External Quality Assurance – Can you see the wood for the trees?

EQA provision has become highly competitive and it is often difficult for Laboratories to select the right programme, with a marked lack of harmonisation of Best Practice amongst EQA Providers, it is understandable why participants are confused and often comment that they are unable to see the wood for the trees. EQA programmes that are accredited are inspected thoroughly for fitness for purpose and deliver confidence to participating laboratories for compliance, accuracy and reliability and “clinical appropriateness” to assist laboratories with their quality assurance.

The organisation of clinical laboratories within the UK is changing, slowly, but with increasing pace, leading to the consolidation of laboratories into fewer, but larger networks. Together with the financial pressures within the NHS, this poses risks to all EQA providers as Laboratories opt for the cheapest provider. However, the recent publication of the Quality Review of Pathology in NHS England identified wide variation in the quality of EQA providers within the UK and has tasked UKAS to work with the expanded JWGQA to reduce the current variation. The JWGQA best practice article on EQA recommends that Laboratories chose their EQA provider based on a set of best practice criteria rather than cost. Weqas complies with all these criteria. UKAS also requires that Laboratories provide a plan of their EQA selection and processes. These initiatives from NHS England may help to deter the move in recent years of Laboratories selecting the “cheapest” option in EQA provision.

EQA impacts on laboratory quality and patient safety by providing a mechanism for assessing performance, identifying problems and actually rectifying them before the system is out of control and puts patients at risk. EQA Best Practice superbly summarises what constitutes best practice, written as a guide to assist laboratories select their EQA programmes based on quality provided, to move away from the simple “tick in the box” solution and assist with compliance for accreditation to ISO 15189.