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• Haematology Laboratory Out of Hours Services
  Michael Galloway
  Published on: 1 October 2001

• Published on: 1 October 2001

  Haematology Laboratory Out of Hours Services

  • Michael Galloway
  • Other Contributors:
    • "L Rushworth, D Whitney"

  Dear Editor

  Janet Shirley and colleagues [1] have made a useful contribution to the costings of laboratory out of hours services. Their study is based on the findings from 22 laboratories. Some of their results have been confirmed in the latest annual report from the national Pathology Benchmarking Study [2]. In this study 93 haematology departments participated and 86 provided details of their out of hours service...

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  Dear Editor

  Janet Shirley and colleagues [1] have made a useful contribution to the costings of laboratory out of hours services. Their study is based on the findings from 22 laboratories. Some of their results have been confirmed in the latest annual report from the national Pathology Benchmarking Study [2]. In this study 93 haematology departments participated and 86 provided details of their out of hours service. Only 1 department still pays their staff on a standard Whitley Council contract. 53% of departments now pay their staff a salary based on a fixed amount not related to a notional number of calls. This has been an increasing trend over the last 3 to 4 years with a move away from payment linked to a notional number of calls.

  10 haematology and blood transfusion departments operate either a full or partial shift system covering the full 24 hour period. These shifts have been implemented in all size of hospitals i.e. teaching hospitals,large,medium and small district general hospitals. This compared to only 3 departments that were operating shift systems in 1998 [3]. In addition a separate analysis of combined biochemistry and haematology departments shows that 2 out 9 departments operate a shift system [4].

  Shirley and Wing draw attention to the implementation of the European Working Time Directive [5] and they emphasise the importance of changing working patterns so that laboratory staff can reduce their working hours in order to comply with the directive. The analysis of working hours for Medical Laboratory Scientific Officers (MLSOs) nationally shows a median number of hours worked per week of 53 hours with a "worst case" of 93 hours [2]. This figure represents the MLSO with the longest weekly working hours. The median figure of 53 hours has remained static over the last 2 years. This suggests that there has been little impact of the Working Time Directive on the working hours of laboratory staff.

  The national Pathology Benchmarking Study also analyses the costs of the out of hours service by comparing the costs per request and costs per test between departments. In a comparative analysis of 11 hospitals based in London the costs of the haematology out of hours service as measured by cost per request were lower in the London hospitals than for equivalent hospitals outside London [6].This result appeared to be explained by the observation that there was less floor space available from which the London hospitals were provding their service. We note the addditional analysis of cost per acute bed that has been used by Shirley and Wing. Although this does introduce another variable into the equation i.e. the number of acute beds and how these are defined, we will explore the feasiblity of introducing this analysis into the national report with our participants.

  References

  (1) Shirley J & Wing S. Workload,organisation and costs of haematology out of hours services. J Clin Pathol 2001;54:647-649.
  (2) Pathology Benchmarking Study,Haematology and Blood Transfusion report 1999/000.London:Newchurch Limited,2001.
  (3) Pathology Feedback Report, Haematology and Blood Transfusion 1997/98. London:Clinical Benchmarking Company,1999.
  (4) Pathology Benchmarking Study for Combined Biochemistry and Haematology and Blood Transfusion Departments 1999/00. London:Newchurch 2001.
  (5) European Foundation for the Improvement of Living and Working Conditions.Briefing Paper 98/18. The working time directive.1998.
  (6) Pathology Benchmarking Review London Analysis 1998/99. Clinical Benchmarking Company,2000.

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  Conflict of Interest:
  None declared.

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