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ACB President's Statement on Innovation, learning and investment: reflections on four months of COVID-19

19/06/2020 12:15:53

Hand with purple hygiene glove with sample pot and pippette

Image credit: Lancashire Teaching Hospitals

By Professor Neil Anderson, President, Association for Clinical Biochemistry and Laboratory Medicine (ACB).

Public Health and NHS laboratories continue to significantly contribute to the government’s COVID-19 testing targets.  Many of the ACB’s members work in these laboratories to help prevent, diagnose and treat illness using their knowledge of science and their technical skills. Through their hard work, skill and innovation ACB members have supported the UK’s COVID-19 response by supporting the roll out with high quality testing on a novel pathogen unheard of four months ago.

This ability to respond rapidly to pandemics must be built on and invested in if we are to be ready for future urgent public health needs.

Reflecting on our profession’s efforts since March 2020, I outline three areas of innovation and learning that need continued investment and resources:

1. Validating and rolling out new tests

Innovation

Within a few weeks of a COVID-19 pandemic being announced a daily test capacity of tens of thousands was established in Public Health and NHS laboratories by a dedicated, expert professional workforce of Clinical and Biomedical Scientists and Medical Staff. This capacity was achieved by Public Health and NHS Laboratories rapidly validating and rolling out testing for a novel pathogen against a backdrop of unprecedented global demand for reagents and consumables.

Innovation across the diagnostics community contributed to this rapid response. NHS laboratories reconfigured their workforces to establish COVID-19 testing labs to provide 24/7 services to patients within six weeks. Colleagues in industry scaled up the production of swabs and testing reagents - both vital to carrying out the most accurate testing methods for COVID-19 and new markers for patient management. Clinical and Biomedical Scientists carried out cutting-edge research and rapidly shared new information with peers in laboratories across the UK.

Learning 
  • Invest in existing highly skilled public health and NHS staff and accredited laboratories
    Public Health and NHS laboratories are able to respond rapidly to increased demand for testing if they are given the resources, freedom to innovate and create networks with peers in sister laboratories. Effective coordination and use of Public Health and NHS laboratories at the start of the COVID-19 pandemic could have led to a rapid mobilisation of existing highly skilled workforce and infrastructure allowing existing Public Health and NHS laboratories to have met the required testing capacity without the need for the creation of additional laboratories.
  • Consult the diagnostics community at the start of an urgent public health need for a rapid response 
    Consulting the diagnostics community, including professional bodies, at the start of an urgent public health need, such as a pandemic, would result in a fast response as supply chains could be set up quickly and existing laboratories with qualified, regulated, experienced staff reconfigured could be mobilised rapidly to provide round the clock access.

2. Infrastructure and pathways to rapidly test vast numbers of people

Innovation

Existing Public Health and NHS laboratory staff are skilled at communicating the value of test results to those who need them; clinicians, infection prevention and control teams, and public health experts.

In the case of COVID-19, reliable antibody tests introduced at scale can give some indication of how many of the population have been infected. Central to providing accurate test results on a vast number of people is ensuring the end-to-end quality of the test - from identification of the individual, taking the sample, transportation, testing, interpretation, and reporting of the result. It is vital that each component is joined up in order to deliver a rapid response, high quality testing and useful data that can inform effective clinical and public health action.

Public Health and NHS laboratories have well-established, strong links across each part of the process for many existing tests. This process is the best way to carry out the large scale adoption of novel tests. To meet the COVID-19 testing needs, Public Health and NHS laboratory staff built on this existing process and introduced innovations such as setting up new IT systems for rapid communication of results, standardising processes to make sure quality is maintained across laboratories and establishing new communication networks between laboratories for rapid sharing of information. 

Learning
Invest in existing, well-established and high quality testing processes and communication networks

The best way to carry out mass testing is through adapting well-established processes and communication networks where end-to-end quality testing can be relied upon. Investing in these established networks and pathways will make sure Public Health and NHS laboratories remain ready for any future mass testing programmes.

3. Using test data to shape public health policy and patient care

Innovation

Clinical and Biomedical Scientists and medical staff are now looking at how to use data from mass testing for COVID-19 beyond surveillance into improving patient care.

Linking COVID-19 test results with other data sets, such as patients with coagulation disorders, will help Clinical and Biomedical Scientists understand the way COVID-19 infection works in people with different risk factors.

Learning
  • Invest in trained, registered scientists to make the most of testing data

    Trained, registered Clinical and Biomedical Scientists have the skills to innovatively use data sets in a way to improve patient health outcomes.

  • Consult Clinical and Biomedical Scientists at the start of urgent public health needs to get the most out of tests and data
    Involving our community in responses to urgent public health needs, such as pandemics, will make sure new tests are adopted with clear advice on the intended purpose of the test as well as make sure data collected through testing is useful, relevant and contributes to better patient care.

Investment in pathology services is vital for the future preparedness

The COVID-19 pandemic has shown the invaluable service laboratory medicine provides. We must continue to invest in the innovations Clinical and Biomedical Scientists have developed over the last four months if we are to be ready for future urgent public health situations. 

What’s needed for rapid responses to future urgent public health situations:

  • Invest in existing highly skilled public health and NHS staff and accredited laboratories for rapid responses
  • Invest in existing, well-established and high quality testing processes and communications networks including equipment and supplies as well as communication networks between laboratories across the UK and supply chains.
  • Consult the diagnostics community at the start of an urgent public health situation for a rapid response, informed decision making and effective use of data and resources

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The Association for Clinical Biochemistry and Laboratory Medicine (ACB) is a professional body dedicated to the practice and promotion of clinical science in the UK. The Association has medical and non-medical members in all major UK healthcare laboratories, in many university departments and in several commercial companies involved in healthcare. 

Contact: communications@acb.org.uk  

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