IBMS Congress 2022 – Chief Editor’s Overview

Introduction

The return of face-to-face meetings certainly couldn’t come much bigger than the Institute of Biomedical Science (IBMS) Congress held at the International Convention Centre Birmingham, UK 14-17^th March 2022. Attended by clinical, scientific and support staff from across the healthcare landscape, attendees took advantage of an extensive programme of presentations, interactive events and seminars. Representatives from the diagnostics sector were also in full force, including established global vendors to independent distributors and health-tech start-ups.

I cannot say how many hundred stalls and stands were open, but it would take more than the full three and a half days of congress to speak with all companies of interest. Therefore, a strategic approach was required, engaging with new and known vendors between key presentations to ensure exposure to the many inspirational and aspirational innovations on show.

I must congratulate the IBMS in holding the prestigious event this year, for what must be a logistical nightmare for those working in the background to ensure all went smoothly. Of course, some things cannot be anticipated, like the almost inevitable spectre of COVID-19 impacting the speaker line-ups. On that note, a big thank you goes out to those who stepped in to fill the void with equally valuable content for the attendees.

Overall, the full congress went quickly, a good indicator of the quality of the content, the networking and the venue. With a background in Clinical Chemistry, Laboratory Management and Point of Care Testing my own logistical planning was put to the test. The following overview covers snippets of my experience at congress this year, and I look forward to the next one.

Day One (Monday 14^th March)

After an early start travelling from base, losing two passengers to COVID-19 concerns, I arrived in Birmingham at lunchtime ready for the afternoon session. The sessions I attended were primarily around Pathology Management including quality tools and service improvement. I won’t dwell on this too much but sessions included Getting It Right First Time (GIRFT) which you may already be aware of and is essential for all disciplines within Pathology including point of care testing (POCT) and rapid diagnostics. However, it is very laboratory focussed and needs further discussion on the standardised application to POCT. For more information on GIRFT visit https://www.gettingitrightfirsttime.co.uk/.

This was followed up by the Pathology Quality Assurance Dashboard (PQAD), something many of you will be involved in populating on a monthly basis in your NHS roles. The dashboard is a benchmarking tool which allows you to assess how your organisation’s services are performing with an emphasis on improving quality through standardisation. One thing that is recognised is that some sites report their data in different ways meaning the outputs are subject to variability which NHS England is seeking to address. More information can be found here https://www.england.nhs.uk/wp-content/uploads/2020/08/Pathology_quality_assurance_dashboard_PQAD.pdf.

This session was swiftly followed up with information around the emerging Pathology networks, formed as part of the NHS Improvement and NHS England strategy for reducing waste, improving collaborative working and standardising care across regions. Information included how mature some networks were in comparison with others with London leading the way, being classified as mature. Others lagged some way behind and there is clearly work to be done in establishing some networks and improving the effectiveness of others. We were told that the original 29 networks would soon potentially become 27 with sites merging as part of their strategic plans.

The next session included insight into the new Practice Educator roles which cover each region of NHS England. These roles have been defined in order to address challenges in the NHS workforce which include shortages and increased demand on existing teams. Although the solutions and strategy offered will not provide a quick fix for teams already under pressure, there seemed to be a well thought out vision for developing the future pathology workforce through access to education, network engagement and clear career paths.

Sticking with the educational angle, the next session showcased the Pathology Portal presented by Professor Jo Martin, hosted by the Royal College of Pathologists. Essentially a repository of pathology wide educational material in its infancy, Professor Martin was calling for contributors to fill some of the gaps across the disciplines. More information can be accessed here https://www.rcpath.org/discover-pathology/news/pathology-portal.html. I am also looking for collaborators to contribute to the educational content of www.POCTInnovators.com, a website I set up recently to champion point of care, rapid and decentralised diagnostics. Get in touch to discuss further.

This concluded the opening afternoon session and it was time to relax, ready for the full programme.

