The Bulletin of the Royal College of Pathologists Number 191 July 2020 SPECIAL EDITION: Pathology and COVID-19 The role of genomics in shaping the response Cytology and the pandemic Experiences of NHS Nightingale Death certification Establishing convalescent plasma therapy Caring for the deceased Testing in the devolved nations Our COVID-19 seminars Also in this issue: The Royal College of Pathologists Haematology workforce challenges Pathology: the science behind the cure Going digital: training and exams Kate Gould: an appreciation The Royal College of Pathologists CONTENTS Pathology: the science behind the cure July 2020 NuMBER 191 EDITORIALS 114 INTERNATIONAL 150 From the Editor 114 Challenges for pathology laboratories during From the President 115 the pandemic: the view from Australia 150 PATHOLOGY AND COVID-19 117 Reorganisation of mobile blood collections in the age of social distancing 152 A new plague year 117 The role of viral genomics in shaping the TRAINING 154 response to the pandemic 118 FRCPath examinations during the COVID Nightingale tales 121 pandemic 154 The journey from Oxford medical school to Digital pathology and safe workplace the world’s largest ICU 124 station awareness 157 Cytology and the pandemic 125 Creating e-learning modules for undergraduate Establishing convalescent plasma as an medical students 159 effective therapy 126 Digital pathology validation for trainees: 160 Healthcare scientists in pathology: the CLINICAL EFFECTIVENESS 162 challenges of responding to the virus 128 What does patient safety in pathology Death certification: lessons learned within mean to me? 162 the hospital setting 130 Antibiotic prescribing following a positive Caring for deceased patients at the NHS Clostridioides difficile result 163 Nightingale mortuary 131 PEOPLE 166 A chaplaincy view from a multi-faith university hospital community 133 Appreciation: Professor Frances Kate Gould 166 Appreciation: Dr Denis Raymond Stanworth 167 COLLEGE NEWS 134 Appreciation: Dr Michael Gerald Rinsler 168 The RCPath Learning Programme: Appreciation: Professor Mohammed Sami the COVID-19 pandemic 134 Shousha 169 Moving to the new College premises 135 Archive of eminent pathologist Sir Lionel RCPath Consulting 137 Whitby deposited at Downing College 170 ON THE AGENDA 138 Deaths reported to Council 172 Challenges for the haematology workforce 138 Consultants: new appointment offers 172 Tackling haematology scientific workforce REVIEWS 174 challenges 140 The Royal College of Pathologists Book reviews 174 6 Alie Street, London E1 8QT The journey to pathology 3.0: more on New report calls for collaboration to ‘bricks’ and ‘clicks’ 141 improve cancer diagnostics 176 T: 020 7451 6700 E: [email protected] SHARING OUR SUBJECT 144 Charming snakes: a seminar on reptiles 177 www.rcpath.org School’s out but the Schools Science Highlighting chemical pathology Conference must go on 144 and metabolic medicine overseas 178 President Professor Jo Martin Vice Presidents Dr Rachael Liebmann REGIONAL 146 Letter: Reporting of race in autopsy reports 179 Dr Tim Littlewood COVID-19 and the devolved nations 146 On the cover: An illustration Professor Shelley Heard of the COVID-19 virus. Registrar Dr Lance Sandle Highlighting UK workforce concerns 148 Assistant Registrar Dr Esther Youd Treasurer Dr Andrew Boon CEO Daniel Ross Bulletin Editor Dr Shubha Allard Disclaimer: Authors’ views are personal and are not indicative of College policy, except when College Officers write in their official capacity. Errors or admissions are the responsibility of the Production Editor Stacy Baxter authors alone. Advertisements are paid for by external agencies and do not indicate endorsement or otherwise by the College. Editorial & Digital Manager Rob Hucker www.rcpath.org Number 191 July 2020 113 EDITORIAlS EDITORIALS From the President Change all around us the skills for interpretation and quality control, and From the Editor It has been a time of enormous change for everyone, the key infrastructure and data connectivity that all over the world. We have changed what we do we need, rather than just numbers of tests being Welcome to our first digital College Bulletin! The impressive, with greater inclusion and engage- and how we do it, including the services in which performed. We have the support of 22 organisa- theme, understandably, is COVID-19 – a topic ment. While travel is curtailed we can certainly we work, in an incredibly short period of time and tions and the strategy has been very well received that has totally refashioned how we conduct our still push boundaries and reach out to colleagues at a rapid pace with considerable personal effort. by our stakeholders. We have had excellent media working and personal lives. Out of adversity and to work together. The pandemic resulted in a We have done this at a time when there has been coverage and interest and support from politicians. significant personal loss has come some good, with fundamental rethink of working arrangements in huge change in our own circumstances