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Molecular Pathology Diagnostic Service

Click here for the list of Molecular Pathology UKAS accredited Assays

Introduction to The Molecular Pathology Diagnostic Service

The discipline of Molecular Pathology encompasses those investigations which determine the diagnostic, prognostic and predictive profile of pathology specimens through the analysis of alterations to DNA, RNA or-in certain cases-Proteins. This can include small mutations or large chromosomal aberrations, DNA methylation, and changes to RNA transcription and protein expression levels.

Service Background

The Molecular Pathology Diagnostic Service (MPDS) provides a diagnostic molecular pathology service to internal users within the Trust, external users regional; national and international. The department processes over 20,000 samples per year and offers services in both solid tumour testing and circulating tumour DNA.

The department utilizes a broad range of molecular techniques including immunohistochemistry, FISH, PCR based targeted assays (Sanger Sequencing, real time PCR, pyrosequencing) and next generation sequencing (NGS) to provide testing for protein expression, gene mutation, gene methylation, gene amplification and chromosome translocation. 

The laboratory is accredited to ISO 15189:2012. Tests that fall under this scope can be found using the link above and is also indicted in the 'Test Repertoire' section below.

The department of Molecular Pathology is part of Clinical Laboratory Services and operates within the Quality Management System of the Clinical Laboratory Services, it is led by a Consultant Clinical Service Lead, a Principal Clinical Scientist and an Operations Manager. MPDS participates fully in UK NEQAS and GENQA External Quality Assurance schemes where appropriate.

MPDS provides a comprehensive molecular pathology service to the Trust, and nationally, between 8:30 and 17:00 Monday - Friday. Please contact the laboratory for any pricing enquiries.

Contacting The Laboratory

Several key personnel are involved with the management of the department at QEHB. For general enquiries, please contact the Specimen Reception.

Clinical Service Lead
  Dr Philippe Taniere
Principal Clinical Scientist
Dr Matthew Smith
Molecular Operations Manager
Brendan O'Sullivan
Quality Lead
Helen Stokes
Molecular Specimen Reception

Requesting a Test

In order to process specimens efficiently, it is essential that request forms are fully completed in a clear and legible format. The use of patient ID stickers is permitted however please ensure you use the full patient sticker NOT the smaller blood tube sticker. All specimens received into MPDS must meet the agreed laboratory minimum data set; any specimens not meeting the criteria may be returned to the requesting department. Please ensure that any important information (e.g. clinical history, etc.) is clearly indicated on the form and ensure that any priority or urgent cases are marked as such.

Click the link below to view and download the latest versions of our request forms.

Molecular Testing Request Forms

Minimum Data set Required

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. Where possible a copy of the pathology report should be provided.

Patient Data Item Request Form Specimen
Forename (not just initials)  
Date of Birth  
Hospital ID &/or NHS number  
Block ID
Report Destination  
Requesting Practitioner  
Consultant (if different from above)  
Clinical Details  
Date sample sent  
Specimen type (& site if appropriate)  
Investigations required  

Sending Samples To Us & Subsequent Return of Material

For information on how to send samples to MPDS including packaging and transport, and information on the return of samples, please click here.

Molecular Test Repertoire & Turnaround Times

From the 1st September 2020 onwards, the FISH service previously provided by the ROH Pathology Department will be transferred to the Molecular Pathology Diagnostic Service (MPDS) based at the QEHB.

All FISH tests previously performed in the ROH Pathology Laboratory have been validated again at the QEHB site following UKAS standards; these tests are awaiting submission for consideration within an extension to scope (ETS) application for accreditation. In the mean time, those tests will not fall under our scope of accredited tests but will be performed within our ISO accredited Laboratory.

Any external requests should be made to MPDS directly, as below. If you have any query, please feel free calling or/and emailing us.

Breast Cancers

The section offers a comprehensive HER2analysis service for breast cancers. Immunohistochemistry, with the Roche/Ventana 4B5 antibody, is used to screen patients for expression levels of the HER2 protein and identify those “over-expressers” who are most likely to benefit from treatment with Trastuzumab (Herceptin). Where expression levels are equivocal, FISH is used to determine amplification at the gene level. Service users may access the full service, or submit cases for FISH analysis only if performing their own IHC.

Gastric Cancers

As with breast cancers, HER2 analysis is performed in Gastric cancers to assist in predicting which therapies patients will benefit from. As well as this standard-of-care testing, mismatch-repair analysis and ISH for EBV are also available on demand.

