Bethany Williams is the Lead for Training and Education at the National Pathology Imaging Co-operative (NPIC) based in Leeds. A pathologist by background, she has spent the last eight years working exclusively in the field of digital pathology deployment and research.
n 2015, as a senior histopathology trainee, I decided to take a year out of my training to pursue a clinical leadership fellowship project focussed on piloting the use of a single whole slide imaging scanner to digitise breast specimens in the histopathology department of St James University Hospital. Eight years (and a lot of teamwork) later I am delighted to look back and see how that initial, single specialty deployment has grown into a national digital pathology deployment, research and education programme, the National Pathology Imaging Co-operative (NPIC).
NPIC is one of five United Kingdom Research and Innovation Centres of Excellence in digital imaging and artificial intelligence, receiving a mix of public and industry funding to deliver a comprehensive and innovative digital pathology programme to future-proof pathology services in the NHS, and benefit the patients and public we serve.
Clinical deployment and networks
The success of the breast pathology pilot programme at Leeds lead to a full digitisation of the histology output of our hospital laboratory. Lessons learned from this deployment continue to inform our regional network deployment, encompassing three NHS improvement networks in the north of England. 15 NHS Trusts and 238 pathologists, serving a population of six million people will connect to a single vendor-neutral digital pathology archive which will receive in the region of 2.4 million diagnostic images a year.
This represents a massive change management project, requiring the co-ordination and co-operation of IT, management, clinical and laboratory personnel. Scanners have been deployed across the region, and laboratories will continue to join the network across the course of the year. It is hoped that this infrastructure will benefit pathology services by providing more equitable and timely access to expert second opinion, streamlining local and regional MDT referrals, enabling inter-institutional collaboration and supporting flexible training and employment opportunities.
In addition to a clinical North of England network, NPIC is facilitating the formation of two national specialist networks to support diagnosis in two crucial areas – paediatric tumours and sarcoma diagnosis. Great Ormond Street Hospital, London and the Royal National Orthopaedic Hospital, Stanmore, will each form the hub of their respective networks, enabling specialists to collaborate for diagnosis, education and research.
Education and training
One of NPIC’s biggest priorities is the dissemination of best practice in digital pathology. Over the years, Leeds and NPIC have endeavoured to publish pragmatic advice and evidence covering the topics we feel are most relevant for laboratories deploying digital; which include ISO accreditation of digital services, the training and validation of digital practice for pathologists, remote reporting of digital slides and building a business case for digital deployment.
Our free guides to digital pathology (Leeds Guide to Digital Pathology Volumes 1 and 2) provide a comprehensive introduction to real world deployment, and have been supplemented by a free webinar series, Innovation into Practice. Both have gained an international audience, with the original guide now available in 13 languages, and the webinars attracting participants from more than 40 countries across six continents! We have also instituted a new national centre for digital pathology knowledge and training, where multi-professional groups can learn alongside each other, and the pathology workforce can prepare for the challenges of the future!
Research and innovation
Collaboration between the NHS, academia, and industry to deliver quality research and innovation lies at the core of NPIC. In addition to developing and evaluating novel artificial intelligence based diagnostic tools for the 21st century pathology department, our state-of-the-art multi-vendor scanning facility is being utilised to support novel work in digital pathology quality assurance, and to assist in national clinical trials and digitisation projects, including work on the 100,000 genomes project.
NPIC is committed to authentically involving patients and members of the public into the work we do, whether that be clinical or research programmes. Our active patient and public advisory group provide valuable feedback and insights that continue to shape the work we do. Actively engaging with diverse groups representing the communities we serve has been a fantastic experience.
The future
The last eight years have been an incredibly exciting and rewarding journey. Attitudes to digitisation of pathology slides have shifted considerably, and the challenges of the COVID-19 global pandemic have accelerated clinical uptake. Whilst there are challenges in the implementation of the technology, the opportunities afforded to clinicians, biomedical scientists and researchers are immense. In the near future, we will see further developments in the deployment of clinical digital pathology systems, and the development and implementation of computer assisted diagnostic aids and workflow tools. The pathology community as a whole will continue to adapt to this changing environment and utilise new skills to evaluate how best to leverage digital images to improve services for our patients and public
Dr Bethany Williams
Learn more about NPIC at www.npic.ac.uk, where you can download The Leeds Guide to Digital Pathology Volumes 1 and 2. You’ll find lots of practical tips and discussion of some of the latest trends and hot topics in clinical digital pathology deployment and practice.
Funding statement: National Pathology Imaging Co-operative, NPIC (Project no. 104687) is supported by a £50m investment from the Data to Early Diagnosis and Precision Medicine challenge, managed and delivered by UK Research and Innovation (UKRI).
About Bethany Williams
Bethany is the Lead for Training and Education at the National Pathology Imaging Co-operative (NPIC) based in Leeds. A pathologist by background, she has spent the last eight years working exclusively in the field of digital pathology deployment and research. She has published extensively on the evidence base for digital pathology, pragmatic issues regarding clinical deployment, and patient safety. The training and validation protocol she developed for pathologists has been adopted by the Royal College of Pathologists and incorporated into its official guidance for safe digital pathology implementation.