The Pathology Partnership (’the Partnership’) – update 7
To: All GPs in East and North Hertfordshire, via Practice Managers
29 July 2015
Dear colleague,
This is the seventh regular update report, to keep you informed of the CCG’s actions and the
Partnership’s progress towards delivering a high quality pathology service to GP practices.
East and North Hertfordshire CCG representatives continue to meet with the Partnership
and Cambridge and Peterborough CCG on a weekly basis to review the Remedial Action Plan.
Key progress made this week includes:

Delayed test reports
I am pleased to report that the national issue with delayed test reports has now been
resolved. The Partnership is working through the backlog of results from the last 24
hours. Abnormal results will continue to be telephoned through to practices in line
with procedures. In the meantime, if you have clinical concerns about particular
patients you can all the Partnership’s helpline on 0333 103 2220 and press 1 for GP
practice queries.

First clinical forum meeting
Thursday 23rd July 2015 saw the first CCG and Pathology Partnership Clinical Forum.
The meeting was well represented by CCG Directors and GP leads, the Partnership
and Public Health England (PHE). The following key items were discussed:
o Chris Nolan has been appointed as the new Interim Chief Executive of the
Partnership and has started in post.
o Batch reports: From, the 18th September, GPs will be able to view results from
a batch of tests ordered for a patient at the same time. To make this happen,
the Partnership is implementing an interim IT solution, prior to Epic, the
software manufacturer of the Electronic Patient Record System used at
Cambridge University Hospitals (which includes the pathology IT system)
makes longer term changes to the underlying software. This is in-line with
the delivery date agreed within the remedial action plan. Epic is currently
estimating the delivery date for changes to the underlying system to be in
place by the end of December 2015.
o Change control process: The Partnership has developed a collaborative
‘change control process’ which was discussed at the Forum. This is an
important document which ensures that approval from commissioners is
sought before any non-contractual changes are made which impact upon GPs
and patients. Before changes are introduced, the Partnership will outline the
reasons for the requested change and demonstrate that it has considered the
impact on practices.
A draft of this document has also now been shared with all CCGs and we will
let you know when a final version is in place.
o Date and time sample taken: GPs have reported that they are unable to see
the time and date the sample has been taken. This data is being captured but
there are problems with this information feeding into GPs’ clinical systems.
The Partnership is working with clinical system providers to find a resolution.
o Communication of severely abnormal results: We are aware that some
practices have not been notified of severely abnormal results. The Partnership
has stated that it works to the Royal College of Pathology guidelines, but it
has become apparent that not all calls are being logged. The CCG has asked
the Partnership to be more rigorous in its call logging and undertake an audit
to provide assurance that standards are being met.
o Delays in Microbiology: the Partnership informs us that laboratory turnaround times for microbiology tests are now being achieved. Please let us
know via the contract hotline if you are experiencing delays in microbiology.
o Duplicate Results: The CCG has provided the Partnership with a list of specific
cases raised through the hotline and has asked the Partnership to review and
provide feedback for each case.
o Delays in HBA1C results – the Partnership has confirmed that results for a
HBA1C test should be reported back to practices within two days. If you find
that results are taking longer, please report via the contract hotline to enable
us to review on a case by case basis.
o Falsely elevated potassium levels – We have been told by one practice of a
number of results with falsely raised potassium levels. The Partnership is
reviewing these cases and the CCG is looking into whether there is any link
between the incorrect results and the pick-up schedule for samples. The
Partnership has audited this issue and don’t believe it to be indicative of a
wider problem but the CCG will continue to keep an eye on the issue.
o Introduction of new ‘Starstedt monovettes’ urine pots – The CCG has agreed
with the Partnership that these new urine sample collection pots will not be
introduced until a full impact assessment is undertaken, the CCG has been
provided with evidence to support the change and the LMC has been briefed
on the implications. This is a good example of how the new ‘change control’
process should be used to introduce new ways of working and minimise the
impact on practices.
o Recall of patients – It has now been agreed that the recall service for East and
North Hertfordshire CCG patients, which is currently delivered from the
pathology laboratory at the Lister will move to Cambridge, because this is
where the pathology service for GPs is now provided. The date for
implementation is to be confirmed and we will let you know through this
bulletin once it has been agreed.
o Response to hotline queries – As set out in the action plan, the Partnership is
on track to respond to all queries raised through the hotline within 21 days.
o Pathology user guide handbook – the Partnership is revising the current
handbook and producing an at-a-glance guide to turnaround times for results.
Both of these documents will be available via East and North Hertfordshire
NHS Trust’s website shortly.
o The Clinical Forum is next due to meet later in August. A final date has yet to
be confirmed but it is expected to be on 20 August. If you have items you
would like to be addressed at the forum, or would like to comment or share
your experiences, please email them to Paula Simms no later than close of
play on the 20 July 2015: paula.simms@enhertsccg.nhs.uk

Educational Topics
The Partnership’s team of specialist clinicians has offered to provide educational
sessions to practices at TARGET days to share their knowledge and experience.
Suggested topics so far include the diagnosis of infections; diagnostics to rule out
infection and appropriate treatment or point of care testing for C-reactive protein
(CRP).
If practices have a specific topic they would like the Partnership to cover in one of
these sessions, please contact your locality manager.
Reporting concerns
If your practice continues to have problems with the service provided by the Partnership,
please use the contract hotline webform to refer specific concerns to the Quality Team as
they arise.
Alternatively you can email contracthotline.enccg@nhs.net or ring the hotline co-ordinator
on 07786 625 043. All of the issues that you raise are investigated, passed to the
Partnership for resolution, and will be reported back to the practices that raised them.
Thank you for your patience during this difficult period. Please be assured that all available
contractual levers are being used to resolve outstanding issues as soon as possible.
With regards,
Sheilagh Reavey
Director of Nursing and Quality
East and North Hertfordshire CCG