XEM122761 EMB Summer 14 09/06/2014 12:15 Page 1 www.embryologists.org.uk Summer 2014 ISSUE 78 XEM122761 EMB Summer 14 09/06/2014 12:15 Page 2 EDITORIAL LETTER FROM THE CHAIR! As the temperature slowly creeps up, it can only mean one Well it’s fair to say it has not been a slow start to 2014 for ACE thing. Summer is here! So grab yourself a cup of tea and and I hope this is a sign of things to come. Nicky Monks has settle down with the latest jam packed edition of 'The been working like a Trojan leading the Practitioner Training Embryologist'. Programme team and we now have a syllabus which is in a workable form and should soon be approved for Firstly, a huge congratulations to Jackson Kirkman-Brown implementation. This will for the first time allow a route for who was awarded Healthcare Scientist of the year 2014. practitioner level staff to receive formal training and will Jackson is an exceptionally worthy winner for his work with underpin the existing STP scheme seamlessly. Many thanks helping our armed servicemen who have been injured in to Nicky, Victoria, Jane and everyone else who have been action to achieve a family. Read more about Jackson's work working in the background to push this project through later in this issue. under very tight time pressure. You will find all the latest updates in the world of You may remember that at the AGM in Sheffield I mentioned embryology in this issue, including an insight into NEQAS for that ACE were planning to establish a Scientific Advisory embryos. Committee (SAC) to work with the Executive Committee on matters where the input of key academics in our field would And finally, as World Cup fever grips the world, Bryan has be beneficial. I am delighted to say that we have now combined his love of embryology and football to mastermind established the SAC with 4 initial members. It is my pleasure an aptly themed Brainteaser. Why not challenge yourself? to welcome Daniel Brison, Mary Herbert, Roger Sturmey and Dagan Wells to the committee and to thank them for their Hope you enjoy it. support and enthusiasm towards establishing the SAC; this can only be for the benefit of ACE and all of our members Sue moving forwards. This summer also sees the roll out of the ACE CPD smart Front cover photo shows Jackson Kirkman-Brown with phone app which we have developed in conjunction with Celia Ingham-clark and Professor Sue Hill OBE Premier IT to allow a more life-friendly mechanism for CPD subscribing members to keep up to date with recording of CPD on the go and from portable devices. The app will be available to all CPD subscribing members at no additional Congratulations to the following embryologists cost. on the award of the ACE Certificate Finally, yet very importantly, you may be aware that a group Ingrida Krasauskaite - Birmingham Women's called ‘One of Us’ have been lobbying the European Fertility Centre Parliament this Spring with the intention of halting investment in human embryo research and development. Malwina Paul - Assisted Conception Unit, ACE was among 60 other UK and EU organisations who King's College Hospital London signed a joint statement co-ordinated by the Wellcome Trust Emma Woodland - Salisbury Fertility Centre, resisting this motion and supporting the benefits of human Salisbury NHS Foundation Trust embryo and stem cell research. This intervention was gratefully received by many MEPs, several of whom have Susannah Sargeant - Centre for Reproductive and disseminated it on Twitter and engaged with us. We also Genetic Health, London received positive feedback from the Commission on the Eleanor Taylor - The Hewitt Fertility Centre, statement. Liverpool Women's Hospital I hope you enjoy this edition of The Embryologist and have a Jemma Currington - Bourn Hall Clinic, Cambridge wonderful summer! Laura Pastorelli - Edinburgh Fertility & Reproductive Endocrine Centre, Stephen Harbottle Royal Infirmary of Edinburgh Ashley Hyde - Assisted Conception Services Unit, Glasgow Nuffield Hospital 2 THE EMBRYOLOGIST XEM122761 EMB Summer 14 09/06/2014 12:15 Page 3 WEBMASTER CORNER Update on the Scientist Training Programme (STP): the first trainees are now starting their job hunting for those who are not able to stay in their host unit on completion of their Don't forget to log in from time to time to the 3-year fixed term contract. (For those people who have not website. If you need to renew you will be yet grasped this fact, hosting a STP trainee is ENTIRELY asked to do so, but much more than that you funded by the NHS, whether the training is delivered in a NHS can make use of countless features. From the or private unit). A huge thanks to Jason Kasraie and his "My ACE" page you can access the calendar tireless team who have written and tested the stations for the and see what events are coming up. You can Observed Structured Final Assessment, or OSFA. STP mock engage in polls: did you know that the examinations recently took place at the General Medical majority of your peers hold their breath when handling Council in Manchester, which provided a challenging