Colorectal Cancers

RAS (KRAS and NRAS) mutations confer resistance to anti-EGFR monoclonal antibodies, and act as a negative predictive marker for these therapies.  The National Institute for Clinical Excellence (NICE) has approved the use of Cetuximab and Panitumumab for the treatment of metastatic colorectal cancer in patients who carry normal, “wild-type” RAS genes. RAS testing is mandatory prior to their prescription.

BRAF gene mutation analysis is provided on demand for colorectal cancer patients. This can be used to inform patient management or, in combination with mismatch repair expression (see below), to help establish the presence of the inherited cancer syndrome HNPCC (Lynch syndrome).

We are a reference centre for Mismatch repair(MMR) protein expression analysis in patients suspected to have Lynch syndrome; we test over 700 cases a year. immunohistochemical testing allows identification of patients without normal DNA repair processes, who are therefore more likely to have Lynch syndrome. In patients with MLH1 loss we can also perform reflex testing for BRAF V600E mutations and MLH1 promoter methylation status. Mismatch repair protein expression is also requested increasingly to help inform patient chemotherapy decisions, as patients lacking MMR expression appear to have reduced sensitivity to certain cytotoxic treatments.

BRAF p.Val600Glu (“V600E”) specific immunohistochemistry (IHC) is available on demand.

Lung Cancers

EGFR mutations correlate with the effectiveness of certain Tyrosine Kinase Inhibitors (TKIs) such as Gefitinib, Erlotinib, Afatinib, and Osimertinib against some Non-Small Cell Lung Cancers (NSCLCs). Activating mutations are reported to correlate with significant responses to such treatment, whilst certain other mutations correlate with resistance to first- and second-generation TKIs, but predict response to newer agents. EGFR mutation status is therefore vital in deciding the most appropriate treatment regime. The service also offers EGFR analysis on circulating tumour DNA extracted from plasma. This is of particular use in testing patients for acquired, targetable secondary mutations when they begin to progress whilst on treatment that targets their primary EGFR mutation. It may also function as a surrogate where clinical circumstances make obtaining a more representative tissue specimen for initial diagnostic testing difficult or impossible. The service can provide specialised collection tubes for users wishing to submit samples.

Anaplastic lymphoma kinase (ALK) gene fusions can be targeted with specific inhibitors, and translocation analysis using immunohistochemistry or Fluorescence In-Situ Hybridisation (FISH) is now standard alongside EGFR mutation analysis to determine 1st line treatment for lung NSCLC. In addition to ALK analysis, the service provides FISH and IHC testing for ROS1 fusions in lung cancer. 

PD-L1 expression analysis is also important in informing first (and second) line anti PD-1 / anti-PD-L1 monoclonal antibody treatment for lung NSCLC. A relatively recent addition to the testing landscape, in 2016, immunohistochemical analysis using companion-diagnostic antibodies specific to the relevant treatments gives a quantitative expression result.

Gastrointestinal Stromal Tumours (GIST)

Up to 90% of all malignant GISTs harbour gain-of function mutations in the KIT / PDGFRA genes. Primary mutations have been described in exons 8, 9, 11, 13 & 17 of KIT, and exons 12, 14 & 18 of PDGFRA. Secondary (acquired or treatment associated) mutations have also been described. Selective TKIs have a high response rate in patients with advanced GISTs, which are largely radiotherapy and chemotherapy resistant. Evidence suggests that the type and location of KIT or PDGFRA mutations in GISTs predicts the response to TKI treatment.


The BRAF gene is frequently mutated in human melanomas, with mutations seen in 35-50% of cases. Mutations lead to constitutive activation and aberrant signalling, and subsequent malignant behaviour. Drugs that treat those cancers by inhibiting BRAF are now licensed for use in metastatic disease.

The NRAS gene is also frequently mutated in melanoma; between 10-20% of tumours show an NRAS mutation, and these are thought to be mutually exclusive with alterations in BRAF. NRAS testing is offered as a supporting aid in selecting patients for access to novel therapeutic interventions or clinical trials targeting the pathway activated by mutant NRAS.

Mutations in the KIT gene are seen in Acral and mucosal melanomas and represent potential therapeutic targets.

