Joint Working Group on quality assurance in pathology: guidance to the professions.

Accepted for publication 29 July 1993 Introduction Professional motivation has been central to the conduct of quality assurance programmes throughout the United Kingdom, Europe, and other parts of the world for many years, the single common aim being to effect continuous improvement in the quality of health care. A general account of the operation of UK NEQAS is given by Lewis and Jennings.' A National External Quality Assessment Scheme (NEQAS) for clinical chemistry in the United Kingdom was introduced in 1969. Since then NEQAS has been extended to encompass most of the pathology disciplines and their subspecialities. Schemes are still experimental in histopathology and cytopathology, but progress is being made towards establishing them definitively from 1993 (UKNEQAS, 1993).2 Funding for EQAs in the United Kingdom was provided centrally by health departments until April 1992, but EQAs are now self funding through levies on participants. In the United Kingdom the Joint Working Group on Quality Assurance in Pathology is charged, on behalf of the professions concerned and through their learned organisations, with the formulation of general guidance to participants in quality assurance schemes and to all who are concerned with quality assurance in pathology. Its constituent membership is drawn from the Association of Clinical Biochemists (n = 1), the Association of Clinical Geneticists (n = 1), the Association of Clinical Pathologists (n = 2), the Association of Medical Microbiologists (n = 1), the British Society of Clinical Cytology (n = 1), the British Society for Haematology (n = 1), the British Society for Immunology (n = 1), the Institute of Medical Laboratory Sciences (n = 4), the Pathological Society of Great Britain and Ireland (n = 1), and the Royal College of Pathologists (n = 4). Its members include the chairs of the National Quality Assurance Advisory Panels (NQAAPs) (n = 5), and the chair of the former Advisory Committee on the Assessment of Laboratory Standards of the Department of Health. Meetings are attended by an observer from the Department of Health and a director of the board of Clinical Pathology Accreditation UK Ltd (CPA). The group meets twice a year at the headquarters of the main professional associations in rotation. Members report to, and seek counsel from, their parent organisations before the advice of the group is formulated and promulgated. The Joint Working Group is thus independent of government, and exercises a general coordinating role as professional monitor of existing quality assurance schemes. The detailed operation of this is controlled by steering groups in each discipline. The Joint Working Group has no access to analyses of performance by individual participants, but receives regular reports from the chairs of NQAAPs on the philosophy and operation of national quality assurance schemes. In rare instances the chair of the group may be called to arbitrate between an aggrieved participant and the chair of a panel. The terms of reference of the Joint Working Group are: (1) To support and monitor, on behalf of the parent professional bodies and their members, the activity of the advisory panels on quality assurance and particularly their relationships with participant members of the professions, with organisers of relevant UKNEQAS and with other panels; (2) To comment to organisers of schemes, either through the advisory panels or directly, on the quality of their liaison with advisory panels and participants; (3) To receive and discuss complaints about quality assurance practices, from members of the pathology professions, which have not been resolved by the steering committees in the disciplines concerned, or by organisers or panels; (4) To consider suggestions for development of quality assurance schemes, to stimulate and foster any worthy new quality assurance activities within existing or additional areas of laboratory practice, and to indicate to the professions, the appropriate professional body or the Health Departments, the Joint Working Group's views on the need for: (a) the formulation of further advisory panels on quality assurance in any specialty, (b) expansion of external quality assessment (EQA) in any field, (c) modifications to practice of EQAs, I