A Born Biomedical Leader

We spoke with David Wells, Chief Executive of The Institute of Biomedical Science and Scientific Lead for Pathology for the NHS London Region, on his path to pathology, challenges in the field, and the highlights of his career.

The following interview has been edited for readability. Watch the full, unabridged interview above.

What does a day in the life of David Wells look like?
 

At the moment, I’m quite busy doing good stuff. We spend a lot of time at the Institute working on raising the profile of people who work within pathology, particularly biomedical scientists and clinical scientists. We spend a lot of time working with policymakers and system leaders to really educate them on what we’re doing, why we’re doing it, and how our members can make a real difference. If I look at my diary right now, I’m working on a commission piece where we’re looking at how systems can use diagnostics in a far more proactive way. I spent the day yesterday working with colleagues around point-of-care testing to identify how we use it on the diagnostic continuum to improve patient care within the NHS. 

My day job includes making sure that the Institute has got the right qualifications available to arm scientists and our members, as well as making sure that we respond to the challenges our members face. For my NHS role, it involves making sure the policies and systems that are put forward by the government and digital health and the NHS are being adopted in a way that makes most sense for patients.

What led you to biomedical science in the first place?
 

Like many people, I suspect biomedical science found me! I did a degree in biomedical science at Anglia Ruskin University and it was always my intention to finish that and go into medicine. Instead, I found that once I got to a role in a hospital laboratory, I loved it. It was fantastic. I was able to do a lot more across medicine than I ever thought I’d do if I had become a doctor. I say it quite often, but it’s a privilege to work in a profession that covers pre-conception, after death, and everything in between. It’s such a fantastic view of medicine. The impact that we can have as individuals on patients is what first drew me in and got me hooked. My passion for pathology and for biological science have pushed me to do different things – and it’s given me a career that I wouldn’t ever have imagined possible in any other profession.

Could you give us a whistle-stop tour of your career so far?
 

I’ve been very lucky to have worked in some very prestigious places. I’ve had opportunities to do some quite marvelous things in my career. I was fortunate to train at the fantastic Addenbrooke’s Hospital in Cambridge – and that really put me in good stead as I moved around. 

I’ve also worked in some great hospitals in very deprived areas – and challenging environments in terms of staff numbers and budgets. I’ve worked at Great Ormond Street Hospital, leading quite unique services across the globe in terms of pathology. When the pandemic hit, my role of ensuring that we had the right testing within the NHS was really important. I was able to call upon all of my previous experience to make sure that it was a success for us all.

The secret of my success, to use a phrase, has been that I’ve taken every opportunity that’s been presented to me. I’ve often put my head above the parapet. I’ve definitely been authentic in terms of doing what I believe is the right thing – and I think that’s really where I’ve got to in my career. Going forward, there’s still a lot to do. I believe diagnostics has a much greater role to play within modern health care; we don’t make enough of it yet. One of my ambitions is to get diagnostics mentioned in the headlines when we talk about healthcare – not just doctors and nurses. There’s more we can do across the globe as well. Pathology is a small area of medicine in general and the more we can do with other countries, the faster we can bring new technologies to bear.

What was it like leading the laboratory response to COVID-19 for NHS England?
 

It was a very difficult time. The pandemic was clearly coming and there was a slow burn of incident management meetings that were going on. I think I had a phone call from somebody who was working with what was then Public Health England saying that they had finished their involvement in terms of the immediate response. They said the NHS needed to step up its capabilities. I don’t think there was anyone else in the central office function of the NHS that could take the reins, so I wasn’t really ’chosen.’ We didn’t know what was going to happen. We didn’t know the scale and size of the challenge. And the fact it was a global issue meant that there were some unique challenges in terms of supply chain. 

I have to mention that Jane Mills, who now occupies the role of Head of heading up Pathology Transformation in NHS England, was a really key person in making sure that we were getting the right, sustainable supplies for the country. The rest was about bringing the system together to respond in a way that was the most appropriate: was everyone spending the right time on test development? Were they spending the right amount of resources in building their capacity? Was their capacity matching demand? And how could we support them when it wasn’t? 