PD-1 and PD-L1 inhibition, particularly in combination with anti-CTLA4 therapies, has shown profound and sustained effects against metastatic melanoma. Whilst PD-L1 expression analysis is not mandatory for prescription, as it is with some lung NSCLC therapies, it has been shown to be helpful in informing decisions on whether to use mono- or combination-therapy.

Brain Tumours

The revision of the WHO classification of CNS tumours in 2016 has expanded the range of essential and desirable molecular analyses performed.

Epigenetic silencing of the MGMT(O6-methylguanine–DNA methyltransferase) gene by promoter methylation is associated with longer overall survival in patients with glioblastoma who, in addition to radiotherapy, received alkylating chemotherapy with temozolomide. High levels of MGMT activity in cancer cells create a resistant phenotype by hindering the therapeutic effect of alkylating agents and may be an important determinant of treatment failure.

Combined loss of chromosome arms 1p and 19q (denoted as 1p-/19q-) is a powerful predictor of chemotherapeutic response and survival in oligodendrogliomas. A FISH based analysis of these loci is available as a tool to assist patient management. More recently it has been employed diagnostically in the differentiation of ATRX-positive Oligodendrogliomas and Astrocytomas.

Mutation analysis of the IDH1 and IDH2 genes is used as a supplement to immunohistochemistry. Whilst the IDH1 R132H-specific antibody detects the majority of IDH mutated tumours, mutation analysis for rarer R132 variants along with IDH R100 and IDH2 R172 mutations is used in particular relevant clinical scenarios.

Turnaround Times

Turnaround Times from sample receipt to result issued are variable dependent on the test requested.

Service users are advised to directly contact the service in instances where a shorter turnaround time is essential for patient management, or where a report has not reached them within the stated turnaround time.

 Test Quoted Turnaround time (working days)  Assays currently included in our application for ISO15189:2012 accreditation scope
ALK translocation testing by FISH >90% in 7-10 days Yes
ALK translocation testing by IHC >90% in 5-7 days Yes
BRAF V600 mutation testing  >90% in 5-7 days Yes 
COL1A1-PDGFb FISH  >90% in 7-12 days  No
EBERS ISH  >90% in 5-7 days  No
EGFR (Exon 18-21 mutations) & ALK IHC  >90% in 5-7 days  Yes 
EGFR plasma mutation testing (Exon 18-21 mutations)  >90% in 5-7 days  Yes 
EGFR tissue mutation testing (Exon 18-21 mutations) >90% in 5-7 days  Yes 
HER-2 testing (FISH) >90% in 7-12 days  Yes 
HER-2 testing (IHC) >90% in 7-12 days  Yes
IDH1 (codon 132) /IDH2 (codon 172) please contact laboratory Submitted for ETS July 2019
KIT (8,9,11,13,17), PDGFRa (12,14,18) testing by Sanger Sequencing (1-2 exons) >90% in 7-15 days Capillary sequencing method; submitted for ETS July 2019. On scope by NGS targeted panel.
KIT (8,9,11,13,17), PDGFRa (12,14,18) testing by Sanger Sequencing (3+ exons) >90% in 15-30 days Capillary sequencing method; submitted for ETS July 2019. On scope by NGS targeted panel.
KRAS testing (codons 12,13,117,61,146) >90% in 5-7 days Yes
MDM2 amplification (FISH) >90% in 7-12 days Submitted for ETS July 2019
MGMT promoter methylation >90% in 7-10 days Yes
MLH promoter hypermethylation >90% in 7-10 days Yes
MMR testing by IHC >90% in 7-10 days Yes (provided by the QEHB Cellular Pathology department, under terms of MOU for service provision)
N/KRAS testing (KRAS codons 12,13,61,117,146 and NRAS 12,13,61) >90% in 7-10 days Yes
Next Generation Sequencing (Hotspot panel (KRAS, NRAS, IDH1, IDH2, BRAF, EGFR, KIT, PDGFRA) please contact laboratory Yes
NRAS testing (codons 12,13,61) >90% in 5-7 days  Yes
PD-L1 (Agilent 22C3 assay) >90% in 5-7 days  Yes
PD-L1 (Agilent 28-8 assay) >90% in 5-7 days  Submitted for ETS July 2019
PD-L1 (Roche SP142 assay)  >90% in 5-7 days  Submitted for ETS July 2019
ROS testing (FISH) >90% in 7-10 days Submitted for ETS July 2019
ROS testing (IHC) >90% in 5-7 days  Yes
SS18 FISH >90% in 7-12 days No
1p/19q co-deletion analysis >90% in 7-12 days Submitted for ETS July 2019


Specimens are reported on the Laboratory Information Management System. For internal patients the reports are then automatically uploaded to the Clinical Portal For external users, reporting is provided electronically. A list of recipients and nhs.net email addresses is required. All reports are stored with the laboratory LIMS system indefinitely.

