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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
155,455
222,800
Blood Samples
Urine Samples
Histology Samples
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
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