The second of a the motivation behind three-part series on...

FOR BIOMEDICALSCIENTISTSWorking smarter to deliver more services

BIOMEDICAL SCIENTISTTHE

THEBIOMEDICALSCIENTIST.NET JANUARY 2018

THE BIOMEDICAL SCIEN

TIST JAN

UARY 2018

CLINICAL CHEMISTRY

CARDIAC MARKERSThe second of a three-part series on pioneering work: p.30

GENOMICS PROJECT

100,000 GENOMES A Professor of Molecular Pathology casts a critical eye: p.22

ONE-TO-ONE

HARVEY‘S GANGMalcolm Robinson on the motivation behind his charity: p.16

P01_IBMS January18_Cover_v4gh.indd 7 14/12/2017 17:08

Explore the future

The Yumizen effect !

HORIBA Medical presents “Yumizen”the new brand for all analysers and solutions including, Haematology, Clinical Chemistry, Coagulation and Care Products.

Today, choose Yumizen and you will stay zen.

Solution for Laboratories

Follow us onwww.horiba.com/medical

Stay zen ...

[email protected]

01604 542500

BIO.01.18.002.indd 2 13/12/2017 16:44

EDITORIAL5 An important consultation on

regulation is in the pipeline

NEWS7 News in numbers

8 Research, funding, developments and clinical updates

13 Product advances and launches

OPINION14 The big question: Will

pathology lab consolidation lead to increased POCT?

16 One-to-one: Malcolm Robinson, co-founder of charity Harvey’s Gang, discusses empowering children with lab tours

SCIENCE18 Advanced roles for biomedical

scientists: Can smarter services be provided through embracing collaborative working?

22 100,000 genomes: Professor of Molecular Pathology Gerry Thomas casts a critical eye over the project

26 Supporting research: A look at six projects supported by IBMS research grants

30 The big story: Second of three articles on cardiac markers, in this series analysing landmark moments in clinical chemistry

CONTENTS34 Future generations: The work

that is being undertaken at the UK Biobank

ADVICE36 How to... become a

STEM Ambassador

38 Time to refl ect: How far has CPD come in the last 25 years?

MY IBMS40 Institute news: The latest

from the IBMS

43 CPD update: Training courses, events and activities

45 Journal-based learning: CPD exercises based on journal articles

46 Here to help: Jocelyn Pryce answers common queries

MY LAB50 Ruth Riisnaes gives a guided

tour of her Histopathology lab at the Institute of Cancer Research in Sutton

16

26

22

JANUARY 2018IBMS.ORG

18

COVERFEATURE

RECRUITMENT ADVERTISINGShamil Bhoyroo

ISSN 1352- 7673© 2018 Institute of Biomedical Science

PRINTED BYHenry Stone LtdBanbury, Oxon,OX16 3ES

Neither the publisher nor the IBMS is able to take responsibility for any views or opinions expressed in this publication. Readers are advised that while the contents are believed to be accurate, correct and complete, no reliance should be placed upon its contents being applicable to any particular circumstances. Any advice or information published is done so without the Institute, its servants or agents and any contributors having liability in respect of its content.

PUBLISHED BYRedactive Publishing LtdLevel 5, 78 Chamber Street, London, E1 8BL+44 (0)20 7880 6200 redactive.co.uk

DISPLAY ADVERTISINGJames Rundle-Brown

EDITORRob DabrowskiSENIOR DESIGNERSGary Hill, Sarah AuldPICTURE EDITORAkin FalopePUBLISHING DIRECTORAaron NichollsPRODUCTIONRachel Young

3THE BIOMEDICALSCIENTIST

JANUARY 2018Contents

P03_IBMS January18_Contents_v1gh.indd 3 15/12/2017 14:09

Telephone: 0118 944 4100

BIO.01.18.004.indd 4 13/12/2017 16:47

Adecision made on the basis of

ignorance, cheap economics,

or for political expediency is

unlikely to be a good decision.

It is for this reason that I

want to make you aware of

something of profound

signifi cance to our profession

that has the potential to change the

regulatory status of biomedical scientists.

I am referring to the current Department

of Health consultation “Promoting

professionalism, reforming regulation”.

This consultation is seeking views on

proposals for far-reaching reforms to the

regulation of UK health professionals and

the statutory bodies through which the

regulatory process is delivered. The aim is

to “simplify, streamline and modernise”

and reduce the current nine regulators

down to three or four. In addition, it is

seeking views on proposals for regulation

to be related to risk, thereby bringing

some professions into statutory

regulation that are currently absent and

to potentially de-regulate others in favour

of some form of voluntary regulation,

where this is felt to provide a more

proportionate level of patient protection.

I feel this is a consultation that has

considerable merit in many of its

proposals. However, I do not want to see

the regulatory future of biomedical

scientists determined by a system that

has the potential to under-recognise the

scope of our profession. I worry that our

signifi cance in healthcare delivery could

be under-recognised by assessment

REGULATIONMembers are urged to read a regulation consultation and safeguard the future of the profession.

regulated by statute. Our roles and title

have evolved considerably in the

intervening time in way that has

increased our level of responsibility and,

therefore, our potential risk.

Words cannot adequately convey the

strength of my feeling on the importance

of this consultation and the impact its

outcome could have on us. I urge everyone

to ensure that the regulatory future of our

profession is determined from an

informed perspective by responding to

this consultation. We cannot allow the

“back room service” misconception to

determine our regulatory future.

criteria that do not adequately

accommodate us and are more refl ective

of the therapy-orientated professions. I

worry that this could be used to change

the regulatory status of biomedical

scientists to deliver some notional

political objective. It is for this reason that

I am appealing to our profession to read

this consultation and to respond. I want

to ensure that the outcome will enable

the scope and impact that biomedical

scientists have on the patient care

pathways to be fully recognised.

We have 22,000 registrants, whose roles

include reporting, analysis, interpretation

of results, and providing expert input to

multi-disciplinary team meetings in the

course of handling 150 million samples

each year. I think there is a considerable

risk potential, as did the powers that

decreed almost 60 years ago that medical

laboratory technicians should be Sarah MayDeputy Chief Executive

Institute of Biomedical Science is the professional body for the biomedical science profession.

INSTITUTE OF BIOMEDICAL SCIENCE12 Coldbath SquareLondon, EC1R 5HLUnited Kingdom+44 (0)20 7713 0214+44 (0)20 7837 9658Email: [email protected]: www.ibms.org

FOLLOW THE INSTITUTE

Join us on facebook.com/

biomedicalscience

Follow us on Twitter@BiomedScience

Find us on Linkedin

PRESIDENTIan Sturdgess CSci FIBMS

CHIEF EXECUTIVEJill Rodney

DEPUTY CHIEF EXECUTIVESarah May CSci FIBMS

EXECUTIVE HEAD OF EDUCATIONAlan Wainwright CSci FIBMS

EXECUTIVE HEAD OF MARKETING AND MEMBERSHIPLynda Rigby

EDUCATION AND [email protected]

[email protected]

[email protected]

CHARTERED [email protected]


EDITORIALSarah May

P05_IBMS January18_Editorial_v1gh.indd 5 15/12/2017 14:14

For more information please contact us on:

Tel: 01932 581200Email: [email protected]: www.clinisys.co.uk

Is your pathology service empowered to manage tomorrow’s challenges?

We care about your service......pathology, it’s in our DNA

BIO.01.18.006.indd 6 13/12/2017 16:46

CONTRACEPTIVE STUDYNew research shows a20% higher risk of breast canceramong women who were currently using or had recently used hormonal contraceptives than among those who had never used them.The study included 1.8 million women in Denmark who were followed up for nearly11 years on averageAmong women taking the pill for fi ve years,the study suggests, there would be

an extra one case for every 1,500 women.

Exposure to higher levels of damaging PM2.5 particlescaused by traffi c can mean a

6% increasein risk of giving birth to ababy with low birthweight.The figure comes from a study by scientists from Imperial College London, King’s College and St George’s, published in the British Medical Journal.

WOMENBESTCamden

WORSTWestDunbartonshire

MEN BESTChelsea

& Kensington

WORSTGlasgow

City

86.8

78.8

83.7

73.4


NEWSNews in numbers

SCIENCE NEWS

IN NUMBERS

UK LIFE EXPECTANCYThe Offi ce for National Statistics has released the latest fi gures for life expectancy in all regions across the UK

120%The increase in the

patients who have waited more than four hours at

A&E in the last 12 months in the UK. By comparison, the number of visits has

risen by just over 7%.

CHILDHOOD OBESITYA study of nearly 12,000 UK children

25%were overweight orobese at age seven,rising to

35% at 11Rates of excessweight variedby nation:

35%in both Scotland and England

40%of young people in Northern Ireland

38%in Wales

P07 IBMS Jan18_News In Numbers_v1sa.indd 7 18/12/2017 12:01

8 THE BIOMEDICAL SCIENTIST

NEWSScience

The fi rst drug targeting the

cause of Huntington’s disease

was safe and well-tolerated in

its fi rst human trial.

It also successfully lowered

the level of the harmful

huntingtin protein in the

nervous system, results show.

Over a decade in pre-clinical

development, this fi rst human

trial of huntingtin-lowering

drug began in late 2015, led by

Professor Sarah Tabrizi from

University College London.

The trial involved 46 patients

with early Huntington’s disease

at nine study centres in the UK,

Germany and Canada.

Each patient received four

doses of either IONIS-HTTRx or

placebo, given by injection into

the spinal fl uid to enable it to

reach the brain.

As the phase 1/2a trial

progressed, the dose of IONIS-

HTTRx was increased several

times according to the

ascending-dose trial design.

Sarah Tabrizi said: “The

results of this trial are of

ground-breaking importance for

Huntington’s disease patients

and families.

“For the fi rst time a drug has

lowered the level of the toxic

disease-causing protein in the

nervous system, and the drug

was safe and well-tolerated.

“The key now is to move

quickly to a larger trial to test

whether the drug slows

disease progression.”

The results of the trial and

plans for the ongoing IONIS-

HTTRx programme will be

presented in detail at

forthcoming scientifi c meetings

and are being prepared for

peer-reviewed publication.

bit.ly/BS_JanNews1

MICROBIAL DISEASES

Eff ective future antibioticsTuberculosis and other life-threatening microbial

diseases could be more eff ectively tackled with future

drugs. The claim comes in new research into an old

antibiotic by the Francis Crick Institute and the

University of Warwick.

Led by Group Leader at the Crick, Luiz Pedro Carvalho,

and Professor David Roper at the university, the results

have been published in Nature Communications.

Their work reveals a deeper understanding of how the

antibiotic D-cycloserineuniquely works at a molecular

level. This could lead to more eff ective future antibiotics,

which are desperately needed to fi ght increasingly

drug-resistant and deadly bacteria.

D-cycloserine is an old antibiotic drug that is eff ective

against many microbial diseases, such as tuberculosis,

but is often used as a second line treatment, because of

some adverse side-eff ects.

The researchers have discovered that it acts chemically

in very diff erent ways on multiple bacterial targets –

possibly the only antibiotic in the world to do so.

go.nature.com/2l018I3

People aged 75 years and older are under-represented in blood cancer clinical trials, according to a comprehensive analysis of clinical trial.

Researchers from the US Food and Drug Administration (FDA) found signifi cant gaps in participation among those aged 75 and older, when considered against the incidence of these malignancies in this age group.

The research was presented

at the 59th American Society of Haematology Annual Meeting and Exposition in Atlanta in December.

The researchers found that, by comparison, adults under 65 years tend to be overly represented, despite the fact that a majority of blood cancers are most frequently diagnosed in those over 65 years of age.

Lead study author Bindu Kanapuru said: “Until now,

there has been very little information about the enrolment of adults with haematologic cancers. Based on our fi ndings, the occurrence of cancer is much higher in adults over 75 years of age compared with the proportion of patients in this age group who enrol in clinical trials.

“With so few patients aged 75 or older enrolled in clinical trials, critical information on the safety and effectiveness of new therapies in this age group is greatly lacking.”

bit.ly/BS_JanNews2

CLINICAL TRAILS

BLOOD CANCER TRIAL PARTICIPANTS

HUMAN TRIAL

HUNTINGTON’SDISEASE BREAKTHROUGH

IMAG

ES: I

STOC

K/SH

UTTE

RSTO

CK/S

CIEN

CEPH

OTO

LIBR

ARY/

ALAM

Y

SCIENCE

NEWS

P08-11 IBMS Jan18_News_News Tech_v1sa.indd 8 15/12/2017 14:15


NEWSScience

WH

AT’S

HO

T A

ND

WH

AT’S

NO

T

Health Education England (HEE) has published a long-awaited

plan for how to tackle staffi ng issues in NHS cancer services.

It acknowledges that more staff are needed, including

pathologists, radiologists, radiographers and endoscopists.

The plans were unveiled at the Britain Against Cancer

Conference by Secretary of State for Health, Jeremy Hunt and

promise over 5000 extra staff by 2021.

They focus on two key groups of NHS staff : those who diagnose

cancer and those who treat it.

The plans includes 668 extra clinical radiologists, 316 extra

gastroenterologists, 94 extra histopathologists, 2227 extra

diagnostic radiographers.

They also include 200 existing health professionals trained to

do endoscopies and 300 radiographers trained to interpret scans.

The report’s executive summary says: “The prevalence of

cancer is forecast to increase, and scientifi c and technological

innovations off er the potential to transform our ability to

prevent, diagnose, treat and care for people aff ected.

“We know that some key parts of the workforce are under

pressure now and unless we take action then we may not

have enough staff with the right skills to deliver the Cancer

Taskforce Strategy.”

A longer-term approach will be developed alongside HEE’s

wider workforce strategy, which is due to be published in the

summer of 2018.

bit.ly/BS_JanNews3

A London hospital trust has been placed in special measures due to funding problems.

NHS Improvement announced the sanction against King’s College Hospital NHS Foundation Trust the day after chairman Lord Kerslake resigned, criticising the “unrealistic” approach to NHS fi nances.

The regulator said a £92m defi cit is now forecast this year – more than twice the original fi gure £38m.

Chief Executive Ian Dalton said the position was “not acceptable” and “has deteriorated very seriously over recent months”.

