Blood sciences operates 24 hours a day; with a routine service between 8am and 5pm Monday to Friday.
Outside of the core day, i.e. 5pm – 9am, nights and weekends, the department is manned by two biomedical scientists, one covering haematology and blood transfusion and the other covering biochemistry. These can be contacted via the bleep system.
The phlebotomy service works 8am – 5.45pm Monday to Friday, and 8am – 10am Saturday and Sunday (and bank holidays). From Monday to Friday, a full service is available. Outpatient phlebotomy is a walk-in service located on hospital route 002. The inpatient service is available to all wards, with a routine visit at least once a day. The weekend service is for routine inpatient requests and is a limited service only. In addition, there is one phlebotomist available 24/7 via the bleep to take blood cultures and other urgent requests.
Most requests received by the laboratory can be ordered using the Order Comms system. The system is in place in most areas including in-patients, out-patients and GPs. This is an electronic ordering system that reduces the need for written forms. Once the order is complete, barcodes are printed for the tests requested, including the tube type required. These can then be used to label the tubes once the have been taken. On receipt at specimen reception the request is simply scanned into the laboratory information system ready to process. There are a number of advantages to using this system, including a reduction in clerical activity in specimen reception resulting in improved turn around times, a significant reduction in error rates and helping the Trust become paper-lite.
In the event of the Order Comms system being unavailable, please revert to using the written request forms. Details on how to complete forms and samples can be seen in the ‘Completion of Request Forms and Labelling of Specimen Containers’ section of this page.
Full training on the use of Order Comms is provided by the Trust IT department.
Different tests require different sample types. The common tests can be seen on the tube guide, supplied by the manufacturer. This is provided to all areas and GPs for reference.
Specific requirements for specialised tests should be discussed with the lab prior to the sample being taken.
Certain tests will require special arrangements, e.g., delivery on ice. These must be discussed and arrangements made with the laboratory to ensure the samples are processed correctly prior to the samples being taken.
Please state the fasting status on the request form.
For requests for Antenatal serology, Haemoglobinopathy screening and infectious disease screening (Microbiology) the same form should be used. This form also incorporates the Family Origin Questionnaire that is an essential requirement to process the Haemoglobinopathy screens. These forms are provided by the laboratory.
Antenatal screen (AFP/HCG) must only be requested using the specific request form, which must be completed in full. Supplies of these forms are available from Biochemistry.
Please state the LMP date on request form.
Please state sample collection time on request form and specimen when relevant e.g. cortisol, serial glucose measurements, therapeutic drug monitoring.
Tests may be added to samples already sent to the laboratory by sending a further request form. THERE IS NO NEED TO PHONE THE LABORATORY BEFORE HAND. Add on tests can be requested using the order comms system which will generate a paper request form that must be signed and sent to the laboratory. No tests will be added purely as a result of a telephone call.
It is possible to add most tests to a previous request during this time, with the exception of tests that have labile components, e.g. Insulin, Amino Acids. Tests can only be added where a suitable specimen has been received.
Incorrect or illegible data on request forms or specimen labels can lead to error in collection from the patient, incorrect or inappropriate analyses being performed or results not reaching their correct destination. The request form must be completed legibly and in full and the laboratory reserves the right to refuse to accept any incomplete request form or inadequately labelled specimen. Incomplete request forms will be returned to the appropriate ward if this can be identified.
All specimens, including blood specimens, should be treated with care. Appropriate labelling and handling of specimens and request forms are part of good medical practice.
The following precautions apply to the submission of specimens from any patient known to be in a ‘high risk’ group.
It is required and facilitates the handling especially of urgent requests to inform Pathology when it is intended to send specimens from ‘high risk’ patients. Investigations should be restricted to those essential for patient management. Blood and blood-stained fluids are potentially infectious.
b. Specimen enclosure, labelling and transport.
Each specimen container and request form must show the identity and source (location) of the patient.
The container must be closed securely.
A danger of infection label must be affixed to both container and request form.
The container must be placed in the appropriate compartment of the transport bag.
The request form must be placed in the adjoining pocket.
Only the warning label need be clearly visible during transport. In this way, the confidentiality of the clinical material may be maintained.
