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The evolution of quality assessment

In 2011, UK NEQAS Cellular Pathology Technique (CPT) carried out tests across four schemes – it now covers 12 schemes with two in the pipeline. We hear from Chantell Hodgson, UK NEQAS CPT Scheme Manager.

UK NEQAS Cellular Pathology Technique (CPT) carries out quality assessment for laboratories and organisations across the UK, Europe and further afield. It has a roster of over 150 independent Expert Peer Assessors around the world who carry out the assessment of quality for laboratory tests, to ensure that patient safety is maintained at all times.

It offers a range of accredited EQA and proficiency testing (PT) programmes in cellular pathology through a set of schemes for both clinical and non- clinical laboratories.

UK NEQAS CPT was established in 1991 when a group of regional EQA services, operating between laboratories and hospitals across the UK came together to create one organisation.

Prior to 2011, UK NEQAS CPT was managed on a part-time basis, with 400 participants in total, an 80/20 split between UK and overseas, respectively. Although the four schemes (General Histology, Neuropathology, Renal Biopsy, Muscle Histochemistry) were effective, the appointment of a dedicated full-time Scheme Manager in October 2011 allowed us to focus on expanding and improving service delivery. Since this time our objective has been to assure that developments are both customer-focused and value-adding, which has created a strong foundation for development.

UK NEQAS CPT now provides EQA/PT services for over 1000 international laboratories and organisations, across the UK and 50 other countries, with 1/3 participants being overseas.

Assessment reports are typically available within 24 hours of the assessment being performed

Going online

April 2011 also saw a change in host and the evolution of electronic reporting and web-based assessment, moving away from the traditional paper-based systems. Reports also became available to view and download online, rather than a dependence on printed reports. Membership and assessment is now managed online and assessment reports are typically available within 24 hours of the assessment being performed.

Ten years on, participants continue to be assessed six times annually. Each assessment run (circulation) requires participants to submit representative examples from their own laboratory workload. Submission can be physical, as a tissue section on a microscope slide or tissue block, or digital, via submission of images to our website.

Material is appraised and scored by a team of expert peer assessors from the field of cellular pathology and reports are issued within 48 hours of assessment.


The initial service developments also included establishing an educational programme for participants. Educational workshops were introduced in 2012 for beginners/refreshers, which the following year included dedicated “specialist” workshops, which supported the completion of the IBMS Cellular Pathology Specialist Portfolio. Since then, they have developed to cover all the specialisms covered by the UK NEQAS CPT scheme repertoire and other specialist areas as requested by participants to support their in-house training, resulting in over 20 workshops being delivered, with more than 450 attendees in 2019–20. During the COVID-19 pandemic, with the imposed restrictions, the educational portfolio was moved to virtual provision via webinars to allow continued support to training and education across the full portfolio of areas. Social media was also established to complement this and provide extended accessibility.

Scheme expansion

In the past 10 years, UK NEQAS CPT has developed the format and the range of specialisms within cellular pathology that are offered, which now includes both slide- and digital-based schemes, as well as interpretive schemes. The expansion of our schemes to include both digital-based and interpretive schemes has allowed us to build a professional voice, which has resulted in contributing to national and international guidelines and best practice statements. The Digital Diagnostic Cytopathology scheme, currently in its final pilot phase and due to go live in the autumn, aims to promote quality and education for all those involved in screening and reporting diagnostic cytology. It is open to both medical and biomedical staff, as well as cytopathology trainees, to provide good examples of cytological entities, which will allow for individual feedback and education, and promote education within cytology. Currently, there is no established scheme or scheme in progress globally to allow such opportunities.

Strategy and format

Throughout the positive developments of the past almost 30 years the format of UK NEQAS CPT EQA schemes has remained the same. As laboratory and organisation workloads have increased, the level being tested through EQA has not. The UK NEQAS CPT strategy and format is therefore being adjusted in 2021, starting with our General Pathology (Routine Histopathology) scheme to ensure that UK NEQAS CPT are peer assessing a more representative sample of tests, i.e. a true representation of a laboratory’s or organisation’s quality across all systems, cycles and platforms. This will improve proficiency testing specificity and support our participant’s compliance with International Accreditation Standards.

This is an exciting time for UK NEQAS CPT and its participants – hosted in a new purpose-built facility, we are investigating innovative ways to improve in line with the new advances in cellular pathology technology. At the same time, UK NEQAS CPT continues to uphold the quality in all areas of cellular pathology techniques, which remain invaluable to ensure accurate patient diagnosis.

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Image credit | iStock

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