Pathology specimens should be sent via the sample delivery system to the laboratory or delivered by hand and left at the reception desk.
All samples sent to the laboratory should be packed so as to comply with the Carriage Dangerous Goods (Classification, Packaging and Labelling) Regulations 1996
Specific transport requirements are identified where applicable in the test database for individual tests. Please check here if you are unsure.
Use containers provided by the Trust. These are designed to be robust and not leak in normal use.
Ensure that the container is appropriate for the purpose, is closed and not contaminated on the outside.
After labelling, the samples should be placed in individual plastic transport bags and sealed, not secured with clips or staples
Please do not place the request form with the sample, instead separately in the side pocket.
Samples may be sent to the Laboratory in the following ways:
On site transport
Specifically designed for purpose, specimen transport bags/boxes are used to transport samples within the Trust, by an on site portering service to Pathology reception
If a spillage occurs and is not contained within the specimen transport carrier please ring the number provided on the side of the box and assistance will be provided.
Do not leave a spill unattended
A pneumatic air tube system can be used to transport samples. This system should not be used to send urgent Microbiology samples such as CSFs as it is possible these samples may go astray resulting in a delay in processing and therefore provision of results. Samples containing large volumes of liquid (>50ml) should not be sent by tube because disinfection following leakage is extremely difficult to achieve.
Off site arrangements
There is a daily courier pick up system, provided by the Trust for General Practitioners.
This service is subject to safety audit and inspection. Assistance for dealing with spillage can be obtained by phoning the numbers on the transport carriers.
There is a Hospital transport system linking the laboratory to other hospitals and clinics Trust wide.
Customers may raise concerns through various methods such as phone calls, visits, letters. Specific clinical or technical queries should be via the appropriate Laboratory Manager or Duty On-Call Biomedical Scientist (whichever is most appropriate) – see Department Contacts for details.
A full laboratory service is available from each department between 8.00 and 20.00 weekdays but each individual laboratory may have extended core service times; please consult each section for details. Specimens for routine analysis should be submitted as soon as possible to the individual laboratories.
A more limited laboratory service is available in the following laboratories.
Samples requiring analysis for daily monitoring purposes should reach the laboratory by 11.00 so that they can process by the staff available. Samples sent after this time for routine analysis will be processed in strict order and after dealing with true emergency samples. Some specialist biochemistry investigations can be performed by prior arrangement with the laboratory, and should reach the laboratory earlier in the day. A limited number of staff work in the laboratories on Saturday morning. Investigations should be restricted to those patients who require monitoring to alter or prescribe therapy for that day. The Specimen Delivery System is available for sending most specimens. There are limited collections by the portering staff. Ad hoc porters can be called to take urgent specimens to the laboratory specimen reception. Transport should be contacted directly if the specimen cannot wait. Tests requiring urgent analysis should be brought to the attention of the laboratory staff by a prior telephone call.
Limited services are provided to UHB Trust on a Sunday and vary dependent on the laboratory. Investigations should be restricted to those patients who require monitoring to alter or prescribe therapy for that day. Specimens for this type of analysis must be in the departments by 11.00. The Specimen Delivery System is available for sending most specimens. There are limited collections by portering staff. Ad hoc porters can be called to take urgent specimens to the laboratory specimen reception. Transport should be contacted directly if the specimen cannot wait. Tests requiring urgent analysis should be brought to the attention of the laboratory staff by a prior telephone call.
A limited service is available in the laboratories, and vary dependent on the laboratory.
An out-of-hours service is provided by the following departments:
These services operate at all times when the laboratories are not open for 'routine' service. Out-of-hours you must make contact with the Duty Biomedical Scientist in each laboratory prior to dispatching any specimen. Investigations should only be requested out-of-hours when the results are required for immediate patient management. The out-of-hours Mortuary viewing service is provided by the Trust on-call manager.
All arrangements for specimen delivery to the departments must be made by the requesting doctor. Each department has a published repertoire of tests available out-of-hours and guidelines for requesting are available (see below). A senior member of the scientific or medical staff is available in each department for consultation at all times. If asked by the Duty Biomedical Scientist for your reasons for requesting a test, you should give the clinical indications; no reasonable request will be refused but the Biomedical Scientist will be at liberty to ask you to consult a senior member of the laboratory staff to discuss the necessity for the investigation.