King’s College Hospital released a statement, which said Lord Kerslake has led King’s “through a challenging period which has also seen some notable successes [...] and some of the highest patient outcomes of any trust in the UK”.

FUNDING

TRUST IN SPECIAL MEASURES

HOT

PIZZAAcademy of Medical Royal Colleges guidance to winter pressures says: “Organising a pizza delivery for hard-pressed doctors and nurses can buy an awful lot of goodwill.”

NOT

FOOTBALLAlmost a third of

professional footballers may suffer from exercise-

induced asthma, according to new research.

HOT

EDUCATIONA BMJ study gives

further weight to the argument that education

is associated with a reduced risk of

Alzheimer’s disease.

NOT

FLOUR The US Food and Drug Administration has warned against eating raw dough, batter or cake mixture because of the risk of E. coli from fl our.

HOT

RETIREMENT When people retire, their duration of sleep increases an d sleeping diffi culties decrease, a new study shows.

NOT

BALDNESSEarly baldness is a higher

heart disease risk factor than obesity, according to a

European Society of Cardiology’s study.

CANCER CARE

NHS workforceboost planned

W

f

NOT

BALDNESSalddness is a higher disease risk factor

sityy, according to a uroopean Society of Carrdiology’s study.


SEE YOU IN

2018

26th International Trade Fair for Laboratory Technology, Analysis, Biotechnology and analytica conferencewww.analytica.de

April 10–13, 2018 I analytica exhibition April 10–12, 2018 I analytica conference

The World’s No. 1The largest laboratory trade fair in the world features the entire range of products and solutions for industry and research laboratories.

The first-rate scientific analytica conference, world premieres, the latest product developments, unique Live Labs, special shows, forums and Focus Days await you!

Contact: Pattern Limited, Tel. +44 20 3375 8230, [email protected]

F3

U2

TU RE4

GL 03

B2

AL2

NE3

TW O4

RK

BIO.01.18.010.indd 10 13/12/2017 16:51


NEWSScience

UNDER THE MICROSCOPEThis month:the Mozart eff ectWhat is the Mozart effect?It is the theory that listening to Mozart’s music can result in a short-term improvement on the performance of specifi c mental tasks, namely, those involving spatial-temporal reasoning. It is the reason that some expectant

parents play classical music to their unborn babies.

What kind of tasks?Spatial-temporal reasoning is the cognitive ability to picture a spatial pattern and understand how items or pieces can fi t into that space.

It is used in problem-solving and organisational skills.

What is the evidence?While some research supports a link between prenatal sound

exposure and improved brain function, scientists had not,

until now, identifi ed any structures responsible for this link in the developing brain.

What do you mean “until now”?A new study from University of Maryland School of Medicine scientists claims to be the fi rst to identify a mechanism that could explain an early link between sound input and cognitive function. Working with an animal model, the researchers found that a type of cell in the brain’s primary processing area during early development, long

thought to have no role in transmitting sensory information, may conduct such signals after all.

What are the implications?By identifying a source of early sensory nerve signals, the current study could lead to new ways to diagnose cognitive defi cits that emerge early in development.

So what now?The next step is to begin studying in more detail how subplate neurons affect brain development.

New research shows that giving a

stronger single-dose of a live oral cholera

vaccine could be an eff ective tool in

controlling outbreaks more quickly.

Each year there are more than three

million cases of cholera worldwide.

The standard regimen for protecting

against cholera with existing non-living

oral cholera vaccines includes

administering two doses over a two-

week period.

The latest University of Maryland

School of Medicine (UMSOM) research

was conducted in Mali and included

150 participants.

Researchers assessed the eff ectiveness

(ability to stimulate vibriocidal antibody,

an immune response that correlates with

protection) of a single high-dose of live

cholera vaccine CVD 103-HgR.

This was developed by UMSOM’s

Center for Vaccine Development and

licensed and manufactured by PaxVax,

versus the standard two-dose killed

vaccine approach.

While the two-dose inactivated vaccine

approach has been used and made

available for protecting against seasonal

increases in cholera cases, a stronger

single-dose live oral vaccine approach

may be a more eff ective way to rapidly

protect individuals in big outbreaks, the

research found.

The work has been published in Clinical

and Vaccine Immunology.

bit.ly/BS_JanNews4

Patients in London now have the option of booking GP appointments for evenings, weekends and bank holidays.

An extra 75,000 routine appointments a month will be available in the capital, as part of an NHS England scheme.

The £26m initiative is hoped to reduce pressures on stretched A&E departments.

The British Medical Association said it is “encouraged” that the plans cover extra staffi ng expenses, but was worried by doctors’ rising workloads.

London is the fi rst area to offer the extended service.

If surgeries are fully booked or closed when registered patients call up, then they will be able to book with other nearby practices.

GPs will have access to electronic patient records, so that patients do not have to be seen by their regular doctor.

NHS England’s Prof Jane Cummings said: “Appointments at evenings and weekends will help manage pressures on urgent and emergency care services, especially over the busy winter period.”

NHS ENGLAND

EVENING AND WEEKEND GP APPOINTMENTS

IMAG

ES: G

ETTY

/SHU

TTER

STOC

K

CHOLERA VACCINE

SINGLE DOSE MORE EFFECTIVE?


Phone: +44 (0)1235 431 390Email: [email protected]

www.oxfordbiosystems.com

Following the success of the original ImmuView test for Streptococcus pneumoniae and Legionella pneumophila Urinary an gens, SSI Diagnos ca have announced the availability of new products in the ImmuView range.

IMMUVIEW®

• ImmuView Streptococcus pneumoniae For Urine and CSF samples High sensi vity Detec on of all pneumococcal serotypes

• ImmuView Legionella For Urine samples L. pneumophila and L. longbeachae Detects all serovars of L. pneumophila sg 1

NEW for 2018!

The new ImmuView Reader is a qualita ve reader designed for the growing family of ImmuView rapid tests. It provides fast objec ve results enabling clinicians to ini ate the correct an bio c treatment.

IVD solutions through partnership

R

Streamlining Urine Microbiology

Contact MAST® today for more information [email protected] www.mastgrp.com

BIO.01.18.012.indd 12 13/12/2017 16:56


NEWSTechnology

TECH

NEWS

FAST TRACK DIAGNOSTICS

NEW INTERPRETATION SOFTWARE

The government has announced that it is in discussion with Roche Diagnostics and partners to support the mainstream implementation of Digital Pathology services across the NHS.

This could see the trialling of an innovative approach to cancer testing that includes whole slide scanners, image management software and image analysis algorithms.

It is hoped the partnership will lead to greater effi ciency in tissue pathology services and will help deliver faster and more accurate test results across the NHS.

Geoff Twist, Managing Director of Roche Diagnostics UK & Ireland, said: “We are proud to be working with the government at an exciting time for the future of our NHS.”

roche.co.uk

Fast Track Diagnostics (FTD), one of the leading global suppliers of syndromic real-time Polymerase chain reaction (PCR) multiplexing kits, has been partnering for several months with UgenTec NV – a medical device software company that develops artifi cially intelligent PCR

interpretation software.From now on, all FTD

kits will be available on UgenTec’s FastFinder, a fully automated real-time PCR interpretation platform.

This module will allow technicians to fully automate and standardise analysis of FTD kits with Applied Biosystems 7500

and LightCycler 480 PCR platforms.

The software will be developed for nearly all other clinical PCR machines by mid-2018 and rolled out to users over that period.

The software is developed under ISO13485 standards and is CE IVD-certifi ed.

fast-trackdiagnostics.com

MARKET REPORT

LAB AUTOMATION GROWTH EXPECTED

ROCHE DIAGNOSTICS

DIGITAL PATHOLOGY FOR NHS

The lab automation market is forecast to reach $5.20bn by 2022 from $4.06bn in 2017.

This is expected to be driven by miniaturisation, high demand for lab automation equipment in drug discovery and clinical diagnostics, higher reproducibility and accuracy, and large workforce demand and supply gap.

The genomics solutions segment is expected to grow at the highest rate during this period.

The rising need for high-throughput genomics in research labs and an increase in genetic testing in diagnostic labs, along with better accuracy and reproducibility, is contributing to the growth of lab automation solutions in genomics.

reportsnreports.com IMAG

E: IS

TOCK

www.cityassays.org.uk

[email protected] 507 5348

www.cityassays.org.uk Address for samples:

Clinical Biochemistry, City HospitalDudley Rd, Birmingham B18 7QH

Enhanced OralFluid Drugs ofAbuse ServiceLC-MS/MS techniques• Low limits of detection

• Salivary test packs available

• Detection of newer ‘street’ drugs including4-MEC (NRG-2), meow meow (mephedrone),bath salts (MDVP) and more...

Price: £25. Oral fluid collection kit: £7 each Turn round target: 1-2 working days

SWBH Path TV News

SWBH Pathology

@Cityassays

Downlo

ad u

ser i

nfo

leaf

let fr

omour

web

site

P13 IBMS Jan18_News_News Tech_v1sa (advert).indd 13 15/12/2017 14:19

THE BIG QUESTIONTHIS MONTH WE ASK

Will pathology lab consolidation lead to increased point of care testing (POCT)?


OPINIONThe big question

P14-15 IBMS Jan18_Big Question_v1sa.indd 14 15/12/2017 14:19

Charlie HoustonLaboratory Sector Manager

NHS Greater Glasgow and Clyde

N o, in my opinion pathology

consolidation will not lead to

increased POCT.

In NHS Greater Glasgow and

Clyde over the past 10 years we have

undergone a large amount of

organisational change, which has meant

a fair amount of consolidation of

laboratory medicine with hub and spoke

models being implemented across a large

geographical area and there has been no

signifi cant increase in POCT due to this.

POCT tends to be signifi cantly more

expensive than traditional laboratory

methods. For example HbA1c analysed by

HPLC in the laboratory is approximately

£0.20 per test, whereas when analysed

by a POCT boronate affi nity assay it is

approximately 10 times more expensive.

If POCT were cheaper, perhaps there

would be an increase, however, cost per

test is not the only cost involved.

The evidence on cost eff ectiveness and

clinical eff ectiveness of POCT is limited

and more work needs to be done on this.

We need to have better information on

the resource utilisation across all

elements of the care pathway, and how

that can bring economic benefi t to the

stakeholders. If POCT is introduced, there

need to be clear business cases with clear

benefi ts identifi ed. If the care pathway for

patients does not change with the

introduction of POCT, if implemented in

consolidation, then the perceived benefi ts

of POCT, whether in the spoke, hub or the

community, will not be realised.

Sarah Glover POCT Clinical Lead

Harrogate and District NHS Foundation Trust

P athology consolidation will no

doubt increase the POCT demand,

as demonstrated by rationalisation

projects undertaken recently, for

example, the service redesign carried out

by Northumbria Healthcare NHS

Foundation Trust. It is essential we

consider whether POCT is the most

appropriate service model to support

clinically eff ective care pathways for

patients. We have a responsibility to

ensure it is clinically- and cost-eff ective.

Jamie WestDeputy Head Biomedical Scientist

North West Anglia NHS Foundation Trust

T he recently proposed pathology

reconfi guration plan, set out by

NHS Improvement, involves the

formation of a series of 29 networks

across England, with non-urgent work

centralised at “hub” laboratories. This is

based on the recommendations of the

Carter report into NHS Pathology Services

in England, which identifi ed cost savings

of 10% to 20%, which could be achieved by

laboratory consolidation of services.

POCT can add great value to patient

care. It has huge advantages in being able

to provide results quickly during a patient

care episode, which can support early

interventions in acute care and allow

immediate discussions with patients

about their care in non-acute settings.

The cost per test is generally higher than

tests undertaken in a medical laboratory,

and the integration of POCT into quality

management systems and clinical

governance systems is variable. It is also

limited in the repertoire of tests it can

provide by the technology available.

NHS Impovement has advised that

“access to pathology services won’t

change – core services will remain in

hospital labs”, reaffi rming the importance

of on-site pathology for hospitals that

off er acute services. The question then

remains as to whether POCT will be used

in non-acute settings to support clinical

services, and the answer should be clear

– we all have a responsibility to ensure

that the quality of laboratory services are

maintained so POCT is implemented

where an evidence based improvement

in patient care can be demonstrated.

We must ensure quality and patient safety are at the heart of our diagnostic and clinical services

IMAG

E: S

UPER

STOC

K15THE BIOMEDICAL

SCIENTISTOPINION

The big question

P14-15 IBMS Jan18_Big Question_v1sa.indd 15 15/12/2017 14:19

IMAG

E: IS

TOCK


OPINIONOne-to-one

Malcolm Robinson is a

man on a mission.

Through his work for

the charity Harvey’s

Gang, he has helped

more than 200 children

get a behind-the-scenes

laboratory tour, enabling

them to understand where their blood

samples go, and how they are processed.

Something “so simple” he says, has

not only empowered these children,

answering their questions, allaying their

fears and even helping some overcome

needle phobias, but also improved the

working lives of his colleagues, by

allowing them to connect with the

patients they help care for.

Having seen for himself how powerful

the experience can be, he wants it to

become part of the care pathway for every

child. Malcolm, who is Blood Transfusion

Manager at the Western Sussex Hospitals

NHS Trust, says: “I have had a consultant

paediatrician request a Harvey’s Gang

tour as a treatment for their patient

– that’s really something. That’s the

ultimate goal, that’s why we’ve set up

the charity – we want to be involved in

improving patients’ healthcare.”

Harvey Buster BaldwinMalcolm’s inspiration was, and is, Harvey

Buster Baldwin, who passed away on 6

October 2014, aged just eight.

Harvey became ill with acute myeloid

leukaemia when he was six years old,

necessitating a raft of blood tests and

transfusions as part of his treatment

at Worthing Hospital, East Sussex.

“He wanted to know where they

went, what happened to them, and

who did it – he was a curious young

lad,” explains Malcolm.

To answer his questions, a laboratory

visit was arranged. Malcolm found him

the smallest lab coat he could, which still

hung down to his ankles, a goody bag, and

even a cardboard ‘trainee biomedical

scientist’ security pass. He gave him a

tour, and showed him how to process

his own blood.

Malcolm recalls Harvey sitting in

front of the blood grouping machine

throughout the full 33-minute process,

“watching it and asking questions all

the way through”.

