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Lindsey A. Gough: Lindsey A. Gough is Pathology Service Manager, Birmingham Heartlands Hospital, Birmingham, UK.
Tim M. Reynolds: Tim M. Reynolds is Professor of Chemical Pathology, Queen's Hospital, Burton-on-Trent, UK
Introduction
Purpose and value of accreditation
The purpose of accreditation is simple. It is a process by which an organisation gains recognition that its activities and products comply with an agreed minimum standard. It involves an external audit of the ability to provide a service of high quality. By declaring a defined standard of practice and having this independently confirmed, accredited organisations are able to attain a hallmark of performance and offer reassurance to users of their service. Clinical Pathology Accreditation (UK) Ltd (CPA) provides a means by which this can be achieved but do laboratories believe that they get value from accreditation?
History of UK pathology accreditation
In 1988, following study of accreditation schemes for pathology services in North America and Australasia, the Royal College of Pathologists explored the feasibility and desirability of a similar initiative in the UK. Funded by a grant from the Trent Regional Health Authority, in 1989 a pilot study was commissioned. Loosely following the protocol of the College of American Pathologists' accreditation programme, documents defining standards based on the Royal College's own Codes of Practice (Royal College of Pathologists, 1990), a protocol for on-site inspection and discipline specific checklist questionnaires were created. These were tested in a small experiment involving eight inspectors and 20 departments in South Yorkshire, and the results published (Audit Steering Committee, 1990). It was decided from this pilot that the initiative was worth pursuing.
The Royal College of Pathologists Audit Steering Committee expanded and invited representatives from other professional groups: The Institute of Biomedical Sciences (IBMS), the Association of Clinical Biochemists (ACB), the Association of Clinical Pathologists (ACP), the National Health Service Management Executive (NHSME), the Independent Healthcare Association (IHA) and the Chairman of the Department of Health Advisory Committee on the Assessment of Laboratory Standards (ACALS, the group monitoring the activity of the UK External Quality Assessment schemes). Observers were also invited from the four UK government health departments in England, Scotland, Wales and Northern Ireland, together with the manager of the King's Fund Organisational Audit initiative.
A second, larger scale pilot study was...