and embryos? You can also access the forum for ideas, questions effective test of the pre-registrant’s abilities. A side benefit and general chat. And don't forget download central for that may be that people from other professions will get to see the document you were looking for. We are very proud of our complex tasks that embryologists perform on a daily basis, discounted access to Human Fertility. Why not tag this on to and the considerable skills and empathy we bring to our your membership the next time you renew at a measly £25? interactions with patients. Watch this space too for news of the new CPD app as it get released. The proposed training pathway for Practitioners is developing rapidly. There are two programmes: Helen Priddle PROGRAMME ONE:Accredited Additional Scientific Practice in Reproductive Science: Quality, Culture Systems and Gametes for Reproductive Science Practitioners. This MESSAGE FROM THE CHAIR OF programme encompasses tasks for Regulation, Quality and THE TRAINING COMMITTEE Safety, setting up and monitoring culture systems, assessing, procuring and processing sperm and oocytes. The ACE Certificate continues to thrive as the candidates PROGRAMME TWO:Accredited Additional Scientific Practice complete their training and occasional new candidates are in Reproductive Science: Embryo Culture and welcomed from Scotland, Northern Ireland and Ireland. Cryopreservation for Reproductive Science Practitioners. Currently we have 80 registered Trainees and 152 registered This programme includes removal of cumulus cells before Supervisors. Three trainees and eleven supervisors are not ICSI, fertilisation check, embryo assessment and monitoring currently up-to-date with their ACE membership. Please and cryopreservation of gametes and embryos. remember that all trainees, supervisors and trainers for the Certificate need to be active members of ACE. It is very The schemes contain workplace learning guides and difficult for the ACE Assessors to keep track of this. The academic elements taught by a University provider at BSc Training Committee recently circulated a new document to level. The programmes will equip graduate entrants into the Trainees and Supervisors, to be completed and sent with workforce with the skills and knowledge to deliver a range of your final submission of ACE Certificate work, and copied to protocol-controlled procedures and to take responsibility for the ACE Office. In this way, your Assessor will have a a number of key monitoring and safety roles in the complete record of the delivery of your Certificate. You will laboratory. Practitioners will not make any decisions that be able to compile the information from your 3-monthly would affect patient care but will work alongside the Clinical reports, which are especially important if you have had Scientists. The training consultation has involved the changes during your training. If you are missing any of these Infertility Network UK, the HFEA and our colleagues in ABA documents, check out the ACE Certificate page on the (to name the most important). Many thanks to the keen band website. of ACE “documenteers” who have made this happen. Message to ACE Certificate Supervisors: ACE has arranged The proposed training pathways for Associates and two dates for ACE Certificate Supervisors, on 18th June in Assistants have also been clarified. There will be a modular Birmingham and 24th October in London. Please make sure curriculum for which ACE is providing the specialist modules you attend these training days well in advance of your own relating to Reproductive Sciences. Training will be through expiry. The next date in 2015 is likely to be in Scotland. If you apprenticeships or CPD programmes that are mapped to do not have an in-date supervisor in your unit, your trainee occupational standards. The Government is revising the will not be able to continue with training until new specification and delivery of Apprenticeships and future arrangements are in place. We have to ensure that the funding will go directly to the employer, providing another Certificate is delivered in a robust way if it is to be taken as new way to obtain external funding to support training posts. evidence towards future registration. People will be trained to be fully competent in a job role rather than focussed on achieving a qualification. The new The Association of Clinical Embryologists 3 XEM122761 EMB Summer 14 09/06/2014 12:15 Page 4 Healthcare Science Apprenticeship standards will be June 2015 Confirmation of appointment available for delivery from April 2015. The documents for September 2015 Candidate starts program rotational Reproductive Science are in nearly-final form and the ACE placements, University Masters course team would welcome interested individuals to help finalise September 2016 Candidate based in host department and deliver these documents. Again, participation is by email September 2018 Candidate completes program – if you would like to be involved please contact me at Clinical Scientist [email protected]. SIMPLES! Nicky Monks YOUR