Day Two (Tuesday 15^th March)

What can I say about Hall 4? I’ve presented in this room before at the IBMS and it is certainly a challenge, so I have every sympathy for the speakers. Situated in the back of the second largest exhibit hall is the delegate area where speakers battle with the background din and only two speakers limply providing the sound. I struggled to hear the talk on having an effective risk register so won’t attempt to summarise here. A lost opportunity?

I then had to hot-foot it to Hall 9 to hear David Ricketts speak about the impact of the pandemic and the challenges faced in providing clinical biochemistry services in the future. The content was not quite what I was expecting, thinking it would be how the laboratories coped during the pandemic and how we can improve services in the future. To my surprise and more thought provoking, the session discussed taking services closer to the patient. This did not stop at POCT but rightly addressed the boom in home self-testing and postal services whereby individuals are now taking control of their own health and testing approaches. In detailing the use of capillary samples, David purposefully opened up a can of worms and highlighted that most laboratory automated analysers are not validated to run capillary samples. The parting message – we run thousands of paediatric and hard to bleed patients’ capillary samples every day across the pathology networks. Something to consider moving forward, especially with accreditation in mind. Should we be labelling all capillary sample results with ‘non-accredited test’?

My decision following this session was to walk the various exhibit areas. I will provide a summary later in this overview.

The afternoon session saw me return to Hall 4 to attempt to hear Ian Smith, Oxford University Hospitals, talk about high sensitivity troponin I analysis in the emergency department using the PATHFAST point of care analyser distributed by AB Scientific. The emphasis was on the troponin performance but the platform also allowed for up to six biomarkers to be run at once – hsTroponin I, NT-proBNP, CK-MB, D-Dimer, hsCRP and Myoglobin offering good flexibility and versatility. More can be found here https://www.pathfast.com/ about the system. There are now a few hsTroponin I point of care solutions on the market. Measuring cardiac markers in the acute setting at the point of care is becoming more and more a reality thanks to these developments and there are also discussions around safely using this test in the community.

I then had the pleasure of listening to Professor Sir Jonathan Van-Tam’s address in Hall 1, finding myself in the heavens due to the uptake of this talk on managing the UK response to the COVID-19 pandemic. Alongside thanking the NHS and those working in laboratory medicine, the production of vaccines and their roll out, the role played by the commercial diagnostics and health-tech sectors was specifically recognised. Official Office of National Statistics (ONS) data was shared to illustrate how medical advice has supported the lifting of restrictions based on the effectiveness of vaccines on hospitalisations and the acutely unwell patient. Professor Sir Van-Tam’s parting message was that whilst advising the government as Deputy Chief Medical Officer, the final decisions were to be made by the politicians, and the advice offered throughout the pandemic was just that, advice.

A few talks started to overlap with Monday afternoon’s sessions so I joined the exhibition for the rest of the day which will be summarised later.

Day Three (Wednesday 16^th March)

Wow, what an inspiring start to the day, following my coffee breakfast and relatively good night of sleep! There are some talks that make you want to get up and make significant changes to your world and the world around you. This was one of those moments and Major General (retired) Paul Nanson CB CBE, delivered one of those inspirational talks that will remain with you for some time. The topic was leading in a crisis, and the speaker drew parallels between leading in a crisis situation in the military and leadership in healthcare services. Although not in battle, and for most not an environment we will ever experience or fully appreciate, our own frontline from time to time throws us into a crisis and developing strong leadership in those situations will improve outcomes and save lives.

The speaker quite rightly illustrated how healthcare workers put themselves in harm’s way to deliver optimised patient care during the pandemic, putting themselves and their loved ones at potential risk in doing so. One of the standout messages from the speaker was linked to empowering teams and individuals to make decisions, learn by mistakes and to operate within established boundaries whilst not micro-managing staff. Let staff utilise their knowledge and skills, learn from the experience and they will improve the culture as a result. Preparation was also emphasised during this talk, investing in leaders who will prepare the workforce for those crisis situations. The audience was encouraged to view the accountability ladder, readily available in multiple forms on the web.

