Departments

Clinical Biochemistry

About EPA Biochemistry

The Clinical Biochemistry and Immunology Department is part of the Eastern Pathology Alliance (EPA), a managed Pathology network involving laboratories at the Norfolk and Norwich University Hospital (NNUH), the James Paget University Hospital (JPUH), and the Queen Elizabeth Hospital (QEH). The service provides a wide range of routine and specialist diagnostic and therapy monitoring services. All Clinical Biochemistry work from GPs and non-urgent and specialist work from JPUH and QEH is processed at NNUH. The Department is divided into the following sections:

  • Automation
  • Analytical and Specialist Chemistry
  • Immunology

These pages cover the Automation Biochemistry sections at NNUH, JPUH, and QEH. Please see separate department pages for Analytical and Specialist Chemistry and Immunology.

The laboratories at NNUH and QEH are accredited by the United Kingdom Accreditation Service (UKAS) to ISO 15189:2012. The defined schedule of tests for which the laboratory is accredited can be found by clicking on the following links; for NNUH schedule no. 10294* or for QEH schedule no. 20494*.

In order to maintain high standards of analysis this Department participates in national external quality assessment (EQA) schemes and maintains its own internal system of quality control checks (IQC), routine validation and calibrations on all assays. Full details of EQA scheme participation are available on request.

This website provides information about how users can access our services, who to contact for advice, which tests we perform, sample requirements, reference intervals, and turnaround times. The information within this manual is accurate at time of issue and is reviewed and updated regularly.

For patients using these pages, please note that any information provided should not be used for self-diagnosis and should you have any concerns about your health please consult your GP.

If you find any errors within this information or would like to make any comments and/or suggestions for improvement, please contact Diane Murley, EPA Quality Manager on 01603 286900 or email diane.murley@nnuh.nhs.uk

*Downloaded on 09/01/2024

Test Samples

General Sample Guidelines can be downloaded here.

Sample Acceptance/Rejection Criteria can be downloaded here.

Guide to Changing Internet Explorer Margins for all ICE Forms here.

Patient Consent

NOTE: All procedures and investigations carried out on a patient need the informed consent of the patient.

For most routine laboratory procedures, consent can be inferred when the patient presents themselves at a phlebotomy clinic, laboratory, or other suitable area, within a primary or secondary care setting, with a request form and willingly submits to the usual collecting procedure.

The laboratory infers informed consent has been obtained when samples are received. It is the responsibility of the clinician requesting the test to ensure that informed consent has been obtained.

Preparation, Packaging, and Transport of Samples

For guidance on blood sample centrifugation and storage prior to transport to specimen reception at the Norfolk and Norwich University Hospital, click here.

Samples are a potential source of infection and should be treated accordingly. Samples must be placed into the appropriate container and be securely fastened; leaking samples with gross contamination of contents and containers are discarded. Samples should be placed into a marsupial bag (a clear, re-sealable plastic bag with a pocket), and be accompanied by a request form placed in the side pouch. 

The transport of samples from GP surgeries or other primary care locations is carried out by the Logistics Service staff who will collect all samples from dedicated collection points.

Samples from within the hospital can be transported to Pathology either by the Pneumatic Tube System (PTS), if suitable, or by a porter. For urgent samples ward staff are required to arrange delivery to the laboratory. Samples must first be placed in the plastic sample bags together with the completed request form.

The safe transport of specimens to the laboratory is the responsibility of the requesting doctor or carrier. Laboratory responsibility for the sample begins when it has arrived at the laboratory. 

Sending sample via the Pneumatic Tube System

The Pneumatic Tube System is for the transport of Blood Sciences specimens to the laboratories only.

  • All items MUST be sent in the carriers provided.
  • Samples MUST NOT be placed directly into the carriers.
  • ALL Pathology samples MUST be placed in specimen bags and the lids of all items with the potential to leak (fluids etc.) tightly secured BEFORE placing them in the carriers.
  • Do not cram samples/items into the carrier as this may lead to breakage/leakage and system failure.
  • Only one carrier at a time should be placed in a delivery station.
  • Ensure that carriers are closed securely at both ends to avoid them jamming in the tube network.
  • If any defect is noticed with the operation of the air-tube systems, please notify the laboratory at the earliest opportunity.
  • The system must not be used for sending consumables and other “forbidden items” around the hospital.

