Page 153 - HA Convention 2016 [Full Version]

Symposiums HOSPITAL AUTHORITY CONVENTION 2016

S8.1 Service Reorganisation 10:45 Theatre 1

Story of Consolidation — Centralisation of a Pathology Service
Charlton C
Pathology Department, Queen Elizabeth Hospital, Hong Kong

The Pathology Centre, which opened at the Queen Elizabeth Hospital, Gateshead, in 2014, is the result of many years of
discussion and collaborative working.

Lord Carter’s Report for pathology modernisation and the subsequent requirement to achieve substantial cost savings in the
region’s pathology spend, lead the Chief Executives of Gateshead Health NHS Foundation Trust, City Hospitals Sunderland
NHS Foundation Trust and South Tyneside NHS Foundation Trust to work towards a new pathology model that would meet
current and future pathology needs.

Initially discussions centred on what the model should look like and what was consolidation going to achieve. However, one
thing that was acknowledged as “obvious” was that the three labs could not sustain themselves as individual entities forever.
Various solutions were considered. These included the management of three individual labs as a single service or placing
one pathology discipline on each site. Both options were discounted for a combination of factors: inefficiency, no reduction in
cost and greater patient risk.

An offsite option was also discussed to see if it would be possible to sight a new, purpose built laboratory in a non-hospital
location, central to all three Trusts, supported by hot labs at each site.Although consolidation on to one central site, located
midway between all three Trusts, looked like the answer, as the new lab would only be two to three miles from any hospital,
poor public transport links, increased costs for building and data security, and power generation equated to this being a very
expensive solution, not a cost saving exercise.

Consideration was then given to the availability of build space on at all three Trusts, where Gateshead identified an empty
laundry facility, which was due to be replaced by a car park. This was located at the Queen Elizabeth Hospital Gateshead,
and was identified as the ideal site. The funding for the conversion was approved by government and received in January
2012.

With staff in place from all three Trusts (now employed by Gateshead Health NHS Foundation Trust), the Pathology Centre
now operates 24/7, delivering a high quality, efficient pathology service to the North East of England.

S8.2 Service Reorganisation 10:45 Theatre 1

Beyond Service Reorganisation, What Role of Central Recruitment Can Play? Wednesday, 4 May
Pang FC
Cluster Services Division, Hospital Authority Head Office, Hong Kong

To introduce new technology and super-specialised treatment, it is the trend to centralise services demanding highly
intensive skill training and strong clinical team support. In addition, there is also an increasing integration of multidisciplinary
care provision. In order to have successful re-engineering of services, healthcare authority would adopt central recruitment
or centrally coordinated allocation of medical trainees to enable integration and re-organisation of services.

Central recruitment of fresh graduates aims to build a platform for a healthcare system to engage clinicians to concentrate
expertise but at the same time to cross-fertilise in skill transfer. However, all specialties would compete for talent graduates
and every single department would like to participate in selection exercise. A good platform needs to ride on trust and a
transparent system to ensure fairness and an efficient process. Besides, the platform should play more roles in enabling
rotation and deployment as well as succession of small specialties.

Hospital Authority starts to centralise recruitment and change the platform from cluster-based to specialty-based in order
to develop a common platform among hospitals in selection of trainees. This is critically important for pressurised or small
specialities with significant manpower shortfall due to workload. It was also found that the central recruitment of senior
positions would also helpful for acute shortage of certain specialties through deployment to minimise service impact.
Through this platform, it could facilitate the development of new service network by formation of central pool of doctors such
as paediatric service network.

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