Recommended minimum standards for hospital transfusion laboratories.

[Malcolm Needs ☆]

I agree with you Steve (as I always tend to) about the huge vacuum in London, but it is not for the want of trying on the part of some people.

Mike Gorge, of the University of Westminster (for whom I have huge respect), and others have tried very hard to get such a course off the ground, but to do so, there has to be sufficient interest shown by potential students and their employers. From what Mike tells me, it is the latter problem that is the stumbling block (although, that having been said, even the former is a problem).

If there were to be a concerted effort by all parties, and I mean concerted, there is a very good chance that such a course be run, but at the moment, most of the efforts are disparate.

:confuse:

[jayjay]

Thanks Malcolm, there are many variables in this. Do other transfusion Lab managers also take fiull responsibility for haemovigilance reporting or is this generally devolved to the transfusion practitioners?

In my opinion no one person should take full responsibility for haemovigilance reporting this should be an HTT responsibility involving the transfusion lab manager, the TP, the consultant Haematologist and should be "signed off" by the Quality Manager or their nominated person. To me that then becomes Incident Management in its fullest sense

[RR1]

In my opinion no one person should take full responsibility for haemovigilance reporting this should be an HTT responsibility involving the transfusion lab manager, the TP, the consultant Haematologist and should be "signed off" by the Quality Manager or their nominated person. To me that then becomes Incident Management in its fullest sense

Thanks jayjay, it's great if this works, but if a dept has severe time constraints and additionally the lab staff have to also to pick up all of traceability, incident reporting to root cause and building and maintaining the quality system, this will generally fall to the blood bank manager and their senior team.

THE NPSA competencies seem to have taken over as the full role of some TP's such that we don't get any real help with some of the key tasks needed.

I have to admit I do enjoy having a more varied role to my job, life's never boring nowadays, but there needs to be a team approach to ensure everything is being done properly otherwise it becomes overwhelming for us all.

[ekarlstad]

What type of minimum standards are you talking about?

[RR1]

What type of minimum standards are you talking about?

These are good practice standards set out in the UK primarily for hospital transfusion labs regarding staff qualifications, training and competency requirements, staffing levels and specific equipment use.

There is a hyperlink to the document supplied on this thread by Tonyd, but i can't seem to get this to open. If you do a google search 'UK transfusion laboratory collaborative '... you should be able to find this.

[AndyMiller]

Hi Malcolm

I spoke to one of the authors of the standard who said that it is definitely aimed at hospital transfusion rather than transfusion service labs. I can't help thinking that it will applied to both (and the transfusion service labs just don't fit with some of the contents)

Andy

[Malcolm Needs ☆]

Hi Malcolm

I spoke to one of the authors of the standard who said that it is definitely aimed at hospital transfusion rather than transfusion service labs. I can't help thinking that it will applied to both (and the transfusion service labs just don't fit with some of the contents)

Andy

Hi Andy,

Yes, that is what I meant in my post.

By the way, welcome to the site; you will be a great asset.

:D:D:D:D

[bmsjbatt]

These are good practice standards set out in the UK primarily for hospital transfusion labs regarding staff qualifications, training and competency requirements, staffing levels and specific equipment use.

There is a hyperlink to the document supplied on this thread by Tonyd, but i can't seem to get this to open. If you do a google search 'UK transfusion laboratory collaborative '... you should be able to find this.

http://www3.interscience.wiley.com/cgi-bin/fulltext/122573960/PDFSTART is the correct link (the last bit of the one tonyd posted was incorrect

BTW i must agree with Jay jay about incident management, as the Quality manager for all of Pathology, I still co-ordinate and drive the RCA for all incidents including Haemovigilance episodes. this is done in conjunction with the BBM and TP, I try to take much of the pressure offas i can, but i am responsible for ensuring it is all followed up, particularly internally.

as for the query about how much time the quality manager should devote to the QMS in Transfusion, I had a rather long and heated discussion with MHRA inspector about my time split, I am 0.5WTE for all of Pathology, with responsibility for CPA in 4 disciplines, the MHRA stuff in BT and HTA stuff in the cell Path / mortuary, so this equates to less than 0.1 WTE for each thing, in reality, most of the CPA stuff is already well established and just requires me to facilitate and monitor certain elements, plus concentrating on the core common areas, this takes up approx 0.3 of my time allowing me to in reality alternate between giving 0.2 per week to BT and Mortuary. but the MHRA representative felt this to be a tall order!!, although he was not unsatisfied with what we had managed to acheive, so it is a case of being inventive and blunt, I am the hammer to crack the nut;)