ASSOCIATION HOW TO APPLY TO HOST A NEEDS YOU! SCIENTIST TRAINING PROGRAMME (STP) TRAINEE Looking for a new challenge? Want to contribute to your profession? Encourage those starting out in the Read about the scheme in the many descriptions available on profession? Expand your CV and experience? line – just type “Scientist Training Programme” into your Could you be an ACE assessor? favourite search engine. ACE in conjunction with the Association of Clinical Scientists Decide whether you would like to host one of the national is looking to recruit assessors for examination of portfolios posts (in which case all the salary and training costs are met), and undertake vivas for award of the certificate of attainment or whether you have a person in your laboratory who would leading to HCPC registration. be suitable to be enrolled on the STP on the in-service There is an acute need to increase the current pool of training route. Existing employees need to be part of your assessors, ACE currently has 8 assessors but with personal workforce with a permanent contract and need a Upper commitments and the number of applications for HCPC regis- Second Class Honours degree (or higher) to be considered. tration rising there is a serious need for additional assessors. Currently the shortage of assessors means that pre- Identify a Training Lead in your department. registrants submitting their portfolios are having to wait up to 6 months for an assessment date, clearly this is not If you are in a NHS hospital, approach your Trust Lead acceptable so we need to encourage our colleagues to take Scientist and your Education Centre, and local health part in this programme. community lead and/or other departments that have been in STP, get agreement from Trust, team, rotational laboratories Being an assessor is very rewarding, it is a real pleasure to etc, make contact with your Local Education and Training interview and get the best from candidates whose ambition Board (LETB). Check that your request is included in your and passion is to become an embryologist. It’s a great Trust’s workforce plan. opportunity to identify the rising stars of the future, to learn from others and test your own knowledge. If you are in a private hospital, make contact with your Local Education and Training Board (LETB) and explain that you You receive the candidate’s portfolios in advance and after understand that you are able to host a training post in your reading through them you make a recommendation to ACS as department. Work together with your Hospital management to whether the candidate should progress to the viva stage, and the LETB to find out how you can provide the training (in then along with another experienced ACE assessor you will the same way as you would provide any other service to the interview the candidate for 45-60 minutes. I know some NHS). candidates find this a really scary experience, just think how your contribution could help ease these fears; it's not meant Summer 2014 Initial expression of interest to LETB to be a traumatic experience for anyone, just an opportunity Sept 2014 Submit workforce plan to LETB for candidates to show their knowledge and competencies. Dec 2014 Approval or rejection of request by LETB Are you the sort of person who can put a very nervous candidate at ease and get the best from them? Jan 2015 National adverts go live on website Enquiries; informal visits; Open Days; You will undergo training; including observing vivas and you Facebook will receive travel expenses. The vivas are held at the March 2015 National shortlisting Association of Clinical Biochemistry offices in Tooley Street London. The number of candidates allocated to each assessor per assessment round is 3-4. April 2015 National interview - assessment 4 THE EMBRYOLOGIST XEM122761 EMB Summer 14 09/06/2014 12:15 Page 5 This really is a great way to contribute to your profession and MESSAGE FROM THE ACADEMY shape the embryologists of the future. OF HEALTHCARE SCIENCE In order to be eligible to be an assessor you need to be a current member of the your professional body and must be The Academy for Healthcare Science is the single overarching HCPC registered as a Clinical Scientist for at least six years. body for the whole Healthcare Science profession. They would normally be considered working to the equivalent of ‘Consultant’ level, at AfC band 8b or above (or As part of our work, we are pulling together a briefing for equivalent), and preferably be actively involved in the policy-makers and opinion-formers about the key issues training of current pre-registration clinical scientists. facing the profession at the moment. The Nomination form can be downloaded from the following This survey asks you for information about the three biggest weblink issues facing healthcare science at the moment (you can give www.embryologists.org.uk/Education/acs_assessor_ us fewer issues if you wish). We will pull this information together into an anonymised report, which we will use to nomination inform our influencing activity. • Nomination form is