Frederick Valentine FlynnBMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e1223 (Published 22 February 2012) Cite this as: BMJ 2012;344:e1223
- David Flynn,
- Marta Lapsley,
- Anthony Norden
Frederick Valentine Flynn (“Freddie”) made major contributions to our understanding of proteinuria, taught clinical biochemistry to generations of medical students and medical and non-medical postgraduates, and developed one of the first programmes for continuing medical education (CME) in the UK. However, it is for his work on the development of laboratory information systems that he is best known.
Freddie was the elder of two sons of Frederick Walter Flynn and Jane Laing Flynn (née Valentine). His parents sacrificed much throughout the Great Depression of the 1930s, and this made a lasting impression on him. As a result he always had a strong work ethic.
After attending St Andrew’s School in Oakleigh Park and Northern Polytechnic in 1941-2, he received his medical education at University College London (UCL) and UCL School of Medicine where he was awarded the Erichsen prize for practical surgery. After house appointments at University College Hospital he was research assistant and registrar in UCH’s department of clinical pathology from 1947 to 1960. His first paper, coauthored in 1949 with Professor Montague Maizels (later FRS), was devoted to basic studies of cation flux in human erythrocytes. He was awarded his MD 1951 and a British postgraduate medical federation travelling fellowship in 1954-55, during which he studied practice, education, and research in chemical pathology in Canada and the US and spent time at the Pepper Laboratory of Clinical Medicine at the University of Pennsylvania.
In 1955, Freddie married Catherine Ann Warrick, MD, whom he met at UCH, where she was then working as a research assistant.
In 1958 with Elizabeth Butler, Freddie co-authored one of the first descriptions of “tubular” (low molecular weight) proteinuria. This was followed by several papers that further defined this form of proteinuria. Coworkers at this time included Charles Dent (later FRS), Harry Harris (later FRS), J M Walshe, George Kazantzis, and Ernest Huehns. He was greatly influenced in his outlook on medicine by Professor Max (later Baron) Rosenheim (later FRS), professor of medicine at UCL. His research collaboration with J M Walshe carried on to well past both their retirements.
In the early 1960s Freddie’s interest in the application of computing to pathology began to develop. “Batch” processing on early computers—such as the 803/903 series manufactured by Elliot Automation in the UK—was by now widely available. These machines allowed offline data handling of analytical raw results, and during this period he exhibited at the Royal Society how a multichannel hospital chemistry analyser could be linked to this type of computer. However, his work went much further than this: he was one of the first to realise the value of “cumulative reporting”—that is, the display of a time series of results from patients. Although taken for granted today this was new and gave laboratory staff and clinicians important insights. The former primarily used it as a form of quality control and the latter as a means of quantifying the progress of their patients. Data processing limited what could be achieved. Given that large datasets had to be extracted from a database of many patients, data presentation was slow and almost never in real time. This led many clinicians to question its usefulness. Hardware breakdowns were common in the 1970s and, compounded with difficult software implementation, a whole day’s reporting from the UCH chemistry department was frequently lost and had to be laboriously restored from original analyser data tapes. Many staff worked repeatedly late into the night to make this possible, always accompanied by Freddie.
Freddie became MRCPath in 1963, MRCP in 1967, FRCPath in 1971, and FRCP in 1973. In 1970 he assumed the chair of chemical pathology at UCL medical school and continued his academic work until formal retirement in 1989, when he became professor emeritus. It is notable that he continued to devote himself to his profession for at least 10 years after retirement.
Freddie Flynn used the rapid advances in data processing during the 1970s and 1980s to improve laboratory computing systems. A clinically useful system—known as SOCRATES—which had been developed with numerous colleagues including David Gardner, Mo Morris, and Mark Buckley-Sharp, was installed for the new pathology laboratory of the combined UCH and Middlesex Hospitals at the end of the 1980s. Such advances in data processing were not universally welcomed by medical pathologists. Many thought that the very large amounts of data far exceeded the ability of clinicians to interpret them. Responding to such concerns Flynn made sure that clinically relevant changes to results, rather than merely a series of numbers, were highlighted to clinicians. He, too, criticised the increasing tendency to repeat pathology investigations routinely, without a clear clinical rationale. Even in the late 1980s this more intelligent approach to data presentation offered formidable data processing challenges, and systems were often confined to single pathology disciplines. This could limit their usefulness. Although Freddie clearly wished for full integration of pathology results into hospital information systems, this was a later development, and is not always achieved seamlessly even today.
