Berne’s Blog – October 2021

A personal perspective

20 months into the pandemic. 20 months after we were forced to step into an altered working, massively scaled down social and cultural world caused by a fairly scary, dangerous and capricious RNA-virus which continues to dictate the pattern of our everyday lives. That COVID-19 is here to stay is clear and no doubt we will all be subjected to many books, articles, documentaries, select committees and commissioned reports on its appearance and management and vaccine roll out in the future.

The first COVID-19 lockdown arrived in the UK in March 2020, the second lockdown came into force on November 5th 2020, and the Richards Report on  ‘Diagnostics; Recovery and Renewal‘ was published on November 27th 2020.

COVID increased the visibility of the immensely diverse work of healthcare scientists and allowed patients and NHS colleagues to begin to recognise what a valuable resource the NHS had in this small but integral NHS workforce. The Richards report shone a bright light on diagnostics and the workforce required to deliver them and it is NHS scientists who constitute a key part of that diagnostics workforce.

In his introduction Richards said “The Covid-19 pandemic has further amplified the need for radical change in the provision of diagnostic services but has also provided an opportunity for change.” Richards also wondered “Why it has taken 73 years for the NHS to understand the central importance of diagnostics to every patient pathway?” I do not know why it has taken so long for the importance of diagnostics to all patient pathways to be recognised, but I do know that it is in the diagnostic arenas of the NHS that around 90% of us healthcare scientists hang out and perform our work. So, if the critical role of diagnostics was not well known until recently, then it is perhaps unsurprising that our roles as NHS scientists are only now beginning to become vaguely familiar to our NHS colleagues and out in the general public.

We healthcare scientists are generally a quiet unassuming bunch, we like being in our laboratories and departments perfecting and delivering our diagnostic assays in some cases directly with patients, and often, especially in pathology, with patient tissues. During COVID, however, like all our fellow NHS colleagues we wanted to help where we could and it is clear that the role of the healthcare scientist proved to be particularly vital to efforts against COVID-19 in the UK. Scientists were (still are) involved in services across all frontline areas, contributing to the processing of tests for COVID-19, decontaminating and managing ventilators, imaging patients and, so much more.

Highly skilled physiologists in respiratory, cardiac, and critical care were key in working within multidisciplinary teams treating COVID-19 patients with severe respiratory problems by providing non-invasive and mechanical ventilatory support and diagnosis and monitoring cardiac complications with rhythm management and echocardiography. Clinical engineers provided expertise and support for crucial logistics and equipment operation. They also oversaw and helped maintain laboratories, critical care, and high dependency settings. Both our clinical engineers and medical physics colleagues were key in setting up field hospitals by coordinating regional equipment procurement, compliance with regulation, equipment assessment, installation, maintenance and were vital in the rapid application of new techniques in both clinical care and other non-clinical settings.

Getting a grip on who had or didn’t have coronavirus and what their immune status was relied on pathology scientists, these immunologists, biochemists, microbiologists, bioinformaticians, virologists in hospitals and in industrial laboratories not only developed the COVID tests but performed them on tens of millions of people and continue to do so today. Pathology scientists around the country worked with academic scientific colleagues in contributing to many different types of clinical trials including crucial studies to evaluate novel and reliable diagnostic tests for antibody detection. Genetic scientists in NHS genomic laboratory hubs in conjunction with microbiology labs throughout the NHS/PHE continue to help identify the variants of concern that the virus throws out.

On a personal level, my friends and neighbours can not only spell Immunology, but they even have a vague idea of what the immune system does in the body. My family cheerfully discuss PCR and r values in general conversation and tell me that they now have some inkling about what I have been up to over the last forty years! More importantly though, I think people are a lot less afraid of science, even a little interested in it and will have a go at talking about it. This is brilliant. And bodes well for STEM development in the future.

Whereas COVID-19 and ‘following the science’ may have helped the public be less afraid of scientists (and science itself) and in many ways has helped to soften the image people have of us, the promotion of the importance of diagnostics to more efficient and faster patient journeys has and will continue to highlight the critical role of healthcare scientists in the NHS.

In the newly formed NHSEI Diagnostics programme, there are five diagnostic workforce pillars:

• Pathology
• Genomics
• Physiological
• Measurement
• Imaging and Endoscopy

It is a fact that more than any other NHS professional group, healthcare scientists are not only critical in all these clinical specialties but constitute most of the workforce that delivers service in pathology, physiological measurement, and genomics. There has never been a more opportune time for healthcare science and scientists to show how brilliant and vital their work is to patient care and the future of the NHS. It is up to healthcare scientists to step into the light and take a more visible place alongside our NHS professional colleagues in medicine, nursing, dental, AHPs and pharmacy to name but a few. Look forward to seeing that happen.