ARTICLE a
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b 68 15 Yes No
Instead, training was often provided by commercial equipment providers, who were often the first point of contact for surgeries. Simon describes this as a ‘no kite mark’ scenario.
Armed with this knowledge, the project undertook its first pilot training and demonstration at the Manor Medical Practice in June 2012, before finally opening the Clinical Skills Suite at MMU in 2013. As the project reached the end of its first year, Simon considered that many valuable lessons had been learned. “We realised we had to communicate our POCT and training to primary care staff in a language they understood. We also realised that this wasn’t exactly the best time to engage GPs with a new concept, as it was then a period of great change for primary care due to ongoing NHS reforms. Consequently, we began to wonder if this may turn out to have been a case of ‘a good idea but at the wrong time’.”
FOCUS GROUPS
Owing to the lack of clarity in some areas at the end of Year 1, Metro-POCT began Year 2 by hosting a one-day focus group meeting of hand-picked experts from backgrounds including pathology, the diagnostics trade, academia and a representative from the local CCG, all to act as a sounding board for the project’s progress so far. Many valuable comments were gathered, but the overwhelming verdict from those present was: “carry on, but please slow down, take your time and get better engaged with your target audience and their market needs”. Reassured by this resounding thumbs up,
Metro-POCT forged ahead by designing and evaluating a training programme for POCT users in the community as part of a PhD research project, which aimed to assess parameters such as quality, competence and user confidence as well as the general attitudes towards POCT in the community. Gathering the correct data was fundamental to this, as Simon explains: “We decided to send out a questionnaire to local GP practices assessed by the Greater Manchester Pathology Network (GMPN) and other members of the wider Metro-POCT project team, as well as releasing an online survey and also visiting local GP practices to talk directly with practice staff.
706 THE BIOMEDICAL SCIENTIST 17 Don’t know
100 90 80 70 60 50 40 30 20 10 0
55 26 6 Manufacturer Colleague What training is currently delivered? a) Staff receiving training in POCT; b) type of training.
“Typical questions we posed were: ‘What POCT is currently in use in primary care and how well established is it?’ and ‘What are the general attitudes toward POCT?’. We also focused on the types of training primary care staff received, as well as other important areas such as whether or not the practice participated in any type of EQA scheme. It was interesting to see that some practices only provided urinalysis POCT due to the fact it was cheap and useful, but not necessarily urgent. Cholesterol testing was invariably performed as part of a routine health check, and although HbA1c testing is ideally suited to POCT, many found it too expensive to
METRO-POCT: WHAT IS IT? A proof-of-concept project to:
• establish a one-stop facility for POCT using HEIF funding
• train community POCT practitioners using pathology staff
• develop eLearning • provide an equipment demonstration showcase
METRO-POCT: PRIMARY OBJECTIVES
• Deliver competence in primary care POC testing • Improve patient safety by creating better POC testing practitioners
• Raise awareness of POC issues by delivering end-to-end POC training
ensure that the associated diagnostic POCT equipment was serviced and maintained regularly. “Although we received many expected comments, attitudes expressed to training were somewhat indifferent; for example, 40% saw training as a disadvantage, while 60% thought it disadvantageous that POCT could cost more than central laboratory testing. However, almost 50% of practices said that they were still actively considering some form of POCT in the near future, which was good news for Metro-POCT. “Generally, however, POCT was regarded
as more expensive than central laboratory testing, with international normalised ratio (INR) and HbA1c being good examples of this. The main message was that the introduction of more POCT in primary care would provide a better service for patients, although the big advantage POCT has always held over traditional laboratory testing, namely rapid result turnaround time, is being eroded by more electronic reporting links between both parties.”
THE FUTURE So, what’s next for Metro-POCT? Simon believes that this is only the start of what could become an even bigger project. “At this stage, we have to consider all eventualities and the POC tests that are established or emerging, as well as accessing the expertise we need to provide POC training. More
Disc insert 13 Unknown
Training in selected pilot sites will assess the effectiveness of training and the level of practitioner and patient satisfaction.
DECEMBER 2013
Staff (%)
Percnetage
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