Freddie was heavily involved in the running of the Royal College of Pathologists. He was vice president in 1975-78, treasurer in 1978-83, and member of council in 1973-83 and 1984-87. Numerous medical and non-medical trainees came under his wing and benefited from his encyclopaedic and critical knowledge of chemical pathology. From 1972 to 19-82 he chaired the college examinations panel in the specialty. As the head of a large NHS teaching hospital department, Freddie was responsible for some 100 medical and non-medical staff. He was always sympathetic to those with professional or personal problems, irrespective of their post within the department. But he never tolerated low professional standards— instead he supported and led those around him to reach the high standards he demanded of himself. Freddie made major contributions to improving the quality of laboratory pathology in the UK. He championed the advantages of larger laboratories, which could invest heavily in highly automated equipment as well as adequate systems for quality control and quality assurance. He ensured that his department at UCH worked as a single team of non-medical and medical staff. Flynn laboured hard with his new Middlesex colleagues, led by Arthur Miller, to facilitate the merger of the Middlesex Hospital and UCH departments of chemical pathology in the late 1980s. The department of chemical pathology serving the “3Ps” (St Peter’s, St Paul, and St Philip’s nephrourology hospitals), headed by Alan Rose, was also incorporated into the new department based at the Middlesex Hospital.
With his long association with the Royal College of Pathologists he made it one of the first medical royal colleges to promote continuing medical education (CME). After formally retiring from full time academic work he became the college director of CME in 1992 and continued until 1997. In 1995 he was awarded the college medal, and in 2000 the college started to support the “Flynn lectures” delivered at the annual conference of the Association for Clinical Biochemistry, in honour of Freddie’s work; Professor Sir David Weatherall was the first lecturer.
Freddie Flynn worked tirelessly to pursue the broader subject of pathology service and education. He was a member of the Royal Society of Medicine’s pathology section council from 1968-72 and was vice-president in 1971-72 and 1989-91. He chaired the working party on data processing in laboratories of the Association of Clinical Pathologists (ACP) from 1964 to 1967, was a member of ACP council from 1988-89, and the association’s president in 1989-90. Freddie was also on the editorial board of the Journal of Clinical Pathology from 1995 to 1996. He advised the Royal Navy as civilian consultant in chemical pathology from 1978 to 1992.
Freddie served on the Sir Jules Thorn Trust’s medical advisory committee from 1983 to 97 and was a trustee between 1988 and 2006. In this role he helped with the judicious provision of substantial funds for medical and other research in the UK.
During the period 1960-88 he was a member of numerous committees, working parties, and advisory groups for the Department of Health, regional health authority, British Medical Association, Medical Research Council, and NHS committees. Most of these activities were devoted to computing and laboratory automation in medicine. He made major contributions to the work of the Körner committee (chaired by Edith Körner, CBE, 1921-2000) over four years from 1980. It was the first major examination of the way the NHS collected and used its data. This committee’s recommendations were immediately accepted by the Secretary of State for Health and paved the way for improvements in NHS statistics.
Freddie was widowed in 1997, moved to Dorset in 2005 and finally to Cambridge in early 2011, where he later died in Addenbrooke’s Hospital. His later years were dogged by chronic ill-health which he bore stoically. He is survived by a son, David, a computer scientist; a daughter, Frances, a music therapist; three grandsons; and one great grand-daughter.
Cite this as: BMJ 2012;344:e1223
Emeritus professor of chemical pathology University College Hospital (b 1924; q 1946 University College London School of Medicine; MD, FRCP, FRCPath), died of heart failure on 4 July 2011.