Harvey continued his treatment and

received a bone marrow transplant from

his elder brother – but sadly his body

rejected it. It was then a matter of

palliative care.

Only after his death did Malcom truly

appreciate the impact that visit had on him.

He recalls the emotional moment,

when, among the special images from

Harvey’s life being shown on a screen at

his funeral, he saw a photo, taken on that

day, of him and Harvey side-by-side in

front of the machine.

“I was a complete wreck,” says Malcolm,

who later learned from Harvey’s parents

what the tour had meant to their son.

When a consultant paediatrician said he

had seven more critically ill children who

wanted a tour too, Malcolm got to work.

Malcolm Robinson, co-founder of Harvey’s Gang, tells how allowing children into pathology labs is transforming their healthcare experiences – and those of the staff who meet them.

“WE SEE PEOPLE,NOT BLOOD TUBES”

P16-17 IBMS Jan18_OneToOne_v2gh.indd 16 18/12/2017 15:47


OPINIONOne-to-one

Harvey’s Gang Within two weeks, Harvey’s Gang was

launched. The fi rst tour took place 11

days after Harvey’s funeral, and three

years on, it is in 22 trusts, with 28 more

expected to go live by the end of the year,

and many more interested across the UK

– and beyond.

Malcolm and his colleagues were

presented with the Kate Granger 2015

Team Award for Compassionate Care,

and Malcolm won the 2016 Chief

Scientifi c Offi cer’s Award for Patient

and Public Participation.

Harvey’s Gang was mentioned fi ve

times and praised as “exemplary” in the

trust’s 2016 ‘outstanding’ CQC report.

“The positive response is just

incredible,” says Malcolm. “And it’s

something so simple.”

Indeed, he has made it as simple as

possible for others to follow in his

footsteps, producing start-up kits for

new sites, complete with child-sized lab

coats, certifi cates, goody bags, and even

sample risk assessments and application

forms for parents.

And he is sharing the idea as widely as

possible, presenting at meetings and

conferences and to individual trusts. He

also still gives tours, and is chairman of

trustees for the charity.

“Yes, it does take up my time, but I get

so much positivity back,” says Malcolm.

“When another place starts up and you

see the pictures – the smiles on the

children’s faces – you take pride in that.

“The children will remember you and

the answers you give them for a long

time,” he says. “We talk at their level – not

down to them – and that empowers

them. They have less questions for the

doctors and nurses, because the scientists

have answered them. And they come back

with some questions of their own, which

have the doctors perplexed, wondering

‘how does a child know all this stuff ?’

“Hopefully in a generation we might

have lots more biomedical scientists

coming into our profession as a result.”

Making the profession betterNot only does Harvey’s Gang improve

children’s experiences, but in meeting

them, staff are given a boost, believes

Malcolm, who now sees less sickness

and stress, and improved morale and

job satisfaction in those around him.

“We have all got woes,” he says.

“We all know we haven’t had pay

rises that are actually worth

anything in quite some time,

the bills are going up – life is

tough. But these children have

all their woes, and they come in

with smiles on their faces – that

really puts you in your place.

“I think Harvey’s gang has helped us

to come together as a team. The team

camaraderie is so much better – not

just among the biomedical scientists,

but the MLAs too. All the staff really

go that extra mile for each other and

for the patients.

“Anybody that starts doing this,

and starts hearing the stories, gets so

moved by it, that it builds on their

compassion – it makes them a better

person, a better manager. They learn

to listen a bit more, to respond in a

better way to their staff and colleagues

and their patients.”

He adds: “It’s making our profession

better. It starts breaking down the

walls of the laboratories, so people

realise there are humans in there

doing their damndest to produce

the best possible service for our

patients – it’s not just about budgets

and turnaround times.”

And, while he and his colleagues

used to “complain bitterly” when

imperfect samples came in, having

“no idea of the story behind the

sample or the trauma a young person

may have had to go through to get it,”

now they do.

“Instead of seeing blood tubes we

now see people – we recognise the

names, we are now giving better quality

care,” he adds.

Harvey’s legacy“I think Harvey would be amazed,”

says Malcolm. “His parents are trustees

of the charity, and they are blown away

at where this has gone in the name of

their son.

“He aff ected me, and we have

aff ected everybody else. It’s all

come from that one very

inquisitive lad singing our

positive praises when he went

back to the ward – that has

made a huge diff erence, and

will continue to do so.”

ALISON KYDD'S STORYDuring her treatment for bone cancer, my daughter Caitlin, 13, was intrigued about what happened to the blood samples they took and how they worked out the important numbers that came back. So she was invited to tour the labs at William Harvey Hospital in Ashford.

It was very helpful to Caitlin to see the whole process completed for every blood sample, throat swabs and blood cultures that she had taken. This ‘mystery’ of what happened has now been explained, and has helped her to make sense of and understand the importance of that part of her treatment.

Caitlin has her sights set on becoming a Research Scientist so this was an invaluable experience. Just being in the labs, observing what goes on and encountering the lab environment was so benefi cial for her. And she loved every minute. All the way around the tour she was itching to join in and start working.

The tour increased her appetite for science and has given her encouragement to continue to reach for her goals and look to the future, a very important mindset to have.

We are touched and humbled for Caitlin to be a member of Harvey’s Gang. It is very close to our hearts, as she shared time in hospital with Harvey.

P16-17 IBMS Jan18_OneToOne_v2gh.indd 17 15/12/2017 14:20

FOR BIOMEDICALSCIENTISTSSpecialist Biomedical Scientist Shahid Nazir Muhammad looks at how smarter services can be provided through embracing collaborative working.

Healthcare access and delivery

face signifi cant global and

local challenges – funding

restraints in healthcare

practices mean that there

is now more need than ever

to ensure technology is

available to better integrate

services, to allow swifter delivery of

clinical and biomedical-centred care for

patients in community.

To ensure better health of the general

population through smarter working,

there is a need to highlight the scientist’s

role in wider community and this can be

achieved through better use of technology

and collaborative working.

Scientists have traditionally been

perceived (if at all) as “those who support

diagnosis in secondary care”, or those

who “run the tests behind the scenes”

– the public do not really understand

who we are and what we do.

However, there is now scope for

scientists to become involved in

community services and to support

integrated care and best practice.

Perceived challenges The creation of new technologies could

support scientists to develop a more

clinical role, providing information on


SCIENCECover story

P18-21 IBMS JAN18_Cover Feature_v2gh.indd 18 18/12/2017 09:12

IMAG

ES: I

STOC

K/SA

RAH

AULD

My role as a scientist has advanced and evolved in ways that I never even imagined

CONSULTANT BIOMEDICAL SCIENTIST PATRICK KUMAH ON EVOLVING ROLESIt is important to look at smart and innovative ways of working in pathology, to motivate existing members of staff and to attract new members of staff. Advancing roles for scientists is a way of providing new career pathways, and ways in which individuals can grow and develop.

During my time in the Department of Histopathology at the Royal Derby Hospital, my role as a scientist has advanced and evolved in ways that I never even imagined. When I started as a trainee biomedical scientist in the 1990s, specimen dissection was something that only the medics did. However, with the support and training that I received in Derby, I have gained both the Diploma of Expert Practice in Specimen Dissection and the Advanced Specialist Diploma in Breast Specimen Dissection.

Derby participated in the biomedical science histopathology reporting pilot study. I started my training in gastrointestinal pathology reporting in 2012. I was successful in my fi nal exams in 2016, and was awarded the IBMS/RCPath Advanced Specialist Diploma in GI Histopathology Reporting. I am currently in Stage D of my GI reporting training and being progressively signed off to report GI pathology cases independently. My new role as a Consultant Biomedical Scientist is a combination of reporting, dissection, teaching, training and clinical audit. I also participate in the General GI EQA Scheme.

Now Derby has put forward other colleagues of mine to undergo training to report Gynaecological Pathology and Dermatopathology. Our Clinical Director has a vision of the Derby histopathology department having specialist teams containing both medical and non-medical staff who can all dissect and report. This is defi nitely a far cry from how things were when I started out back in the 1990s.

Patrick Kumah is a Consultant Biomedical

Scientist in Gastrointestinal Pathology at

Royal Derby Hospital.

screening and diagnostic services and

health promotion.

Patients are being encouraged to use

technology, web portals, social media and

phone apps, to help them better manage

their own health. While websites, such as

LabTests Online, provide patients with

information on what tests are for and

why they are being requested from a

healthcare provider. In this context, the

climate is right for scientists to identify

novel ways of working and collaborating

with other healthcare teams.

For example, in collaboration with

community pharmacists, scientists could

provide simple explanations on the

purpose of certain tests and the broad

implications of results.

Primary care is evolving, however,

there is little collaboration and uptake

of technology to support patients in

managing their healthcare needs more

innovation, using the knowledge that

is resident within the biomedical

science workforce.


SCIENCECover story


While community pharmacists have

roles and skillsets for delivery of

medicines management, they too have

similar challenges to biomedical

scientists relating to wider practice.

It has been highlighted that point of

care testing (POCT) or near-patient

testing (NPT) are becoming increasingly

important. The up-front costs of POCT

initiatives can deliver greater “down

stream” savings, through the better use of

early stage pathology screening tests.

Further development of POCT/NPT

programmes involving collaborations

between biomedical scientists and

community pharmacists would allow

wider service availability in primary care.

While scientists have unique aptitudes

and capabilities, their skillset and

knowledge have not been utilised in

community-based services because

scientists have not been regarded as

having a primary role in patient care.

Technology providing scope With the expanding utilisation of

technology by public health providers and

service users, there is a need to evaluate

the scientist’s role in the wider

community. Studies have found that a

signifi cant proportion of the public rely

on the internet to make critical health

decisions and often bring information

retrieved from the internet into

healthcare consultation. Whilst long-

term conditions can be managed by

the appropriate use of medicines and

ongoing care-plans, there is the potential

for scientists to provide services and

information that support patient

self-care.

Patient Group Directions allow certain

healthcare professionals to supply and

administer specifi ed medicines to

pre-defi ned groups of patients, without a

prescription. There is a case for including

biomedical scientists in this group of

We know from the many NHS reviews, reports and our experiences, that demand for highquality healthcare is limitless and the resources to deliver are not. It is recognised that there is a wealth of knowledge, skills and expertise residing within the workforce, and that includes, biomedical scientists, which needs to be used effectively to deliver the quality care that patients need now and for the future.

Many of our members are already working in advanced roles, having developed their expertise, knowledge and skills to a very high standard through continuously developing clinical and scientifi c practice, within the laboratory

professions to better support patient care

in defi ned clinic and community settings.

ConclusionScientists and pharmacists should be

playing an important role in supporting

care for patients with complex needs, as

well as in providing educational events in

community settings, based on health and

care needs relating to ailment and

disease. A range of developments have

been called for in support of the further

expansion of medicines optimisation

activity. This includes referring patients

to a community pharmacy for medication

planning before starting any treatment,

and strengthening the transfer of

medicines information, for example, by

providing all community pharmacists

with NHS.net website addresses.

CLINICAL LEAD JANE NEEDHAM ON GRASPING OPPORTUNITY


SCIENCECover story


There is a need to evaluate the scientist’s role in the wider community

setting and branching out into the clinical patient environment. We need to continue to promote and take the opportunities to develop advanced roles within the wider healthcare community.

I have a clinic seeing adult patients for investigation of suspected mild bleeding disorders. My passion is the fi eld of haemostasis and thrombosis and the opportunity arose to develop my practice into the clinic setting. It is a privilege and very rewarding to have my own patient caseload, take their clinical history, follow through investigations within the laboratory, present newly identifi ed disorders at MDT meetings and discuss the result fi ndings, diagnosis and meaning with the patient. So, where did my journey start? Right at the bottom, as a trainee biomedical scientist in Haematology, followed by a

systematic step up the career ladder with associated professional (IBMS) and academic qualifi cations, supported by the development of scientifi c and clinical practice. On top of the “day job” I have been a life-long student, driven by having moved a step, then realising there was another one above. Persistence, love of my subject and applying this knowledge to benefi t patient care, have culminated in a PhD and by examination FRCPath.

Possible questions for you: Where can I apply or developed my

scientifi c expertise to improve my care? Where can I improve the quality of the

diagnostic report to benefi t the patient? Can I contribute to multi-discipline

clinical meetings? Where can my knowledge and skills be

applied to improve/streamline patient care pathways?

Is there a community role for me as a biomedical scientist?

So focus on “can do” (there are many myths surrounding what biomedical scientists “can’t do”). Be confi dent, know your value, abilities and potential and actively seek opportunities. Be passionate about the service you provide or want to provide and remember – you care for patients, not specimens. The NHS needs you. Grasp the opportunities to improve the care of patients who rely on you.

Jane Needham is Clinical Lead, Haemophilia Haemostasis & Thrombosis Diagnostic Service, at Hampshire Hospitals NHS Foundation Trust.

Understanding how the expansion of

roles, economics, and technology will

allow better care and management of

patients in community is key.

At present, however the evidence-base

for collaborative working has been

insubstantial. Biomedical science practice

as a “hidden” service remains largely

unchanged and cross-profession

collaborative working for delivering

care, monitoring practice is still not

widely considered.

To identify what strategy and

mechanisms are required to encourage

collaborative working means research and

an evidence-based approach is needed to

inform both biomedical and pharmacy

practices to strengthen ways of evaluating

the delivery of better timely care and

ensuring productivity during normal

and out of hours and through greater use

of technology.

Shahid Nazir Muhammad is a Specialist

Biomedical Scientist and Senior Research

Scientist Assistant at Invatech Health Ltd.


SCIENCECover story


Gerry Thomas, Professor of Molecular Pathology, casts a critical eye over the 100,000 Genomes Project.*

IMAG

E: G

ETTY

In 2012, the UK government

announced the establishment of

the 100,000 Genomes Project. It is

billed as a project that would

revolutionise patient diagnosis and

treatment, off ering the prospect of

personalised treatment for many

patients. The project is run by

Genomics England, a company that is

wholly owned by the Department of

Health, but is delivered through 13 newly

established Genomic Medicine Centres,

comprising a lead NHS trust and a series

of local delivery partners – usually smaller

NHS trusts geographically close

to the lead organisation.