The air-tube system should NOT be used for:

  • Danger of Infection samples
  • Blood gases
  • Blood cultures
  • Unrepeatable samples
  • CSFs (for culture, protein, glucose, xanthochromia, etc.)

SEE INDIVIDUAL TRUST POLICIES

Requesting tests at James Paget University Hospital

Forms can now be requested on Web ICE

Requesting tests at Norfolk and Norwich University Hospital

  • ICE forms must be requested on Web ICE by 06:00 for that day’s phlebotomy round.
  • Extra forms will not be accepted by the phlebotomists during the ward round.
  • Requests marked ‘URGENT’ WILL NOT be taken by the Phlebotomist – these must be taken by the requesting clinician.
  • Request forms which have the incorrect location on the request form will be sent to the correct location (if identified) via the pneumatic air tube system. If the phlebotomist on the correct location has already completed their ward round, the request form will become the responsibility of the ward staff to obtain blood sample collection for their patient.
  • If the phlebotomist is unable to obtain blood sample collection the request form will be returned to the clinician.

Requesting tests at Queen Elizabeth Hospital

Forms can now be requested on Web ICE 

“High Risk” samples

Medical officers responsible for the care of patients have a duty of care towards other members of staff – therefore all samples from patients who are known to have, or strongly suspected of having the conditions noted below must be identified. 

  • Creutzfeldt-Jakob disease (CJD).
  • Viral haemorrhagic fever (VHF) of any type.
  • Microorganisms, (biological agents) in Hazard Group 3 or 4.
  • Pyrexia of unknown origin (PUO) recently returned from Africa.

Medical staff should ensure that appropriate information, including relevant travel history, is provided in order to alert laboratory staff of potential dangers. Clinical details supplied on sample request forms must contain clear information regarding the nature of the test being requested and sufficient detail to inform laboratory staff upon the safety precautions they need to take in order to process the sample without risk of infection.

If, during patient intervention, further information becomes available that has implications for the safety of laboratory staff this must be communicated immediately to the laboratory so that appropriate steps regarding containment can be taken.

Contact details for the Infection Protection and Control Nurses:

James Paget University Hospital

Mon–Fri 08:00–18:00

Tel 01493 452612

Email: infectioncontrolteam@jpaget.nhs.uk

Norfolk and Norwich University Hospital

Mon–Fri 09:00–17:00

Tel 01603 289847 (Ext: 5847)

Email: IPandCadministrator@nnuh.nhs.uk

Queen Elizabeth Hospital

Mon–Fri 08:00–17:00

Tel (via switchboard 01553 613613) Ext: 2596

Email: infectioncontrol.team@qehkl.nhs.uk

Referred Tests

Some specialised or low volume assays are referred to external laboratories for analysis; these may take weeks for a result to become available. Please contact the laboratory if there is any urgency for these investigations. Information regarding specimen type for referred tests can be obtained by contacting the laboratory.

In line with accreditation requirements, we endeavour to use accredited laboratories whenever possible. Further information on the reference laboratories we use can be obtained from the Quality Manager if required.

Add on Tests

There are occasions when additional tests are required to be added to existing samples for patient management.

Procedure for add-on investigations from within Trusts

Only those tests in the agreed list are authorised for add-ons. Additionally, only add-on requests from certain locations will be accepted (see information for individual hospitals below).

 View Full list of agreed Add on Tests (PDF)

If other investigations are required, or for locations outside of those listed below, they will have to be discussed with the Duty Biochemist who is contactable via NNUH switchboard. 

James Paget University Hospital Add-on Requests

An ‘Additional Test Request Form’ must be filled and sent to the laboratory. You can also contact the lab on 01493 452846 (or internal ext. 2846).

Download Additional Test Request Form (PDF) (for use at JPUH & QEH only)

Only add-on requests from the following locations will be accepted, unless the sample cannot be repeated:

  • Accident and Emergency
  • Emergency Assessment and Discharge Unit (EADU)
  • Ambulatory
  • Intensive Treatment Unit
  • Paediatrics Ward 10
  • Special Care Baby Unit

Norfolk and Norwich University Hospital Add-on Requests

Telephone the laboratory on 01603 286929 (or internal ext. 2929) to request an add-on. Only add-on requests from the following locations will be accepted, unless the sample cannot be repeated:

  • Emergency Medicine – Emergency Department (ED) Admissions Units Medical and Surgical (AMUL/M, EAUS)  Aylsham suite
  • Critical Care
  • All Paediatric Locations including Buxton, Children’s Assessment Unit (CAU), Children’s Day Ward (CDW)
  • Urgent Care Centre
  • Delivery Suite

Queen Elizabeth Hospital Add-on Requests

An ‘Additional Test Request Form’ must be filled and sent to the laboratory. You can also contact the lab on 01553 613490 (or internal ext. 3490).