Before any urgent specimens are sent to Biochemistry or Microbiology out-of-hours, you must make prior contact with the department concerned and discuss your requirements. You must complete the request form and include your contact point (telephone or bleep number).
All results are electronically transferred to the PICS and Browser systems. The results of urgent requests may be notified to the requesting source if there are abnormal results that exceed critical limits. You must be prepared to accept results and must not delegate this responsibility to anyone else unless you have made arrangements that are made clear to the department concerned.
NB Without prior notification requests for priority written on request forms (e.g. "urgent" or "please telephone") may be ignored by the laboratory
Cellular Pathology Service Hours
In general terms the opening hours are as follows :
Cellular Pathology: 08:00 to 17:00 weekdays and 07:00-15:00 on Sundays
Mortuary : 08:00 to 16:00 weekdays.
On Call Service
There is currently no formal on call routine diagnostic Cellular Pathology service or on call consultant in Cellular Pathology. On occasions a specialist pathologist may be approached out of hours by clinicians or transplant teams requesting out of hours urgent histology biopsy processing or frozen section reporting for clinically urgent cases. In these cases where a consultant pathologist is available then the Department can support with technical biomedical scientist support and also for back up support for critical equipment downtime. The on call biomedical scientist is available via switchboard. There is also a Cell Path manager on call via switchboard for example to support with for example major incidents or mortuary capacity issues, or critical refrigerated equipment failures for Cellular Pathology and Mortuary.
For same day processing these must reach the Cellular Pathology Reception by 13:30 Mon-Fri. Such urgent requests received after this time will be processed for reporting on the next working day. on the same day.
Ensure that the request form is legible and completed as fully as possible. The correct request form must be completed and must accompany any specimen to the correct laboratory. Both the specimen label and the request form must contain the appropriate minimum data set.
There must be:
Unequivocal identification of the patient and matched to the specimen to the request - bear in mind the regional and cultural predominance of certain common names;
Sufficient information to allow the specimen collector to make the correct choice of timing, specimen to collect (specimen type) and container to use;
Sufficient information to identify the exact site of sampling (e.g. for biopsies, some culture swabs, etc.). Where different sample sites are included on one request form the site of each specimen must be unequivocally noted on the specimen label also;
Sufficient information to aid the audit trail of a specimen from request to laboratory;
Sufficient clinical details to allow laboratory interpretation of the result an analysis, including any current condition or therapy that might interfere with analyses.
Time of sample collection ~ for some assays the time a specimen has been in transit can greatly affect the quality of the result.
All details on the request card should be completed including details of current therapy. Please include the NHS number if known on both the request card and specimen bottle. If printed labels are available please double check you are using the correct one: the large label with the bar code should be applied to the request card and the small labels attached to the specimen containers. You must ensure that the correct location is entered on the request card. Failure to record this will mean that a report cannot reach the patient’s notes. This is particularly important if the patient has moved and labels from the previous location are used, you must ensure that the correct current location is entered on the label. Where a two-part form is used please ensure that information is legible on both parts of the form.
NB: it is not acceptable to use a pre-printed label on a specimen for transfusion purposes, this must be handwritten, legibly and unambiguously.
Poorly labelled or mismatched specimens may not be analysed for medical legal reasons.
It is a requirement of the Blood Safety and Quality Regulations that the blood bank and pathology reception operate zero tolerance with regards to the minimum data set requirement for blood transfusion product requests forms and sample labelling.
1.1. Specimen Tracking
A specimen tracking audit trail is crucial (for quality assurance, clinical governance clinical governance and medical-legal reasons).
There must be a traceable history and "chain-of-custody" which should include:
the identification and location of the responsible clinician ordering the test;
the analytical tests/examinations required;
the patient, location and medical specialty (i.e. the original source of the specimen unambiguously identified);
the person collecting the specimen with the date and time collected;
the nature of the specimen collected (and if appropriate, anatomical site of origin);
the analytical tests required;
the laboratory undertaking the analysis;
identification of priority status;
where the results should be sent (if different from above);
the resulting analytical data relating to that specimen (and sub-samples thereof);
the reported result.
1.2. Minimum Data-set
Data on the request form and the specimen must be compatible. All specimens must carry a minimum, legible and compatible data-set on both the request form and the specimen label.