The key aims of the project are to

promote genetic research in order to bring

benefi t to NHS patients and to support the

development of the UK genomics industry.

Sequencing is carried out by a single

provider, Illumina, at a purpose-built

facility in Cambridgeshire. The

programme has two strands – rare disease

and cancer. It is designed to be a

transformative project and to make

interpretation of our DNA sequence sit

alongside conventional diagnostic

procedures and tests to inform the

appropriate clinical pathways for

treatment of disease.

For rare disease, only a blood sample is

required – usually from the patient and

their parents, and most of these families

are already aware that a germline genetic

component to their disease is a likely cause.

For cancer patients, a paired sample of

blood and tissue is required. It is this second

arm of the project that is more challenging

to deliver both practically and ethically.

The aims of the project are laudable and

given the recent announcement of

investment by big pharma in the UK, the

project is already bearing fruit. The old

adage of “right treatment to the right

patient at the right time saves money”

should encourage all of us who fund the

NHS through our taxes to engage with

the project. However, the delivery of this

project is not easy and will involve

substantial changes in the skills needed

in the histopathology workforce, as well

as changes to workfl ow through the

departments. It also raises important

ethical issues.

Challenges for pathology departmentsEarly pilot work carried out in the project

suggested that FFPE tissue produced a

number of sequencing artifacts and

produced noisy profi les for the

bioinformaticists to work with. This

would predictably lead to the need for

more validation of genetic alterations to

determine what was real and what was

noise, and make translation into the

clinical arena more challenging. A

decision was therefore taken to use only

frozen tissue samples. This is a sea-

change in pathology departments that

for years have worked to optimise

THE 100,000

GENOMES IT'S NOT JUST ABOUT DNA


SCIENCEGenomics

P22-24 IBMS JAN18_geonomes_v1sa.indd 22 15/12/2017 16:45

* TH

E VI

EWS

EXPR

ESSE

D AR

E TH

E OP

INIO

NS

OF T

HE A

UTHO

R AN

D DO

NOT

REP

RESE

NT

THOS

E OF

IMPE

RIAL

COL

LEGE

LON

DON

OR

THE

WES

T LO

NDO

N G

ENOM

E M

EDIC

INE

CEN

TRE

fi xation and processing protocols to

ensure that downstream diagnostic

patterns can be identifi ed using, for

example, immunocytochemistry.

The provision of frozen samples means

that material must be transferred from

the operating theatre to the pathology

department rapidly and the pathologist

must be on hand to perform cut-up with

minimal delay. While this would be

practical with onsite pathology

departments, the amalgamation of

pathology services that has taken place

means that histopathology services are

often centralised and sometimes at

diff erent geographical locations from

operating theatres. Transfer of specimens

would need to be carried out at 4°C to

prevent degradation of protein (for later

immunocytochemistry) and DNA/RNA.

This raises issues of possible cross-

infection and has a cost implication

regarding couriers using temperature

controlled transport.

Ethical dilemmasThe timing of consent also raises ethical

issues. Until the use of WGS is proven to

be of diagnostic value, pathologists are

quite rightly likely to take frozen samples

only when this will not have deleterious

eff ects on the diagnostic process. Where

patients are consented prior to their

operation, it cannot be known whether

the pathologist will be able to take a

frozen sample safely, and therefore

whether the patient would be eligible

for the 100,000 genomes project. It

might be considered to be more ethical

to only take the detailed consent for the

project when the eligibility of the patient

is known. The lack of availability of

suitable samples (either with respect to

biological format or amount) has been

shown to be a signifi cant issue in

stratifi ed medicine trials such as CRUK’s

Stratifi ed Medicine 2 project. Cancer

patients are made aware that they

themselves are unlikely to benefi t from

the project; but there is still expectation

that they will be entered into the project.

Few centres take routine generic consent

that would enable retention of tissue for

later enrolment in clinical studies that

require frozen samples, and few

histopathology departments have the

PROJECT


SCIENCEGenomics

70,000The project will sequence100,000 genomes fromaround 70,000 people

3.2bnA genome contains all 3.2 billion

letters of a person’s DNA

2DAYS

The time it takes to sequencea single genome


capacity to store frozen tissue as part

of the diagnostic record.

There are other ethical issues. Better

diagnosis through improved imaging

means that we are identifying smaller

cancers, and these are the least likely

to provide material that can be frozen

without a potential eff ect on the

diagnostic process. Does this mean that

those with small tumours will denied

access to the benefi ts of whole genome

sequencing? Will the cost of transferring

samples from small hospitals that have

no local histopathology facilities mean

that access to genomic medicine will

become a postcode lottery?

There are also repercussions for the

science of the project. The requirement

for frozen samples biases the dataset

towards larger tumours – can we apply

what we learn from this to guide

patient treatment for those with

smaller tumours? Inevitably, only a

small sample of the operative specimen

will be taken for sequencing – is this

representative of the whole tumour?

If not, how many samples are required to

counteract the inevitable bias of tumour

heterogeneity? How does this impact the

cost of delivering a meaningful genetic

sequence on which to base future

therapy decisions?

Identifi cation of drivers of disease and

indicators for treatment will only come

from pooling both the genetic sequence

data with large and detailed clinical

datasets. In the absence of a unifi ed

electronic patient record that mandates

collection of defi ned clinical datasets,

this is probably even more of a

signifi cant challenge than those facing

histopathology. The need to link

electronic patient records with genetic

information may sit uncomfortably with

some – but doesn’t Dr Google know more

about you from the way you share your

life on social media than can ever be

gleaned from your genetic code and

medical record? Can your political views

or sporting allegiances be gleaned from

your medical record and DNA?

The delivery of the promise of better

healthcare will come at a cost to our

autonomy. We must recognise that

consent taken at the time of sample

donation cannot cover all possible

outcomes, as technology changes so

quickly that all potential uses of our data

and samples cannot be foreseen. Consent,

therefore, can never be completely

informed at the time it is taken.

Feedback of data Considerable thought will need to be

given to what information needs to be

given back and to whom. In taking part in

the 100,000 Genomes Project participants

agree to receive information back that is

directly relevant to their disease, but

inevitably there will be some unexpected

fi ndings in the germline that have

potential relevance to close relatives or

may become relevant much later in life.

Variation at over 40 loci is associated with

the risk of developing type 2 diabetes, but

lifestyle factors contribute far more to the

absolute risk of developing the disease. Is

it useful to feed back genetic information

We should be aware of the risks and benefi ts and be cautious of overpromising to patients

to the patient and their family when

changing their lifestyle might have a

greater eff ect?

Clinical translation from DNA sequenceFinally, the biggest challenges will be

translation of our newly-gleaned

knowledge of the DNA sequence into

better clinical outcomes. Despite the

early promises, genomic research has not

yet created more personalised healthcare.

This could be mainly due to the fact that

genomics is still the new kid on the

block, and these things take time to

develop. New clinical trial designs will be

required, which will be complex and will

inevitably involve triaging the patient

population to identify those with the

right biomarkers for specifi c molecularly

targeted agents. The lack of a properly

informed workforce could be another

stumbling block, something that is being

addressed by HEE’s programme in

genomic education. It might also be that

there is quite simply more to life (and

disease) than DNA alone. The DNA after

all is just the start – identical twins only

show some identical aspects. The way

they lead their lives is often strikingly

diff erent which may result in very

diff erent health profi les.

As a fi nal word – we are on a journey.

All knowledge is useful, but we should

be aware of the risks and the benefi ts,

both individually, and to society, and be

cautious of overpromising to patients. It

is better to use the genomic revolution to

add to what we have already, rather than

to throw the baby out with the bathwater.

Pathology, as a discipline, needs to

embrace the genomic revolution – if only

to make sure we do not reinvent a more

expensive wheel!

Gerry Thomas is Professor of Molecular

Pathology at Imperial College London’s

Department of Surgery and Cancer.

SCIENCEGenomics24 THE BIOMEDICAL

SCIENTIST


For further information contact:

Telephone: +441225 810361 E-mail: [email protected] www.mwe.co.uk

Good swabs aren’t cheap & cheap swabs aren’t good –will ISO 15189 catch you out?

Neisseria gonorrhoeae recovered on VCAT from MWE Transwab® with Amies Charcoal

Nam

e

D.O

.B.

Wa

rd

Ho

sp

. N

o.

CAP BA

Nam

e

D.O

.B.

Wa

rd

Ho

sp

. N

o.

CAP BA

Transwab®

The original is still the best

Fully compliant with CLSI M40-A2

each batch

ISO 15189 compliance? If not, contact MWE now,

sure YOU are compliant!

M40-A2COMPLIANT

hhe e bebess

hh C CLSLS

T

cccct MMt Mt MWE WE WE nownownow,,

Nam

e

O.B

.B

..D

.O.B

rd

ar

Wa

Wa

osp

. H

oHH

No

.

CAP BAA

Nam

e

D.O

.B.

Wa

rd

CAP BA

stst

I I M4M40-0-A2A2

For more information please contact us on:Tel: 01932 581200Email: [email protected] Web: www.clinisys.co.uk

With 30 years’ expertise in developing and delivering innovation to pathology services, we provide solutions to resolve tomorrow’s challenges today.

We care about your service......pathology, it’s in our DNA

BIO.01.18.025.indd 25 13/12/2017 16:58

SUPPORTING RESEARCH AT HOME AND OVERSEASIn 2017, the IBMS awarded research grants totalling almost £25,500 to six Fellows. Here the recipients explain their grant-supported projects.

IMAG

ES: S

CIEN

CEPH

OTOL

IBRA

RY

This work looks at modelling

of the binding of

antitrypanosomal

compounds to Trypanosoma

brucei PTR1. Neglected

tropical diseases (NTD)

impose a severe threat to

global health through

continuous spread and a lack

of eff ective medicines, with more

than a billion people aff ected by these

diseases. Sleeping sickness, a two-stage

NTD, caused by Trypanosoma parasites,

contributes to the burden of NTDs

occurring predominantly in eastern and

southern Africa.

Treatment for sleeping sickness is

dated and potentially lethal, consisting

of pentamidine or suramin for the

haemolymphatic phase, and efl ornithine,

melarsoprol or nifurtimox-efl ornithine

combination therapy for the neurological

phase. Advances in antitrypanosomal drug

development have been limited and drug

resistance is increasing, highlighting the

urgent need for a robust pipeline of new

drugs to replace existing therapies to

support global health strategies.

Work undertaken by Dr Bhambra

and colleagues has delivered novel

compounds demonstrating signifi cant

antitrypanosomal activities against

Trypanosoma brucei rhodesiense, while

showing limited off -target toxicities. This

has provided the platform for the project

to exploit in silico drug development

approaches to assess potential drug-target

interactions and the subsequent design

of further compounds with improved

on-target and off -target activity profi les.

DR AVNINDER S BHAMBRA


SCIENCEIBMS funding

P26-29 IBMS JAN18_Supporting Research_v2gh.indd 26 18/12/2017 12:02

HELEN LOCKBehçet’s disease (BD) is a

multisystem infl ammatory condition characterised predominantly by urogenital aphthous ulceration and ocular infl ammation, the aetiology of which remains

to be elucidated. There is no test for BD and diagnosis

is based on clinical features. However, it is known that the pathogenesis of BD is complex, involving both the innate and adaptive immune response, causing features of both autoimmune disease and autoinfl ammatory disease. The lack of clarity in immune pathogenesis means that treatment of BD is targeted at symptom management and prevention of major complications. Some patients do not respond well to initial treatment, which results to prolonged morbidity and impaired quality of life. It is likely that the actions of the many different immune cells involved in Behçet’s pathogenesis are also responsible for a differential response.

In the grant-supported work undertaken by Helen Lock, pre- and post-treatment blood samples will be taken from a clinically defi ned cohort of patients receiving immunosuppressive or anti-infl ammatory treatment, and also from matched controls. Flow cytometry analysis will be used to measure B regulatory (Breg) cell surface markers, a recently identifi ed B-cell phenotype defi ned as interleukin (IL)-10-secreting infl ammatory suppressive cells that may affect treatment response in BD. The presence/absence of different Breg biomarkers will be used to stratify BD patients into groups through post hoc analysis to determine if Breg biomarkers are altered pre- and post-treatment in treatment responders and non-responders. Clinicians will use the grouping to inform treatment and management. The grouped patient will receive personalised treatment, reducing pain and alleviating symptoms.


SCIENCEIBMS funding


Osteoarthritis (OA) is one of

the most widespread

skeletal diseases, which

negatively aff ects the

quality life of more than

eight million people in

the UK. It is characterised

by cartilage degradation

and deterioration of the

underlying subchondral bone within

the joints, commonly as a result of ageing

(long-term wear and tear), joint injury or

other risk factors that result in the

generation of a pro-infl ammatory

environment. This environment has been

shown to cause suppression and apoptotic

death of chondrocytes, the only cell type

present in the cartilage matrix, which

normally provide cartilage maintenance

and repair functions. A decrease in the

number of active chondrocytes within the

matrix correlates closely with the severity

of the cartilage damage.

Although chondrocytes are the only

cells present in the cartilage matrix, the

picture becomes more complex at the

cartilage-bone interface, where

development of the pro-infl ammatory,

pro-apoptotic environment in the

cartilage can infl uence the balance of

osteoclast and osteoblast activity, the cells

responsible for turnover and maintenance

of the bone. Communication between

cartilage and bone cells has been

demonstrated both in in vivo and ex vivo

experiments, and, although the exact

nature of this communication has yet to

DR IAN LOCKEbe fully elucidated, this cross-signalling

from the damaged cartilage to the bone

may contribute to the subchondral bone

loss/damage observed in OA.

Dr Locke and his team’s research,

Understanding urocortin 1 regulation of

chondrocytes and osteoclasts: a new prospective

for pharmacological intervention in osteoarthritis,

so far suggests that the urocortin (Ucn)

system may be a potential candidate

for this cross-signalling role, with

components of this system expressed in

both chondrocytes and subchondral bone

cells, and elevated in the synovial fl uid of

individuals with OA. They have shown

that Ucn1 exhibits a dual role as both an

essential survival factor for chondrocytes,

and a potent inhibitor of osteoclast

maturation, motility and resorption.

