Nottingham pathology under the spotlight

Hospital bosses in Nottingham are aiming to raise awareness of the little-understood discipline of pathology. Rob Parsons got an exclusive look at the QMC's state-of-the-art facilities and found out how it impacts daily on patients.

FOR some, 'pathology' might conjure images of TV's Silent Witness and its dead bodies.

But in reality it's something that affects people in Nottingham nearly every time they visit a hospital.

Pathology is about understanding disease, and its applications include detecting a massive increase in mumps cases and providing human tissue for complex eye surgery.

And hospital bosses say millions of pounds of new investment in pathology means patients in the city get as good a service here as anywhere.

A major part of pathology is the testing which forms a vital part of hospital life – whether it be checks for cholesterol, kidney function or signs of cancer.

Until recently tests taken at a GP practice would have been sorted and sent to the relevant team by hand, a process that took a day to complete. But in the last year both the Queen's Medical Centre and City Hospital have had auto-care laboratories installed.

Now each blood sample is given a barcode when it arrives in the laboratory and is sorted by a robotic hand, so it can be returned in less than three hours.

Arthur Broughton, the QMC's clinical pathology manager, said the new technology makes the process quicker and less vulnerable to mistakes.

He said: "We have shortened the process from the time of referral to the time of treatment for patients. It used to be very labour-intensive. If we get a blood sample in the morning your GPs will be able to give you your result in the afternoon."

Building work to create the new labs at both campuses cost £4.2m over two years, while new equipment cost the same again. As the Post discovered on a visit to the QMC's pathology lab for National Pathology Week, there are a few areas of hospital life which aren't affected by this form of medicine.

Some 25,000 people work in pathology in England and NHS spending accounts for nearly £4 billion – four per cent of the NHS budget.

Typical tests include a blood test, cervical smear or biopsy.

And it also deals with the detection and treatment of viruses like HIV or bacterial infections such as C Difficile and MRSA.

But Tony Scriven, the QMC's head of pathology services, said the role it played was often misunderstood. He said: "Pathology provides a diagnosis for most forms of disease – if we didn't have it the GPs and consultants within the hospital would be unable to do their jobs."

Over at the microbiology service, part of the 100-strong team's work is assessing the number of cases of particular infections. Their research reveals that the number of cases of mumps in the city has increased by 300% in recent months.

Service manager George Sharp says the rise can be traced to a 1990s mumps, measles and rubella vaccine scare which saw thousands of parents refuse to get their children immunised.

Mr Sharp said: "We are beginning to get the children through from the last MMR scare. They go to university and their germs go round a limited population. Because of that the number of cases goes up."

His team are also helping to drive down MRSA and C Diff rates by increasing the number of screenings.

By March there will be 250,000 a year carried out – almost three times the current rate.

Mr Sharp said: "The connection between screening and infection wasn't there before.

"It is only part of the process of dealing with superbugs but it is really beginning to pay off."

Elsewhere, a recently set-up human tissue laboratory allows cells to be stored for future use in transplants, blood infusions and other operations.

The facility cost around £1m to set up but has helped experts including the QMC's Harminder Dua carry out pioneering eye procedures.

For more details visit www.nationalpathologyweek.org.