completed and signed by the We want the survey to be as quick and easy as possible, and potential assessor, and countersigned by a member of are looking for no more than 200 words for each issue. We the Executive Committee of ACE. will ask you for your email at the end of this survey so we can • Form then sent to ACS admin complete with a brief CV come back to you if we need any clarification with any of your of the proposed assessor. issues. • ACS admin forward documentation to ACS Executive who take a decision based on the appropriate criteria Thank you for your assistance in helping to shape the future and relevant ACS Director’s advice. of Healthcare Science and to ensure the voice of the • If approved, the proposed assessor is sent assessor log profession is heard at the highest level. in details to ACS website, instruction manuals, details of upcoming assessment rounds and assessors’ update Update on Professional Indemnity (taken from HCPC sessions. website) www.hcpc-uk.org/mediaandevents/news/index. • Proposed assessor should observe at least one set of asp?id=619&utm_source=VoxApr14 assessments conducted by experienced assessors as part of their training. The experienced assessors should take the time to explain the process to the proposed assessor and the administrative staff would normally be Professional indemnity, an update available to help with any further enquiries if required. HCPC on professional indemnity • The individual is then considered a full ACS assessor but (where possible) they would be partnered with an We have previously updated on the progress of government experienced co-assessor for at least their first round. plans to introduce legislation which will require registrants to have appropriate professional indemnity arrangements in place as a condition of their registration with the HCPC. We were anticipating this legislation to be in place at the end of October 2013. However, this has not been the case and we understand this will not now happen until at least July 2014. Once in place, and when the relevant changes to the HCPC rules have been made, we will start asking registrants to confirm that they meet the requirement by making a declaration each time they renew their registration. We will also publish full guidance on the requirements, based on feedback from our consultation on the draft guidance available atwww.hcpc-uk.org/aboutus/ consultations/ closed/index.asp?id 158 = The Association of Clinical Embryologists 5 XEM122761 EMB Summer 14 09/06/2014 12:15 Page 6 The requirement to have a professional indemnity There were several driving forces behind the establishment arrangement in place will not mean that all registrants need of an embryo morphology EQA scheme: to take out individual professional indemnity insurance to • No standardised embryo grading system existed in the meet the requirements. The majority of registrants are likely UK or overseas to already meet this requirement and will not need to take • Morphological parameters were often ‘combined’ in any action. This is because they are covered by their embryo grading systems employers’ arrangements or they have already made their • Grading was subjective and variable between operators own arrangements – for example, through a professional and laboratories body, defence organisation, union or insurer. • The HFEA ‘Multiple Birth Minimisation Strategy’ Further information about how this requirement may affect • A unified embryo grading scheme was developed by you, along with some ‘Frequently Asked Questions’, is Critchlow and Morroll for the Novocellus/Origio amino available at www.hcpc-uk.org/registrants/indemnity acid turnover study in 2007 (unpublished) • ACE identified a need for a UK embryo grading scheme We will continue to provide updates on our website and in leading to the ACE/BFS National grading scheme future editions of HCPC In Focus. (Cutting et al, 2008) • The Alpha/ESHRE published a consensus paper with similar grading parameters to ACE /BFS scheme (2011) UK NEQAS EMBRYOLOGY SCHEME EXPLAINED The current Embryology Scheme was developed from an ACE PLUS THE INTRODUCTION OF NEW ‘HUB’ AND ‘SPOKE’ pilot study in 2006 which utilised still images of early REPORTS TO AID INTERNAL QUALITY CONTROL FOR cleavage embryos. In 2009, a further pilot study utilizing EMBRYO MORPHOLOGY ASSESSMENT ‘rolling’ embryo video clips of early cleavage and blastocyst stage embryos developed into the present UK NEQAS Dr Diane Critchlow, Deputy Organiser, UK NEQAS scheme, and now also uses timelapse images. It is a Reproductive Science Schemes requirement of scheme participation that the ACE/BFS National Grading Scheme is used (see History of the Embryo Morphology Assessment Scheme www.cmft.nhs.uk/ukneqasrepsci.aspx)and may be the rea- son that some labs choose not to participate, particularly The Embryology Scheme together with the Andrology where a different grading system is used for clinical practice. Scheme forms the United Kingdom National External Quality Assessment Service (UK NEQAS) for Reproductive Science. The grading scheme