Donna Horncastle MSc, CSci, FIBMS, DMS BMS3 Immunocytochemistry Unit Histopathology Department, Hammersmith Hospital Imperial College Healthcare NHS Trust Window on Europe: II° European Hysto-Cytotechnicians meeting. Coordinatori: A. Bondi, S. Simonazzi

 There are numerous entry requirements for working in the laboratory. A trainee BMS would normally enter the profession with a degree in a related Biomedical subject, although they are able to come in with A levels and obtain a degree on the job. BMS1 would need a degree, a BMS2 would need a MSc, and a BMS3 and above would need all of these plus a management qualification.  Medical Lab assistants can enter with just English and Maths GCSE. BIOMEDICAL LABORATORY TECHNICIAN  BMS’s generally specialise in one off the following areas: Cellular Pathology, Clinical Biochemistry, Haematology and Blood Trasfusion, Microbiology, and Virology and Immunology. However, in smaller trusts staff may rotate round all labs.  BMS’s are generally employed in an NHS/private laboratory. However, some BMS’s chose to work as a locum, giving them more flexibility. In this scenario, the locum BMS would be registered with an agency

 The Health Professions Council (HPC) keep a register of health professionals. BIOMEDICAL LABORATORY TECHNICIAN  There are 2 main professional associations for BMS’s.  HPC:  Institute of Biomedical Science (IBMS): 4 5

 The IBMS CPD scheme encourages biomedical scientists to maintain, improve and extend their knowledge, skills and practice for the purpose of maintaining Continuing Professional Development (CPD).  All registrants have a professional responsibility to adhere to these standards for CPD, in order to remain on the HPC register and to practice as a biomedical scientist  There are a number of ways to develop/improve a professional career:  Degrees (BSc, MSc, MBA),  Courses (NEBOSH for Health and Safety, or Quality),  Specialist diplomas via the IBMS BIOMEDICAL LABORATORY TECHNICIAN 6 7

LABORATORY FEATURES  The laboratory Manager with manager the department with the help of other technicians.  Each laboratory will have a Laboratory Manager. This person will have a vast knowledge and many years of experience in their chosen field. They would be appointed in view of their experience, qualifications and interview. 8 9

 Cellular Pathology actively supports and is involved with research projects.  Biomedical Scientists will cooperate with a number of professionals from other departments, such as:  Organizing MDT meetings,  When carrying out frozen sections/FNS’s,  Providing technical advice/ participating in project work,  User surveys to assess users needs/requirements. LABORATORY FEATURES 10 11

 The size of the department will determine whether staff rotate. Larger teaching hospitals will have dedicated staff for Cytology, Immunocytochemistry and Electron Microscopy. LABORATORY FEATURES  Most NHS trusts will appoint senior Biomedical Scientists with additional responsibilities such as Training and IT, Health and Safety, Quality and Immunocytochemistry.

LABORATORY FEATURES  Each trust will have a different system to evaluate BMS skill and rating. For example, Imperial College NHS trust uses competency testing. This involves a self- assessment followed by a review by senior staff and an objective setting one 2 one meeting. 14

LABORATORY FEATURES  Most Cellular Pathology labs will operate a daytime service, ie 8am-5.30pm. Im the case of an emergency, a member of staff will be on-call and carry a bleep. 15

 Most laboratories do not have the authority to chose its staff and equipment autonomously. Large equipment must go through an equipment bid, or go out for tender. Staffing is agreed through higher management, though if agreed then the laboratory manager has the right to chose through the interview process. LABORATORY FEATURES 16

 The main fixative of chose is 10% neutral buffered formalin. Bouins used occasionally for specimens such as testicular biopsies.  Our department uses a variety of reagents/ commercial kits. The Immunocytochemistry unit buys commercial kits for routing ICC staining, but not pre diluted antibodies. The routine lab buys pre made haematoxylin, but makes other special stains.  Xylene and/or toluene substitutes are not used in Cellular Pathology at ICSM LABORATORY TOOLS

 Histology specimens are processed overnight, accounting for hours.  Cytology ????Roberto  Qualified Biomedical scientists can sign out cytology screening reports. Roberto to expand????? LABORATORY TOOLS

 Personal protective equipment (PPE) is provided to all staff: lab coat, gloves, eye/face protection (if necessary). No compensation for risk exposure as every procedure is risk assessed and appropriate PPE is supplied to reduce exposure.  No personal insurance is available in the trust LABORATORY TOOLS

24  The department has a comprehensive audit system:  11 horizontal audits a year,  2 vertical audits in each section a year,  At least 1 examination audit a month.  The department also use comprehensive quality check measures that follow the specimen from booking in to signing out. LABORATORY TOOLS

 The department is involved in a number of external QA services:  CPA: Clinical Pathology Accreditation  HTA: Human Tissue Authority  UKNEQAS: for immunocytochemistry, for routine LABORATORY TOOLS

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