An interview with Dr Tony Cooke our CEO

It’s been a year of huge demand for Cambridge Clinical Laboratories and not the year our CEO, Dr Tony Cooke, had planned. In 2020 CCL’s team has doubled, they are processing the equivalent of four months (pre pandemic) testing every week, and Tony has been at the forefront in enabling private labs to support with Coronavirus testing.

Here we reflect on the past nine months. 

How are you?

It’s been an interesting year. Nothing like we expected. Our original plans for last year, keeping in mind we took over the company last year, and the plan for this year was to expand in different areas – gastroenterology, cancer, women’s health and fertility – that’s all slipped away. You can see by our regular oncology and virology business that people aren’t being tested as frequently. That’s a result of Coronavirus. 

Instead of expanding our business into lots of disciplines and looking at where the company needs to go for the future, we’re just really focusing on one thing right now which is Coronavirus. 

We had a pretty quiet first quarter, but since April we’ve been building our testing capacity, and getting more people and equipment in. It’s been a completely different year to what we expected, and I think we’re doing a good job. But it also leaves the question – what do we do next year? The plan that we would have had this year can’t be implemented next year because we don’t know what is going to happen with the pandemic. Businesses usually have a three to five-year business plan. We are currently looking at a two-month plan realistically. 

Coping personally, I thrive in chaos so for me it’s fine! It’s very dynamic. For those who like routine this must be so difficult, for me it’s fine. I find it quite exciting; I like a challenge. 

Can you talk us through the role CCL has played in the fight against Coronavirus in the last nine months?

When the pandemic hit the UK, we had a real issue with getting any government attention to start supporting with testing. In late April we got together with a bunch of other labs to form the Covid Testing Volunteer Network, and as a conglomerate we were in a stronger position. At the end of April, we started our Department of Health and Social Care Pillar 4 contracts, supporting care homes. There have been a few hiccups on the way with the contract, but we now look after about 25 care homes in Cambridgeshire. We test each staff member weekly, and residents monthly. That will go on for at least the remainder of 2020. 

We’ve also picked up some support contracts from the Department of Health and Social Care and the Network. We’re running breakout testing for Wigan, have picked up a contract for Hounslow council, and we have one for Cambridge and Peterborough Clinical Commissioning Group. We’re processing between 400 and 600 tests a day. 

Privately we’re doing a lot of TV and film set testing, and I and a few others came up with the idea of an app for self-monitoring wellness that occupational health organisations could use to monitor staff in large businesses. That’s doing well. It is a separate company but we’re a supporting lab. 

As a result of the busier schedules we’ve taken on more staff – four lab technicians, and one extra customer service support.

We’re trying not to get involved in things that have a lower strategic value to the nation such as the fit to fly work. When we set up Lab 21 (CCL’s former company name) in 2005, the whole premise of the business was to try and provide really cutting-edge healthcare and up the game of the NHS. We wanted to try and improve the opportunities people have. Some of the routine oncology tests you see now – we were the first lab to run them in the country. In this crisis we need to still have a moral drive. We can be profitable and ethical. We’re focusing a lot on DHSE contracts because that is socially what we prefer to do.

How has CCL been impacted?

Four of our new intakes are graduates. We’ve been careful to recruit people who fit with our company culture. They understand what we’re trying to do. They’re very grateful to be given the opportunity to learn. We have a loyal employee base and I think our newer team members will be the same. They know they can learn and grow here. Our dynamic hasn’t changed, even though we’ve grown quickly. We’re very much a family. We have a friendly, productive atmosphere. We’re all working for something bigger.

I’m thinking of this year as a gap year. We’re working really hard. We’ve gone from being 9-5 five days a week to 8-10 six days a week. The strategy is on hold, at the moment we are working to short term goals. 

What are your thoughts on Coronavirus testing moving forward?

If you think of any major disease area so cervical cancer for example – it’s a common disease, so we have a screening programme to screen mass population to determine who is at risk and needs further testing. If you look at Coronavirus testing – the only test we have had was real-time PCR – it’s not a screening test, it’s a confirmation test. It takes too long, costs too much, is too complex, and not enough labs can run it. 

What we ultimately need is a screening test – that is what these newer antigen tests are. They are very good at negative predictive value. If you’re ok, you’re ok. If you’re not ok, you need to be assessed further. You won’t necessarily have Coronavirus, but a PCR test can then be used to determine further. That’s how it should have been done from the start, but we didn’t have the technology. 

The antigen tests won’t be as precise but they’re cheap and you can mass produce them. We’re missing those with no symptoms at the moment, the antigen test should pick those up. The two tests fit alongside a vaccination. It’s a jigsaw, and with everything working together technology and science will solve this. 

What are your hopes for CCL post Coronavirus?

We’re going to change because the market has changed. People are much more aware of their wellness, and getting diagnostics done themselves. 

The plan for CCL is to really improve its brand image and not just work with the NHS and private health care providers but go directly to the public. We are working towards CQC registration and then we will expand our portfolio – in fertility, oncology, gastroenterology, and women’s health – where self-testing can play a massive role. Also post Coronavirus, we will look at long Covid and how we can support there. 

A whole new area for us will be stepping into next generation sequencing which is predictive healthcare so we will look at that – risk factors, lifestyle etc… 

We’re doing a good job; I’d like to do more. It’s just very difficult, it’s so dynamic. I’ve never seen the diagnostic landscape change so quickly. Normally you’re looking at tests taking a couple of years to get on the market, then you have to develop a market, and do NICE approvals etc. We’re talking six months from the start of this to where we are now, and the diagnostic landscape is completely different to where it was six months ago. It’s absolutely unprecedented.