has been endorsed by NICE and is now External Quality Assessment (EQA) allows comparison of included in their new guidelines for Fertility (February 2013). performance with other laboratories and ensures clinicians The Scheme also allows for assessment of ‘whole embryo and patients have confidence in your service. Additionally, it quality’ e.g. by asking participants to rank graded embryos provides evidence of continuing quality as required by from best to worst, indicating the choice of embryo(s) for various accrediting bodies. The primary aim of all UK NEQAS transfer in a clinical setting. The ‘quality assessment’ results Schemes however is education, and to help ensure results are not currently used to monitor performance, but help are comparable wherever they are produced. participating laboratories to compare how they assess Initially launched in 1993, the UK NEQAS Andrology Scheme embryo quality in relation to other laboratories and which is now well established with 294 participants (215 UK; 79 grades are used in their unit to categorize embryos as ‘top’ overseas). The Embryology scheme launched in 2011 has 72 quality, ‘good’, ‘poor’ quality etc. This is often used to participants (53 UK; 19 overseas). Our aim is to encourage all indicate suitability of embryos for cryostorage or selection of HFEA licensed IVF units in the UK to participate in the patient cycles for extended culture/day of embryo transfer Embryology scheme. Generation of a larger data set from UK etc. and performance is not formally monitored by the and overseas units will mean more meaningful and useful Scheme as criteria differ between IVF units. EQA results will be for embryologists and the clinical service they provide. Most feedback from participants about the current scheme arises from the following two issues: 1. How does the Scheme derive target values? Target values are crucial to scheme design and usefulness and are the basis for accurate performance scores. For quantitative schemes including semen analysis, an All Laboratory Trimmed Mean (ALTM) is used for motility and a 6 THE EMBRYOLOGIST XEM122761 EMB Summer 14 09/06/2014 12:15 Page 7 Method Related Trimmed Mean (MRTM) is used for sperm assigned/submitted per lab when assessing the embryo clips concentration (see participants handbook). There are via the Gamete Expert website. This report compares currently no ‘gold standard’ methods to determine ‘correct’ or embryo grading between labs using consensus results. target values for embryo morphology assessment. It was decided in April 2011 that target values for embryo grading The second report shows embryologist ranking from parameters e.g. cell number, cell size/evenness, percentage individual licence results from a report accessed via the cell fragmentation, blastocyst expansion etc. would be Gamete Expert website (gamete-expert.com). This report derived from all laboratory results to give ‘consensus’ compares embryo grading between all embryologists values. A consensus result is provided if more than 50% of submitting results (therefore a larger data set is used laboratories agree. If fewer than 50% agree, then no target compared to the UK NEQAS data, but the consensus could be value is given. Therefore, a consensus result is not a ‘correct’ skewed if a large number of individual licences is held by or ‘gold standard’ result, and only reflects how a majority of some participating units). This is why the Gamete Expert participating laboratories are interpreting the National target values can bedifferentto the UK NEQAS target values Grading Scheme. as additional data is used. The graphs show whether individual results are in the top 25%, middle 50% or lower Quantitative morphometric measurement of blastomeres for 25% of participating embryologists. cleavage stage embryos to determine evenness and cell count has been considered by the Embryology Steering From June 2014, we aim to provide a further third part to our Committee (ESC), but is more difficult for blastocyst stage reporting system to promote and aid with Internal Quality embryos. As more participants join the Scheme, the data will Control (IQC) within units using a new UK NEQAS Hub and become more robust. Spoke Report. The reports are available when individual licences for embryologists within a unit are purchased with 2. Interpretation of the National Grading Scheme the basic licence. Each participating laboratory will be a ‘Hub’ Participants have reported problems with interpretation of and the individuals within each unit holding individual/per- the grading scheme particularly when embryos have cleaved sonal licences will be the ‘Spokes’. The Hub report (Figure 2) asynchronously e.g. 3, 5, 7 cell stages. This is because a has the following benefits: · ‘typical’ or ‘normal’ asynchronous embryo should have • Less work for laboratory managers - no need to uneven sized cells but would therefore be assigned a lower produce data spread sheets for IQC embryo grading grade (e.g. 3/2/4), than an ‘atypical’ asynchronous cleaving comparisons! embryo with even sized