The department will not send reports by Faxitron.

Members of MPDS are available from 08:30 – 17:00 Monday – Friday for the reporting of specimens and to offer advice. 


Molecular Pathology Diagnostic Service (update)

Service Background

The Molecular Pathology Diagnostic Service (MPDS) provides a diagnostic molecular pathology service to internal users within the University Hospitals Birmingham Trust as well as regional, national and international service users. The department processes over 25,000 samples per year and offers services in both solid tumour testing and circulating tumour DNA.

The department utilizes a broad range of molecular techniques including immunohistochemistry, FISH, PCR based targeted assays (Sanger Sequencing, real time PCR, pyrosequencing) and next generation sequencing (NGS) to provide testing for protein expression, gene mutation, gene methylation, gene amplification and chromosome translocation. 

Molecular Pathology is a UKAS accredited medical laboratory No. 8759

The department of Molecular Pathology is part of Clinical Laboratory Services and operates within the Quality Management System of the Clinical Laboratory Services, it is led by a Consultant Clinical Service Lead, a Principal Clinical Scientist and an Operations Manager. MPDS participates fully in UK NEQAS and GENQA External Quality Assurance schemes where appropriate.

Operating hours: 08:30 - 17:00 , Monday - Friday

Please contact the laboratory for any pricing enquiries.

For a full list of Molecular Pathology UKAS accredited assays, please click below:


Queen Elizabeth Hospital, Birmingham


Blood Bank

Blood Transfusion carries risk and good clinical practice requires that blood components should be prescribed only when the benefit to the patient is likely to outweigh the risks. Prescription of these components shall be in conjunction with the Maximum Surgical Blood Ordering Schedule (MSBOS) and Trust Transfusion Policy all of which can be found on the Trust Intranet.

The requirement for transfusion of blood or blood components shall be recorded in the notes prior to completing a request form. The patient should be informed that they require a transfusion and given the appropriate information leaflets if circumstances allow. These should available in all clinical areas. The component type and quantity required should be requested in conjunction with the above guidance, to request further information leaflets contact the Hospital Transfusion Practitioner on ext. 15966.

A comprehensive guide to UHB Transfusion Services, Guidelines, Sample Requirements and Indications for Blood Use can be found in the Blood Transfusion Policy and its linked Procedures 1-8 available on the Trust Intranet

The guidelines have been drawn up in line with nationally agreed indication codes and recommendations

Laboratory hours and telephone numbers are as listed under Laboratory Haematology Contact QEHB Blood Bank on ext. 13297/8 or bleep 1376, there is a member of staff on duty 24/7.

Samples for complex red cell, platelet and granulocyte antibody tests, will be referred to the NHSBT. It is recommended that if patients require these investigations it should be discussed with a Clinical H

Blood Bank Request Procedure

All requests for blood or blood components (red cells, plasma, platelets and cryoprecipitate) should be made on the request form or by telephoning blood bank, if there is already a valid group and save available. Please note blood bank have a two sample rule, which requires all patients to have a historical blood group on file along with a current valid group and save prior to any crossmatched blood being issued. All urgent requests should be discussed with blood bank so they can process the samples as a priority.

All patients requiring a blood transfusion are required to have a historic blood group on file and a current valid group and save prior to receiving any crossmatched blood.

There is zero tolerance regarding sample labelling and requesting in blood bank. Only samples that meet the following criteria will be accepted:

  • All samples must be hand written onto the bottle label, sticky labels of any kind are not acceptable.
  • The details on the sample and request card must match.
  • Pre-printed addressographs are acceptable on the request form but should be initialled.
  • On the sample and the form there must be;
    • Registration number.
    • Surname.
    • Forename.
    • Date of Birth.
    • Gender.