Unlike chondrocytes and osteoclasts,

osteoblasts do not express (or respond to)

Ucn1, but do express CRF-BP, providing a

potential candidate for the regulation of

free Ucn1 levels in the local environment.

Understanding the role of the urocortin

system in the communication between

bone and cartilage cells will provide novel

insight into how this system may be

manipulated to prevent chondrocyte

death and reduce bone resorption – key

factors in osteoarthritis and other skeletal

disorders such as osteoporosis. It is hoped

this will reveal prospects for therapeutic

intervention and the development of

drugs that mimic the protective function

of the urocortin system, to prevent and

treat OA and related conditions.

DR OLAYINKAOSUOLALE

Dengue is the most prevalent arthropod-transmitted

virus, with conservative estimates placing half of the world’s population at risk of infection. Transmission of the mosquito-borne dengue

virus appears to be largely driven by infections in and

around the home, with the majority of cases related to one another – occurring in people who live less than 200 metres apart.

Leishmaniasis is responsible for the second-highest number of deaths due to parasitic infection globally and is overwhelmingly associated with poverty. It is almost always fatal, if not treated, and morbidity caused by cutaneous leishmaniasis is also important.

These diseases are neglected, under recognised and under-reported in Nigeria due to lack of awareness by healthcare providers and lack of prioritisation by the public health authorities. Due to poor disease surveillance and lack of reporting, the true incidence and impact of the diseases in Nigeria is unknown.

The research by Dr Osuolale, A preliminary study of a possible dengue fever and Leishmaniasis among university students and staffs in a tertiary institution in Nigeria, aims to investigate cases of febrile infection with possible links to dengue fever and leishmaniasis among the students and staff of Elizade University. The purpose of this study will be to identify epidemiology and immunology of unapparent infection due to dengue disease and leishmaniasis.


SCIENCEIBMS funding


DR MARIA TERESA ESPOSITOChromosomal rearrangements

of the MLL gene located

at 11q23 give rise to

aggressive and drug-

resistant forms of acute

lymphoblastic leukaemia

(ALL) and acute myeloid

leukaemia (AML), hence

the name mixed lineage

leukaemia (MLL). No targeted

therapeutics are available and the

prognosis is dismal, with survival rates

of just 20% to 50%.

Although phenotypically MLL can be

classifi ed as either lymphoblastic or

myeloid, the gene expression profi le is

unique and distinct from ALL and AML.

Transcriptomics-based characterisation

and chemical interrogation identifi ed

kinases as key mediators in MLL.

Accordingly, inhibitors of kinase

GSK-3-β, Flt3, CDK9 and ATM/ATR showed

effi cacy in MLL animal models; however,

their toxicity is still clinically prohibitive.

This also implies that eff orts to target

multiple kinases at the same time might

not be clinically feasible.

PP2A is a phosphatase and a critical

upstream mediator of the above kinases,

found inactivated in solid and

haematological malignancies PP2A has

been studied extensively in chronic

myeloid leukaemia (CML).

Notably, PP2A-activating drugs (PADs)

show therapeutic effi cacy in AML and

CML, with no cytotoxic eff ect on

haematopoietic cells. However, PP2A has

not been explored in MLL.

Preliminary data obtain by Dr Esposito’s

group show that, like AML and CML, PP2A

is inactivated in MLL-AML cell lines.

Analysis of MLL-primary AML samples’

transcriptome data, collected as part of

The Cancer Genome Atlas (TCGA) project,

suggests that epigenetic mechanisms

might govern PP2A inactivation in MLL.

These data, together with the fast

development of PADs, provide a

compelling rationale for investigating

PP2A as both a prognostic marker and a

novel therapeutic target for MLL.

The research grant to Dr Esposito will

facilitate the generation of data in

support of further collaborative work

(Analysis of phosphatase PP2A activity and

gene expression in MLL-rearranged leukaemia)

aimed at testing the therapeutic strategy

of PADs in xenotransplants in in vivo

models and extending the study to

paediatric patients.

Chronic wound infections are

diagnosed at 100,000 cases

per annum and their

management is complex,

costing the NHS more

than £4bn each year.

Patients with chronic

wound infections are

affl icted for months or years

and experience persistent or

recurrent wound infection that is diffi cult

to resolve. Swabs taken from patients for

microbiological assessment frequently

recover unusually slow-growing species

of bacteria, which grow as very small

colonies on agar. Often these bacteria are

overlooked as an artefact of culturing

techniques and are, therefore, excluded

from diagnostic analyses. Designated as

“small-colony variants” (SCV), research

has suggested that these bacteria are

more than a laboratory curiosity and

instead could play a signifi cant role in

persistent, recurrent infection in wounds.

Supported work by Sarah Maddocks,

with Ambikesh Jayal, Small-colony variant

bacteria: a laboratory curiosity or cause of

persistent, recurrent infection?, proposes to

sequence a library of SCVs derived from

Pseudomonas aeruginosa, to identify a set of

SCV-specifi c genetic changes that can be

developed into a diagnostic tool to detect

SCVs in chronic infected wounds. This

will be of benefi t because SCVs do not

grow well in laboratories and produce

spurious results with standard diagnostic

assays. Identifying patients carrying SCVs

using molecular probes would be an

accurate and rapid means of diagnosis,

allowing clinicians to amend treatments,

such as increasing antimicrobial

treatment to counter the higher

resistance profi le of SCVs, and thus limit

the likelihood of recurrent infection.

SARAH MADDOCKS

For more information on IBMS grantsand awards and how to apply,

visit ibms.org/grants-prizes-and-awards


SCIENCEIBMS funding


CLINICAL CHEMISTRY CLASSICS

In the second instalment of his three-part look at cardiac markers, Stephen Clarke continues his historic analysis of landmark moments in clinical chemistry.

PT 4B

IMAG

E: S

CIEN

CE P

HOTO

LIB

RARYT

his short review selects

landmark papers with

background notes, paying

tribute to those early pioneers

who developed assays for the

analysis of blood serum

cardiac markers, for the

diagnosis and investigation of

cardiovascular disease, notably coronary

heart disease, which may lead to life

threatening acute myocardial infarction

(AMI). A previous article, published in the

November issue of The Biomedical Scientist,

described two early cardiac markers –

aspartate transminase and lactate

dehydrogenase. Here, a more recent

biomarker serum creatine kinase and its

clinical use are reviewed.

Creatine kinase (CK)Muscle physiology research studies

performed in 1927 by British biochemist


SCIENCEBig story

P30-33 IBMS JAN18_Big Story Markers_v1sa.indd 30 18/12/2017 12:03


SCIENCEBig story


Philip Eggleton and his wife Grace,

identifi ed potential high energy

phosphate compounds, notably

phosphocreatine in skeletal muscle

extracts. Two years later, adenosine

triphosphate (ATP), the key source of

energy for life, was discovered by the

German chemist Karl Lohmann who later

proposed that CK was associated with

ATP, and Lehmann in 1936 described the

reversible reaction which allows storage

or release of energy as required.

Consequently, CK is most abundant in

tissues with high-energy requirements

and so is found mainly in brain, cardiac,

skeletal and smooth muscle.

The properties of sheep skeletal CK

were studied by Australian biochemists

Ennor and Rosenberg in 1953, who found

that thiol groups (cysteine) and Ca++

and Mg++ were activators for CK. CK

activity was measured using a

colorimetric method for creatine by

Hughes (1962), whilst Kudy (1954)

measured the liberation of phosphate

after hydrolysis using the formation

of phosphomolybdenum blue.

Assays for total serum CK An early spectrophotometric method was

developed by IT Oliver at Sheffi eld

University in 1955 based on the procedure

devised by the noted US biochemist

laureate Arthur Kornberg (1918-2007).

ATP produced was used to form glucose 6

phosphate from glucose catalysed by

hexokinase and coupled to the reduction

of nicotinamide adenine dinucleotide

phosphate (NADP) and monitoring the

absorbance change at 340nm. This was

one of many methods which used rabbit

muscle homogenates as source material.

Spectrophometric methods based

on this principle for serum CK were

developed by Tanzer and Gilvarg in 1959

and, most notably, by Sidney Rosalki, then

at St Mary’s Hospital, London in 1966,

with an improved optimised assay that

combined the substrates and coupling

enzymes in innovative commercially IMAG

E: G

ETTY

Total serum CK, CKMB isoenzyme and CKMB mass assays held the centre ground for two decades


SCIENCEBig story


Left. Arthur Kornberg (1918-2007).The American biochemist who won the Nobel Prize in Physiology or Medicine in 1959.

produced gelatin capsules, which

simplifi ed the procedure and reduced

time without losing performance quality.

This has become a classic technique and,

remarkably, current autoanalyser

methods are based on this same principle.

Clinical reportsMany of the early reports related only to

muscle disorders, some notably by

the distinguished Japanese

physiologist Setsuro Ebashi

(1922-2006) a pioneer in

muscle research who in 1959

reported elevated serum CK

results in patients with

Duchenne muscular dystrophy. A

year later, Dreyfus and colleagues

reported a series of patients with raised

serum CK in AMI and this fi nding was

confi rmed by many other groups,

including Niels Sorenson who in 1963

reported a sensitivity of 98% when CK

was measured within 72 hours. He also

predicted a poor prognosis if the serum

CK was still high after this period.

However, total serum CK has a low

specifi city and is raised in many non-

cardiac conditions, such as skeletal, liver

and kidney and cerebrovascular diseases.

Research was undertaken in this period

to study the physical and chemical

properties of CK from various tissues

and with the introduction of agar gel or

cellulose acetate electrophoresis, it

became clear that CK was dimeric and

consisted of two subunits termed M & B,

with MM (skeletal & heart muscle), BB

(brain, GI tract) and hybrid MB mainly

associated with heart. These are cytosolic

whilst more recently, during the 1990s,

creatine kinases have been identifi ed in

the mitochondria and their potential

clinical implications recently reviewed.

CKMB isoenzyme, CKMB isoforms and CKMB MASSElectrophoretic methods for CKMB were

devised during 1960s, but a routine and

reliable zone electrophoresis method was

published in 1972 by a group at Duke

University, North Carolina led by Charles

Roe. The more specifi c use of anion

exchange column chromatography was

introduced in 1974 by Donald Mercer at

the Montefi ori Hospital, Pittsburgh, with

a simple and rapid technique, CK activity

in the column effl uents was assayed by

the Rosalki CK procedure. A sensitive

radioimmunoassay using antibodies

to the B subunit was reported by

Robert Roberts et al in 1976.

Further studies by Roberts and

the Washington University of

Missouri team lead by Burton

Sobel devised tests in 1984 for

the presence of CKMB isoforms,

post-synthetic modifi ed forms of

CKMB, which, although promising –

giving a rapid diagnosis of AMI within

two to four hours of the onset of

symptoms – was not taken into wide

use, possibly due the added complexity

of testing “cleaved” to “uncleaved”

CKMB as a ratio. With the emphasis on

immunoassays, a Washington research

team, now led by Jack Ledenson, focussed

its attention on the use of the “new”

monoclonal techniques for CKMB and

with commercial support led to the

development of the Conan antibody, a

sensitive and specifi c antibody for CKMB

fi rst used in 1986. With further

refi nements, it was paired with an

antibody to the B subunit to make

a two-site mass immunoassay,

which was made commercially

available in 1988 by Dade

International. CKMB mass test

cartridges (e.g. Abbott

Diagnostics) are now

commercially available for point of

care testing to provide rapid results,

their use has been widely reviewed.

Comparison studiesThe release time pattern after AMI for

CKMB and CKMB mass are similar with

a rise at four to six hours, peak 10 to 24

hours, with a return to normal 48 to 72

hours. However, CKMB2 isoform rises

earlier at two to four hours and peaks at

four to six hours, which can be valuable in

providing thrombolytic therapy. However,

the CKMB isoform assay requires

considerable technical skill, specialised

equipment and so has a limited workload

capacity. CKMB isoform and CKMB assays

have been replaced by CKMB mass assays,

due to the ease of analysis, enhanced

sensitivity with results available within

10 minutes. CKMB mass has been

reported to be the preferred marker to

identify re-infarction and in the

prognosis of unstable angina pectoris.

However, all variations of CK, whether

CKMB isoform or CKMB mass, have the

inherent limitation of non-specifi city

and that “false” positive results for AMI

may be obtained with severe skeletal

injury in conditions such as polymyositis

and rhabdomyositis and equivocal results

may occur with a small infarct combined

with skeletal necrosis. False results may

also be due the presence of macro CK or

mitochondrial CK.

Short commentsTotal serum CK, CKMB isoenzyme and

CKMB mass assays held the centre

ground for at least two decades from

the 1960s, as the most commonly used

cardiac biomarkers in the diagnosis and

treatment of AMI. This was mainly due

to the pioneer research work,

notably by Sidney Rosalki, David

Dawson and later the

Washington University School

of Medicine Group. But with

the limitations described, the

quest for a more specifi c cardiac

biomarker was already in progress.

These will be described in the third and

fi nal article on cardiac markers.

Stephen Clarke is a retired IBMS Fellow.

He previously worked in clinical chemistry

at Southmead Hospital, Bristol. To see

the references, view the article online at

thebiomedicalscientist.net IMAG

E: P

UBLI

C DO

MAI

N V

IA W

IKI


SCIENCEBig story



SCIENCEBiobank

Tucked away on an industrial

estate in Stockport, lies a

major national and

international resource. The

adage “looks can be deceptive”

certainly applies when most

people fi rst lay eyes on a large

warehouse guarded by two

towering liquid nitrogen silos. This is in

fact the UK Biobank co-ordinating centre

and currently it houses the UK Biobank

Biomarker Enhancement Project

laboratories. This facility was initially the

co-ordinating centre during baseline

recruitment and sample collection, but

now houses: multi-purpose laboratories

(six in total, three of which are the

Biomarker laboratories), automated stores

for participant sample storage, an

imaging assessment centre and offi ces.

The site (including laboratories) is ISO

9001:2015 and ISO 27001:2013 accredited

and the laboratories used for the

Biomarker Enhancement Project are also

ISO 17025:2015 accredited.