in the face Feedback from the government has been positive the pandemic being the unlikely enabler of inno- many countries so that we can share lessons (p150 of personal loss or significant difficulties. Thank and we are determined to ensure it informs policy Professor Jo Martin vation and novel ideas. Contrary to my initial fears and p152), even if significantly lower numbers of you for all you continue to do for our patients and development in the UK. Do have a look at it if you that authors would be unable to contribute, this is COVID-19 cases were encountered than in the UK. for our profession. We really value your skills, your have not had a chance so far. It’s a strong message an extraordinary ‘bumper’ edition and I have been The strengthening of IT with remote working effort and your enormous dedication. in a clear format. delighted by the immense breadth of the contribu- and greater interconnectivity will hopefully also We have also made significant and large-scale The College has been heavily involved in the Dr Shubha Allard tions received. help support greater digitisation of pathology changes at the College. You will have seen the speed development and championing of an innovative The introduction to the theme by David Jenkins and transformation of services across organisa- with which we have been responding to the need crowdsourcing platform ‘Testing Methods 2020’. (p117) eloquently captures the essence of key tional boundaries (p141). However, the workforce for information-specific guidance across a whole This has posed specific challenges for the commu- events and milestones as the pandemic unfolded. remains our greatest resource, with a progressive range of issues during the epidemic. This has been nity of pathologists, laboratory professionals and A heady mix of articles on COVID-19 covers approach needed to the development of medical achieved by the efforts of our Specialty Advisory industry related to COVID-19. Examples have molecular science and the role of whole genome and scientific staff. Clearly there are major chal- Committees and Chairs and our Communications included extraction-free rtPCR methods, alterna- sequencing in mapping global progression (p118), lenges ahead and much still to do (p138 and p140). directorate, with exceptional responsiveness to tives to swab methods and multiplexing. A new finishing with the challenges of supporting the The increasing focus on diversity and inequality professional needs. Some of the other changes were challenge has also just been launched on ‘greener bereaved in a multi-faith university chaplaincy is timely and we must surely now pursue this already planned, but have now been accelerated by testing’ that is being championed by Dr Esther (p133). Along the way we hear about the significant dialogue across our specialties. I do look forward the advent of COVID-19 – a digital Bulletin being Youd, our Assistant Registrar, who is also our achievements of setting up a new pathology service to hearing thoughts and comments on reporting of one of these. The era of posted journals is being RCPath Trustee Board sustainability champion. (virtually overnight) to support the emergency race at autopsy (p179). Is it time to review practice superseded by the era of digital media. This is good This has suggestions on plastic-free swabs, and we field Nightingale hospital at the Excel site (pp121 and recommend change? for both the finances and the environment, and are looking forward to ways in which we might be and p131), addressing the increased demands for I have been really pleased with the increasing especially good during the epidemic. I do know able to reduce our plastic usage for the transport of death certification in adverse circumstances (p30) number of books coming our way and the ready that there will be nostalgia for the paper format for samples. Do get involved to help spread great ideas together with the impressive contribution of many volunteers willing to review these, hopefully some, but I hope that you will enjoy this version and new ways of working! healthcare scientists across a breadth of specialties igniting your interest in the topics covered. We equally. As we move into the next phase of dealing (p128). hope to maintain this trend and are happy to with the epidemic, and as we try to build back up The need for high-quality research to support receive your suggestions and input. Virtual meetings and education to some form of normality in our health services, the introduction of any new therapies, however We must sadly remember colleagues we have We have moved to online meetings for all our I am acutely aware that many of the problems persuasive retrospective surveys and anecdotal use lost and acknowledge their significant achieve- committees, Council and Trustee Board and will around lack of workforce, especially in transfu- may seem, is emphasised in an article (p126) on the ments (ppp166–169), including Kate Gould, who continue with the virtual format for the vast sion and histopathology, are still there.