The Scheme covers Scotland and Northern Ireland and has the following aims:
- Promotion of consistency in reporting and contribution to the establishment of minimum standards
- Contribution to continuing medical education
- Provision of a mechanism for individual performance appraisal and enhancement of participant’s reporting practice.
- The current Scheme Organiser i.e. Chairman of the Management Committee is Dr G. O’Dowd, Consultant Pathologist at Monklands Hospital, Airdrie.
- The current Scheme Administrator is Dr. N. Kernohan, Consultant Pathologist at Ninewells Hospital, Dundee.
- The current Scheme Secretary is Linda McDonald.
There are currently 18 departments in this Scheme, aggregated into 22 clusters and with generally between 130 and 140 participating consultant pathologists.
The EQA Scheme is managed by a Management Committee comprising the Chairman, Administrator (ex officio) and ordinary members from both district general and major teaching hospitals in Scotland and Northern Ireland. The Administrator and Chairman are supported by a part time Secretary, Data Administrator and Quality Manager. The Committee administers the Scheme, determines the composition of each EQA circulation and reviews the performance of the Scheme and individual participants.
Circulation Cases
There are 10 slides per circulation and 4 additional cases of special educational interest. Two circulations per year are provided, the slides being circulated to 20 centres. A registered participant is expected to submit a return in no less than two out of every three circulations unless an action point has been triggered previously. Failure to participate in two out of three circulations will be referred to the Executive Committee for action. Results are received and collated by the Scheme Secretary.
Selection of cases
The Scheme is a diagnostic histopathology EQA Scheme designed to emulate any material which a general histopathologist should be capable of reporting in routine practice. Inevitably there will be straightforward cases from areas of pathology which are covered by specialist EQA schemes but this should not preclude participation in more specialised schemes organised on a supraregional or national basis. Cases are submitted for assessment by 2 members of the Management Committee prior to selection of the definitive 10 cases for circulation. A further 2 members of the Management Committee provide cases of special educational value. All relevant clinical information available at the time of reporting to the submitting pathologist is provided to participants. Cases for assessment are received from suitably accredited laboratories and participating satisfactorily in an appropriate technical EQA scheme.
The Scheme Secretary maintains records in respect of the source of cases and is responsible for the secure retention of previous circulated EQA material.
Scoring of responses
A personal score is provided for each participant for each circulation. The score for each case is based on the proffered diagnosis from the submitting pathologist agreed by the Management Committee and ratified at the subsequent participants’ meeting. A numeric score is assigned for each case as follows: correct answer 1; answer with minor diagnostic error 2; answer with major diagnostic error likely to affect patient management 3. For each circulation therefore a perfect response would attract a score of 10. Provisional results for each circulation are sent by the Scheme Secretary to each participant with definitive results being issued following the participants’ general meeting at the appropriate Caledonian Branch Meeting of the Association of Clinical Pathologists. The scoring system and circulation of the submitted responses allows participating pathologists to identify those areas where their response is discrepant from the consensus diagnosis. This should allow self-directed learning by reassessing the appropriate slides of the circulation under consideration. Substandard performance is monitored in accordance with the criteria established by the Royal College of Pathologists’ Steering Committee for Interpretive EQA and also the National Quality Assurance Advisory Panel for Histopathology/Cytopathology.
Financial aspects
The cost of running the Scheme and its supervision is covered by a renewable annual grant from the Scottish Executive. Fees for all non-Scottish participants currently stands at £250.
Accreditation
The scheme has been awarded accreditation by UKAS under ISO 17043:2010. All Standard Operating Procedures (SOP’s) for the Scheme are available here
Membership of the scheme is open to all Consultant Pathologists in Scotland and Northern Ireland. Application to join the scheme should be submitted to the Scheme Secretary whose contact details are shown above.
Address
Scotland and Northern Ireland EQA Scheme in General Histopathology
Department of Pathology
Ninewells Hospital and Medical School
Dundee DD1 9SY
Tel: 01382 660111 ext. 33545
Fax: 01382 632837
Email: Lianne Duffy – Senior Biomedical Scientist Lianne.Duffy@lanarkshire.scot.nhs.uk OR Scheme Secretary linda.mcdonald3@nhs.scot