Chemical pathology, haematology and immunology

Derby

Telephone: 01332 789 400

Location:
Pathology, Level 5
Royal Derby Hospital
Uttoxeter Road
Derby
DE22 3NE

Burton

Telephone: 01283566333 ext 4048

Location:
Pathology,
Lower ground floor
Queen's Hospital Burton

Opening times

Royal Derby Hospital 

Laboratory routine opening times: Monday to Friday, 9am — 5pm
Urgent opening times: 5pm — 9pm, 7am — 9am

Queen's Hospital Burton

Monday to Friday, 9am - 5.30pm

Outside of core hours, there is a limited service for analysis. The laboratory is open 24/7 for receipt of samples and process of samples (see out of hours tab).

Patients

Results can only be issued to the requesting physician or unit and will not be given to patients directly under any circumstances.

Authenticity of callers is checked in order to protect the confidentiality of patient personal details for information governance purposes.

Colleagues

Please check Lorenzo, Integrated Clinical Environment (ICE) or Meditech for all test results.

No results will be emailed.

At Derby

If results cannot be accessed, please contact:

Telephone: 01332 789400

The results line is available Monday to Friday, 8am - 7pm (excluding Bank Holidays).

For urgent out of hours advice and information, call switchboard via 01332 340131.

Blood sciences clinical advice 

Available Monday to Friday, 8am - 7pm.

Telephone: 01332 789383

Haematology clinical advice

The consultant on-duty for Haematology is available via switchboard:

Telephone: 01332 340131

Clinical advice is available 24/7.

At Burton

If results cannot be accessed, please contact:

Telephone: 01283 511511 (ext 4048)

The results line is available Monday to Friday, 9am - 6pm.

For urgent out of hours advice and information, call switchboard via 01283 511511.

Biochemistry Clinical Advice

The consultant on-duty for Biochemistry is available via switchboard.

Telephone: 01283 511511, ext 4233 or direct number 01283593313.

Haematology clinical advice

The consultant on-duty for Haematology is available via switchboard:

Telephone: 01283 511511.

Please use electronic requesting through Lorenzo (RDH), Meditech (QHB) and Integrated Clinical Environment (ICE).

Each specimen request must be accompanied by the relevant request form, it is vital the forms are legible and completed fully. The location and requesting source must be completed for the results to be sent out. Failure to do so may lead to specimens being inappropriately dealt with or not being analysed at all.

Blood sciences

Electronic requesting is always advised. Manual requests will only be accepted if the requesting source does not have access to electronic requesting. The requesting source and clinician must be completed, with no abbreviations.

Instructions for transportation of samples

Samples should be sent to the laboratory with minimum delay. Delays in sample delivery to the laboratory can compromise the accuracy of many analyses. Where blood serum is required for routine analysis, centrifugation should occur within 6 hours. Samples more than 6 hours old can look normal but may already begin to show increasing potassium and falling glucose concentrations.

If the container is undated, the reported results may be grossly misleading. ALWAYS put the time and date the sample was taken on the request form.

 

How to submit samples

Blood Sciences (Chemistry, Haematology and Immunology) specimen labelling criteria:

Specimen

Essential identifiers:

• Patient’s full name (last name and first name)
  
  
• Plus either an NHS or hospital number, or the patient's date of birth (in full)

Desirable:

• Date and time
  
  
• Nature of the specimen (e.g. venous, atrial, central line)
  
  
• Patient’s address

Request form

A form should only be used where electronic request is not possible.

Essential identifiers:

• Patient’s full name (last name and first name)
  
  
• NHS or hospital number, or the patient's date of birth (in full)
  
  
• Plus one of the following identifiers:
  
  • Investigations(s) required
  • Location/destination or the report
  • Requesting clinician

Desirable:

• Clinical information including relevant medication
  
  
• Date and time the specimen was collected
  
  
• Patient’s address including postcode
  
  
• Clinician’s contact number/bleep
  
  
• Patient’s address including postcode

The patient’s NHS or hospital number may not be readily available in community locations. In these circumstances, the patient’s address (including postcode) is a suitable identifier if it is given on both the specimen and request form.

In addition, the ID of the person collecting the primary sample should be recorded.

For medico-legal and safety reasons unlabelled or mislabelled specimens must be repeated where possible.

Addressograph labels

If used on request forms, addressograph labels must be affixed to all three copies of the multi -part form. Alternatively, a ball point pen, pressed firmly, should be used to fill out forms. Addressograph labels should not be used on any sample containers; please note that samples with addressograph labels for crossmatching will not be accepted under any circumstances and will require a repeat sample to be taken. Users are referred to the Trust's written policy on taking blood samples.

