My name is Dr. Jo Horne and I am a Consultant Healthcare Scientist working within a large Cellular Pathology department at University Hospital Southampton NHS Foundation Trust (UHS). UHS is a large UK teaching hospital in Southampton, which is a city on the central south coast of England. I work within Cellular Pathology, which is part of a large department with approximately 150 staff working in various general and specialist sections, as well as over four separate floors of the hospital. UHS is a regional referral centre and so we deal with the most complex patient samples within the south central region of England.
I work full time at UHS and have done so for my entire career within Pathology, which started more than 20 years ago. There are two main aspects to my role at UHS, clinical and educational. In my clinical role, I work as part of the specialist gastrointestinal pathology consultant team, independently dissecting and reporting the entire range of gastrointestinal histopathology specimens, which can be anything from a duodenal biopsy to a complex resection specimen. I also support dissection of other specimen types and undertake supervised reporting of specimens where I do not have the relevant reporting qualification to work independently. I have been working as part of the consultant team for a few years now, since gaining my qualification and certification in 2016, and I have been formally in the role since January 2020. A really enjoyable part of my role is participating in clinical multidisciplinary team meetings, where I present histopathology results to clinical colleagues, participate in discussions and provide advice relating to pathology which may include both histopathology and molecular pathology testing and results. To be able to undertake this role is a huge privilege for me, especially as I know that the UK is forging ahead with regard to the development of advanced clinical practice and consultant-level roles for Healthcare scientists, in comparison to other countries.
The other roles that I undertake at UHS are Education Lead for Cellular Pathology and organisation Lead Healthcare Scientist. Both of these roles fulfil my other professional passions, in that I get to support, mentor and lift up others who are aspiring to reach registered, senior, or advanced roles, both within Cellular Pathology and also within other Healthcare Science professions within the organisation. As Education Lead I look after the educational and training development needs of my colleagues across Cellular Pathology, and support them by organising funding for courses and meetings, negotiating for funding and other requirements on their behalf, and providing structured support for colleagues completing the variety of knowledge and competency based portfolios that are available from my professional body, the Institute of Biomedical Science (IBMS) which supports scientists throughout their careers. The most common portfolio is the ‘Registration Portfolio’ which is a workplace-based requirement for all Biomedical Scientists wishing to become nationally registered with the regulatory body for many healthcare professions, the Health and Care Professions Council (HCPC).
Outside of my UHS work, I work with professional organisations to develop Advanced and Consultant level practice for Healthcare Scientists within the UK. I am a national Council member of the IBMS and am working on various projects to improve and develop a range of inter-organisational national qualifications in histopathology dissection and reporting for Healthcare Scientists across the UK. I am also interested in mentoring, leadership and wellbeing, and am working on projects relating to these areas within my organisation, with professional bodies, and independently on my Healthcare Science website.
I started my career in histopathology as a trainee Biomedical Scientist in the late 1990s. To achieve this, I studied for an accredited Biomedical Science degree at my local university. I then developed my career in the workplace into a senior position, and this was accompanied by Masters degree study, at the same local university. At this point, like most experienced Biomedical Scientists I was moving towards a career in management, which to be honest I wasn’t particularly excited about! I was always more interested in histological dissection and the role of histopathologists than I was in managing quality systems or people. I remember feeling frustrated that there was no clear route to develop my own career past management, when medics were able to develop amazing careers in reporting, research, teaching, and leadership when they reached consultant status.
Looking back it was inevitable that I would begin my career in clinical histopathology by gaining certification in histological specimen dissection from the IBMS in 2009, known as the Diploma of Expert Practice in Histological Dissection. This is a nationally recognised qualification for Healthcare Scientists working in histopathology that has been available for more than 15 years in the UK. I then began working as an Advanced Clinical Practitioner, and initially as part of the quality cycle I reviewed and began to undertake supervised reporting of the specimens that I dissected. In 2012, a pilot study run by a conjoint group from the IBMS and the Royal College of Pathologists (RCPath) offered the opportunity to undertake training in histopathology reporting. I was accepted into the pilot study and in 2015 was one of a small group who sat the first final examination in either gastrointestinal or gynaecological pathology. The examination is the same format and set at the same level as the UK medical histopathology exam, albeit in a narrower scope of practice. I passed the exam on my first attempt and completed the training programme, which by this time had been shown to be successful and had become a formal programme, conjointly run by the IBMS and the RCPath. Working with professional bodies, I developed the final preceptorship stage of the training programme and in 2016 gained certification from the RCPath and began to work independently. Four years on, I am incredibly proud and privileged to now be working in a formal Consultant Healthcare Scientist position, providing a high-quality clinical histopathology service alongside my medically trained colleagues. My role now is to help support and advise others so that they can reach the same position that I have achieved, as well as to embed and expand qualifications within the UK.
I am aware that the UK is forward thinking in this area of practice for scientists, and the UK pilot study was initiated on the basis of the success of the dissection qualification, increasing workload and shortage of medical histopathologists in the UK. To perform this role in other countries, professional bodies need to work with scientists and medical histopathologists to design national standardised training programmes. The positive and negative lessons learned within the UK form a solid basis of evidence and advice that can be used to advocate for the development of extended and consultant-level Healthcare Scientist roles within histopathology, as well as other pathology specialties.