Speakers
Rav Sodi
Bernie Croal
Tim McDonald
Parallel session
Chair: Rav Sodi
9:30-9:40 Introduction to home self-testing - Rav Sodi
9:40-10:00 Home Self-Testing: a paradigm shift in laboratory testing - Bernie Croal
10:00- 10:20 Applications of home self-testing in the NHS - Timothy McDonald
10:20-10:40 Operational Considerations & UKAS accreditation - Timothy Woolley
10:40-11:00 Discussion session open to the audience
Home Self-testing: a paradigm shift in the delivery of laboratory services and personalised healthcare.
It is well recognised that there are many situations where the usual venous blood collection systems may not be suitable. These include many underserved populations: the neonatal and paediatric population; the frail and elderly where venous access is challenging; those with severe needle phobia in whom blood collection for medical reasons is impossible; those with mental health issues or learning disability who are unlikely to be willing to give blood; and, in clinical situations where blood collection remotely might translate into better outcomes as has been shown by diabetics who monitor their blood glucose at home. In all these circumstances, capillary blood sampling (CBS) may offer an excellent alternative.
Improving access to health care for the underserved
To improve access to better health care and to address inequalities, Public Health England has issued a report entitled ‘Blood Tests for people with learning disabilities: making reasonable adjustments.’ There are well known barriers to access to phlebotomy such as people living in remote areas far from health care centres, those who are housebound, lack of access to good transport links and those with severe anxiety related issues. There is good evidence to show that patients with mental health disorders are not being properly monitored. The recent Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD) clearly showed that in the cases examined, 43% of the deaths were unexpected owing to underlying co-morbidities such as cardiovascular disease (22%) and cancer (20%). The report called for reasonable adjustments to be made to facilitate diagnosis and management of the underserved groups of patients.
Making laboratory tests accessible: capillary blood sampling (CBS)
CBS is the use of capillary blood samples for the analyses of a vast array of biochemical, haematological, and immunological tests for the purposes of diagnosis, monitoring and treating diseases. CBS relies on micro-sampling devices to collect capillary blood from the finger or other skin surfaces. The advantages include: the collection of a small volume of blood, relative ease and painless collection of blood; amenability to remote monitoring of patients without the need to visit a primary care practice or phlebotomy centre.
As this technology is relatively new, many central laboratories have equipment that have not been designed to measure tests in small volume collections or in blood bottles that are not of the usual dimensions. This has been the main barrier to widespread adoption of CBS in mainstream healthcare, but it appears this is set to change. In addition, there are no External Quality Assurance schemes available for capillary blood testing. There is also no quality control material for use with capillary blood samples. The analytical specifications and quality goals for CBS are extrapolated from those in use for venous or whole blood testing systems.
In this symposium, we draw on the expertise of Dr Rav Sodi, Dr Bernie Croal, Prof Timothy McDonald and Mr Timothy Woolley all of whom have had experience with home self-testing. Dr Bernie Croal will define home self-testing, discuss the pros and cons of this modality. Prof Timothy McDonald will show how home self-testing is used in the NHS setting and how this can complement the routine service. Mr Timothy Woolley is head of the one of the first laboratories that is fully UKAS accredited for testing using CBS and will share his experience on how this was achieved and discuss the testing process and how the verification was undertaken.
Testing using CBS is likely destined to stay and is considered one of the disruptors of how the current clinical laboratory functions. In this exciting session we invite you as professionals and custodians of the art to join us as we discuss our experience and open the floor to you to share your thoughts. See you on Wednesday 12th June 2024 in Brighton.
Dr Rav Sodi is a Consultant Clinical Biochemist at the Department of Clinical Biochemistry, Mid & South Essex NHS Trust. He undertook undergraduate studies in Canada and postgraduate studies and specialization in Clinical Biochemistry in the UK. He holds a number of teaching roles and has published widely in the field of Clinical Biochemistry and Laboratory Medicine and is an author in the leading textbooks of the profession including the Tietz Textbook of Clinical Chemistry. He is passionate about implementing clinical pathways to manage patients effectively and efficiently. His current research interests are home self-testing particularly with regards to monitoring cancer, artificial intelligence, and genomic medicine. He has contributed to numerous innovative e-learning laboratory medicine education platforms including the award-winning Learning Lab developed by the Association for Diagnostics & Laboratory Medicine (USA). He is a member of the Scientific Committee of the Association for Laboratory Medicine (UK), a reviewer for several leading scientific and medical journals and previously Deputy Editor of the Annals of Clinical Biochemistry.
Bernie graduated in Honours Physiology (1989) and Medicine (1992) from Glasgow University and went on to train in General Medicine (FRCP 1998) and Clinical Biochemistry (FRCPath 1999). He moved to Aberdeen to take up an academic Senior Lecturer post in Health Services Research, obtaining an MSc (2000) and MD (2003) degree in Public Health and Health Services Research.
Over the last 15 years he has filled many roles at RCPath including Chairs of Scottish Council, the Clinical Biochemistry SAC, the Informatics Committee, the National Laboratory Medicine Catalogue and the Quality Assurance Management Group. He was RCPath Vice-President (2011-14) and has been a member of Council/Exec for 15 years, as well as a member of both ACB, ACP and IBMS Councils. He was President of The Association for Laboratory Medicine from 2021-2023. He is RCPath President from 2023-26.
Professor Timothy McDonald is a Consultant Clinical Biochemist and Director of the Blood Sciences Department at the Royal Devon and Exeter Hospital and an NIHR Senior Clinical Lecturer in the Diabetes Unit at the University of Exeter Medical School, UK. His research focuses on the use of biochemical and immunological tests to improve classification and treatment of patients with diabetes. He has published over 100 peer reviewed papers and is chief investigator or PI on several major NIHR, MRC and EU projects.
Tim trained as a BMS at the Institute of Pathology and Tropical Medicine, RAF Halton; completing his BSc and MSc at the Royal Naval Hospital Haslar. During this time, he undertook research at Porton Down and Collingdale, before being seconded into the NHS. After leaving the forces Tim has worked primarily in the private sector, co-founding Inuvi Diagnostics in 2018.
Based in Gloucestershire Inuvi was the first laboratory in the UK to gain ISO 15189 including flexible scope for capillary blood testing. The laboratories research focus is on whole process verification, patient centric collection methods, reference ranges, sample stability and the use of capillary blood testing for mass population testing.