Download Additional Test Request Form (PDF) (for use at JPUH & QEH only)

Only add-on requests from the following locations will be accepted, unless the sample cannot be repeated:

  • Accident and Emergency (AE)
  • Medical Assessment Unit (MAU)
  • Ambulatory Emergency Care (AEC)
  • Surgical Assessment Unit (SAU)
  • Central Delivery Suite (CDS)
  • The Appleton Unit
  • Intensive Treatment Unit (ITU)
  • Critical Care Unit (CCU)
  • Neonatal Intensive Care Unit (NICU)

Procedure for Add-on Investigations from Primary Care

Only those tests in the agreed list are authorised for add-ons. If other investigations are required, they will have to be discussed with the Duty Biochemist who is contactable via NNUH switchboard. 

View Full list of agreed Add on Tests (PDF)

Telephone the laboratory on 01603 286929 (or internal ext. 2929) to request an add-on, or NNUH switchboard on 01603 286286 to speak to the Duty Biochemist.

Results

Result enquiries / Telephoned results

Authorised results are available on the ICE system, which is updated in real time throughout the day. If a result is needed urgently and/or cannot be found via the ICE system, the laboratory may be contacted on the phone numbers below. Note: Primary Care users should contact the NNUH laboratory.

James Paget University Hospital:              01493 452846 (or internal ext. 2846)

Norfolk and Norwich University Hospital: 01603 286929 (or internal ext. 2929)

Queen Elizabeth Hospital:                          01553 613490 (or internal ext. 3490)

Critical test results will be telephoned or sent via Alertive (NNUH secondary care only) in line with the Critical and Escalation Protocols for Telephoning Critical Results in Clinical Biochemistry and Immunology.

In the event that the laboratory is unable to deliver the required service due to equipment failure we will endeavour to contact all relevant users.

Guidance

For Clinical Biochemistry telephone limits please click here

For Acute Kidney Injury algorithm click here

For guidance on the reporting of estimated GFR (eGFR) click here

For guidance for the interpretation of elevated serum potassium in primary care click here

For information about key factors that are known to affect test performance and result interpretation click here

Clinical Liaison

Consultation about investigation and management of conditions is welcomed. For advice on diagnosis and the interpretation of Clinical Biochemistry results or advice on treatment during normal working hours (Mon–Fri 09:00–17:30) contact the Duty Biochemist on 01603 646685 or email nnuh.dutybiochemist@nnuh.nhs.uk.

Outside normal hours of service they can be contacted through the hospital switchboard. Tel: 01603 286286. Due to information governance compliance requirements, results or clinical advice cannot be communicated directly to patients.

Patient Information Leaflets

Opening Times

James Paget University Hospital Laboratory

Open 24 hours, 7 days a week. However, routinely staffed and most responsive during our core working hours.

Core Hours:

Monday09:00 - 18:00
Tuesday09:00 - 18:00
Wednesday09:00 - 18:00
Thursday09:00 - 18:00
Friday09:00 - 18:00
Saturday08:00 - 16:00
Sunday08:00 - 16:00
Bank Holiday08:00 - 16:00

The JPUH laboratory can be found at the rear of the building on the ground floor sign-posted “Pathology – Blood Tests”

Norfolk and Norwich University Hospital Laboratory

Open 24 hours a day 365 days of the year

The NNUH laboratory can be found in East Block Level One sign-posted “Pathology”

Queen Elizabeth Hospital Laboratory

Open 24 hours, 7 days a week. However, routinely staffed and most responsive during our core working hours.

Core Hours:

Monday08:00 - 18:00
Tuesday08:00 - 18:00
Wednesday08:00 - 18:00
Thursday08:00 - 18:00
Friday08:00 - 18:00
Saturday08:00 - 13:00
Sunday08:00 - 16:00
Bank Holiday08:00 - 16:00

The QEH laboratory can be found at the rear of the building on the ground floor, in area 4, the green section sign-posted “Pathology & Blood Tests”

EWC-D-001 Last updated 09/01/2024 (2)