previous British Committee for Standards in Haematology guideline published in 2011 on laboratory diagnosis of heritable disorders of platelet function. The remit has been expanded to include clinical diagnosis and heritable thrombocytopenia under the overarching term: heritable platelet disorder (HPD). Acquired disorders such as immune thrombocytopenia and drug-induced platelet dysfunction are not covered.
Since the previous guideline there have been significant advances in the clinical assessment of HPD. For example, bleeding assessment tools have been developed to standardise clinical evaluation and provide a quantitative analysis of bleeding symptoms. A major laboratory advance has been in the use of high-throughput sequencing which is now available in routine clinical practice in the UK. As a result there has been a large increase in distinct HPD with a better understanding of their underlying molecular basis and clinical effects. While these are individually rare disorders, collectively HPD comprise 10% of registered cases in the National Haemophilia Database, the fourth most common group of disorders after von Willebrand disease, haemophilia A and factor XI deficiency.
This presentation will focus on the key recommendations for the laboratory diagnosis of HPD and cover standards for aggregometry, assessment of platelet count and size, point of care testing, quality assurance and genomic testing.
Sponsored by
Speakers
Dr Keith Gomez
British Society for Haematology Guidelines – laboratory assays
British Society for Haematology Guidelines – laboratory assays
Haematology
Learning outcomes
Delegates attending this presentation will gain knowledge on the recommendations from the BSH guideline writing group on various aspects including:
- Preanalytical variables and their effects on haemostasis tests
- Recommendations for assays to use when investigating factor deficiencies, and requirements for these assays including assay design.
- Recommendations on which assays to perform for thrombophilia testing.
- Considerations for quality assurance, including internal quality control and external quality assessment.
Abstract
The British Society for Haematology guideline committees are made up of expert haematology consultants and scientists from across the UK. They provide up to date guidance on the diagnosis and treatment of haematological disease. Three levels of report are produced depending on the available published evidence. Guidelines are evidence based with a full literature search generated from a convened writing group, Good Practice Papers recommend good practice in areas where less robust evidence is available to gain a degree of consensus and Position Papers provide adoption/adaptation of non-UK evidence-based guidance for the UK.
‘Guidelines on the laboratory aspects of assays used in haemostasis and thrombosis’ was published in 2020 during lockdown and provides an update and amalgamation of 2 previous guidelines on haemostasis laboratory assays. This presentation will give a brief overview of its key components and recommendations using real world examples.
Broad subject areas covered include pre-analytical variables impacting blood collection, sample handling and storage and preparation as well as factors affecting assay construction, calibration, and control. The techniques discussed are then reviewed in the context of the investigation and monitoring of bleeding tendencies including fibrinogen estimation, awareness of reagent sensitivities to new haemophilia treatment options and the detection of acquired inhibitors. Finally, techniques and recommendations are made for the investigation of a thrombotic tendency concluding with guidelines for the diagnosis of the microangiopathy (TMA) Thrombotic Thrombocytopaenia Purpura (TTP).
Sponsored by
Speakers
Peter Baker
Chimeric Antigen Receptor Therapy (CAR-T) for treatment of haematological malignancies
Chimeric Antigen Receptor Therapy (CAR-T) for treatment of haematological malignancies
Haematology
Learning outcomes
Delegates attending this presentation will:
- Gain a greater understanding CAR-T therapy
- Develop an awareness of the advantages of the therapy
- Understand some of the technical aspects of the therapy
Sponsored by
Immunophenotyping
P.Knowlesi
P.Knowlesi
Haematology
Learning outcomes
Through the discussion of a patient case study that attended the Trust, delegates will:
- Understand the Pre-analytical, analytical and post analytical processes involved in a malaria request
- Learn about the morphological features of P.Knowlesi
- Have an understanding of the clinical presentation, treatment and clinical management of a patient with P.Knowlesi
Sponsored by
EQA Governance – the road ahead for the UK
Cytospin case studies
Cytospin case studies
Haematology
Learning outcomes
Through a discussion based on case studies found in the Trust delegates will:
- Understand what cytospins are.
- Learn about types of fluids that may be examined.
- Understand their role in the diagnosis and monitoring of haematological malignancy.
Abstract
An introduction to cytospins, what they are, the specimen types that we might use and how we obtain them.