In addition to this the form must also have:-

  • Consultant details.
  • A contact number.
  • Reason for the request.
  • Location of patient.
  • Phlebotomist’s name.
  • Signature of the requestor.
  • Date and time when sample drawn.
  • Type of Request i.e. G&S, Crossmatch and number of units if required.
  • Special Instructions - The laboratory must be informed if these are required
    • e.g. Irradiated, CMV negative, HLA selected, sickle negative etc.

Information on the request form and the blood tube should be double-checked to ensure that it is both complete and correct. Patient information on the blood tube must be taken from the patient not the form.

In an emergency, the registration number, gender and phonetic trauma name will be acceptable.

Blood transfusion errors are most often those of patient identification. Full details on patient identification can be found on the Blood Transfusion Policy Procedure 2. Patients identity much be confirmed by asking the patient to state their

  • First and Surname
  • Date of Birth
  • Check this information and the hospital registration number against the wrist band and request form.

Blood Collection

Blood Bank Issue room and Satellite Blood Issue Fridges for storage of blood are situated at:

Location/ Department

Door number

Blood bank

Level -1: A/-1/CLS/C5a


level 2: A/2/CC/160

Cardiac Theatre 

Level 2: A/2/TH/158

Main Theatres

Level 2: A/2/STR/20A

Ambulatory Care

Level 0: A/0/AC/130

Emergency Department

Level 1: A/1/AE/7

Interventional Radiology

Interventional Radiology Department

Centre for Clinical Haematology (CCH) Centre for Clinical Haematology Department (CCH)

Queen Elizabeth Hospital

The main issue area in the QEHB is secure at all times and will require a Trust identity card for access.

Collection of Blood or Components

This procedure of collection of platelets and FFP is the same as blood. The only difference is the storage and transport temperature. The full procedure is discussed in the Transfusion Policy (available on the Trust Intranet). Only those trained and assessed as competent in the procedure can collect blood and blood components. The procedure is also prominently displayed in the blood bank issue areas. Only one unit of blood can be collected at a time. Exceptions are generally associated with emergencies in theatres, Critical Care Units or Accident and Emergency. When components of different types are collected at the same time they should be carried in separately.

Blood Products

Prothrombin complex concentrate (Beriplex)

Available from the emergency pharmacy fridges at QEH. Guidelines for use are on the hospital intranet under P (Prothrombin complex concentrate)

See Guidelines on trust intranet for the use of Prothrombin Complex Concentrate (Beriplex) in life-threatening haemorrhage in patients on warfarin or acquired deficiency of vitamin K dependant clotting factors.


Obtained from Pharmacy

Activated factor VII - rFVIIa (Novoseven)

Available from emergency pharmacy fridges at QEH.

Guidelines for use are on the hospital intranet for the use of recombinant activated factor VII (NOVOSEVEN) in life-threatening uncontrolled haemorrhage.

Anti D

Obtained from the Women’s Unit after consultation with Haematology Medical staff

If unsure discuss the use of these products with Blood Bank or Haematology medical staff.

Cellular Pathology - University Hospitals Birmingham

Cellular Pathology is based across UHB sites at QE Hospital Birmingham, at Birmingham Heartlands Hospital, Solihull Hospital and at Good Hope Hospital.

The majority but not all of Cellular Pathology tests that are performed and equipment in use are accredited to internationally recognised standards for medical laboratories ISO 15189.  This is important for the Department and for service users as it provides assurance on quality and competence.   There is increasingly an integrated approach across  the different UHB hospital sites where staff, equipment and testing may be shared to deliver the highest possible quality services to our service users. The full range and nature of accredited tests is detailed on the United Kingdom Accreditation Service website https://www.ukas.com 10141 Schedule of Accreditation .

At the QE site the laboratory has recently updated equipment H&E, special stains and immunohistochemistry staining platforms to support high quality diagnostic cellular pathology reporting and to ensure full traceability of samples within the laboratory.  Other new tests to meet clinical requirements are regularly added to the testing repertoire.  Consequently not all platforms, special stains and antibodies have been assessed by UKAS and so will not currently be covered by published UKAS Accreditation scope to ISO15189.   

The Department is currently supporting the Trust with significant increases in clinical activity.  For some specialties reporting times have fallen bellow targets and so the Department is working with service users to minimise the impact of this.  The Department is prioritising clinically urgent requests and patients on cancer pathways, recruiting and working additional sessions.  The Department is also outsourcing reporting of some requests to two external specialist UKAS Accredited suppliers that hold contracts with the Trust.