These three ISO accredited laboratories

were set up to measure a wide range of

biochemical markers from biological

samples collected at baseline from

approximately 500,000 participants aged

between 40 to 69 years old. Participants

were recruited during 2006 to 2010, from

22 assessment centres across England,

Scotland and Wales. UK Biobank is a large

prospective cohort study with the aim to

improve the health of future generations

by understanding why some individuals

are more susceptible to certain diseases

than others.

Analysing biomarkersThe Biomarker Enhancement Project

forms one of several projects designed to

enhance the UK Biobank resource by

adding supplementary data. Other

enhancement projects include

genotyping, imaging and activity

measurements. The biomarkers were

selected by the UK Biobank’s

Enhancements Working Group, following

consultation with scientifi c experts to

identify biomarkers that are likely to be of

most scientifi c relevance for studying a

broad spectrum of diseases. Selected

biomarkers were chosen because they are

established risk factors for disease (e.g.

lipid markers for vascular disease),

diagnostic measures (e.g. HbA1c for

diabetes) or characterise phenotypes not

otherwise well assessed (e.g. biomarkers

for renal and liver function). Analysis of

biomarkers was performed for the whole

cohort (500,000 participants) and on

three sample types; urine, packed red

blood cells and serum.

Data for the four urine biomarkers

(which include urine creatinine and

microalbumin – chosen for their

association with diabetes), are already

available to the scientifi c research

community via access to the UK Biobank

Data Showcase, available is on its website.

These were measured on a single clinical

chemistry analyser. Hba1c analysis is

complete and data is currently being

reviewed prior to release to researchers in

2018. HbA1c was measured on packed red

blood cells, rather than whole blood

samples using 5 HPLC systems. Serum

analysis comprised 29 diff erent

biomarkers, the majority of which are

commonly measured in routine clinical

chemistry laboratories (AST, ALT, calcium,

phosphate, creatinine, urea etc.), along

with more specialised markers, such as

IGF-1, vitamin D, cystatin-C, rheumatoid

factor, and lipoprotein (a). Serum analysis

utilised 10 immunoassay analysers (two

diff erent platforms) and four clinical

chemistry analysers (two diff erent

platforms). Analysis of serum is now

complete with data review ongoing. It is

anticipated that serum data release will

be in 2018.

In total, the UK Biobank biomarker

laboratories have analysed 34 diff erent

biomarkers on approximately 500,000

samples – over 17 million results. At the

peak of analysis, up to 2,000 samples

were analysed per day for the urine phase

of the project and up to 1,900 samples per

day for serum. Analysis of the three

sample types has taken almost four years

to complete. As the samples are a precious

resource, laboratory quality is paramount

thus an extensive and rigorous internal

quality control (IQC) regime utilising

Westgard rules and sigma-metric scores

have been implemented during the

project, typically consisting of analysing

multiple levels of QC material every 200

Parmesher Singh explains the work that is being undertaken at UK Biobank and the impact that it is hoped to have.

IMPROVING THE HEALTHOF FUTURE GENERATIONS

P34-35 IBMS Jan 18_Advice_v2gh.indd 34 15/12/2017 14:23


SCIENCEBiobank

with experts at the Clinical Trial Service

Unit and Epidemiological Studies Unit

based in Oxford, with whom UK Biobank

has close links.

TeamworkLike all laboratories, the overall objectives

cannot be reached without a dedicated

and conscientious workforce.

Approximately 50 members of staff

have been directly employed by the

Biomarker project, supported by a wider

number of staff from UK Biobank

including – quality, the core laboratory

team, human resources and information

technology teams. The Biomarker project

has typically consisted of three teams,

two teams working seven-day shift

patterns and one team working a fi ve-day

week to facilitate communication and

handover across multiple shifts. Other

than myself, there are two other senior

HCPC registered Biomedical Scientists

(Team Leaders) and we have over 45 years

of combined experience in clinical

chemistry. We report to a Project

Manager/Laboratory Manager who is

responsible for the overall management

of the project. As team leads on this

project, our duties and responsibilities

include; analyser/method verifi cation

and validation, managing stock control

and liaising with manufacturers,

implementation and development of

overall technical quality aspects, training

laboratory staff , assisting and ensuring

quality management systems are adhered

to, technical validation of results and

troubleshooting, amongst many others.

Each team consists of a Team Leader,

Biomarker Specialists, Scientists,

Technicians and Assistants, each playing

a vital role in the completion of the

project. Only a small number of the team

are HCPC registered Biomedical

Scientists, with the majority consisting of

individuals with scientifi c qualifi cations,

but limited laboratory experience. One of

the many great achievements of the

Biomarker project has been training and

mentoring staff , to enable them to

competently and independently run,

maintain and troubleshoot common

problems on the 20 analysers, as well as

identifying and rectifying QC failures.

Another great achievement has been

successfully obtaining ISO 17025:2015

accreditation for all the biomarker assays

for each of the three sample types.

This was challenging, but with a lot

of teamwork and many document-

controlled procedures and forms later,

accreditation was achieved ensuring the

data available to researchers at the end of

the project is of the highest standard.

Parmesher Singh is a Team Leader in the

Biochemistry Lab at UK Biobank, along with

Stewart Moffat and Mark Gordon.

For more information visit

www.ukbiobank.co.uk

IMAG

ES:IS

TOCK

500,000participants

provided samples

samples. Over 720,000 separate IQC

measurements have been performed and

validated. In addition, the biomarker

project registered with at least four

diff erent EQA providers to maintain

and comply with ISO 17025 standards.

Furthermore, data is reviewed regularly

the age ofparticipants was

40-69years old

17mOver 17 million results

720,000Over 720,000

IQC data points

34biomarkers in

analysis of samples

NUMBERS FROM THE UK BIOBANK

Analysers used

20

P34-35 IBMS Jan 18_Advice_v2gh.indd 35 15/12/2017 14:23

HOW TO… BECOME A STEM AMBASSADORNatalie Clerke, from the National STEM Learning Network, explains how to become a STEM Ambassador and why it is an important role.

STEM Ambassadors are

volunteers from a broad

range of jobs and

backgrounds who are

passionate about inspiring

young people to pursue

science, technology,

engineering and

mathematics (STEM) studies and careers.

With a community of over 30,000

volunteers nationally, they are an

important and exciting, free-of-charge

resource for learners, teachers, youth and

community groups and other individuals

working with young people across the UK.

As professionals and specialists in their

fi elds, STEM Ambassadors bring real-life

industry experience into context and

enrich young people’s knowledge of the

breadth of STEM-related careers and

opportunities available.

STEM Ambassadors get involved in a

wide variety of activities both in and

outside of the classroom, all of which

can have an impact on young people’s

learning and enjoyment of STEM

subjects, including:


ADVICEHow to

P36-37 IBMS Jan18_How to_v3gh.indd 36 18/12/2017 12:03

already raising awareness and aspirations

in STEM and helping young people to

make informed decisions about their

future careers. We’ll support you to

become an eff ective part of our volunteer

network and you’ll get the opportunity

to develop new skills and gain increased

satisfaction from your work. Being a

STEM Ambassador is rewarding and

challenging and can contribute to both

personal and professional development.

Volunteering as a STEM Ambassador is

your chance to share your enthusiasm for

STEM and inspire the next generation of

employees. Evidence shows that 90% of

young people who engage with STEM

Ambassadors say that it increases their

engagement with STEM, helping them

to make informed decisions about their

future careers.

“Becoming a STEM Ambassador is a great opportunity for professionals and researchers across the sector to help young people make informed decisions about their career opportunities and direction. Working in this sector offers exciting opportunities that many young people may not know exist. It is all about inspiration: creating a ‘biochemical reaction’ to encourage young people to consider prospects of which they may not have previously been aware.

“Volunteering is not only a fun and enjoyable experience but also raises the profile and understanding of the sector to more young people, thereby addressing current and forthcoming skill shortages.”

Dr Ajay Sharman, Regional Network

Lead for London and the South East at

STEM Learning

“When I talk to groups of students, it’s great to excite young people about STEM subjects and explain to them that what they are learning applies to real life. It’s great to provide a platform where we can challenge their understanding and skills, which is different to their normal learning environment.

“There are lots of great benefits to becoming a STEM Ambassador including: a sense of excitement when you engage students and they genuinely become interested and ask questions, helping to make a difference in the local community, as well as developing new skills, such as being able to communicate with a younger audience.

“By encouraging students to ask questions it also helps students to build their self-confidence and motivation for their future.”

Pav Jeeta IBMS Member

and STEM Ambassador

Supporting lessons and STEM clubs

Careers talks and networking events

Providing advice to teachers or practical

support for STEM projects

Science or careers fairs

Helping develop resources or other

forms of support.

How to become a STEM Ambassador?Anyone who is over the age of 17, who

uses STEM skills and is willing and able to

excite young people about STEM subjects,

can apply to become a STEM Ambassador.

Simply register at: www.stem.org.uk/

stem-ambassadors to volunteer and start

making an impact today.

You will be required to carry out an

induction and complete an enhanced DBS

check to become a STEM Ambassador.

STEM Ambassadors must take part in

a minimum of one activity each year,

which could be a careers event, a

classroom visit, a Skype chat or even

a youth group visit.

To ensure that our members who

undertake public engagement are fully For more information, and to apply to

be a STEM Ambassador, visit stem.org.uk

prepared and supported at their events,

we will be hosting STEM Ambassador

training sessions in 2018.

Why become a STEM Ambassador? The STEM Ambassadors programme is

working to make a diff erence in STEM

education and address the UK’s skills gap.

STEM Ambassadors are role models for

young people of all backgrounds and

abilities, helping them to understand

real-world applications of STEM subjects

and experience hands-on STEM

activities. This can raise young people’s

engagement and achievement in STEM

and can increase the numbers of young

people progressing into STEM studies

and careers. People at any stage of their

career, who are enthusiastic about

engaging with young people to promote

STEM subjects and professions, are

encouraged to volunteer.

As a STEM Ambassador, you will be

joining a community of volunteers


ADVICEHow to

P36-37 IBMS Jan18_How to_v3gh.indd 37 18/12/2017 12:03

It is 25 years since the IBMS Council

defi ned CPD as: “A process of lifelong

learning, which enables you to meet

the prerequisite knowledge and skill

levels that relate to your evolving

scope of practice, thereby

maintaining competence in your

scope of practice as a practitioner in

biomedical science” and formalised its

approach to CPD with the introduction

of a CPD diploma: a comprehensive

scheme that allowed members to

“have their personal and professional

commitment recognised”.

Ten years later, a review in 2002 saw

the introduction of a new portfolio, a new

credit system and the addition of

refl ective learning. In 2006, it became a

legal requirement for statutory regulation

as the HPC (as it was then) introduced

How far has Continuing Professional Development (CPD) come in the last 25 years? Alan Wainwright fromthe IBMS looks to the past.

TIME TO REFLECT


ADVICEEducation update

THE BIOMEDICAL SCIENTIST38

P38-39 IBMS JAN18_Time To_v2gh.indd 38 15/12/2017 14:24

through its policies and member

engagement programmes, the biggest

and most successful of which is the

biennial Congress.

Institute infl uenceOne question that arises periodically is

how much control should the Institute

exert? For example, should it be

mandatory for membership? Should

diff erent grades of membership have

diff erent CPD requirements? How should

it be assessed? Should members be

provided with feedback on their CPD

activities? Overwhelmingly, in a recent

survey, feedback from members focussed

on how members could be supported to

meet the requirements of the HCPC and

their periodic audit.

The Institute responded positively to

this by simplifying the CPD ePortfolio

facility that enables members to submit

courses for CPD recognition and access

them as a recorded CPD activity aligned to

the HCPC standards for CPD. Diplomas are

automatically awarded when 24 activities

(with refl ective practice on each one)

across a minimum of three categories

have been logged. Admittedly, members

may not always feel the need, but by

being required to refl ect on submitted

activities this supports the acquisition of

recorded evidence that can be used in the

CPD profi le that is part of the response to

the HCPC or Science Council audit.

Arguably the Institute processes for CPD

are now simpler, more logical and fi t for

purpose, but how far have we come in the

last 25 years?

Embraced by manyCurrently, about 25% of members are

actively engaged with the Institute’s CPD

scheme. This isn’t to say other members

are not doing CPD, as evidenced by the

widespread number of published CPD

activities, and CPD audits always show a

good response from biomedical scientists,

so clearly individuals are able to evidence

their CPD.

However, a presentation on CPD is

probably one of the most frequent

requests made to the Institute’s education

department and there is a perception that

members still see CPD as a bit of a

mystery, especially the refl ective practice

element. It is as though the concept of

CPD is embraced by many but is not yet

understood suffi ciently well enough to be

embedded fully in our culture.

So how far have we come? I like to think

that Russ Allison, as Chairman of the CPD

Unit, would be proud that after 25 years

the CPD scheme is still going strong and

the Institute continues to invest in CPD. I

am sure he would fully support how we

encourage members to take a more

value-added approach to CPD: to focus on

learning outcomes and the benefi ts of

these on their ability to practice and the

benefi ts of this to others as a recipient of

their services. He would probably also say

there is still a long way to go, that we

should recognise there are no barriers to

CPD other than those in the mind and,

most importantly, emphasise that CPD is

an expectation of being a professional.

Alan Wainwright is the Executive Head of

Education at the IBMS.IMAG

E: IS

TOCK

The Institute responded positively to this by simplifying the CPD ePortfolio facility

CPD standards for continuing

registration, thus completing the three

pillars of professional regulation: entry

qualifi cations, codes of ethics and CPD.

Biomedical scientists are now required

to continually develop themselves and

demonstrate they are doing so, it being

now recognised that initial qualifi cations

as a one-off activity are no longer a

suffi cient education and training basis to

support career-long competency to

practice, or for that matter a guarantee of

a career-long professional attitude.

Constantly developingScientifi c theory, technology and practice

in biomedical science are constantly

developing and biomedical scientists, like

many professionals, can argue they have

always “just done” CPD through formal

education and training activities,

observing others, discussing problems,

networking and learning from personal

practice. Before the introduction of a

formal scheme, the Institute supported

this by providing opportunities for

professional development: networking

through local branches, dinners, awards;

and dissemination of new development

through journals, websites, lectures,

workshops. But is this enough?

