Laboratory servicing – as easy as child’s play

How can a managed laboratory service help improve efficiency and maintain quality for effective patient-centred care? Laboratory News finds out

Increasing budgetary demands and financial pressures mean that clinical laboratories, like many services in the NHS, are being forced to consider new ways of realising cost efficiencies, whilst still maintaining a quality service. As a result, an increasing number of hospitals in the UK are choosing to deliver their pathology services through innovative Managed Laboratory Service agreements.  

In a Managed Laboratory Service (MLS) agreement, the pathology department outsources the provision, management and maintenance of analytical equipment and associated products/reagents to a single supplier, while the laboratory retains responsibility for the day to day running of the equipment and interpretation of results. An MLS can incorporate operational, service and financial elements that benefit Trusts, pathology laboratories, service users and patients alike (table 1), and can be flexible enough to accommodate changes in workflow and/or updates in technology.

The flexibility of these MLS agreements allow laboratories to replace or refresh ageing equipment in an affordable way, enabling them to take full advantage of the very latest technology to realise further workflow and cost efficiencies in the laboratory.

The advantages of an MLS are experienced not just by the laboratory, but also by the Trust, the users of the pathology service and the patients themselves.

MLS agreements give laboratories the opportunity to increase automation for routine analyses. With subsequent improvements to turnaround times and potential reductions in costs, this helps them to meet service targets. In addition, an MLS enhances the relationship between the supplier and the laboratory so that, together, they can achieve the very best performance from the equipment for improved workflow efficiencies. Such affordable investment in the latest technology allows laboratory managers to make the most of their workforce, their equipment and their available space.

Improvements to workforce and workflow efficiencies can enable Trusts to make substantial savings, to meet performance objectives and to reduce patient waiting times. In addition, having one point of contact and a unitary charge reduces administration costs and, since financial and operational risks are shared with the supplier, there is the potential to reclaim VAT.  

The latest technology and increased automation allows service users (the medical professionals) to have access to a more efficient service, faster results and possibly a wider range of assays available 24/7. This enables them to receive important information quickly and efficiently so that they can make timely clinical decisions.

Most importantly, in an efficient patient-centred health service, patients can receive faster results. This means they have less time to wait, which improves the patient experience, and they receive appropriate care at the earliest opportunity.

Realising the potential for improving their pathology service, whilst meeting demands for greater cost effectiveness, Maidstone and Tunbridge Wells NHS Trust has recently opted for a fully automated MLS solution from Roche. This landmark agreement is predicted to save the Trust at least £2.5million over the next 7 years.

The Trust’s pathology and procurement departments worked on this joint venture for about a year to ensure the best total pathology solution for the Trust. Under the terms of the MLS agreement, Roche will provide everything the Trust needs (including enabling instrumentation, training, service and maintenance, reagents/consumables and equipment/software updates) to deliver its analytical requirements in chemistry, haematology, immunoassay and coagulation testing services.

Maidstone and Tunbridge Wells NHS Trust Chief Executive Glenn Douglas said: “Our pathology department serves hospitals and the primary care sector across Kent and Sussex. Over 150 GP practices send samples to us for diagnosis. This new Managed Service Agreement with Roche provides everything we need in a single package to provide a first-rate service with no waste of precious resources. We will be able to treat more patients, with improved outcomes and at lower cost. It will bring major benefits to our patients and allow substantial savings over the duration of the contract.”

Processing around 5,000 blood samples every day, the new equipment supplied under the MLS will allow the pathology department to reconfigure and streamline their services to benefit both staff and patients.

Following laboratory refurbishment, the main laboratory at Maidstone will increase their capacity and capability with two lines of cobas 8000 serum work area platforms, each with two cobas c701 high throughput clinical chemistry modules that can deliver up to 2,000 photometric tests per hour. In the near future, these will be connected to a Modular Pre-Analytics (MPA) system, which will help to automate many steps of the laboratory sampling handling process. Together, these systems will deliver efficiency savings to the Trust and will reduce sample analysis and reporting turn around timed (TAT). Next year, the contract will also cover analytical equipment in a brand new satellite laboratory at the new hospital in Pembury Hospital.

The contract will also include cobas immunoassay modules, the cobas Inventory Management System (cIMS), the Roche PSM data management system and Sysmex Haematology instruments as well as some equipment from third party suppliers. Roche has also contributed to some enabling works, which are designed to improve the space available and facilitate a blood sciences laboratory for the Trust.

“The new Managed Service Contract will give the opportunity for unprecedented change as our pathology and laboratory medicine services seek to modernise in line with new technology, patient focused care, evidence based practice and the demand for greater cost effectiveness,” commented general manager, pathology, Nigel Leftley.

“Having a single source of supply for the Trust means greater cost effectiveness and reduced administration costs,” Leftley continued. “In addition, the introduction of the Roche inventory management package (cIMS) will also provide benefits in controlling stock expenditure. The single contract for all locations will also provide greater standardisation across the laboratories, increasing productivity and improving communication and connectivity.”

“All in all,” Leftley concluded, “This helps us to meet key performance objectives by enabling effective financial control of variance. Furthermore, by transferring risk to Roche, the Trust will be able to recover VAT in full. This MLS agreement supports my aim of treating of more patients with improved outcomes at a lower cost.”

Roche centralised diagnostics sales specialist, John Glynn commented: “We have enjoyed a very good working relationship with Maidstone and Tunbridge Wells NHS Trust. The team in the Pathology Department have a clear vision of where they want to take their service and I think they saw that Roche could help them achieve this with our MLS contract and the advantages it offers, our technology and our continuing partnership.”

The MLS at Maidstone and Tunbridge Wells NHS Trust will run for a term of seven years, with the flexibility to expand the equipment and services covered by the agreement over the life of the contract in order to meet the changing needs of the Trust.