[Tonyd]

http://www3.interscience.wiley.com/cgi-bin/fulltext/122573960/PDFSTART is the correct link (the last bit of the one tonyd posted was incorrect

Sorry about that - must have got corrupted in the posting

[RR1]

What would be really useful is a 'formula' to work out approx the number of WTE of each staff role that is required based on number of samples and units transfused.

Firstly concentrating on BBM, senior BMS, Quality manager, SPOT, quality officer. If the hours calculated were based only on core hours 09;00- 17;00hrs.

any thoughts?

[pluto]

Few queries

3.1 The collaborative recommends that all staff at career framework level 7

This is not the same as agenda for change band 7 so I interpret this as head of dept , is that correct ?

Which leads to 3.6 A senior member of staff, as defined in recommendation 3.1 will be available to provide appropriate specialist transfusion advice during non-core hours. This may require local collaboration with other hospitals and trusts.

Surely this does not mean solely head of dept but also includes others who have qualifications as outlined in 3.1

Does 1.5 To help facilitate compliance with the BSQR 20054 the collaborative recommends that blood transfusion laboratory lead biomedical scientists will be excluded from the following:

• The staff establishment required for core hours service provision
  

• The rota for non-core hours service provision if there is any impact on core hours availability
  

Clash with

3.4 In order to maintain competency for non-core hours working, lead biomedical scientists will complete the equivalent of 10 working days per annum lone, autonomous or independent working in a hospital blood transfusion department and also meet recommendation 1.5 above.

Or is this saying you can work out of hours as long as it is a Friday night or Saturday so you still be available core hours Mon- Friday

regards pluto

[RR1]

Hi Pluto,

I took 3.1 as meaning AFC Band 7 and above. Some Blood bank managers/ Lead BMS staff are banded as 7 , with others at 8 .

For 3.6 this would then refer to any blood bank senior including the lead BMS.

As for 3.4 I think what you stated is generally what it means except the Lead BMS should not do Friday nights as they would be off during Friday during the day. This would leave only Saturdays day and night shifts and Sunday dayshifts to participate in. Of course if you have a fully WTD compliant system even these hours would impact on the Lead,as suitable compensation time would need to be given to make up for the additional hours worked at weekends.

It would be really good to hear from others in the UK with their thoughts on this.

Thanks.

[Malcolm Needs ☆]

What you say concerning Friday is true, but only true if you get compensatory leave prior to doing an on-call duty. This is not true of all Laboratories.

I should think that, if you have an arrangement whereby a senior Biomedical Scientist from another hospital can field telephoned problems at night, the same would apply to the core hours??? I don't know; I just wonder.

Of course, the Blood Bank staff can always ask the most senior person in Haematology, because they always seem to know more about blood transfusion than the actual individual in charge of the Blood Bank Laboratory in the UK; or so it would seem!!!!!!!!!!!!!!!!!

:sarcasm::sarcasm:

[pluto]

At first I thought 3.1 was seniors and above then I though it was head of dept due to definition of career framework level 7 and now I am back to seniors and above

Senior or Specialist Healthcare Scientist (Stage 6). These are HCSs with a higher degree of autonomy and responsibilitythan practitioners performing a complex scientific/technical role and/or managing/supervising a team. A senior or specialistHCS performs a highly complex clinical, scientific or technical role and supervises a team. Specialist HCS will include clinical

scientist in first post registration job who perform a complex clinical and scientific role.

Advanced Healthcare Scientist (Stage 7). An advanced HCS will have developed skills and theoretical knowledge to a very high standard and will be performing an in depth highly complex role, and continuously developing clinical, scientific or technical practice within a defined field and/or has management responsibilities for a section/small department, or be largely involved in research and development

seehttp://www.dh.gov.uk/en/publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4123205

depends on what you mean by " team " in 6 or "section / small department" in 7

Had a member of staff attend the NEQSAS meeting in Birmingham yesterday where this document was on the agenda so perhaps will be wiser soon

thanks

[Malcolm Needs ☆]

I think that people may be talking at cross-purposes here.