Also includes a selection of cytospin cases that demonstrate how cytospins can aid in the diagnosis of infection, and haematological and non-haematological malignancy.
Sponsored by
Speakers
Nicki Lawrence
Peritoneal dialysate fluid – testing for peritonitis
Immunology
Emerging concepts of type I interferon regulation in Systemic Lupus Erythematosus
Emerging concepts of type I interferon regulation in Systemic Lupus Erythematosus
Immunology
Abstract
Type I interferons (IFNs) have been known to have a crucial role in the pathogenesis of systemic lupus erythematosus (SLE) for decades. Recent evidence has overturned several long-held assumptions about how IFNs are regulated and cause pathology. For instance, plasmacytoid dendritic cells (pDCs), the main type I IFN producing cells, are proven to be functionally impaired, incapable of inducing adequate immune responses, even in individuals with benign preclinical autoimmunity. This has offered a new view of lupus pathogenesis that answers longstanding clinical dilemmas.
More data show the greater importance of non-haematopoietic cellular sources of type I IFNs such as keratinocytes, renal tubular cells, glial cells and synovial stromal cells, as well as local responses to type I IFNs within these tissues. These local effects are found not only in inflamed target organs in established SLE, but also in histologically normal skin during asymptomatic preclinical phases, suggesting a role in disease initiation.
Therefore, the development of biomarkers to characterise the complex type I IFN system, and monitor recently-licensed IFN-blocking therapies are of pivotal importance. These novel approaches in SLE may lead to disease reclassification and preventative strategies in preclinical phases.
Speakers
Dr Anthony Psarras
Neuroscience laboratories services
Neuroscience laboratories services
Immunology
Learning outcomes
Delegates will learn how:
- The Neuroscience Laboratories support a specialist tertiary Neurology and Neurosurgery Hospital and the wider population.
- How we work as a cross discipline team to deliver our Neuropathology, Neuroimmunology and Neurobiochemistry services.
- What the risks and opportunities are of being such a specialist service.
Abstract
The Neuroscience Laboratories are part of The Walton Centre NHS Foundation Trust, a unique specialist tertiary neurology and neurosurgical Hospital providing care for a population of 3.3 million across the Northwest of England and North Wales. Neurobiochemistry, Neuroimmunology and Neuropathology services are provided by a team of twenty-one highly skilled staff comprised of neuropathologists, clinical scientists, biomedical scientists, associate practitioners with medical laboratory assistant and secretarial support.
They work as a cross discipline team to aid in the diagnosis of tumours and neurological conditions. They have established a neuroscience biobank –The Liverpool Neuroscience Biobank at The Walton Centre, which supports translational research with local health partners. This presentation will describe the services provided, the unique challenges they face as a specialist service and some interesting cases they have investigated.
Speakers
Carrie Chadwick FRCPath EuSpLM
Clinical applications of the predicted indirectly recognisable HLA epitopes (PIRCHE) software tool in solid organ and bone marrow transplant
Investigating cryoproteins – are we offering the best service possible?
Investigating cryoproteins – are we offering the best service possible?
Immunology
Learning outcomes
This presentation will include:
- Reminder of types of cryoglobulin and requirements for effective analysis
- Discussion of importance of cryofibrinogen and testing plasma samples as well as serum samples for cryoprotein studies.
- Presentation of relevant clinical cases.
Abstract
The investigation of cryoglobulins is a technically challenging lab test, requiring a stringent, validated process for sample collection. Published protocols agree on the vital importance of collecting, clotting and separating samples in a way that maintains samples at 37C but this remains a challenging area, particularly when labs are serving a network of healthcare providers. The impact of pre-analytical factors on cryoglobulin results is likely to vary depending on the individual cryoprotein.
Cryoglobulins can be associated with B cell malignancy, autoimmune disease and some viral infections, particularly hepatitis viruses. The detection and typing of cryoglobulins can provide a valuable clue to the underlying pathology driving a patient’s symptoms, and help direct patient treatment.
This talk will use example cases to explore the variation in the appearance and behaviour of cryoglobulins, the factors that can confound result interpretation, and the impact of cryoprotein studies on patient care.
