Download Pathology in Leeds – now and in the future

Pathology in Leeds – now and in
the future
Dr Phil Wood
Clinical Director, Oncology, LTHT
(Formerly Clinical Director,
Pathology)
Consultant Immunologist
What does pathology do?
Workload of NHS Pathology
Forensic pathology
1%
Other specialties
77%
Leeds Current workload
•
•
•
•
•
5,204,900 Blood tubes annually
155,455 Urine tubes annually
222,800 Histology samples annually
60,681,301 Blood tests annually
10,274,259 Microbiology tests annually
5,204,900
Blood Samples
Urine Samples
Histology Samples
155,455
222,800
Current Pathology Locations
Current Pathology Locations
Current Pathology Locations
Diagnostics in today's NHS
Pathology has a key role across ALL of these areas
What is changing pathology?
Leeds Pathology
The Old Medical School
• The original medical
school dissection room
• Used for the study of
visible human anatomy
• Limits of pathology at
that time
Traditional Biochemistry
Laboratory – Old Medical School
Leeds Pathology Managed Service
Leeds Managed Pathology Service
• State of the art automation
• Fully tracked system –
allows single patient blood
sample to have multiple
tests
• Minimal staff involvement
• Electronic result
transmission to the health
professional
• One of the largest
installations in the UK &
Europe
The Grand Opening – March 2016
Traditional Microbiology lab
Microbiology automation – UK first
Digital Cellular Pathology
• Dr Darren Treanor
• Slides are difficult to
transport & store
• Expertise traditionally
at the site of production
• Centres of excellence
for e.g. Cancer
becoming more
focussed – LTHT centre
of excellence
Providing services to patients
across the Region
The next Frontier
The Genomic Revolution
We can now look at ALL a person's DNA – their
GENOME
Unlocking a real understanding of our
inheritance
Proper diagnosis for people with rare diseases
Transformational for cancer diagnosis &
treatment
Technology driving change
• Manual DNA sequencing 1982
– Labour-intensive, research tool
• Polymerase chain reaction 1988
– Cheap, sensitive
– Genetic diagnosis, pathogens, forensics
• “Next-generation” sequencing (NGS) 2009
– Massive numbers of short DNA sequences
– Essentially unlimited data
– Biology (medicine) a computational problem
Traditional DNA sequencing
Next Generation Sequencing
Genomic Pathology
• Leeds is part of the 100,000 genome project
– Regional service working with Sheffield
• Already underway
– First patient's genome sent for analysis
– Aiming for 7000 samples overall
– Cancer & rare disease centre
Leeds Laboratory Genetics
• YRGS DNA lab
– Single-gene testing
• High-throughput testing
of cancer-susceptible
families
– 2010 – first in UK
– Major cost saving
– External income
• Rare recessive disorders
• Strong links with
University of Leeds
The power of Genomics in Cancer
• Lung cancer
– Identified late
– Surgery as treatment
option
– Very poor outcome
– BUT
Genomic Cancer Medicine
Treatment possible and different
• Squamous
– Surgery
– Radiotherapy
– No chemotherapy
options
– Poor survival
• Adenocarcinoma
– ALK-mutation positive
– Novel treatments even
for metastatic disease
– Target growth of cancer
or immune response
– EGFR-mutation positive
– Novel treatments even
for metastatic disease
Where next?
• Technology will get smaller, faster, cheaper
• Public expectation will increase
– Access to tests
– Self-tests
– Less uncomfortable
– More rapid answers
Common Diseases Diagnostics future direction
• Point of Care Testing
– Convenience
– Quality & reproducibility
• Growth in Self-Testing devices
– Patient access to results
– Need to be accurate
– Put patient in control
The future is here
• Phillips Device
• Handheld
• Rapid results from
finger-prick of blood
• Rapid diagnostics at the
bedside or surgery
• OR home – cancer
patients
Wearable diagnostics & beyond!
Customer Needs
• Timely, Precise and Relevant
Laboratory Diagnostic
Information
• Faster, Simpler, Cheaper
PATIENTS
Thank you