Developing and running an EQA scheme in diagnostic histopathology

External quality assessment (EQA) schemes in histopathology form a key part of laboratory quality management, but their principal function is educational. ‘Test’ material is circulated to participants, who evaluate the material following their normal practice and return responses to an organizing laboratory for collation and evaluation. The test material must be representative of the routine workload, but not mundane. Unlike histopathology slide clubs, objective, quantitative, personal feedback for each participant is vital to ensure unambiguously the identification of areas requiring CPD. The objective evaluation of textual responses in EQA is problematic, but various approaches have been used successfully. The participants are individuals, not laboratories, so confidentiality is paramount. Mechanisms to investigate persistent substandard performance must exist, but should be used very rarely; self-improvement is the usual route to protecting standards of patient care.