The next session I attended was ‘Lead, Follow or Get Out of the Way’. My initial thought was that this approach would land managers and leaders in front of human resources, explaining this no-nonsense approach. The more the talk evolved the clearer the message became. Every organisation is made up of individuals, each with their own aspirations, concerns and outlooks. The message conveyed in this talk was that as a leader you will need to assess each of your team members, establish what drives them, capture their imagination, but most of all assess their positive or negative influence on the team or the objective. A note I made whilst listening to the talk read ‘I can lead you and support you to deliver your role, or you can lead others and guide them through an issue or process to deliver a solution within set boundaries.’ Most staff want to either lead others or will follow if given scope to deliver positive change and outcomes. Others will want to be managed, being given clear instructions on what to do and when. Both of these are acceptable in most situations but you need to understand who sits where.

Those who do not want to be leaders or will not follow can have a profoundly negative effect on those around them as they are unlikely to be contributing anything positive. The solution offered here was to have clear, honest and frank discussions around the suitability of the role for that person and the expectations the organisation, yourself and the individual have. May not be for the risk averse!

Overall, the key message I took away from the talks I attended this day was ‘People first, operational results second, as they will follow.’

My day was rounded off by Dr Sarah Titchen, Ministry of Defence who presented a compassion-focussed theory on ‘It’s Okay Not to Cope.’ In this session a number of coping mechanisms were explored including soothing, a technique whereby an individual identifies calming influences and homes in on these factors when things get tough with the aim of re-focussing. More traditional forms of support from colleagues and organisations were also explored. If you are struggling, don’t hide or do this in silence. Seek support. We live in a society where there are more tools, support networks and advisors than ever before.

The final presentation I wanted to attend was ‘Why don’t staff do what they are asked to do?’ It didn’t seem to happen which was a shame because I struggle to understand this myself!

Day Four (Thursday 17^th March)

I spent most of the day in Hall 10a listening to some very good presentations on POCT. Due to COVID-19 the session on POCT in Pathology Networks was not able to be delivered. I was then treated to the energy of David Ryder from Morecambe Bay who presented the findings of a recent questionnaire he’d devised to ascertain how COVID had accelerated the POCT landscape.

The findings illustrated a review of the current and pre-pandemic POCT provision NHS hospitals and community settings. The results were not surprising with an increase in provision being seen in many areas of test provision. Understandably the use of blood gas analysers went up, but also more diversity of equipment and technology beyond the obvious explosion of COVID testing platforms could be seen, including hot labs and off-site services.

Rhian John (Kings Surgery, Port Talbot Resource Centre) followed this up with four case studies which illustrated clear benefits to patients and clinicians through the provision of point of care devices in a community healthcare setting. This ranged from urine dipstick testing and pregnancy testing (discovery of an ectopic pregnancy secondary to abdominal pain), through to coagulation monitoring and CRP measurement. Each case gave clear justification for provision of POCT to assess a wide range of patient symptoms and conditions.

The next presentation was given by Beverley Straker-Bennett and Leanne Cross (Blackpool Teaching Hospitals NHS FT) which covered an impressive anticoagulant service in the community. What stood out in this presentation was the focus on patients first, evidenced through the flexibility of service provision, including a drive through service set up to address the impact of Covid-19 on the ability to see patients in a healthcare setting face to face. This presentation illustrated everything that can be achieved by POCT in supporting the ongoing management of conditions outside of the hospital setting. I am sure every patient accessing this service feels invested in and Beverley and her team can be extremely proud of what has been achieved through their dedication.