During the out of hours period (Royal Derby Hospital, 9pm - 9am and Queen's Hospital Burton 5.30pm - 9am) only two biomedical scientists are on duty at either site to respond to all Haematology, Blood Transfusion and chemical pathology emergency requests for the hospitals and districts. Due to this reason and to facilitate appropriate response to emergency care, only a limited number of investigations are available during these periods. Selected additional investigations can be available if required after prior discussion with the laboratory, see list below.

Derby

Derby Urgent, out of hours samples should be sent to the laboratory in the same manner as urgent samples within normal working hours.

Burton

Burton urgent out of hours samples should be sent to the laboratory in the same manner as urgent samples within normal working hours, with the exception of 12am — 9am. For all urgent out of hours requests between these hours, bleep the laboratory.

Tests available urgently out of hours without prior discussion:

Chemistry

• UE
• LFT
• CK/Troponin
• Paracetamol/Salicylate
• Ammonia
• Amylase
• Bicarbonate
• Calcium
• Carboxyhaemoglobin (RDH lab only)
• Cortisol
• CRP
• CSF Glucose/protein
• Digoxin
• Ethanol
• Glucose
• Gentamycin
• HCG (pregnancy)
• Lactate
• Phosphate
• Pre-eclampsia screen (not QHB)
• Procalcitonin
• Urate
• Vancomycin
   

Haematology

• FBC
• ESR
• INR
• APTT
• Fibrinogen
• D Dimer
• Glandular Fever
• Malaria Screen
• Ascitic fluid cell count (available at RDH only)
   

The following tests can be available urgently out of hours AFTER prior discussion with laboratory to arrange but may have a longer turnaround time than those listed above:

Chemistry

• Lithium
• Methotrexate
• Phenytoin
• Phenobarbitone
• Pre-eclampsia screen
• Theophylline
• CSF Xanthochromia
   

Haematology

• Sickle solubility Screen (QHB requests sent to RDH by lab)
• Blood Film
• Factor VIII (QHB requests sent to RDH by lab)
• Factor IX (QHB requests sent to RDH by lab)
• Von Willebrand activity (QHB requests sent to RDH by lab)
• Low molecular weight heparin (QHB requests sent to RDH by lab)
• Apixaban (QHB requests sent to RDH by lab)
• Rivaroxaban (QHB requests sent to RDH by lab)
• HIT (sent to referral lab)
• ADAMS TS -13 (sent to referral lab)

Derby accelerated requests

Blood sciences accelerated requests

Accelerated samples must be placed in a red accelerated sample bag, supplies of which can be obtained from Pathology Reception.

The laboratory will accelerate these samples within a four hour turn around time window, upon registration.

All red bag samples should be individually signed in, if brought to the hatch.

No phone call is required for these requests, unless there is a particular problem with the sample, or specific conditions relating to the request.

Immunology accelerated requests

All immunology tests that are required urgently must first be discussed with the Immunology department.

Test will only be processed urgently if agreed by the lab, following initial discussion on the telephone.

Telephone: 01332 788502

Burton urgent requests

On the QHB site, samples are sent down using the normal sample bags, A&E, CCU and ITU/HDU samples are treated as urgent, for other locations to ensure samples are processed urgently a call to the laboratory is required.

Appending "urgent" or "please phone" on the request form or ordering as "urgent" in Meditech will not give the request priority.

Other tests are available urgently during normal working hours but only by prior discussion with the laboratory.

• Download GP letter: The required sample type for PTH is changing [pdf] 81KB (opens in new window) >

Changes to the creatinine method and reference ranges

The Serum creatinine method at Queen's Hospital Burton Laboratory is changing to 'enzymatic' from Sunday 2 April 2023. The current assay (Jaffe) was first described a century ago and is no longer able to perform to modern performance standards. These performance standards have recently been tightened and are enforced nationally. Enzymatic creatinine is the method which has been recommended nationally, because of better precision (reproducibility) and less interference from glucose and bilirubin leading to more accurate results.

Users should be aware that there may be a one-off change in creatinine and therefore eGFR results for some patients due to the change in the reagent. The exact effect will depend on the creatinine level and other individual biochemistry but it could be up to 10%. It will be important that serial results on the same patient pre and post method change are interpreted in light of this and if such a change is noted after the reagent change it is advised to repeat the test to confirm trend.

Please note: The method change alone is not significant enough to trigger AKI alerts so these results should continue to be managed according to current clinical protocol.

A summary comment will be added to all relevant results from the laboratory computer system.

If you have any questions about the method change, which has been agreed by the renal consultants at the University Hospitals of Derby and Burton, please contact Dr Nitin Kohle (via renal secretaries) or Julia Forsyth or Sarah Knowles on 01332 789383.