It is the responsibility of the ward/medical staff to ensure that the blood courier is not placed at risk when transporting ‘high risk’ specimens.
The bagged specimens must be placed and sent to the laboratory in pathology transport containers.
All samples are delivered to the main specimen reception where they are processed and booked in prior to analysis in the main lab areas. Samples for the blood transfusion lab are passed directly to the lab without being processed in reception. The requests are booked into the WinPath system and the required tests ordered. Barcodes are generated and the samples labelled accordingly.
There are a number of sites around the Hospital that have access to the PTS. This is used to send samples directly to reception. Before using the PTS Staff must be competency assessed. High-risk samples should not be sent via the PTS due to the risk of possible contamination.
The hospital portering services provide a24-hourr blood porter that will hand deliver any samples to the lab. Any samples must be suitably prepared for transport so that the porter is not put at risk.
Most of the GP requests are delivered via the ISS courier service. All these requests are received around lunch time and processed and labelled prior to analysis.
Phlebotomy ServiceThe samples from blood tests are already booked in so are only sorted into the relevant labs for analysis. Samples from the phlebotomy ward rounds are labelled with bar codes from the ICE system, and therefore need only to be received onto to Winpath system. They are then ready to analyse.
The lab will prioritise any sample that is considered urgent. In order for lab to be able to do this, a phone call to the relevant area must be made.
Some samples are prioritised by the department to provide a service that meets the requirements of the hospital. All samples from A&E, AMU and those called as urgent are given priority. The routine in-patient work followed by the routine out-patient/GP is next.
Click here for the expected turnaround times for blood sciences requests.
The turnaround times of the routine tests performed by haematology, biochemistry and immunology are monitored and reported monthly as part of the key performance indicators for the department.
A&E. 90% reported within 1 hour. Tests monitored: FBC, INR, DDimer, U&E, LFT and Troponin.
Acute Wards. (AMU, ITU, HDU, CTU, NNU). 90% reported in 1 hour. Tests monitored: FBC, INR, U&E, and Troponin.
Inpatient. 90% reported within 2 hours. Tests monitored: FBC, INR, DDimer, U&E, LFT and Troponin.
For immunology turnaround times, see the immunology section.
Click here to view the latest performance figures for our turnaround times.
All results produced by Blood Sciences are available electronically either via the Winpath, Fusion or GP Links systems. All results are available in real time as they are accepted and authorised on the Winpath system. Paper copies are not routinely produced unless requested, for example, for those not able to access one of the systems.
All results received from referral labs are entered manually and checked to ensure accuracy. Some results have a comprehensive written report and if so, a scanned image is made available to view via Fusion as a readable document.
Click here to view a list of reference ranges for blood science analytes.
Reference ranges for FBC parameters obtained from Phase II of the Pathology Harmonisation Project (pathologyharmony.co.uk).
Click here to view our procedure for telephoning abnormal results including the action limits.
The results of tests performed urgently (if requested in the approved manner) are automatically telephoned, as are the results of certain routine requests falling outside critical limits.
Measurement uncertainty is defined as a parameter associated with the result of measurement that characterises the dispersion of the values that could reasonably be attributed to the measurand. By quantifying the possible spread of measurements, an estimate of the confidence in the result may be obtained. Measurement uncertainty stems from imprecision as a result of random effects on the assay systems and laboratories have to minimise the effects of this and acknowledge this uncertainty. Uncertainty can be derived in two ways: 1) from repeated measurements and statistical analysis (sources of this data within Blood Sciences are obtained during assay verification and also through daily observations and monthly review of internal quality control material); and 2) derived from other non-statistical means, such as the manufacturer’s assay validation data (which is supplied within the kit inserts) and intra-individual biological variation. Further information is available by contacting the laboratory directly.
There are a number of specialised tests that are referred to other centres for analysis. A full list of these tests and the referral laboratories can be seen by clicking here.
Complaints may be made directly to staff within the laboratory via telephone, email or face to face contact. For all complaints, contact Sharaz Khan (01922 656896). For clinical complaints, please contact Dr A Hartland (01922 656781) / Dr M Livingston (01922 656780). Complaints can also be made through Patient relations.