cells giving a higher grade (e.g. • A clear record of all individual licence holders’ results 3/4/4; Figure 1). Some participants have been ‘adjusting’ the • Standardisation of embryo grading and quality grading system to give the ‘atypical’ embryo a lower score categories within units: and the typical uneven embryo a lower score. However, after discussion with the ESC, it was decided that participants Fom the data, it is possible to check if embryologists are should grade as seen, as this is the only way to ensure all selecting the same embryo(s) for transfer/the same patient participants interpret the scheme in the same way. Embryo cycles for extended culture, and selecting the same embryos ‘quality’ is then reflected by assessment of the whole embryo for cryostorage according to your unit policy. i.e. that the typical embryo is ‘good’ quality and the atypical embryo is ‘poor’ quality, despite the latter having a higher The Hub report can be accessed by the lab manager via the numerical score. This also allows a ‘slow’ or ‘fast’ embryo on UK NEQAS website with the lab number and password. the designated day of development to be scored as poor Spokes are identified by codes. Anonymised dissemination quality despite having a high numerical score. of the report to spokes will be at the discretion of lab managers/supervisors, but should provide a useful tool for A review of current grading system by ACE may be discussion at lab meetings. considered, particularly in the light of assessing asynchronous cleavage to indicate typical/atypical embryos. The ‘Spoke’ report will also be rolled out in 2014/15. Each individual licence holder will receive a report for their own THE NEW ‘HUB AND SPOKE’ REPORTS TO AID INTERNAL results submitted via Gamete Expert for each distribution, QUALITY CONTROL (IQC) which they can compare with the online archive of embryo images. The report will be in the same format as the UK The Embryology Scheme currently offers a two part results NEQAS EQA report (from Birmingham Quality*) showing report for monitoring performance: individual running performance graphs and penalty plots, but will also allow comparison of personal results with their The first is for External Quality Assessment (EQA) with a hub and with the overall UK NEQAS consensus values. report accessed via the UK NEQAS website with your UK NEQAS lab number and password. (https://results.ukneqas.org.uk). Only one set of results is The Association of Clinical Embryologists 7 XEM122761 EMB Summer 14 09/06/2014 12:15 Page 8 Future development 2014 HEALTHCARE SCIENCE Finally, with increasing use of time lapse imaging (TLI) for AWARDS morphometric assessment of embryos in combination with classical morphology, the future development of the scheme Jane Blower depends on the participation and feedback from as many IVF Leicester Fertility Centre units as possible. Clinical relevance is of the utmost importance to the Scheme, as all IVF units seek to identify On the 31st March 2014 as part of the #LTO14 Healthcare embryos with the highest implantation potential. The Scientists leading and transforming outcomes event, Scheme already includes TLI, and as the primary aim of all UK Professor Sue Hill OBE Chief Scientific Officer, hosted the NEQAS schemes is educational, we aim to develop and HCS award ceremony to celebrate Healthcare Science introduce clinical scenarios which will be relevant to units achievements over the past year. The event was held at the using TLI in addition to those who do not. Therefore we Grand Connaught Rooms in London, compered by Vivienne welcome suggestions from existing and prospective Parry OBE, science writer and broadcaster, and the occasion participants, particularly in relation to new embryo was attended by 250 guests. Reproductive Scientists were assessment parameters. well-represented among the finalists, in fact seven of the twenty eight finalists in the six categories were reproductive scientists. ACE would like to congratulate our members and those in allied professions who were nominated for an award, well done to all those individuals recognised for their outstanding achievements and contribution to Healthcare Science as category finalists in the 2014 awards ceremony. The categories and finalists were: Healthcare Scientist of the Year • Nick Dudley, Lincoln County Hospital • Jackson Kirkman-Brown MBE, Birmingham Women’s Fertility Centre Workforce Innovation • Nicola Monks, Salisbury NHS FT • Leicester Fertility Centre, University Hospitals of Leicester NHS Trust References • Terry Coaker, Royal Victoria Infirmary Alpha Scientists in Reproductive Medicine and ESHRE • Teresa Robinson, Bristol Royal Infirmary Special Interest Group of Embryology (2011) The Istanbul • Christine White, Salisbury NHS FT consensus workshop on embryo assessment: proceedings • Jo Young, King's College Hospital, London of an expert meeting. Hum Reprod.;26(6):1270-83 Ambassador of the Year • Gary Dakin, Health Education North West London Cutting et al (2008) Elective Single Embryo Transfer: • Gina Rogers, Whiston Hospital