Speakers
Dr Rachel Wheeler
Laboratory Management
Decision making in a crisis situation
Decision making in a crisis situation
Laboratory Management
Abstract
This session will explore what happens when we are required to make decisions in times of crisis. Using reflections and learning from the Covid response the session will focus on the sudden requirement to make rapid decisions and the suddenness to change decisions as new and more information emerges. The impact of this fast pace process was felt by many teams and individuals and this session will also include what and how that impact was felt for leaders and managers as well as laboratory teams.
Sponsored by
Speakers
Denise Cook
Developing confident leadership at all levels
Positive onboarding – making staff induction an investment for success
Positive onboarding – making staff induction an investment for success
Laboratory Management
Abstract
This session recognises that there is only one induction / onboarding process for anyone entering a new organisation and department. This is a crucial aspect of entering the workplace and sets the scene for the future perceptions of the new employee.
The session aims to provide insights to make induction a positive, enjoyable and valuable process with consideration of the psychological aspects of induction, integration into the organisational culture and tips on successful induction programmes.
Sponsored by
Speakers
Sue Alexander MSc MSc MBA CSci FIBMS CBiol FRSB MIHM MCQI CQP
Lead, follow or get out of the way
Applying organisation values to your leadership
Applying organisation values to your leadership
Laboratory Management
Abstract
This session will explore the relationship between organisational values, leadership and culture and complements the Positive Onboarding session. It will also explore the concept of personal and organisational values, and how leaders influence and transmit values. It will discuss what values based leadership encompasses and will encourage reflection and discussion on what is needed to lead with values.
Sponsored by
Speakers
Sue Alexander MSc MSc MBA CSci FIBMS CBiol FRSB MIHM MCQI CQP
Pre-empting problems – may the workforce be with you
Pre-empting problems – may the workforce be with you
Laboratory Management
Abstract
"An organisation's most valuable asset is its employees". It's a phrase we've all heard so many times before that it has become a platitude. It does, however, remain true. Aside from the fact that your service simply couldn't run without them, staffing costs are likely to be the single biggest financial expenditure in your organisation. So how often do our management practices genuinely invest in the individuals responsible for delivering our pathology services?
When success is measured against turnaround times and test repertoire, our go to solutions can be reactive and lacking in consideration of human factors. Even our most common people metrics (absence rates, turnover, appraisal completion) can lead us down a road of quick fixes.
The business case for staff engagement, health and wellbeing is clear. It has been widely demonstrated that an engaged workforce can lead to higher productivity, lower absenteeism and improved morale. The bottom line is that it results in a better experience for our patients and service users. So why aren't all our managers and leaders focussed on this more sustainable approach to improving performance? The truth is, it's not easy. It can't be done overnight. But it is worth it.
We'll consider how we can better use the metrics we have at our fingertips to pre-empt potentially costly people challenges and improve performance, and review some tools and techniques for filling in any blanks. We'll also examine how managers can tap into their "soft" skills to improve engagement and what leaders can do to support this approach.
Sponsored by
Speakers
Charley Frampton
Why don’t staff do what they are asked to do?
Why don’t staff do what they are asked to do?
Laboratory Management
Abstract
Has this ever happened to you?
You ask someone to do something at work, they say they are going to do it, and then they don’t do what you want, the way you want.
If this has happened, did it trigger an upset in you such as frustration, disappointment, anger, or any of 200+ emotions that we can experience?
If the answer is yes, you can consider you are not alone.
In this session we will explore potential causes around skills and/or knowledge issues, goals and/or communication issues, organisational issues and motivation issues. We will look to understand what is going on in these moments, and to understand and know the cause of why people don’t do what we ask them to do and what to do about it.
Sponsored by
Speakers
Denise Cook
The exit interview – a meaningful goodbye
The importance of good laboratory design on staff health and wellbeing
Motivating a tired and exhausted workforce
Medical Microbiology
Methods for the isolation of nontuberculous mycobacteria (NTM) from respiratory samples and the environment
Methods for the isolation of nontuberculous mycobacteria (NTM) from respiratory samples and the environment
Medical Microbiology
Abstract
Nontuberculous mycobacteria (NTM) are increasingly implicated as an important cause of respiratory infection in individuals with cystic fibrosis (CF) and other underlying lung diseases. For diagnosis, international guidelines recommend that sputum is decontaminated with alkali prior to culture using both solid and liquid culture media. Chemical decontamination is also recommended for the isolation of NTM from environmental samples (e.g. water samples). Such decontamination can lead to a severe reduction in the viability of NTM, and rapidly-growing species (e.g. Mycobacterium abscessus) are particularly affected. An alternative approach for isolation of NTM is the use of a highly selective culture medium (e.g. RGM medium) without the use of chemical decontamination. This presentation will review the advantages and disadvantages of culture using RGM medium versus culture using conventional methods for both respiratory samples and environmental samples.
