Across the Pond, Lots of Changes in Lab Testing

IN BOTH THE UNITED KINGDOM AND EUROPE, plenty of change is unfolding in clinical laboratory and anatomic pathology testing. Our intrepid Editor-in-Chief, Robert L. Michel, spent last week in England attending our annual Frontiers in Laboratory Medicine conference, now in its eleventh year.

He came back with interesting information on developments in several European nations involving laboratory medicine. Within the United Kingdom, a quality assurance review of pathology was just completed by a National Health Service team and made public. It recommends a number of important improvements to medical laboratory quality assurance, including better performance metrics for each laboratory that can be viewed by the public as they are collected and updated.

Additionally, there is continued progress on achieving regional consolidation and standardization of regional laboratories within the United Kingdom. At the same time, a process called “commissioning” requires that hospital- based laboratories now submit bids to provide lab testing for the general practice clinics and primary care trusts. This is introducing a bit of competition into the mix and creating new financial challenges for the clinical biochemists and pathologists who lead these laboratory organizations.

In Ireland, an ongoing fight over adequate budgets for the Irish Health Service has meant that long-standing plans for revamping medical laboratory testing across the nation continue to stay on hold. News headlines are full of the spats between the Irish Parliament and the Health Service Executive over the money available for improving patient access and the quality of health services.

Meanwhile, over in Denmark, that nation is embarked on an ambitious reorganization of hospitals—and hospital laboratory services. As reported at FiLM by Per E. Jørgensen, M.D., Medical Director at Glostrup University Hospital in Denmark, the move is “to fewer, but bigger” hospitals. Currently there are 46 hospitals in this nation of 5.6 million people. By 2020, it is proposed to reduce that number to 20 acute care hospitals, supported by a few specialty hospitals. In tandem, the medical laboratories of these hospitals will be consolidated.

For me, these are all reminders that our country’s health system is not unique in its own ongoing reforms. Healthcare everywhere is undergoing transformation. Might we actually have it better than we think here in the USA?


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