Departments

Haematology

About EPA Haematology

Haematology services are provided locally by JPUH and QEH, any tests not provided by the spoke laboratories are sent to the hub, for a full list of tests provided by each of the laboratories please see our ‘Tests’ pages.

In order to maintain high standards of analysis this Department participates in national external quality assessment schemes (EQA). The Haematology Department at NNUH is 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 link below

To view accreditation schedule no.10295 please visit https://www.ukas.com/

These help pages provide information about how users can access our services, who to contact for advice, which tests we perform, sample requirements, normal ranges and turnaround times.

The information within this manual is accurate at the time of issue and is reviewed and updated regularly to incorporate new developments.

Test Samples

General Sample Guidelines can be downloaded here.

Sample Acceptance/Rejection Criteria can be downloaded here

Informed Consent

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

Patient consent:
  • NOTE – All procedures 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 himself or herself at a 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.

This consent includes notification to third parties where required by law for example under the Health Protection (Notification) Regulations 2010: we are required to notify
the Health Protection (Notification) Regulations 2010: we are required to notify any infection of public health significance to local public health department as mandated by the regulation. Please ensure your patient is aware of this before submission of samples for testing.

 

Packaging and Transport of Samples

Samples are a potential source of infection and should be treated accordingly. Please fill all sample bottles with the correct volume of blood to ensure correct anticoagulation, and all containers must be securely closed. Leaking samples with gross contamination of contents and containers are discarded. Pocket bags are available for sample transport. Samples should be placed in the appropriate container, which must be securely fastened. This must be placed in a clear plastic bag and sealed. Samples accompanied by forms without specimen bags must be put into marsupial bags with the request form being placed in the side pouch.

Sending Samples

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

  • 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 systems are for the transport of Blood Sciences specimens to the laboratories only.

The air-tube system should NOT to be used for:

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

JPUH

Forms can now be requested on Web ICE. 

NNUH

Request Forms

Forms must be requested on Web ICE by 06:00 for that days 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.

QEH

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
  • 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:

09:00 – 17:00 Mon-Fri   Tel: 01603 289847 (Ext: 5847)

Email: IP&Cadministrator@nnuh.nhs.uk

Rejection of unacceptable specimens

Specimens and request forms are checked on receipt to confirm the patient identification (PID) information provided on the form and specimen agree. There are 4 PID data items; Surname, Forename, Date of Birth and ID Number (Hospital or NHS) which are required by the laboratory and these must match in order for the specimen to be accepted. It is good practice for us to have location and date & time of sample collection. If errors are found the laboratory may contact the requestor, explain the problem and request a repeat specimen.

For samples that are not easily repeated (such as CSF or paediatric samples) the problem will first be discussed with a BMS from the relevant section who will make a decision on whether testing may be allowed to proceed (usually after discussion with the clinician concerned). If the specimen is tested the report will clearly state the nature of the problem as a comment. Alternatively, the requesting clinician will be asked to send a repeat sample.

For further details regarding incompletely labelled samples or forms please contact the laboratory.

Add on Tests

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

Add-on investigations from within the Trust

NOTE – Only Add-On requests from the following locations will be accepted, unless the sample cannot be repeated:

Emergency Medicine A&E, AMUL/M, EAUS
Critical Care
NICU
CCC

  • Only those on the agreed list are added on. If other investigations are required they will have to be discussed with the Haematology Consultant who is contactable via switchboard.
  • With D-Dimer Add-Ons please request clinical reason
  • If Add-On test is accepted then transfer information relating to patient and sample to Add-on Request Slip and send to the laboratory.
  • If samples are insufficient or inappropriate it is the responsibility of the laboratory to inform the requesting clinician of the problem.
Outside normal laboratory hours the following procedure will be followed:
  • The BMS will take the telephone call from the requesting clinician and use the add-on sheet available.
  • While requester is on the phone the following message will be read out to the requesting clinician:

“If we can find the sample it will be processed but this may take a while. Also if you are intending to take another sample at any time in the near future this may be the quicker route.”

  • If there is any doubt regarding the request the BMS may refer the call to either the on-call Consultant or the Duty Manager, whichever is felt more appropriate.
  • Sample is then assayed as appropriate.
  • If insufficient or inappropriate sample then it is the responsibility of the relevant section to inform requesting clinician of problem.

Procedure for requesting add-on investigation(s) from outside the Trust

  • The clinician must phone into the laboratory if add-on investigation(s) required.
  • Only those on the agreed list are added on. If other investigations are required they will have to be discussed with the Haematology Consultant who is contactable via switchboard.
  • While requester is on the phone the following message will be read out to the requesting clinician:

“If we can find the sample it will be processed but this may take a while. Also if you are intending to take another sample at any time in the near future this may be the quicker route.”

  • If insufficient or inappropriate sample then it is the responsibility of the relevant section to inform requesting clinician of problem.

Referred Tests

Some specialised or low volume assays are referred to external laboratories for analysis; these may take up to 4 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 Individual Head of Section or from the Quality Manager if required.

Results

Authorised results are available on the ICE system, which is updated regularly throughout the day.

If a result is needed urgently and/or cannot be found via the ICE system the laboratory may be contacted 01603 286929/286931.

Results of urgent requests if ICE access or electronic delivery is not available and unexpected results, which may aid the immediate patient management, will be telephoned.

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.

Due to IG compliance requirements, results cannot be communicated directly to patients. 

You can download the Haematology Telephoned results criteria here.

Opening Times

JPUH

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

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

The laboratory can be found at the rear of the building on the ground floor sign posted ‘Pathology – Blood Tests’

NNUH

Open 24 hours, 7 days a week. However, routinely staffed and most responsive during our core working hours. Molecular Genetics core hours are Monday – Friday only:

Monday08:00 - 20:00
Tuesday08:00 - 20:00
Wednesday08:00 - 20:00
Thursday08:00 - 20:00
Friday08:00 - 20:00
Saturday09:30 - 12:30
Sunday09:30 - 12:30

The laboratory can be found in East Block Level 1 sign posted ‘Pathology’

QEH

Outside core hours Haematology operates a shift system and qualified Biomedical Scientists are available in the department to undertake emergency and certain routine tests. Special or unusual tests may have to be analysed in batches and may not be available outside the core times.

The laboratory does not need to be contacted if urgent routine investigations are required.

Monday09:00 - 17:00
Tuesday09:00 - 17:00
Wednesday09:00 - 17:00
Thursday09:00 - 17:00
Friday09:00 - 17:00
SaturdayClosed
SundayClosed

The 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’

EWH-D-001 Last updated 23/09/22 (3)