Recently published data claim that the use of 2% sodium hydroxide (NaOH) for decontamination leads to an 87% average decrease in the number of viable M. abscessus in sputum samples, with 4% NaOH causing a 98% reduction. This is reflected by several studies from the UK and the United States which show that M. abscessus can be detected in significantly more respiratory samples when decontamination is avoided. The viability (and recovery) of slow growing species such as M. avium complex is less affected by decontamination. One drawback of direct culture (without decontamination), is the recovery of small numbers of commensal NTM that have little clinical significance in respiratory infection (e.g. M. chelonae). For processing water samples, the use of direct culture (without decontamination) is especially useful leading to the effective inhibition of virtually all non-mycobacteria and substantial savings in the time taken to process samples and the isolates that are recovered.
Speakers
Professor John Perry PhD, DSc
From Acrophialophora to Zygosaccharomyces: Expanding the potential of the Bruker Biotyper for fungal identification
From Acrophialophora to Zygosaccharomyces: Expanding the potential of the Bruker Biotyper for fungal identification
Medical Microbiology
Abstract
Over the past decade, matrix-assisted laser desorption ionisation time of flight mass spectrometry (MALDI-TOF MS) has revolutionised the identification of microbes in clinical diagnostic laboratories. It's application to the identification of yeast is well documented and if adequate laboratory protocols are followed, is very successful. However, its use as a tool for the identification of filamentous fungi (moulds) is still the matter of some development. There is currently no standardised methodology for the processing of moulds for MALDI-TOF MS identification and the commercially available databases are severely lacking in both depth and active development especially within the context of rapidly evolving taxomnomic revision.
At the UKHSA National Mycology Reference Laboratory we have developed, and continue to curate, an expanding adjunctive database for the rapid identification of moulds using MALDI-TOF MS. This talk will share the experiences of handling fungi for MALDI-TOF MS and present an up to date overview of the work of the MRL to expand and improve the commercially available database for the Bruker Biotyper. There will also be hints and tips towards the most successful methods for application of MALDI-TOF MS to the identification of all fungi in the clinical diagnostic laboratory.
Speakers
Dr Mark Fraser
The great and recurrent questions regarding Clostridioides difficile
The great and recurrent questions regarding Clostridioides difficile
Medical Microbiology
Abstract
With the successful incorporation of whole genome sequencing single nucleotide polymorphism (WGS SNP) analysis for C. difficile typing in Wales, our understanding of C. difficile colonisation and infection is increasing.
The launch of the Wales C. difficile Infection Focus Forum (WCDIFF) is helping health care professionals from multiple disciplines to assess and implement latest guidance and to share best practice from across the country, and further afield. During the presentation the latest findings from Welsh WGS SNP analysis and the WCDIFF will be shared and discussed.
Speakers
Michael Perry
Impact of HG3 organisms not being suspected from clinical resulting in processing at CL2
Impact of HG3 organisms not being suspected from clinical resulting in processing at CL2
Medical Microbiology
Abstract
Clinical information on request forms is utilised to direct additional testing that may be required for patients. Scrutiny by laboratory staff of this information additionally allows precautionary action to be undertaken if an organism is suspected to be classified above hazard group 2 resulting in processing or storage for transport at containment level 3.
This presentation reviews and discusses cases within the laboratory setting where the clinical information has not indicated the risk associated with the sample, resulting in those samples being processed at containment level 2.
Speakers
Michelle Peters
Microbiome–associated metabolites and the gut–brain axis
Microbiome–associated metabolites and the gut–brain axis
Medical Microbiology
Learning outcomes
Delegates attending this presentation will:
- Gain an understanding of what the gut–brain axis is.
- Learn how metabolites produced by gut bacteria can have systemic effects.
- Understand the potential medical implications of gut microbiome–brain interactions.