Guidelines for Practice British Fertility Society and • Melanie Watson, University Hospitals Bristol NHSFT Association of Clinical Embryologists. Human Fertility; 11(3): Rising Star 131–146. • Megan Duffy, King's College Hospital NHS Foundation Trust *Ed’s note: • Tiffany Daniels, Central Manchester University Hospitals Birmingham Quality (previously known as the Wolfson EQA • Maja Lesniewsk, Birmingham Womens Hospital Laboratory) is the main UK NEQAS centre for clinical • James Pearson, University Hospital of South Manchester chemistry. The UK NEQAS service began at Birmingham in • Samantha Thorn, University Hospital South Manchester 1969 and now comprises a network of 390 schemes operating from 26 centres based at major hospitals, research Patient involvement • Stuart Allen, Central Manchester University Hospitals institutions and universities throughout the UK. The • Jane McCall, Imperial College Healthcare NHS Trust Reproductive Science UKNEQAS is now operated from • Sandra Richards, Oxford University Hospitals Trust Manchester, although the UK NEQAS centre at Birmingham continues to control the encrypted protected area for web-based reports. 8 THE EMBRYOLOGIST XEM122761 EMB Summer 14 09/06/2014 12:15 Page 9 Service Innovator truly patient focussed service they have been able to ensure • Christine Leary, Hull IVF Unit patients attending the clinic have the best possible chances • Mathew Tomlinson, Nottingham University Hospitals of success. The Leicester Fertility Centre was nominated in NHS Trust Fertility Unit the Service Innovator category after transforming the • Leicester Fertility Centre, University Hospitals of delivery of the reproductive science services over seven days Leicester NHS Trust a week. • Adult Hearing Services, Imperial College Healthcare NHS Trust The Leicester Fertility Centre must be congratulated for • Audiology Team, The Royal Berkshire NHS implementing a ground-breaking training program to allow Foundation Trust ambitious school leavers access to an apprenticeship • Paul Blackett, Lancashire Teaching Hospitals program. Recognising the challenges young people wanting • Pat Clough, Salford Royal NHS Foundation Trust a career in science face when leaving school the team • Jennifer Gilroy-Cheetham, The Walton Centre NHS developed and implemented a rolling training scheme in their Foundation Trust department which has already resulted in its first success • Catherine Irwin, Leeds Teaching Hospital NHS Trust with the first apprentice securing employment in the Trust because of the experience they gathered during their ACE was delighted when Jackson Kirkman-Brown MBE was apprenticeship. announced as the winner of the HCS of the year award for 2014. Jackson was recognised for his pivotal role in Nicky Monks has been key in establishing the STP and developing a service to allow members of the armed forces fledgling PTP training programs which now underpin training who sustain genital trauma injuries in the service of their and development of scientists and practitioners in our country, a mechanism to retrieve and store their sperm for profession. Nicky’s continued and unfaltering commitment future use, ensuring our injured service men the hope of a to this project as seen her lead a complicated and better quality of life. Jackson’s passion and commitment to convoluted process which now represents the future of this work and the science of andrology in general are a training for clinical embryologists in England and Wales. credit to him and the team of scientists he leads. ACE would like to congratulate all the award finalists not only Jackson’s nomination was supported by an emotional those working in the fertility sector. Without their passion, account of events written by a couple who had undergone commitment and expertise we would not be able to continue successful treatment following sperm retrieval after the male to improve the standards and range of effective diagnostic partner was injured by a roadside Improvised Explosive and clinical treatments we are able to offer in the spirit of Device (IED) in Afghanistan. continual service improvement and improved patient outcomes. Extracts from the nominations for the other finalists: Mathew Tomlinson has for the last decade played a key role in improving the quality of semen analysis in the UK. A founder member of the Association of Biomedical Andrologists, Matt’s innovative approach to automating semen assessment coupled with his desire to improve service delivery and address the current UK donor sperm crisis make him stand out from his peers. Christine Leary is a shining example of success. Throughout her career she has proven herself as a committed, highly competent service innovator. She balances clinical and research roles whilst finding time to contribute to education both in the workplace and as a lecturer. Christine is committed to service development; continual improvement and improving the quality and continuity of care for her patient’s experience. The Leicester Fertility Centre is a prime example of a publicly funded fertility