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In the lead up to the 5th Annual National Pathology Conference, we had the chance to catch up with Ken Barr, Executive Director at SA Pathology, who shared with us his views on the role of pathology in Australian healthcare today, his NHS experience in the UK and the vision that he has for SA Pathology.
What role does pathology play in today’s health services in Australia?
Ken: Pathology is playing an ever increasing and critical role in population and patient health in Australia and worldwide.
With major improvements in technology and specificity e.g. automated techniques and molecular/genetic pathology, we now have the ability to protect public health and prevent illness in an accurate, reliable and timely manner with all the clinical, economic and societal benefits that accrue from keeping people at home and at work.
Also early use of pathology in an increasingly consumer based society allows us to meet increasing public expectations, in term of demand as well as need.
Diagnostic investigations early in a patient pathway allows for their value to be better realised in terms of efficient and effective diagnosis and treatment and a significant decrease in morbidity and mortality linked to improved outcomes in high risk clinical events e.g. stroke, cancer, diabetes, organ failure.
As population risk factors continue to rise e.g. age, weight, chronic conditions, with the direct cost implications at a time of limited financial growth, the need to keep the public healthy and improve patient outcomes is paramount and pathology contributes major value to meeting this growing pressure.
How did your experience with the NHS in the UK help you bringing new vision to SA Pathology?
Ken: My involvement with pathology in the UK NHS goes back a while, to 1974 in fact, when I took my first hospital job as a Medical Laboratory Technician and leaping forward 30 – 40 years I have worked as a health performance specialist and with providers, commissioners and with the Department of Health on pathology modernisation based on the Carter Reports and the national QIPP (Quality, Innovation, Prevention and Productivity) program.
This exposure to grass roots as well as operational, strategic, financial and political issues impacting on pathology and other health areas has allowed me to “put a lens” over SA Pathology in its context of a population of 1.5m and review how best to provide safe, quality services underpinned by fair and equitable access for the whole population irrespective of where they live and how much money they have (or do not have in many cases).
My vision is to consolidate pathology services to make best use of tremendous staff skills and new analytical and ICT technology to improve service quality to our patients and our population while delivering our agreed objectives within resources allocated and earned.
How was pathology used in clinical services in the UK comparing to Australia?
Ken: NHS pathology is almost exclusively in the public sector (though starting to change), embedded in hospital providers and funded from general taxation (no co-payments at all), it is able to concentrate on meeting the needs and targets of the clinical services and their patients.
There is little distraction from private sector competition, staff performing private practice and chasing revenue replaced with an emphasis on staying mainly within block budgets (allocated from hospital income via Payment by Results Tariffs and funding from Commissioners/GPs).
This system avoids incentives to drive activity up and pathology concentrates on communication and advice to users to utilise tests as clinically appropriate with feedback to hospital clinicians and GPs (an integrated part of the NHS not a separate sector) on the right tests for a given patient.
Pathology staff are almost exclusively part of the hospital staff so are integrated in planning and performance on key indicators including ED targets and control of infection and readmission and share responsibility and ownership of improvement actions.
You will be speaking at the 5th Annual National Pathology Conference on the topic “Pathology – front line clinical service or back office testing factory?” What are the key messages that you’d like to deliver to the audience?
Ken: For me pathology has always been about meeting the needs of our patients and population in an accessible, safe, timely and quality assured manner, joined up with the rest of the health services in community, primary and secondary/tertiary settings.
I remain convinced that early and appropriate use of diagnostic testing has massive benefits for patients, clinicians and limited dollars by avoiding unnecessary referrals and hospitalisation, unless clinically justified and ensuring patients are discharged as soon as feasible to deliver better treatment outcomes and patient experience.
A key message will be to avoid silo financial and political rhetoric that pathology is an unsustainable and unaffordable “testing factory” that could and should churn out “results” at $1 a time returning major profits for shareholders and reducing an unnecessary burden on taxpayers!
I hope to convince the conference audience that pathology is a vital and early element of most clinical pathways to maximise their full value, and expensive staff time and effort should focus on delivering our responsibilities for patient outcomes not collecting co-payments!
I do see the new integrated models e.g. USA ACOs as the way forward for population health planning with incentives to avoid illness and reduce costs.
Join Ken and many other industry professionals at the upcoming National Pathology Conference on 8th and 9th September in Sydney. For more information about the event program and to register, please visit the National Pathology Conference website.