Abstract
The gut microbiota comprises bacteria, archaea, viruses, and lower and higher eukaryotes. Together, the gut microbiota and its mammalian host contribute to the gut microbiome, a symbiotic entity that exerts a strong influence on host health. A range of metabolites produced by the microbiota from the foods and drugs we ingest can be taken up from the gut via the hepatic portal vein to the liver, where they enter the circulation either unchanged or modified via hepatic enzymes. As such, there is extensive microbial–host co-metabolism within mammalian systems. Circulating microbiome-associated metabolites interact with organs in the body, and it is widely recognized that they influence disease phenotypes in metabolic diseases. Lesser known is the effects these metabolites have on the gut–brain axis, representing the bidirectional communication that occurs between the central and enteric nervous systems. This talk will highlight recent work demonstrating how microbiome-associated metabolites influence the gut–brain axis, with a special focus on studies showing a direct interaction of these metabolites with the mammalian blood–brain barrier and cognitive function..
Speakers
Professor Lesley Hoyles FRSB
Point-of-Care Testing
POCT in pathology networks
How COVID-19 has accelerated the POCT landscape
POCT: Benefit to users and practical outcomes for patients
POCT in the anticoagulant service
POCT in the anticoagulant service
Point-Of-Care Testing
Learning outcomes
Delegates attending this presentation will learn about managing patient INR self-testing, this will include:
- How to choose the appropriate equipment and patients.
- How to train patients to self-test safely.
- Documentation required for setting up INR self-testing services.
- Managing INR self-testing clinics and ongoing monitoring.
Sponsored by
Implementing and managing quality control in a multi-professional POCT team
Molecular advances in POCT testing
CEP in POCT – value of the qualification
Teaching and training of POCT for non-laboratory staff
Teaching and training of POCT for non-laboratory staff
Point-Of-Care Testing
Abstract
Knowledge and understanding of point of care testing (POCT) is now embedded into the undergraduate curriculum of all Biomedical Science degree programmes. However, most users of POCTs are non-laboratory staff and this includes professional registered nurses, for which most POC education occurs post-registration in variable and often ad-hoc ways, dependent on needs at the time.
Alongside device specific skills, there is an important unmet need to embed knowledge and understanding of POCT into relevant undergraduate healthcare professional programmes, to align to NHS long term plans for future workforce and use of technological advancement and support pathology services.
This session discusses a POCT curriculum introduced into the pre-registration undergraduate nursing degree programmes at the University of Sunderland, guided by regional POC Biomedical Science leads. It will discuss the project from conceptualisation to impact on the future POCT workforce, the quality of services provided and the Biomedical Scientists supporting it.
Sponsored by
Speakers
Michelle Payne
Quality Management
ISO15189 it’s all about the patient: What to expect from the new version
ISO15189 it’s all about the patient: What to expect from the new version
Quality Management
Learning outcomes
ISO15189 has been the mainstay of pathology accreditation globally and has entered a review period. The purpose of the standard is not actually as an accrediting document, but as a guide to the minimum requirements for competence and quality in medical laboratories.
This session will describe the progress made in the updated version, including why it is being updated as well as an indication on what to expect from the new version as well as the plans to support medical laboratories in the adopted and roll out. A good example of one of the changes is that point of care testing will now be part of the main standard once it is released.
Speakers
Dr David Ricketts DBMS CSci FIBMS
Maintaining a permanent state of readiness
Maintaining a permanent state of readiness
Quality Management
Abstract
Over the last few decades, development of quality management systems and accreditation within healthcare laboratories has moved forward with enormous strides, in part driven by the introduction of Quality Managers in the last iteration of the CPA standards, and then with the merger of CPA with UKAS, the transition of laboratories from CPA to ISO 15189:2012. Regular assessment to ensure conformity with ISO15189:2012 is paramount to keep the momentum and drive to maintain a quality management system that is fit for purpose, but this must also be tempered with an understanding of overall risk.
This session explores the considerations that the quality management teams within the laboratory service need to address in order to keep the quality management system operating effectively, such that it can react to change, respond to situations and extraordinary events (e.g. responses to pandemics), and also to allay stresses or fears of external assessment teams arriving at short notice.
Revision of the foundations of quality management systems and good practice will be outlined, as well as why we have to do what we do as a quality management team will also be presented.