centre which has shown a desire and commitment to change. In a rapidly evolving science and with limited financial resources, the team have ensured that, by careful implementation of service changes to deliver a The Association of Clinical Embryologists 9 XEM122761 EMB Summer 14 09/06/2014 12:15 Page 10 HEALTHCARE SCIENTIST “When you get the call to tell you that your soldier has been injured – your world falls apart. Not immediately, not for me OF THE YEAR at least, for me my instinct was to survive, to be the rock that Dr Jackson Kirkman Brown my husband needed and to bring the smiles each day for the very long weeks we spent in Birmingham. Jackson was presented with his award by Celia Ingham-Clark National Director for Reducing Premature Deaths at NHS For my husband it was about survival – the doctors and England and Professor Sue Hill OBE, the Chief Scientific surgeons fought hard in those early days and hours to Officer. preserve his life, and as much of his remaining body as they could. After two weeks in an induced coma, we finally dared Jackson's citation read: hope that he would survive, and more than this, that he would find his way back to who he was in mind and spirit. Dr Jackson Kirkman-Brown's clinical work involves working with the Royal Centre for Defence Medicine at the Queen They told us we were lucky, my husband was lucky, because, Elizabeth Hospital, Birmingham, The Queen Elizabeth is the sadly, by this point they had had lots of practice with his receiving hospital for military casualties, many of whom are kinds of wounds, and they were able to save him, when serving in Afghanistan. months before possibly they wouldn’t have. We were also lucky because some time earlier two wonderful men had Jackson’s area of specialist interest is infertility and happened to be sitting in a pub chatting and asking the preserving the fertility of men injured as a result of military questions ‘what about our soldier’s future?’ ‘What about conflict, he has developed a unique service to assist these family?’ Many, if not most of the guys injured in IED blasts, injured men. sustain some injury to their groin, what could be done to ensure that these young men could not only survive these Jackson and his team recognised that following a blast injury, terrible injuries, but go on to raise their own families? men with genital injuries required a rapid effective method to retrieve and preserve sperm for future use. Men with genital These two men were Major John Clarke and Dr. Jackson injuries were diagnosed as facing a future of infertility with Kirkman-Brown. They worked tirelessly to overcome a an inability to conceive their own genetic child as a result of multitude of hurdles related to the practicality, feasibility and the injuries received. Jackson and his team developed an medical viability of the process as well as legal issues related innovative method to retrieve viable sperm from these men. to obtaining consent and performing procedures on a patient Jackson and his team work tirelessly to ensure these men are that may never wake up. given every possible opportunity to have their own genetic child following recovery from injury. Jackson has dedicated an But they persevered because they were convinced of the enormous amount of his personal time and effort into making importance of their work. Of how vitally important it would this innovative approach a reality. He and his team are on call be for these young men to still have the option of fatherhood 24 hours a day to ensure the service is available when not only to enjoy the wonders that this could bring, but also required. to preserve for the injured soldier his sense of manhood in the fullest sense. This service gives hope to those who otherwise might face a life without children. I met Jackson while my husband was still on the ITU, just days after he had woken from his coma. He explained to us the Jackson’s work was recognised nationally when he was procedure he had done and obtained the necessary appointed MBE in the Queen’s New Years Honours list in consents. We didn’t see him again until nearly a year later, 2013. This was followed closely by the birth of the first child when we felt ready to embark on our own journey of starting to be conceived as a result of the team’s pioneering work in our family. spring 2013. We knew we were the very first. We knew there were lots of The significance of Jackson's work to the patients he treats unknowns, and we knew that it possibly wouldn’t work, but was backed up with this personal citation from the first Jackson and his team were warm, and thoughtful, and always family to successfully have a child following his work with very clear and honest and we trusted them completely. defence casualties: It took two attempts of ICSI treatment to get pregnant. I will admit it was a tough process, not least because of the hormones and injections and disappointment of an attempt failed, but also because inevitably it dragged up lots of emotions and anger as to why we were in this position at all. 10 THE EMBRYOLOGIST