Liz Berry (North Cumbria integrated Care NHS FT) then detailed a multi-disciplinary approach to quality control and quality assurance provision, using staff from admin to support the reporting of user results, lightening the burden on time constrained POCT teams and their operatives. Food for thought with other elements of point of care provision? Which staff groups could contribute to the cause? It reminded me of a talk I gave many years ago titled ‘How Big is Your POCT Team?’. My talk looked at a similar use of existing staff to deliver the organisation’s POCT agenda.

Due to an early departure to travel home, my last session was POCT – Into the Future, delivered by David Wells, Chief Executive of the IBMS whom many of you will know from his time leading significant changes across Pathology whilst working with NHS England. David reflected on the response the medical device commercial sector made during the pandemic, and illustrated where the future of point of care may be headed. Quite rightly, the response and sacrifices made by pathology teams including POCT was recognised and celebrated.

During the presentation a number of questions were posed relating to the future of diagnostic tools, especially in the hands of the public whom, as a consequence of the pandemic, are now more comfortable with self-testing and self-sampling. They are now more likely than ever to take control of their health and how it’s monitored. David asked whether we should be referring to this approach to testing as ‘Point of Need Testing’, and I for one can see his point. The future is likely to see members of the public access more medical devices and testing services, whether they are symptomatic or asymptomatic.

Asymptomatic individuals are not in any care plan or under the care of a medical professional, but the future will see curious or suspicious individuals accessing at home testing services or over the counter devices and tests. The ‘at home’ testing/sampling market is undergoing a boom which will see the global spend reach $8 billion per year by 2027, up from less than $6 billion in 2020.

The formation of Community Diagnostic Centres (CDCs) will make diagnostic tests more accessible to the public, especially those who experience healthcare inequality. This is a model that has been proposed for many years but now has real traction and I look forward to contributing to the development of these centres.

How we in our clinical, scientific or commercial roles respond needs a great deal of debate. One thing is certain, healthcare delivery is changing and we need to be prepared to adapt to those changes and evolve in order to support patients wherever their care is being delivered.

And finally, here is a round up of the vendors I spent time with:

Vendors and Distributors

AB Scientific PATHFAST – https://www.pathfast.com/ Cardiac Biomarker Analyser

Becton Dickinson –  https://poctinnovators.com/vendor/becton-dickinson-u-k-limited/ Veritor Plus System

Horiba Medical – https://poctinnovators.com/vendor/horiba/ Microsemi CRP haematology analyser

Pro-Lab Diagnostics– Inflammatix – https://inflammatix.com/  https://www.pro-lab.co.uk/ Assessing immune responses through detection of 29 mRNA biomarkers

Sight Diagnostics – https://poctinnovators.com/vendor/sight/ AI driven haematology diagnostics system

Quidel – https://poctinnovators.com/vendor/quidel-corporation/ Triage MeterPro offering cardiac markers (including high sensitivity Troponin I), Placental Growth Factor (PlGF) and more

Siemens Healthineers – https://poctinnovators.com/vendor/siemens-healthineers/ Atellica VTLi Immunoassay analyser offering high sensitivity Troponin I, and the EPOC handheld blood gas system

Nova Biomedical – https://www.novabiomedical.com/ the Stat Strip and Stat Sensor range of handheld POC devices, and the Prime Blood Gas System

Randox – https://www.randox.com/vivalytic-molecular-point-of-care/# Point of care and quality assurance solutions

PixCell – https://www.pixcell-medical.com/    https://www.pixcell-medical.com/hemoscreen/ Hemoscreen haematology point of care analyser

LumiraDx – https://www.lumiradx.com/uk-en/ The next generation point of care LumiraDx Platform

Oxford Immune Algorithmics – https://immunealgorithmics.com/ a company developing rapid at home testing, AI tools and patient/clinician focussed precision solutions to personalise healthcare

And that concludes my review of the 2022 IBMS Congress. I’ll certainly be at the next one and encourage individuals across the healthcare sector to do the same. Till next time…..

Sign up to the POCTInnovators newsletter for monthly updates on content and events.