Blood Science is the next step on the road to a fully integrated pathology service. Core disciplines of haematology and biochemistry are merged, but many also see the inclusion of immunology in this new super-discipline. Its development is driven by the need for cost reductions, commonality in laboratory processing and by roles in clinical diagnosis and management. The new discipline will demand a new breed of scientist, as Andrew Blann, Ian Jennings and Nessar Ahmed explain. Historically, pathology has evolved into distinct disciplines, and training and practice has reflected this. The past decade has seen the birth and slow development of a new branch of pathology – blood science – which merges aspects of haematology, biochemistry and immunology.
A further aspect of blood science may be molecular science and genetics, but this is far from being a well-developed and independent discipline. This change is being driven, in part, by the demands of routine NHS pathology laboratories. Now that the majority of blood-based work is increasingly becoming automated, there is an efficiency-led move towards merging those departments most amenable to automation (ie haematology and biochemistry). Indeed, the greater part (if not all) of the work of these departments is based on closed-tube systems. There is often an overlap of knowledge and particularly of methodology and techniques, and, with the increased use of automation and the development of common automated methods, the pooling of resources is inevitable in driving down costs. The Department of Health, in its Modernising Scientific Careers document, recognises three strands that flow from what it terms Life Science.1 These are Blood Science, Infection Science (a modern view of microbiology encompassing infection control, epidemiology, bacteriology and virology) and Cell Science (into which histopathology, cytology and cellular pathology are evolving).
It follows that a new breed of scientist will be needed to take an overview of the previously separate disciplines outlined above. Taking this one step further sees the integration of haematology and biochemistry into blood science, together also with immunology, as the latter can be considered a branch of haematology. While many blood transfusion units may have a separate identity and staff (although rotations of junior staff are common), it is naturally at home with haematology, and is almost always physically linked. Indeed, we are witnessing the growing development of combined departments of blood science in hospitals. In parallel, many forward-looking universities, especially those already offering biomedical science degrees, are now developing undergraduate and professional courses in blood sciences that combine these two subjects.
The final piece of the jigsaw is the development of a new professional staff grade (ie the blood scientist). At present, scientists become qualified in any one of the main disciplines (haematology, blood transfusion, immunology or biochemistry): it is the rare individual who can boast dual qualifications. To this end, the Institute of Biomedical Science2 is in the process of writing discussion documents and developing a joint list of skills appropriate to the new practitioner. But what should these skills comprise?
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