A New Era at Maidstone and Tunbridge Wells NHS Trust
Maidstone and Tunbridge Wells NHS Trust was established in February 2000 and is the largest acute hospital trust in the South East of England. Dave Parris and Yolanda Price from the Blood Sciences department talk about their experience evolving their calprotectin testing service.
“Switching from the ELISA to the turbo method is really a good move especially if you have a high volume of work.”
We run the calprotectin service for the whole of Kent and Medway, so it isn’t just Maidstone as we are becoming a network. We already cover the calprotectin testing for the North and East Kent areas which includes Medway, Darrent Valley, Kent and Canterbury, Margate and Ashford, plus Maidstone and Tunbridge Wells hospitals. This means we are doing around 3,000 tests a month (~36,000 per annum) which has increased from ~32,000 per annum in 2023. The samples for analysis derive from primary care for diagnosis and also secondary care where they use the results for monitoring and for flares etc.
Previously, we were using the BÜHLMANN fCAL® ELISA method on the DYNEX DS2 analyser, running 4 plates a day. Each plate would take two and a half hours to run, which meant it was becoming extremely difficult to keep up, especially if a plate failed or there was an analyser issue. Then we became behind as the assay was only run in routine hours and not at weekends or at night. This capacity constraint and the fact that the numbers requiring testing are still increasing, was the main reason for considering an alternative method.
We wanted to continue using a BÜHLMANN assay because of the extraction method remaining the same. In addition the published literature indicated that there wasn’t much difference between the results obtained by the fCAL ELISA and turbo methods. Other manufacturers’ methods would have required greater resource to implement, because of the validation and communication, due to different results and cut-offs that are used.
We were aware that the BÜHLMANN fCAL® turbo assay could be run on the main analysers. We have Roche c702 analysers here, but they are already almost at capacity. The blood work needs prioritising, so we didn’t feel it was a good idea to introduce the calprotectin to these lines. This is why we looked into other ways of switching to the fCAL turbo method, to increase the capacity, but without it being on the main line analysers.
Introducing the BA200
The BioSystems BA200 stand alone bench top analyser seemed like the perfect solution, so this is what we evaluated, starting early 2023. The evaluation was quite straight forward, and we are lucky that we have a high sample throughput because we were able to collect samples that covered the entire range of the assay. The analyser is very user friendly and reliable – you can load the samples on the BA200 and walk away.