Patient Data Item
Forename (not just initials)
Date of Birth
Hospital ID &/or NHS number
Consultant (if different from above)
Date of Collection
Time of Collection
Specimen type (& site if appropriate)
Y (for Histology)
Certain specimens labels may have insufficient room to physically allow a full data set in this case include as many key identifiers as possible.
Additional information may also be required such as notification of known or suspected biohazard of the specimen, priority of the result (or date required if for Cellular Pathology), or to aid the reconciliation of the patient with a record on ‘Lorenzo’ or in the patient’s notes.
Time of collection is crucial in several circumstances, including:
To assess the suitability of a sample for tests where cellular degradation over time (e.g. K+ leakage) may interfere or give an incorrect result.
For tests that are part of a timed series (Dynamic Function Tests, e.g. Glucose Tolerance Tests, Endocrine Function Tests etc.),
To allow the laboratory to properly audit specimen turnaround times.
If sufficient clinical details are not provided then the laboratory will not be in a position to offer an interpretation of the result of the test or examination, in this case the laboratory will note this on the report.
If patient anonymity is important a properly coded identifier may be used but this has to be part of a documented system which properly and unambiguously identifies the patient.
Computer software systems may be in use within the Trust (e.g. PICS) which are capable of generating patient specific printed labels. The use of computer generated patient identification (PID) labels for the request form and specimen introduces a risk of misidentification under certain circumstances. Always double check that the correct label has been affixed to the correct request and is accompanied by the correct specimen.
NB: it is not acceptable to use a pre-printed label on a specimen tube for transfusion purposes; this must be handwritten, legibly and unambiguously.
If and when barcodes might be used to identify a request and specimen or sample, these do not replace the requirement for adequate labelling, but in addition the barcode on the specimen and the request form must be identical.
In exceptional circumstances where the minimum dataset is impossible to collect, such as an unidentified patient attending casualty, the laboratory may process the request but will make it clear on the report supplied that necessary data is missing for the unambiguous reconciliation of the patient with the sample received.
Clinical Laboratory Services provides a high quality, cost-effective service to the University Hospital Birmingham NHS Foundation Trust, GPs and community hospitals mainly within the South Birmingham PCT and is a referral centre for specialist services for other local; national Trusts and international users. It is continually upgrading the test repertoire offered to reflect medical development. The laboratory services currently provided include:
Department of Clinical Biochemistry Department of Laboratory Haematology (Including Transfusion) Department of Clinical Microbiology (Including Virology) Department of Cellular Pathology Department of Molecular Pathology
All laboratories are staffed by qualified and experienced medical, scientific and technical personnel.
Clinical Biochemistry; Laboratory Haematology; Blood Bank and Clinical Microbiology laboratories are subject to external accreditation by UKAS against ISO15189.
Each of the laboratory departments runs a comprehensive quality management system, participating in all relevant National Quality Assessment Schemes, and operates a schedule of internal quality audit, corrective action and quality improvement.
The laboratories are recognised for training by the Health and Care Professions Council, the Royal College of Pathologists, the Association for Clinical Biochemistry and the Institute of Biomedical Sciences.
All work is performed with due care for the health and safety of staff and patients and with proper regard for the environment. The laboratories comply with comprehensive safety procedures and Control of Substances Hazardous to Health (COSHH) regulations.
As part of our quality management system and to ensure that we are meeting the needs of our users, we are always keen to receive any comments you may have regarding the quality of the service we provide and would welcome any suggestions on ways in which we might be able to improve the service. We also take complaints about our work, staff and levels of service very seriously. If you are not satisfied, please contact the Quality Manager to register a complaint. Details of the complaints procedure will be given to you at this time.
Protection of Personal Information – Clinical Laboratory Services comply with the Trust Data Protection Policy and have procedures in place to allow the Directorate and it’s employees to comply with the Data Protection Act 1998 and associated best practice and guidance.
The Trust Laboratories at Heartlands Hospital, University Hospitals Birmingham, Good Hope Hospital and Solihull Hospital were all hold UKAS (United Kingdom Accreditation Service) accreditation to the internationally recognised ISO 15189 standard For a list of accredited tests and other information please visit the UKAS website. For further test information please visit the test database:
Tests not appearing on appearing on the UKAS scope, are either under consideration or in the process of accreditation and so currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.
For further information contact Louise Fallon, Quality Manager, 0121 371 5962