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General Information

The pages on this site were reviewed v1.3,  July 2016.

Introduction

The Blood Sciences department provides a high quality, cost effective service to Walsall Healthcare NHS Trust and comprises of four laboratory services: Biochemistry, Haematology, Blood Transfusion and Immunology. The Department provides a routine and emergency (analytical and consultative) service to assist clinicians with the diagnosis and management of their patients through the examination of blood, other bodily fluids and the provision of blood products.

In addition to the main Blood Sciences laboratory, the department also provides:

  • Maintenance and training for the blood gas analysers located on the Neonatal Unit, ITU, HDU, AMU, A&E, West Wing Theatres and Delivery Suite.
  • Quality control and external quality assurance support for extra-laboratory blood glucose testing.
  • Biomedical Scientist support to the Anticoagulation clinics, Endoscopy suite and Dermatology for INR analysis.
  • Maintenance and monitoring of all satellite blood banks, and training of all staff in blood product collection.
  • Skin Prick Testing clinic: every Monday (9 am - 5 pm) - prior appointments are required.

The department also provides a Phlebotomy service that covers inpatient, outpatient and community requirements.

The department holds external accreditation by Clinical Pathology Accreditation (CPA) UK Ltd and is also regulated by the Medicines and Healthcare Products Regulatory Agency (MHRA) (specific to Blood Transfusion).

The department participates in a comprehensive quality management system, participating in all relevant National External Quality Assessment Schemes, and operates a schedule of internal audits, corrective actions and quality improvements. The quality management system is reviewed on a monthly basis to ensure the provision of a high quality service is maintained.

The laboratory is recognised for training by the Institute of Biomedical Sciences for both generic and specialist portfolio training.

All work is performed with due care for the health and safety of staff and visitors and with proper regard for the environment. The laboratory complies with comprehensive safety procedures and the Control of Substances Hazardous to Health (COSHH) regulations.  

Location and Opening Times

The Blood Sciences laboratory is located in the main Pathology area on Route 020. The address of the department is:

Department of Blood Sciences
Walsall Manor Hospital
Moat Road
Walsall
West Midlands
WS2 9PS

 

Blood Sciences operates 24 hours a day; with a routine service between 8 am and 5 pm Monday to Friday.

Outside of the core day, i.e.,  5.00 pm - 9 am, 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.

Biochemistry bleep number: 8013

Haematology bleep number: 5095

The Phlebotomy service works 8 am - 5.45 pm Monday to Friday, and 8 am - 10 am Saturday and Sunday (and bank holidays). From Monday to Friday, a full service is available. Outpatient Phlebotomy is a walk in service located on 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.

 

 Key Contacts     

 

Departmental Manager

Mr S Khan

Ext. 6896

Blood Bank Manager

Miss G Pahal

Ext. 7847

Transfusion Practitioner

Mrs M Dhanda

Ext. 7041

Phlebotomy Supervisors

Mrs J Robinson & Mr R Edwards

Ext. 7162

Laboratory Areas

 

 

Haematology

Main laboratory

Ext. 6474

 

 

Ext. 6496

 

Out of Hours Bleep

5095

 

 

 

Biochemistry/Immunology

Main Laboratory

Ext. 6782

 

Out of Hours Bleep

8013

Blood transfusion

Main Lab

Ext. 6472

 

 

Ext. 7812

 

Out of Hours Bleep

5095

Blood Tests (route 002)

Reception

Ext. 6517

 

Out of Hours Bleep

8222

Consultants and other clinical staff

Dr A Hartland

Consultant Chemical Pathologist,

Pathology Clinical Director

Ext. 6781

 

Secretary: Mrs K Rubery-Smith

Ext. 7515

Dr M Livingston

Consultant Clinical Biochemist,

Trust Lead Scientist

Ext. 6780
 

Secretary: Mrs Y Lewis

Ext. 6471

Dr V Tandon

Consultant Haematologist,

Clinical Lead for Haematology

Ext. 7609

 

Secretary: Mrs C Restell

Ext. 7485

Dr M Vega-Gonzales

Consultant Haematologist

Ext. 7608

 

Secretary: Mrs S Simcox

Ext. 6487

Dr M Bhole

Consultant Immunologist

Ext. 6782

Dr A Kalansooriya Principal Clinical Scientist Ext. 6784
Mrs V Hartland Clinical Nurse Specialist (Metabolic Medicine) Ext. 7515

 

Sampling requirements

Order Comms

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.

Requests for blood transfusion can also be made using the order comms system, however, a request form must be printed and signed, and the samples completed by hand. (See Blood Transfusion section)

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 unsure the samples are processed correctly prior to the samples being taken.

Requests for lipids and glucose

Please state the fasting status on the request form.

Requests on pregnant patients

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.

Requests for reproductive hormones on females

Please state the LMP date on request form.

Requests for samples at specific times

Please state sample collection time on request form and specimen when relevant e.g. cortisol, serial glucose measurements, therapeutic drug monitoring.

Add on tests

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.

 Completion of Request Forms and Labelling of Specimen Containers

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 from 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.

The minimum acceptable data on a request form comprises:

  1. Patient's full surname and forename
  2. Patient's DOB (NOT age except in exceptional circumstances)
  3. Patient's ward
  4. Patient's Consultant
  5. Patient's Hospital Unit Number (where possible)

On all specimen containers (except Cross Match Tubes which have labels specific to the Blood Transfusion Department, which must be completed in full) the MINIMUM acceptable information is:

  1. Patient's FULL name
  2. Patient's Hospital Unit Number (where possible)
  3. Patient's DOB

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.

All samples should have the initials of the person taking the sample written onto the tube, in the case of order comms requests please ensure the initials are written on the barcode label

'High Risk' Patients

Specimens from the following categories of patients are regarded as 'High Risk':

  1. Jaundice or liver disease of uncertain (but possibly infectious) aetiology
  2. Suspected cases of AIDS
  3. Unknown HbsAg, hepatitis C and HIV positive patients
  4. Male homosexual/bisexual patients and their sexual contacts
  5. Intravenous drug abusers and their sexual contacts;
  6. Uncertain haemophiliacs and recipients of multiple blood/blood product transfusions;
  7. Babies born to HIV positive mothers;
  8. Renal transplant and dialysis patients not shown to be HBsAg negative;
  9. Patients infected with other Hazard Group 3 pathogens ( as defined by the Advisory Committee on Dangerous Pathogens);
  10. Patients returning from abroad with undiagnosed infectious illnesses

The following precautions apply to the submission of specimens from any patient known to be in a 'High Risk' group.

a. Collection of specimens

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.
  • This must then be placed in another 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.

Transport of samples to the laboratory

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. Bar codes are generated and the samples labelled accordingly.

The samples can arrive at the main specimen reception by a number of routes:

Pneumatic Tube System (PTS). 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.

Blood Portering Service. The hospital portering services provide a 24 hour 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. 

Courier Service. 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 Service. The 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.

Urgent requests

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.

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.

Turnaround Times

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.

The targets set for Haematology and Biochemistry are:

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.

GP. 95% reported within 24 hours, 100% reported within 48 hours. Tests monitored: FBC and U&E

For Immunology turnaround times, see the Immunology section of the website.

Click here to view the latest performance figures for our turnaround times.

Result reporting

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.

Reference Ranges

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).

Telephone Ranges

Click here to view our procedure for telephoning abnormal results including the action limits.

Telephone Reports

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

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 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.

Referral laboratories

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 Procedure

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 PALS .