Active engagement in formal CPD

signals a commitment by professionals

and their professional bodies that they

are “keeping up to date” with the

requirements of their practice, with

learning experiences that allow

professional development and

maintenance of professional standards.

It should demonstrate standards of

knowledge, skills, and competence

(fi tness to practice) determined by

employers and professional or regulatory

bodies. It should improve safety and

quality of practice and embrace the

principles of lifelong learning.

For biomedical scientists, it is the

Health and Care Professions Council

(HCPC) and Science Council as

registration authorities that defi ne the

standards for CPD, while the Institute, as

with other professional bodies, promotes

and supports professional development


ADVICEEducation update

P38-39 IBMS JAN18_Time To_v2gh.indd 39 15/12/2017 14:24


MY IBMSNews

MY IBMSNEWS

IBMS APPOINTMENT

New President takes reignsADVANCING HEALTHCARE AWARDS

NOMINATIONS ARE NOW OPEN

COUNCIL ELECTIONS

YOUR CHANCE TO SHAPE THE FUTURE OF THE IBMSThe IBMS prides itself on being a professional body

that is run by its members for its members.

The IBMS Council is elected by Institute

members to make key decisions, provide leadership

for the profession and eff ective and transparent governance, as well as be a

compelling advocate on their behalf.

The Institute is looking for IBMS corporate members to stand for election to

Council; members who will use their professional knowledge, leadership skills

and experience to set the strategic decision of the IBMS, shaping the

professional body’s future and ensuring it continues to meet its members’ needs.

Becoming an IBMS Council member off ers an excellent opportunity to

make a signifi cant contribution to the future direction of the Institute and

the profession and to build your experience, broaden your skills and networks.

Two National and fi ve Regional (East Anglia, East Midlands, London,

North West and North East) Council members are to be elected in 2018.

You can fi nd out more about becoming an IBMS Council member, and access the

online nomination form at the IBMS Website : www.ibms.org/councilelections

IBMS member Alison Geddis has now taken up the role of President of the IBMS.

She began her two-year term of offi ce on 1 January, having taken over from the outgoing President Ian Sturdgess, who said: “I am really excited for Alison taking over the reins and I hope

that she enjoys being President as much as I have.”

Alison has more than 30 years’ experience as a practising biomedical scientist, and has served for more than 20 years as an IBMS committee member.

She has worked in cytology, haematology, blood transfusion, stem cell banking and quality and has recently been appointed as the Laboratory Services Manager for the Northern Ireland Blood Transfusion Service. She also lectures at Ulster University.

Alison said: “I would like to continue to use my proven skills and attributes as President of the IBMS to build and expand on all the fantastic work that the IBMS has achieved.”

The Advancing Healthcare Awards, which are in their 12th year, are now accepting nominations for 2018.

The awards aim to recognise and reward projects and professionals that lead innovative healthcare practice and make a real difference to patients’ lives.

Four of the awards are open to healthcare scientists only and are supported by the Academy for Healthcare Science. In total, there are eight awards open to healthcare scientists. Among these is the newly-sponsored IBMS Award – Inspiring the biomedical workforce of the future. The IBMS award aims to recognise and reward people who are committed to inspiring the next generation of biomedical scientists.

The IBMS hopes to showcase the essential contribution that biomedical scientists make to attracting and developing a workforce that displays the behaviours and values that are needed to deliver professional care.

The deadline is 19 January 2018. To fi nd out more and to apply, visit

ahpandhsawards.co.uk

P40-41 IBMS Jan18_IBMS News_v4gh.indd 40 18/12/2017 12:04


MY IBMSAwards

PRESIDENT’SPRIZES

Continuing the coverage of winners

from around the country

PRESIDENT’S PRIZE WINNERSWOLVERHAMPTON SUCCESS

Fatheha Begum received

the IBMS President’s Prize

for the University of

Wolverhampton at a recent

graduation ceremony. She

graduated with fi rst-class

honours from her Applied

Biomedical Science course

and she completed a 12-

month sandwich placement

and her Registration

Portfolio at Birmingham

Women’s Hospital.

Fatheha, who is currently

employed as a Biomedical

Scientist at Public Health

England, Heartlands Hospital,

aims to complete an IBMS

Specialist Portfolio and

undertake an MSc course in

the future. She is pictured

with Karen McLeod,

Operations Manager/Deputy

Head Biomedical Scientist,

Department of Cellular

Pathology, Birmingham

Heartlands Hospital.

CARDIFF TO CAMBRIDGE

Mohammed Rahi Ahmed

was the 2017 winner of the

IBMS President’s Prize at

Cardiff Metropolitan

University (CMU). Rahi

achieved the best overall mark

for the entire cohort of BSc

Biomedical Science and BSc

Healthcare Science students,

and, thanks to the foundation

of knowledge provided by the

CMU course, is now pursuing

an MPhil in Medical Science

(Medicine) at the University

of Cambridge. He is pictured

receiving his award from

Dr Richard Webb, CMU Head

of Department.

OBITUARY

HELEN WALKER

BRANCH MEETING

IBMS regional AGM

It is with great sadness that we report the loss of our friend and colleague Helen Walker (nee Rouse), who passed away after a short battle with cancer on 25 October 2017.

Helen began her career as a Junior Laboratory Technician in May 1977, specialising in haematology, givingover 40 years’ service to Sheffi eld Hospitals and the NHS.

She was an active member of the IBMS, acting as CPD offi cer for many years, continually promoting its services and contributing to branch activities.

ONLINE WORKSHOP

A digital-ready workforceThe IBMS is encouraging members

to share their views and help build the

digital-ready workforce of the future.

To help improve the digital

capabilities of the health and care

professional community, Health

Education England, NHS England

and NHS Digital are asking

professionals to share their views

in an online workshops.

They want to know what help

and support is needed to improve

the impact of digital expertise, and to

improve the “digital maturity” of others.

The groups are hosting a

three-week national online workshop

to ascertain the needs of those working

in healthcare.

The results of the online workshops

will form the basis for how the

Building a Digital-Ready Workforce

programme will prioritise and invest

its funds over the next four years.

For more information and to

sign up for the workshop,

visit bit.ly/BS_DigitalReady

IMAG

ES: I

STOC

K

The IBMS West Midlands Region and Birmingham

Branch is holding its annual general meeting this month.

It takes place from 5.30pm on 18 January at the

lecture theatre in the Education Resource Centre at

Birmingham Women’s Hospital.

It will be followed by awards for the most

improved students in BSC (Hons) Biomedical Science

for local universities.

There will also be a presentation by Dr Natasha

Ratnaraja, Consultant in Infection, Microbiology

Department, Sandwell and West Birmingham Hospitals

NHS Trust called “Sepsis: a multidisciplinary approach”.

All members are welcome and a light supper is

available on the night.

For further details, please email

[email protected] or call 0121 6236889.

P40-41 IBMS Jan18_IBMS News_v4gh.indd 41 18/12/2017 12:25

Tel: +44 (0)23 8048 3000 | Web: www.alphalabs.co.uk

Join the Calprotectin

www.calprotectin.co.uk

Future proof your Calprotectin testing with BÜHLMANN Assays

IBDoc® patient self-testing for IBD monitoring

Quantum Blue® fCAL - Rapid Point of care or low volume testing

fCAL™ ELISA - High throughput laboratory testing covering the range 10-1800 μg/g fCAL™ turbo - High throughput turbidimetric assay for clinical chemistry platforms covering the range 20 - 8000μg/g

- For all your testing requirements Quantitative Standardised assays for consistent results Simplified sample preparation using CALEX extraction devices Scalable Flexible

Start Your Evolution Today...

...contact the Calprotectin SpecialistsFreephone 0800 38 77 32 or

Email: [email protected]

Meet. Learn. Discover.

• Counts towards CPD• Over 65 market leading exhibitors• Workshops and keynote speakers to be announced

Visit: scientificlaboratoryshow.com

BIO.01.18.042.indd 42 14/12/2017 10:19

DATE TITLE VENUE CONTACTJanuary

9 – 10 Jan UK NEQAS reproductive science semen analysis

one-day workshop

Manchester I [email protected]

15 – 19 Jan Biosafety practitioner level 1 (ISTR accredited) Porton Down I [email protected]

February

13 Feb Manchester bacteriology discussion group Manchester I [email protected]

March

13 Mar Manchester bacteriology discussion group Manchester I [email protected]

20 – 22 Mar Three-day update for cervical cytology Bristol I [email protected]

April

11 Apr Update in cervical cytology for pathologists, consultant BMS’s and holders of the Advanced Specialist Diploma in cervical cytology

Bristol I [email protected]

23 – 27 Apr Introduction to the principles and practices of working at ACDP containment level 3

Porton Down I [email protected]

25 Apr Respiratory cytology Bristol I [email protected]

May

8 May Manchester bacteriology discussion group Manchester I [email protected]

9 May One-day update in cervical cytology audit Bristol I [email protected]

16 May Serous fl uid Bristol I [email protected]

June

6 Jun Cervical histology for technical staff Bristol I [email protected]

12 – 14 Jun Three-day update for cervical cytology Bristol I [email protected]

14 – 15 Jun Practical and clinical microbiology of anaerobes (P&CMAn) Cardiff I deborah_robinson@dwscientifi c.co.uk

July

4 Jul Urinary cytology Bristol I [email protected]

September

4 – 6 Sep Three-day update for cervical cytology Bristol I [email protected]

21 – 22 Sep Advanced course in EBUS/mediastinal EUS and rapid on-site

evaluation for chest physicians and cytopathology teams

Watford I [email protected]

October

17 Oct One-day update in cervical cytology audit Bristol I [email protected]

November

7 Nov Update in cervical cytology for pathologists, consultant

BMS’s and holders of the Advanced Specialist Diploma in

cervical cytology

Bristol I [email protected]

EVENTS AND TRAINING COURSES

A wide range of training courses, CPD and local events and activities is listed below. Members are advised to contact organisers for further information. A full list is available on the IBMS website.


MY IBMSContinuing professional development

P43 IBMS Jan17_CPD Events Training.indd 43 15/12/2017 14:26

At the Heart of Haemostasis

UK

Diagnostica Stago UK Ltd2 Theale Lakes Business Park Moulden WaySulhamsteadThealeRG7 4GBPh. +44 0118 949 7056Fax: +44 0118 949 [email protected]

Conc

eptio

n: L2

R.fr-

©201

7 Diag

nosti

ca St

ago -

All r

ights

reserv

ed - N

on-co

ntrac

tual p

hotos

07/2

017.

Maximum VersatilityAdaptable for

multi-instrument organisation

Maximum ReliabilityGold Standard

viscosity based detection system

Maximum ProductivityIntroducing Pre-analytical

Check, providing complete qualification of sample

integrity and analysis time

Maximum InnovationAutomated validation

of results using expert rules,

with integrated STA Coag Expert

Excellence born from Expertise

EPC module : Expert Preanalytical Check module (Sample integrity check: Haemolysis, Icterus, Lipaemia)

NewINSIDE

EPModuleModule

C

BIO.01.18.044.indd 44 15/12/2017 10:46

JOURNAL-BASED LEARNING EXERCISESEach article’s contents should be read, researched and understood, and you should then come to a decision on each question. The pass mark is 17 out of 20 questions answered correctly. JBL exercises may be completed at any time until the published deadline date. Please select your choice of correct answers and complete the exercises online at: www.ibms.org/cpd/jbl

DEADLINE WEDNESDAY 5 APRIL 2018 Standardization of steroid tests and implications for the endocrine community. Honour JW. Ann Clin Biochem 2017; 54 (6): 628–30.Serum cortisol: an up-to-date assessment of routine assay performance. Hawley JM, Owen LJ, Lockhart SJ et al. Clin Chem 2016; 62 (9): 1220–9.Assessment No: 010318

Managing complaints in the independent healthcare sectorIndependent Healthcare Sector Complaints and Adjudication Service (www.iscas.org.uk/cat_view/121-iscas/70-iscas-publications). Assessment No: 010918

01The analytical method used makes no difference to the cut-off usedfor a synacthen test. 01

The Independent Healthcare Sector Complaints and Adjudication Service (ISCAS) wields regulatory powers in the independent healthcare arena.

02Mass spectrometry methods do not suffer from any interferences.

02This code does not apply to issues around the Mental Health Act.

03Synacthen is a synthetic form of ACTH.

03ISCAS seeks to work fairly and avoid bias.

04Endocrine stimulation test protocols are well established and do not need revisiting.

04There are seven ISCAS principles set out with regard to dealing with complaints.

05For analysis of samples from males, the Beckman Access method displayed a positive bias. 05

ISCAS does not comment on the subject of apologies.

06The Roche E170 generation 1 assay bias was concentration-dependentfor male samples. 06

In general, ISCAS expects complaints to be raised within six months.

07The Abbott Architect and Beckman Access methods had marked negative bias.

07The guidance advocates the use of meetings between the complainant and the independent healthcare provider.

08The reference method in this study was LC-MS/MS.

08A “written” response to a complaint can be issued as an email.

09Metyrapone has similar effects on the bias of all the assays tested.

09The code does not advocate organisations making any sort of fi nancial gesture of good will.

10Of all the assays, the Siemens Centaur shows the largest effect of prednisolone.

10Complaints needing external, independent adjudication are excluded from this process if they raise new issues at this point.

11Cortisol-binding globulin concentrations are likely to affect assay bias.

11There is a specifi c format that independent adjudicators must use when writing to those who have raised the complaint.

12Manufacturers often do not state their method for displacing cortisol from its binding globulin. 12

ISCAS does not undertake ongoing reviews of independent healthcare providers that continue to fail to meet the standards.

13The metyrapone bias is likely to be due to accumulation of cortisol precursors in the sample. 13

It is possible to complain about how ISCAS has managed complaints at the tertiary level.

14The problem of method-dependent bias has only recently come to light.

14Implementation of any improvements derived from a complaint does not have to be issued in writing.

15There are no clinical issues when laboratories move from the Roche I to the Roche II cortisol assay. 15

At stage 2 of a complaint review, the healthcare provider must update patients every 20 days as a minimum with regard to an ongoing review.

