preview:• Pathology is there from the moment of conception all the way through to post-mortem.
• We can see that in the genetic screening of babies before they are born when we can screen for down's syndrome for example and that's prior to a baby born so following conception all the way throug...
We will talk through the laboratory organisation within that pathology department, the
different disciplines you can find within the pathology building with a particular focus of the
clinical biochemistry laboratory, the different types of labs you can find within clinical
biochemistry from the more routine automated labs to the more specialist laboratories, the
different types of personnel you can find.
Personnel include clinical scientists, biomedical scientist, medical laboratory assistants and
associate practitioners.
Accreditation – the UK accreditation service – hospital laboratories have to become
accredited and just because you have accreditation one year doesn’t mean that you will
have it the next year.
Pathology is there from the moment of conception all the way through to post-mortem.
We can see that in the genetic screening of babies before they are born when we can screen
for down's syndrome for example and that's prior to a baby born so following conception all
the way through to post-mortem by trying to identify the cause of death and we will find
mortuaries in larger pathology departments within hospitals.
Primary care – GP surgeries.
Outpatient clinics – an individual was referred to a hospital so maybe they saw a consultant
within hospital and requires a blood test or indeed a urine test.
Acute hospital services – if you were in a patient on a hospital ward somewhere or maybe
you have theatre or post theatre.
All of these samples will be processed in the pathology department within a hospital
regardless of what discipline biomedical scientists work in they will be involved in the
diagnosis, monitoring and screening and preventative medicine (treat condition or prevent it
from occurring in the first place).
It's expected that the number of patients if we look at diabetes as example the patients,
they expect around 5 million people by 2026 will have diabetes in the UK and therefore you
can imagine that will be more patients for us to screen as when we're looking at monitoring
lifelong health conditions.
Around 50 million reports are sent out from pathology laboratories to GPs each year.
1.1 billion tests equate to each person within England having about 14 tests performed each
year.
27,000 BMSs registered with the health and care professionals’ council in order for us to
practise as BMSs.
Each floor contains the different disciplines.
Originally were five disciplines within pathology; haematology and blood transfusion
laboratory (performing full blood counts are crossmatching), clinical microbiology (looking
get bacterial, viral, fungal and parasitic infections), cellular pathology (looking at cells and
tissues for abnormalities is whether that inflammation) and clinical biochemistry.
As technology has developed there's been the advent of new disciplines that have emerged
either as standalone disciplines or sub disciplines within other larger disciplines within
pathology. An example of this includes clinical immunology which can some hospitals be
, 7. Laboratory Organisation
found as a separate discipline but also it can be found in conjunction as a sub discipline
within the clinical biochemistry laboratory as a number of the tests do overlap.
You've got the advent of molecular and that forms a part of clinical micro for example but
also cell path in addition to the other disciplines too but molecular has also been the advent
of a new discipline because of the advances in our understanding of molecular biology and
disease at the molecular level.
Then you’ve got cytogenetics which closely aligns to cellular pathology and looking at DNA
fingerprints, genetic fingerprints associated with different conditions when looking at the
study of cells and tissues.
All of these disciplines fall under the umbrella to of department of pathology.
Haematology, biochemistry, transfusion and immunology have come under the umbrella of
blood sciences. In haematology you'll be performing your full blood counts and in
transfusion cross matches in addition to a number of other tests. In biochemistry you would
be looking at organ function testing and in immunology automation conditions or
immunodeficiency.
Infection sciences is the merger of looking at bacterial, viral, parasitic and fungal infections.
Within cell sciences you've got the merger of histology (looking at our cells, tissues and
organs) and cytology which performs cervical cancer screening amongst a number of other
diagnostic tests looking at cells and looking at abnormalities with cells.
New discipline of genetics and molecular and that's looking at the genetic changes and
molecular changes and looking at the drivers of particular conditions and that's an important
part of diagnosis too.
Whether its automated depends upon the number of tests that we perform and also how
safe it is to perform those tests in one setting versus another.
We have a range of different tests and techniques involved in the pathology laboratory
particularly in clinical biochemistry, it is now largely automated, it is one of most automated
disciplines compared to let's say immunology for example which still maintains some of its
manual techniques.
Biochemistry leads the way in terms of advanced techniques we can before mass
spectrometry, HPLC.
We can also perform more tests and look at new analytes, all of a sudden, we're now being
able to detect COVID-19 and screen for it, that was something if you rewind 12 months ago
wasn't even on anyone's periphery in terms of diagnosis.
There's a need for shorter turnaround times so turnaround times are getting increasingly
shorter and there is a need to get the results out much more quickly and that's to ultimately
benefit the patient.
We have an increasing population, UK and global population as part of that more people can
become poorly and more people living with chronic health conditions, more tests will
obviously therefore need to be performed and this is the same when we're looking at an
ageing population.
This graph looks at different demographics of different ages, in 1966 the number of people
who reached older age was much less than a couple of years ago as it’s forecast to be by
2066. In almost all cases we are getting an increase in people in all age categories so we are
getting an increase in population but also an increasingly ageing population and most of the
conditions we see are these chronic lifelong health conditions or these chronic conditions
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