The Central Quality Assurance Scheme started life in 1974 as a pilot scheme for blood counts operated from Good Hope Hospital, in Sutton Coldfield, for hospitals in the Birmingham area.   Regional support quickly allowed expansion into Staffordshire, Herefordshire, Worcestershire, Warwickshire and Shropshire. The scheme was known as the West Midlands Quality Assurance Scheme at this time.  

 

In 1977, the Queen Elizabeth Hospital joined forces with Good Hope and began to produce samples for monthly assessment of prothrombin time (PT) and activated partial thromboplastin time (APTT).   Freeze drying techniques were quickly developed so that the repertoire could be expanded to include fibrinogen and Factor VIII (1982), von Willebrand Factor Antigen, capillary anticoagulation and haemoglobinopathy screening (all 1984), antithrombin assays (1986), protein C and protein S (1991) and plasma viscosity (1992).  

 

Importantly, it is the opinions of participants which have figured mostly in constructing the repertoire of trial packages that we see today, as well as the timings of distribution and the combination of tests included in the packages.

 

1993 was perhaps one of the most critical year in the history of the scheme in that a decision was made to offer it on a national basis.   There were already a number of "guests" from outside of the region but 1993 saw the beginning of a steady influx of new participants from around the UK and Ireland, which would give the scheme a much broader user base for statistical comparison but would not compromise the rapid turnaround of results.   The scheme eventually changed its name to Central Quality Assurance Scheme, to better reflect its widening participation base.

 

1993 also saw the introduction of haemoglobinopathy interpretation exercises. Occasional blood films and additional factor assays were added in 1995.   Reticulocytes (1996), white cell differentials (1997) and a revised near-patient testing package for capillary anticoagulation control (1999) and Ristocetin Co-factor in 2003 continued the repertoire expansion. The latest addition to the scheduled repertoire, following a successful pilot issue at the end if 2008, is D-dimer estimation.

 

Since 2000, lupus anticoagulant studies surveys have been introduced as extra surveys to those scheduled and participants take part only if relevant to their test repertoire. Blood films have now become regular quarterly components of the routine haematology screening package.

 

In 2005 another milestone occurred in the scheme's history as the opportunity was taken to consolidate all services at the Queen Elizabeth Hospital in Birmingham. We shall be moving to new accommodation in a brand new build in 2011.

 

The scheme was already approved by the Joint Working Group for Quality Assurance but in 1999 it was formally accredited by CPA (EQA) and is now the only nationally accredited scheme to offer haematology, haemostasis, haemoglobinopathy and plasma viscosity packages.