I think the bands that you are talking about pluto, are the bands in the new document from the Chief Scientist.

I think the bands you are talking about Rashmi, are the Agenda for Change bands.

Am I correct?

[Tonyd]

What would be really useful is a 'formula' to work out approx the number of WTE of each staff role that is required based on number of samples and units transfused.

Firstly concentrating on BBM, senior BMS, Quality manager, SPOT, quality officer. If the hours calculated were based only on core hours 09;00- 17;00hrs.

any thoughts?

Unfortunately nobody has bitten the bullet and set out this type of definition, Rashmi - it could vary between departments depending on equipment, automation/robotics and use of electronic issue, for example.

The MHRA have 'commented' on the fact that one TP ( not 'SPOT' !!) cannot effectively cover a Trust with 'x-thousand' employees, but unless there is evidence that work is not being done or is being performed unsafely they seem unlikely to push the matter.

Tony

Edited November 12, 2009 by Tonyd

[Tonyd]

I think that people may be talking at cross-purposes here.

I think the bands that you are talking about pluto, are the bands in the new document from the Chief Scientist.

I think the bands you are talking about Rashmi, are the Agenda for Change bands.

Am I correct?

I suspect you are right, Malcolm - it is VERY easy to interchange the two frameworks, and it leads to confusion.

[RR1]

Thanks Tony and Malcolm, I think you are right in the confusion. So which banding are we meant to be discussing?

Sorry Tony, I meant TP. Could we not try and collectively work out a formula for good staffing levels on this site?

[Julie]

Try this url:

http://www3.interscience.wiley.com/search/allsearch?mode=viewselected&product=journal&ID=122573960&view_selected.x=71&view_selected.y=4&view_selected=view_selected

[jayjay]

3.1 as meaning AFC Band 7 and above. Some Blood bank managers/ Lead BMS staff are banded as 7 , with others at 8

The collaborative document refers to healthcare scientists level 7 NOT AfC band 7

[jayjay]

It would be expected that each organisation will determine their minimum staffing level and skill mix. Trying to work this out as a generic option is just not possible. As well as taking into account automation you would also need to consider:

- work patterns

- emergency v elective

- % EI

- type of patient eg high % thals etc

- 24/7 work patterns

and the list goes on

[Malcolm Needs ☆]

3.1 as meaning AFC Band 7 and above. Some Blood bank managers/ Lead BMS staff are banded as 7 , with others at 8

The collaborative document refers to healthcare scientists level 7 NOT AfC band 7

I think that the document is excellent (personal opinion), but, perhaps, in this one area it could have been more explicit?

:confused:

[RR1]

It would be expected that each organisation will determine their minimum staffing level and skill mix. Trying to work this out as a generic option is just not possible. As well as taking into account automation you would also need to consider:

- work patterns

- emergency v elective

- % EI

- type of patient eg high % thals etc

- 24/7 work patterns

and the list goes on

I understand the complexity of this task, but if we could look at labs where good practices are working , with the relevant staff structures and QMS documentation systems and practices in place, that have no significant problems identified at MHRA inspections, we could use this as a template to format a rough idea of what we need.

[Malcolm Needs ☆]

I understand the complexity of this task, but if we could look at labs where good practices are working , with the relevant staff structures and QMS documentation systems and practices in place, that have no significant problems identified at MHRA inspections, we could use this as a template to format a rough idea of what we need.

Yes, but I can see where jayjay is coming from. It would only be a very rough template, and not necessarily one that could be used in a cogent argument to be used against some very hard-nosed people (the Hospital Board).

They will require purely objective arguments and will regard such a template as extremely subjective.

I can also see where you are coming from, but you would almost certainly have to identify another hospital (or hospitals) within the UK, who have the same catchment area, patient mix, etc, etc, and who satisfies the inspectors, before you could use such a template, and that ain't gonna be easy.

I think that you are going to have to find another way involving local arguments.

This is almost certainly what you don't want to hear.

Sorry.

:redface:

[RR1]

......................

Edited November 12, 2009 by RR1