We can look back and say we made some errors, but, on the whole, I think history will record that we did the right things at the right times – and with utter professionalism. And that meant we were able to come through to the other side. It was daunting and all-consuming, but I had a profession behind me that I knew I could trust. I knew they would deliver when asked – and they did every time. Even when the Prime Minister was making requests, I could put my reputation on the line and say: “Yep, we can do that!” I think that made my job a lot easier.

What initiatives have you helped introduce during your time at IBMS?
 

I had been a trustee at the Institute for a while so I knew how it worked and knew its capabilities. When I joined, I think my main aim was to do more of the same at a greater scale – to really start to consolidate some of our position in influencing the powers that be. I can break our five year strategy in two halves. First, more education at a higher level, supporting advanced roles in clinical practice and making sure that we cover as many disciplines within pathology as possible. And second, greater political engagement, greater visibility of our profession, and improving our reach across the UK and across the globe. 

The last bit I want to mention is improving the peer-reviewed evidence of the value of biomedical science – of diagnostics – in the healthcare setting. Another piece of work we’ve only just started is building an evidential base that shows how highly trained, qualified, statutory-regulated biomedical scientists make a difference to health care. It’s about making sure the future of healthcare takes them into account and builds their roles into future delivery models.

What is the greatest challenge that pathology faces at the moment?
 

If we’re talking about the UK, then the greatest challenge is that the systems are changing rapidly. The push for more care outside of hospitals means that we’ve got to move quite quickly into new arenas that we’ve not normally worked in. The challenge there, of course, is how do you convince people who don’t know who you are? You’re often hidden away in a hospital basement somewhere – how do you convince them that you need to speak to them? We do a lot of leadership work in terms of building that conversation and making sure that we’re on the ground with the decision makers.

The other challenge is that we’ve got to find the funding for that change. My honest view is that pathology can deliver – through innovations and new approaches – a cheaper or more financially efficient healthcare system. But you still need to get over the hump of that change. Not only do we have to tell people that we’re here and can help speed up their patient pathways, but we also have to convince them to spend some money on it. In short we’ve got to have a more flexible approach to diagnostics. That might be more point of care, it might be better logistics to central laboratories, or it might be greater integration and consolidation from the laboratories – and all of those will cost some money.

Globally, the big challenge is around the use of diagnostics and the way diagnostics is viewed. There is a big shift in the public perception of diagnostics. COVID-19 taught people that they can access testing in private laboratories outside of a clinical setting. What happens if people start accessing diagnostics in a way that suits them better, whether it’s right or wrong? If it suits individuals, how do we make sure that those tests are still high quality and that the results of the interpretations are still of high quality?

What advice would you give to someone considering a career in biomedical science?
 

I would absolutely encourage them to do so because I think it is a fantastic profession! But they’ve got to go in with their eyes open; the training is tough and sometimes repetitive, but at the end of it is a career that is very worthwhile and valuable.

I’d also say: think about how your career may change. The days of just being a laboratory scientist are long gone. I think that a career can be outside the laboratory and in the community; it could be in primary or secondary care or in very specialized tertiary centers. The limit is your ambition. If you want to be an advanced reporting scientist or if you want to be a manager, it will be well within your capacity. My ongoing advice will always be that you’ve got to take opportunities as they come up.

It’s one of those professions that gives back what you put in. And you can personally make a difference to lots of people; if you’re working in a traditional patient-facing setting, you may help 20 or 30 patients in a day. In pathology, we help thousands of patients every day.

Which part of your career makes you most proud?
 

I’m very proud of many things I’ve done, which includes being proud of people who I worked with in delivering those things. But one thing that stands out is the work we did during the pandemic. We were able to deliver what was needed, and I saw some great examples of teamwork across the country. I was very proud of the dedication people showed in some very challenging moments for our country – and indeed for the entire globe.

I am also proud that we were able to effect such change for the pathology networks. When I started my career, Lord Carter of Coles produced a report saying that pathology services in England should consolidate into a network-based system; 20 years later, I led the team that delivered it.

^{Credit: Image Supplied by Interviewee}