Dear Colleagues,
The SE-HMDS team would like to share some news and updates with you.
Serious Incident in Laboratory of Molecular Haemato-Oncology
Some of you will already be aware of this, as your patients have been affected, but some incorrect results were reported by the service. The analytical process was paused while a thorough investigation was performed and extensive changes made, with review and audit by independent laboratory and quality representatives. We also did an extensive look back and repeat analysis of samples to identify other potential errors. Referrers with affected patients have been notified and the serious incident report is nearing completion. Once complete we will share the findings with all of you, with potential for an online presentation and an opportunity to ask questions of the diagnostic and clinical team.
SE-HMDS Request Form
The new version of the SE-HMDS request form has been available for some time now. It now incorporates all the tests outlined in the National Genomic Test Directory. The form is available on the Viapath and SE-GLH websites and please dispose of any old versions you may have printed. When completing forms:
- fill out the patient and clinical details as completely as possible, including specimen type and NHS number. It‘s particularly important to include the NHS number as that is now mandated by NHSE for all genomic testing. It will also be the key search field when the web based lookup for external referrers is a launched
- ensure the infection status is completed, if left blank it can mean the sample will not be processed
- indicate specimen type or types on request form and sample as this can result in an inappropriate final comment
- fill out the essential FBC parameters that are relevant to the diagnostic process as indicated on the form, alternatively a print out of the FBC can be sent
- when requesting next generation sequencing specify whether the Myeloid or Lymphoid gene panel is required
We are working on a new version of the request form to be available within the next couple of months, part of this is to give a smoother testing algorithm and include the option for “genomic tests to be performed after flow cytometry/morphology”. We would welcome any suggestions you have to improve it.
In line with NHSE guidance, its essential all genomic Haemato-Oncology tests including whole genome sequencing should be sent to the SE-HMDS central specimen reception at King’s College Hospital, Denmark Hill site. This allows a complete integrated report and better support for MDT meetings.
Laboratory for Molecular Haemato-Oncology (LMH)
The LMH although fully integrated diagnostically into the HMDS pathway on the KCH site was not part of the Viapath laboratories. From April 2021 the laboratory is now part of Viapath Analytics, there will be no change in clinical or diagnostic contacts, sample referral address and analytical or reporting processes.
User Survey Feedback
In 2021 we sent out a SE-HMDS user survey, a big thank you to all that completed it, it’s a useful tool to get feedback from you and to see where we can make improvements to the service and we have some actions as a response to comments
- Communications to users does not reach all referrers. Action – update and review contact list of referrers
- We would like more users to complete the survey and some surveys were not fully completed – Action improve format of survey and change platform to allow improved access on mobile devices
- Results on Line is not easy to use and display format not ideal. Issues with email of PDF results. Action – We have been working for many months now on a new on-line results service for Haem-Onc referrers in the SE-GLH area giving direct access to results and we expect to go live with this in the next few months.
In addition to give you an easier pathway to follow up results we are introducing a single email address for this kch-tr.sehmdsreception@nhs.net. This will allow follow up or referral on to the appropriate section for a response. Please use this email for any result enquiries or to notify of urgent samples - Although feedback on the quality of our reports was favourable some found that in the more complex reports i.e. SNP analysis or gene panels, more clinical interpretation was required. Action – review comments to improve reporting of clinically significant gene mutations
There were questions around turnaround times and the performance of the labs against these, the table below shows our performance against the NHSE targets for the last 6 months.
| SE-HMDS area | TAT days | % within stated TAT |
|---|---|---|
| Immunophenotyping – all tests | 5 | 86 |
| Cytogenetics – urgent FISH | 3 | 90 |
| Cytogenetics – urgent other | 14 | 95 |
| Cytogenetics – non urgent | 21 | 87 |
| LMH – SNP | 14 | 90 |
| LMH- NGS | 14 | 37 |
| LMH – MRD monitoring Q-PCR/Fragment | 14 | 96 |
| LMH – Fragment analysis FLT3-ITD mutation and BCR-ABL1 Multiplex | 5 | 97 |
Funding of genomics tests
Genomics tests included in the National Genomic Test Directory will now be funded centrally through payments to the Genomic Laboratories directly from NHSE rather than provider to provider payment.
Case of the week
Case of the week presentations are held on a Friday at 8.15am via Teams. If you would like to be added to the list please email shireen.kassam@nhs.net. We are only able to add nhs.net email addresses. Looking forward to seeing you there.
With best wishes for 2022
Dr Debby Yallop, Dr Shireen Kassam and Dr Guy Hannah
SE-HMDS Consultants
Email: kch-tr.KHMDC-consultants@nhs.net