Speakers
John Ringrow
ISO 15189 it’s all about the patient: What to expect from the new version
ISO 15189 it’s all about the patient: What to expect from the new version
Quality Management
Learning outcomes
ISO15189 has been the mainstay of pathology accreditation globally and has entered a review period. The purpose of the standard is not actually as an accrediting document, but as a guide to the minimum requirements for competence and quality in medical laboratories.
This session will describe the progress made in the updated version, including why it is being updated as well as an indication on what to expect from the new version as well as the plans to support medical laboratories in the adopted and roll out. A good example of one of the changes is that point of care testing will now be part of the main standard once it is released.
Speakers
Dr David Ricketts DBMS CSci FIBMS
Transfusion Science
Ensuring continuity of the blood supply to English hospitals during the COVID-19 pandemic
Introduction of a new blood component
Introduction of a new blood component
Transfusion Science
Learning outcomes
Delegates attending this presentation will gain an understanding of:
- The key drivers for change and the requirements for new blood components.
- The process for the introduction of a new component:
Phase 0 studies > SACBC review > SACIT component codes > Phase1 studies with/without a clinical trial.
Abstract
Blood has been used for the treatment of patients for more than 200 years and thankfully since Dr James Blundell carried out the first transfusion of human blood for the treatment of haemorrhage a lot has changed, making transfusions today significantly safer now, than they were in the 1800s.
What has been the biggest change in the field of transfusion over this time, is a subject of much debate, but is perhaps the move from the transfusion of fresh whole blood to the manufacture and storage of blood components. This has not only meant that blood is now available on demand but also that patients receive what they need (specific components), rather than what was available (whole blood).
The introduction of a new blood component in the 21st Century takes considerable effort and resources to ensure that they are of good quality, safe and effective in patients meeting the requirements of regulators. In the UK, the introduction of new blood components is standardised by the Guidelines for Blood Transfusion Services in the United Kingdom, or the red book but ultimately it is the Medicines and Healthcare products Regulatory Agency (MHRA) that is ultimately responsible for ensuring that blood components ‘work’ and are acceptably safe.
Speakers
Michael Wiltshire
Interactive Immunohaematology Case Studies
Blood group – Kidd
Blood group – Kidd
Transfusion Science
Learning outcomes
Delegates attending this presentation will:
- Increase their knowledge of the Kidd blood group system antibodies and antigens
- Learn about the functions of Kidd antigens
- Appreciate the relationship between Kidd blood group antibodies and transfusion reactions
Speakers
Martin Maley
International Blood Group Reference Laboratory (IBGRL) – fi nding new blood group antigens
Antibody workshop
Antibody workshop
Transfusion Science
Abstract
Join us at one of our lunchtime sessions where we will be hosting an antibody workshop. We will be looking at different types of antibodies, how to positively identify or eliminate any suspected clinically significant antibodies, whilst testing your knowledge and skills. Our aim to make the session fun and interactive, focusing on some top tips for solving those antibody mysteries.
Speakers
Jill Caulfield
Martin Maley
Column agglutination technology
Column agglutination technology
Transfusion Science
Learning outcomes
This presentation will give the delegate:
- An overview of Column Agglutination technology - how it works and how it is applied in the Transfusion laboratory
- An appreciation of the advantages and disadvantages of Column Agglutination technology
- Information on the future developments.
Speakers
Kerry Dowling
Virology
Pandemic response – from zero to 1 million tests a day. Innovation, lessons learned and legacy
Pandemic response and impact – economic impact on research and scientific development
The June Almeida COVID-19 laboratory set up: lessons learnt
The June Almeida COVID-19 laboratory set up: lessons learnt
Virology
Learning outcomes
Delegates attending this presentation will learn:
- Factors which need to be considered when setting up a laboratory.
- How approach implementation of testing protocols, procurement of reagents and equipment and staff recruitment and training in the context of increasing Covid-19 testing capacity during 2020 and 2021.
- Lessons learned after reflection and review on issues including quality management, recruitment, training, procurement.
Abstract
June Almeida made the discovery of coronavirus in 1964, working as a virologist in St Thomas’. Covid-19 is a new coronavirus in the same family first discovered by June, who helped pioneer virus imaging. The lab has been set up to help increase testing for patients, staff, and the general population.
