INFECTION CONTROL
T More than just detecting infection
Rather than being a department which simply issues test results, clinical microbiologists provide a wide range of support to clinical colleagues. National Health Executive spoke to Dr Jane Stockley, president of the organisation formed through the recent merger of the British Infection Society and Association of Medical Microbiologists, to get a clearer picture of the role which clinical microbiologists play in the NHS
here is a common misconception that microbiologists are
simply laboratory operatives, somehow disconnected from the rest of the health service and continuously churning out test results.
This is an image that the British Infection Society/Association of Medical Microbiologists (BIS/ AMM) is keen to change.
“People often perceive
microbiologists to be very much laboratory based, whereas we are actually linked in to providing infection services as part of a holistic process, with both our clinical colleagues in general and hospital practice, and those in other infection specialties, such as infectious diseases, health protection and infection control. We are connected to a wide range of clinical work, as well as offering diagnostic services,” says Dr Stockley, who is also a consultant medical microbiologist at Worcestershire Royal Hospital.
“I think people often see pathology and microbiology as a place where results are churned out in order for doctors to take action with them, whereas as medical microbiologists we ourselves are providing a patient centred clinical service which helps to support our clinical colleagues in the management of patients with infection, throughout both primary and acute care.”
Clinical microbiologists also have a much wider remit around issues such as public health.
38 nhe
“When you are talking about infection, you are not just thinking about what is making that particular patient ill at this particular point in time. You are thinking about where has this infection come from? Could you prevent people from acquiring it in the first place? How do we stop it spreading?
“Obviously the prevention of healthcare acquired infections does take up a lot of our time and interest but there is also a lot to do with regards to wider public health issues around infection. This covers a broad spread of issues including proactive surveillance of vaccine-preventable diseases and the monitoring of antibiotic resistance, using the laboratory as our tool. It is our diagnostic workhorse and we utilise the information it provides to enable us to advise on the public health agenda as well managing individual patients. This is something which microbiologists hold very dear, but perhaps is not always appreciated.”
That apparent lack of appreciation is about to be compounded by the fact that budgets which are already hard stretched are about to be cut back further, due to the need for efficiencies to be made.
“The issue of funding is of great concern to us. Having worked in the NHS one does become used to managing budgets and I think that the majority of microbiology departments would consider themselves to be pretty lean anyway. I feel that we have always been responsible individuals, in the sense of not
being profligate with resources and managing staff resourcefully whilst ensuring that we are operating in a cost and clinically effective manner.
“As in all branches of medicine, technological advances have provided us with increased opportunities to make new and faster diagnoses and there has been consequent rising public expectation of what can be provided by health services, but we have to remember that we only have finite resources. In this sense we are not unique, as all areas of the health service are having to tighten their belts.
“I think that the one area where we do feel additionally pressured at the moment is that the Carter report has now been published. Although the report recognises pathology and microbiology as an end to end service beginning with the patient, it also identifies a lot of potential for savings.
“These savings are quite substantial, when looked at in a national context, with different areas being given their own targets. My own region, the West Midlands, has been targeted with saving £50 million from its pathology services. This would mean taking £3 million out of my local service which in real terms over the next few years is a 20 per cent reduction in funding.
“It is difficult to know how much of that is going to be achievable and how much is going to be achievable year on year, because as we are already involved in yearly cost reduction programmes, one wonders how much more efficient we can be
before the quality of services begin to suffer. Our main concern is to maintain high quality diagnostic and infection management services.”
It seems that the scale of efficiency savings which have already been made by pathology and microbiology departments has already been so great that it could be hard to find room for anymore. Does Dr Stockley, believe that the Carter report was unfair in it search for more efficiencies?
“I think that the Carter report recognised that there was already huge value for money being achieved by these services alongside the fact that these services were of a very high quality as well. So I suppose we were then a little concerned and surprised that the report went on to identify huge amounts of money which could come out of the system. It seemed rather ambitious. I think that our role as professionals in delivering these services is to be responsible about our budgetary constraints while also making a case for what we think is core to our clinical purpose.”
One way which Dr Stockley believes efficiencies could be made is indirectly though optimal infection management, prevention and control.
“If the health service continues to bring down the rates of healthcare-associated infection, then this both affects the amount of resources required to deal with those infections and also frees up other resources to manage other patients.”
Sep/Oct 10
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92