16Of all the assays, the LC-MS/MS performed the best against GC-MS.

16Professional regulatory bodies are aware that professional, regulated staff must assist with investigations.

17Short chromatography in LC-MS/MS may give rise to endogenous interferences.

17Independent healthcare providers are expected to make complaints procedures fully accessible to all, regardless of whether or not English is their fi rst language.

18Endogenous steroids may interfere in the internal standard signal withLC-MS/MS assays. 18

ISCAS does not take any consideration of the use of mediation.

19The GC-MS assay used in Hawley et al. showed between-assay precision of <2% for all pools. 19

ISCAS recommends an empathetic and refl ective approach tomanaging complaints.

20Immunoassay imprecision ranged from 1.6% to 7.5%.

20The code does not apply to those wishing to make a complaint on behalf of another individual.

REFLECTIVE LEARNING

01

What factors need to be considered when changing supplier, or when a supplier changes their method, for steroid analyses?

01

Should standards of healthcare be any different in the independent sector to those in the NHS or other state-provided healthcare? If so, whyand how different?

02Outline the advantages and disadvantages of using LC-MS/MS for routine steroid analysis in the clinical laboratory. 02

Should there be national regulation to cover standards of healthcareprovision directly rather than by having a separate body? Are therepros and cons either way?


MY IBMSContinuing professional development

P45 IBMS Jan18_IBMS JBL_v1sa.indd 45 15/12/2017 14:26

The IBMS Registration Team receives large numbers of questions, ranging from simple to the very complex. Jocelyn Pryce highlights 10 of the most common answers to members’ questions.

1 As well as being the professional body

for biomedical scientists, the IBMS is an

education provider and awarding body

approved by the HCPC for a number of

routes to HCPC registration.

2 The IBMS Registration Training

Portfolio and Certifi cate of Competence

is a process by which individuals provide

evidence that they have met the

competencies required of the HCPC

standards of profi ciency, are fi t to practice

at threshold level as a biomedical scientist

and are, therefore, eligible to apply for

professional registration with the HCPC.

3 IBMS Registration Training Portfolios

can only be completed in laboratories

holding IBMS training approval at the

pre-registration level.

4 The time limits have recently been

removed from our current Version 4

Registration Portfolios, however, evidence

must be within three years of the date of

verifi cation. There is an expiry limit of

three years on older versions of the

portfolios and all holders of Version 3

must complete by December 2018.

5 The verifi cation visit should be about

satisfaction there is evidence that the

candidate can work to the standards of

profi ciency and not about the technical

aspects, therefore, the verifi er needs to be

HERE TO HELP

10 REGISTRATION FACTS

reassured that the standard has been met

rather than HOW it has been met.

6 Verifi ers do not need to be

discipline specifi c.

7 As the evidence requirements for the

version 3 and version 4 portfolios diff er,

the duration of the tour has been

extended from 30 minutes for Version 3 to

40 minutes for version 4, so that verifi ers

have a chance to probe understanding in

areas where the evidence may be weaker.

8 The verifi er report form should be

returned to the IBMS Registration

Team within one week of the visit and

the candidate will not be referred to the

HCPC until that form is received and

the award of the IBMS Certifi cate of

Competence confi rmed.

9 The verifi er form gives feedback on

the candidate and the lab training and

the lab feedback form gives information

about the IBMS processes and feedback

on the verifi er. The combination of this

gives robustness to all aspects of the

verifi cation process.

10 We are often asked why the

verifi cation process can sometimes

take a long time, and this can be for a

variety of reasons. Our verifi ers are

volunteers who off er their time, often

using annual leave to do so, to assess the

biomedical scientists of the future. The

whole process operates on goodwill and

the enthusiasm of those who volunteer.

I would like to take this opportunity to

thank everyone who is involved in the

training and verifying of our candidates

and wish you all well for 2018.

IMAG

E: IS

TOCK

For more information, visit

www.ibms.org/registration


MY IBMSHere to help

P46 IBMS Jan18_My IBMS HTH_v1sa.indd 46 15/12/2017 14:26

BIOMEDICAL SCIENTISTIBMS.ORG

THE

As the official magazine of the IBMS, The Biomedical Scientist is the main means of regular communication between the Institute and its membership of 20,000.

For all display and recruitment advertising enquiries for The Biomedical Scientist

please contact [email protected]

THE BIOMEDICAL SCIENTIST provides the best route for

manufacturers and suppliers of clinical diagnostic products

and systems, as well as general scientific laboratory

products and services, wishing to influence this extremely important target audience.

As the official magazine of the IBMS

import

, The Biomedical Scientist is the main meansThe Biomedical S

BIO.01.18.047.indd 47 15/12/2017 10:44


RECRUITMENTFor recruitment advertising contact our Sales Team +44 (0)20 7880 6234

To discuss recruitment advertising in The Biomedical Scientist, please contact our Sales Team on +44 (0)20 7880 6234 or email [email protected]

JANUARY 2017

BIOMEDICAL SCIENTISTIBMS.ORG

THE

Collaboration at the Crick

MANY HANDSMAKE BRIGHT WORK

BIOIMAGING

FLUORESCENT TAGGING Dr Marc Vendrell discusses bioimaging technology � p.16

INFECTION CONTROL

ANTIBIOTIC RESISTANCE Dr Elaine Cloutman-Green writes about the issues � p.30

WORKFORCE

PATHOLOGY REPORT Is the workforce keeping up with demand? � p.32

Would you like to advertise your vacancy here?

The only way for your vacancy to reach over 20,000 IBMS members

BIO Recr Jan18.indd 48 15/12/2017 10:23


RECRUITMENTFor recruitment advertising contact our Sales Team +44 (0)20 7880 6234

About UsiPP (Integrated Pathology Services) was established in 2010 to enable UK healthcare

partner to both the NHS and independent healthcare providers. iPP are part of the SYNLAB Group, the market leader in laboratory services in Europe.

iPP, Integrated Pathology Partnerships

If you are looking to develop your career in a state of the art laboratory service in Microbiology, Blood Science (Haematology, Blood Transfusion and Biochemistry) orhistopathology, please visit www.ipp-uk.com and apply online.

development programmes.

Applicants can also send their CVs to [email protected]

Be the change, your new career starts here

OUR VALUES IN ACTION

• Care and Compassion • Quality and Teamwork • Dignity and Respect • Openness, honesty and responsibility

Specialist Biomedical Scientist (Haematology/Transfusion) Borders General Hospital, Blood Sciences Laboratory Band 6 £26,830 - £35,933 per annum, pro rata Permanent, 37.5 hours per week Ref: PTB203

Band 6 candidates must be HCPC registered and have completed an IBMS Specialist Portfolio in Blood Sciences or Haematology (or equivalent) together with relevant experience in a diagnostic clinical Haematology/Transfusion service.

On completion of competency, you will be required to take part in the 24/7 shift pattern.

The Borders General Hospital sits in a beautiful rural setting with a train link to Edinburgh within walking distance.

For any additional information, please contact Jackie Scott on 01896 826238 or email [email protected].

Closing date for completed application forms: 5pm on Thursday 25 January 2018.

www.nhsborders.org.uk

Bòrd SSN nan Eilean Siar

Western Isles Hospital, Macaulay Road, Stornoway, Isle of Lewis HS1 2AF

Specialist Biomedical Scientist (Blood Sciences)Band 6: £26,830 - £35,933 per annum plus £985 Distant Islands Allowance – 37.5 hours per week Ref: WI1963Would you like to experience the challenge of working in a unique, remote and rural location in the UK? The Clinical Laboratory Service of the Western Isles NHS Board is seeking an experienced Biomedical Scientist who would like to join our small, friendly and dynamic team in the Blood Sciences Laboratory at the Western Isles Hospital, Stornoway, Isle of Lewis. The post holder will have experience in either haematology or biochemistry and duties will include rotation in blood transfusion. Participation in the blood sciences and blood transfusion on-call rota may be a requirement of the post.The Western Isles Hospital is located in Stornoway in the Western Isles, situated off the north-west coast of Scotland. The island provides an excellent environment in which to live and work, with low pollution, housing costs and crime rates. Outdoor pursuits are easily accessed; the islands are un-spoilt with unique culture, wildlife and amazing scenery. For more information on living and working in the Western Isles visit the website: www.wihb.scot.nhs.uk/wihrr.pdf.This post is eligible for relocation expenses.Informal discussion is encouraged; please contact Anne Carstairs, Interim Laboratory Manager.All NHS Western Isles vacancies appear on the SHOW website: www.jobs.scot.nhs.uk along with a job description and an application form. Gheibhear bileag-tagraidh agus dealbh-obrach bho Roinn Feachd-obrach, Ospadal nan Eilean Siar, Rathad MhicAmhlaigh, Ste˜rnabhagh, Eilean Le˜dhais, HS1 2AF. F˜n: 01851 762005 or 762027.Return completed application form in Word Format to [email protected] or mail to: Human Resources Department, Western Isles Hospital, Macaulay Road, Stornoway, Isle of Lewis, HS1 2AF. Tel: 01851 762005 or 762027. Closing date: 29 January 2018.Misneachail mu chiorramaich

www.jobs.scot.nhs.uk

BIO Recr Jan18.indd 49 15/12/2017 10:23

Ruth Riisnaes gives a guided tour of her lab at the Institute of Cancer Research in Sutton.

My lab is the

Histopathology

section of a

research team,

led by Professor

Johann de Bono,

comprising six

biomedical

scientists and a pathologist. Our

team is one of many in the

Institute of Cancer Research (ICR).

We oversee samples from cancer

patients on clinical trials

conducted within the Royal

Marsden Hospital (RMH), where

our patients are being cared for. The Vision

Statements for the ICR and the RMH are

“Making the discoveries that defeat

cancer” and “Life demands excellence”.

Our clinical research team works

alongside the ICR/RMH Drug

Development Unit, where patients with

advanced metastatic cancer participate in

clinical trials, and the Prostate Cancer

Targeted Therapy Group.

The Histopathology section has a wide

range of skills including

immunohistochemistry (IHC),

immunofl uorescence (IF), Fluorescence in

situ Hybridisation (FISH) and digital

pathology imaging, as well as array

comparative genomic hybridization and

next generation sequencing.

We have also developed skills not

traditionally considered to be

histopathology based, including organoid

culture and patient derived xenograft

generation, as well as single cell and

MY LAB

THE CANCER BIOMARKERS TEAM

circulating tumour cell (CTC) analyses. We

work closely with pathologists evaluating

all of our stained slides. This means

assisting in identifying tumour in H&E

slides, as well as scoring all the IHC, IF

and FISH with pathologists.

Our lab is totally research based and we

are passionate about our work, constantly

investigating new biomarkers for cancer

therapies and proteins of interest.

We have many collaborators worldwide

including multiple US research partners

and are part of the “International Prostate

Cancer Dream Team” for Stand Up to

Cancer. We work with many drug

companies, and one of our major successes

was the development and trial of the drug

abiraterone (Zytiga) fi rst synthesized and

designed here in Sutton, Surrey, which is

now widely used in the treatment of

castration resistant prostate cancer and

has been given to more than 300,000 men

suff ering from prostate cancer to date.

We are an academic institute

and are actively encouraged to

learn, read publications, attend

courses and present our work.

This means that we are easily able

to gain knowledge for CPD. We are

constantly striving to do the best

for our patients, and a signifi cant

part of this is to publish articles

on a regular basis.

As we in the Histopathology

Team attend all of our biopsies,

we have the privilege of meeting

all our patients, and this brings

into perspective why we are doing

the work we do. As a result of attending

these, we are able to assess the sample

quality, working together to SOPs with

doctors and radiologists, and know

exactly what time the biopsy goes into

formalin or is frozen, ensuring optimal

sample processing with these being fi xed

or frozen immediately. This guarantees

the best possible quality tumour tissue,

and also excellent quality DNA and mRNA

for next generation sequencing.

We make the most of all of our biopsies

by cutting serial sections, as there can be

numerous tests required from them. Who

knows what biomarkers we will be

expected to look for in future projects,

which we are unaware of at present, but

may become essential in our research and

in our quest to fi nd a cure for cancer?

Ruth Riisnaes is a Fellow of the IBMS and

a Senior Scientifi c Offi cer and Laboratory

Manager at the Institute of Cancer Research.


MY LABRuth Riisnaes

P50_IBMS January18_My Lab_v1gh.indd 50 15/12/2017 14:27

Serum Free Light Chain quantification

If your actual FLC units are not coherent

SEBIA ELISA: ANALYTICALLY COHERENT

BEYOND SEPARATION FLC Line

www.sebia.com

Addressing the past for a clearer future

What exactly do you measure ?

FLC-

2017

04-A

DS2-

EN -

© -

Prod

uct C

E M

arke

d - P

rodu

ct n

ot F

DA c

lear

edCh

eck

with

you

r Seb

ia re

pres

enta

tive

for p

rodu

ct a

vaila

bility

.

SPE: 2.3 g/L FLC Nephelometry: 22.4 g/L FLC ELISA: 1.5 g/L

1. 2.

SPE: 3.1 g/L FLC Nephelometry: 32.2 g/L FLC ELISA: 3.1 g/L

SPE: 2.3 g/LFLC Nephelometry: 22.4 g/LFLC ELISA: 1.5 g/L

SPE: 3.1 g/LFLC Nephelometry: 32.2 g/LFLC ELISA: 3.1 g/L

Overestimation of Serum Free Light Chain Concentration by ImmunonephelometryCorrie M. de Kat Angelino, Reinier Raymakers, Maria A. Teunesen, Joannes F.M. Jacobs, Ina S. KlasenClinical Chemistry Jul 2010, 56 (7) 1188-1190; DOI: 10.1373/clinchem.2010.143529(reproduced with permission from the American Association for Clinical Chemistry)

BIO.01.18.051.indd 51 14/12/2017 10:52

Roche Diagnostics gives you The Power of Knowing that you’re using accurate information to make the right decisions today, so your patients can experience a healthier tomorrow.

THE POWER OF KNOWING

I KNOW WE ARE SAVING LIVES

BIO.01.18.052.indd 52 14/12/2017 10:53

The second of a the motivation behind three-part series on...

Documents

Transcript of The second of a the motivation behind three-part series on...