Since the start of the COVID-19 pandemic, the Department of Health and Social Care has vastly expanded the nation’s testing capacity, by doubling the capacity of the NHS and Public Health England laboratories as well as setting up an entirely new nationwide network of testing sites and new Lighthouse Laboratories and partner laboratories to process COVID-19 swab samples.
The June Almeida Initiative (JAL) is a high throughput facility, set up as a collaboration between King’s College London and Viapath, and is dedicated to providing COVID-19 pillar two testing for the National Testing Programme.
Looking back at the set up the June Almeida Lab, Waterloo, London, set up in response to increase Covid-19 testing capacity for pillar 11 samples. Lessons learned to include, what has worked well and areas of improvement. On issues surrounding Quality, recruitment, training, procurement etc.
Speakers
Bamidele Farinre FIBMS, MSc, BSc
Hepatitis C - elimination of a treatable pandemic. Where are we now?
Hepatitis C - elimination of a treatable pandemic. Where are we now?
Virology
Learning outcomes
Delegates will learn about the:
- Current management of hepatitis C
- Current diagnostic pathways
- Novel ways of diagnosing at risk individuals from marginalised communities
- What part can the laboratory play in achieving elimination
- Use and deployment of point of care testing in Hepatitis C
Abstract
In 2016, the WHO Global Health Sector Strategy (GHSS) on viral hepatitis provided the initial roadmap for the elimination of viral hepatitis as a public health problem by 2030. Since then countries have developed programs designed to achieve elimination. There are several challenges that health providers face in delivering elimination including (broadly) identifying and carrying out testing of at risk populations, linkage to care, compliance and completion of treatment, obtaining test of cure, proving successful elimination and finally maintaining that status.
In this talk I will discuss the challenges experienced both at ground level and from an organisational level and discuss novel strategies developed to help achieve elimination.
Speakers
Dr Brendan Healy
Update to enterovirus infections
Microbiological safety of organs for transplantation – assessing the risk–benefit balance
Transplantation – virology clinical case studies
Transplantation – virology clinical case studies
Virology
Learning outcomes
Through the discussion of clinical case studies delegates will:
- Gain insight into virology infections in transplant patients.
- Understand the role of laboratory investigations in the clinical management of transplant patients.
- Learn about specific clinical cases at a specialist referral transplant hospital.
Abstract
A series of cases will be used to illustrate the range of viral infections that have affected cardiothoracic transplant recipients in our centre over the last few years. Rather than focusing on respiratory pathogens such as SARS-CoV2, we will look at less common viral infections such as Parvovirus B19 and Human Herpes Virus 8 that may affect immunosuppressed individuals. The cases will explore challenges in diagnosis, laboratory investigation and management.
Speakers
Dr Stephen Pettit
Vaccine hesitancy – causes and effects
Vaccine hesitancy – causes and effects
Virology
Abstract
Vaccine hesitancy has been described since the time of Edward Jenner but has become much more high profile over past 18 months. The causes of hesitancy are multifactorial and complex and a better understanding will allow the development of better support for vaccine uptake.
In this presentation I will consider different causes that include the 3C model described by the World Health Organisation as well as socio-political reasons. This will be followed by a discussion of the advantages and disadvantages of the measures that can be taken to support vaccine uptake.
Speakers
Dr Rajeka Lazarus
Vaccine development and production
Vaccine development and production
Virology
Abstract
Prior to the Covid pandemic the use of viral vectors for either therapeutic or vaccination uses had been largely focused on the treatment of rare diseases including Zolgensma for treatment of spinal muscular atrophy (SMA) the most expensive drug produced to date at $2.1m/dose, and the only licenced vaccine was against Ebola in December 2019. However despite the limited number of licenced products the use of viral vectors for gene therapy has attracted multibillion dollar investments into both product and manufacturing development. On the back of these investments has come the successful development of Covid vaccines by the Jenner Institute in Oxford, Janssen Biologics and the Gamaleya National Research Centre in Moscow amongst others, and production of over 2bn does of these vaccines which have now become a critical part in the global vaccination strategies against Covid 19.
This presentation will look at the background of the development and use of viral vaccines as both therapeutic entities and as vaccines, the associated manufacturing process and the challenges in producing these products at industrial scale including the associated analytics required to support their clinical use.
Speakers
Tony Hitchcock