Specialist Services  within Cellular Pathology (by site), QE=Queen Elizabeth, BHH=Birmingham Heartlands, SH = Solihull, GH=Good Hope

  • MOHS (QE, SH) -   microscopically controlled surgery used to treat common types of skin cancer. 
  • Neuropathological Smears (QE) -  rapid diagnostic service for intra-operative brain tissue specimens
  • Cytopathology (BHH,QE) - diagnostic cytopathology services for the Trust including fine needle aspirations, endoscopic brushings and washings, EUS-FNAs , serous fluids urines and CSF.  
  • Muscle Biopsy Service (QE) -  part of the investigation of a clinically suspected neuromuscular disorder when other less invasive tests have not provided a firm diagnosis.
  • Electron Microscopy Service (QE) - used routinely at magnifications of between 1500 and 70,000 times to examine the ultrastructure of cells and their surroundings.   
  • Andrology (GHH) - Diagnostic, Post Vasectomy and Retrograde  Semen analysis .  The service operates from a single site located on the 1st Floor of the Sheldon Unit at Good Hope Hospital.
  • Direct Immunofluorescence (BHH and QE) - Direct immunofluorescence is used for the detection of  tissue bound proteins such as antibodies and complement proteins. Two types of tissue, skin or renal, are processed, This method allows for the detection of tissue bound antibodies when there may be insufficient levels to detect in serum.  
  • Mortuary (QE, BHH, SH, GH) - Body storage available on all sites with 10 freezer storage spaces available on the Solihull sites.  Post Mortems can be carried out on the Heartlands and QE sites.    
  • Immunohistochemistry (QE,MSK, BHH) - carried out using different platforms and antibodies across the sites.  See attached UKAS scope for those antibodies accredited.  At present there are several antibodies that are not yet accredited but will be added to the scope in due course.      

Minimum Dataset required for Cellular Pathology Requests

In order to process specimens it is essential that request forms are fully completed in a clear and legible format. The use of patient ID stickers is permitted however please ensure you use the full patient sticker NOT the smaller blood tube sticker. All specimens received into Cellular Pathology must meet the agreed laboratory minimum dataset; any specimens not meeting the criteria will be returned to the requesting department.  Please ensure that any important information (e.g. clinical history, bleep number etc.) is clearly indicated on the form and ensure that any priority or urgent cases are marked as such.

  • Trust users can make request via a theatre request book entry or by completing an internal UHB histopathology / cytopathology request form. 
  • GP and dental practices should complete the external request form which can be supplied on request from the Department and for internal service users this link http://www.uhb.nhs.uk/gps/laboratory-information/ shows this request form together with specific request forms used within the Trust (QE site)  for liver and breast biopsy cases.  For Heartlands, Good Hope and Solihull users then request forms are available from the Department of via a request to This email address is being protected from spambots. You need JavaScript enabled to view it. 

TWO unique patient identifiers must be present on both the request form and specimen container i.e. a minimum of the PID, NHS number or the DOB together with the patient surname and forename/initial in order to be accepted by the department. Other missing data (e.g. full clinical details) may be clarified over the phone or by email as needed.

Sample pot requirements                                   

  • Patients full name  (or as a minimum; surname with initial) 
  • Hospital or clinic PID / NHS no. AND/OR Date of birth

Request form                                              

  • Patient’s full name.                                 

  • Date of birth.                                             

  • Hospital or clinic PID / NHS no.

  • Address

  • Location

  • Clinical details

  • Request form must be signed

  • Consultant / GP

If one or more than one specimen is taken from the same patient the specimen containers and request form must be clearly labelled with the sites of the spec and indicated as parts 1,2,3 etc.

Hazardous Specimens

Specimens arising from patients with known or suspected transmissible diseases (e.g. tuberculosis, viral hepatitis, HIV) must be clearly labelled as such to prevent unnecessary risk to laboratory staff.

Specimen Containers 

When requesting stock a member of staff from the Cellular Pathology department will inform the requestor when they will be ready for collection by the portering staff. Consumables provided by the lab should be transported via the porters so please allow time for preparation and transport.   External requests for sample pots and request forms are through contacting the Department.  For Heartlands site please e-mail This email address is being protected from spambots. You need JavaScript enabled to view it., for QE site use This email address is being protected from spambots. You need JavaScript enabled to view it. and for QE ROH/Bone requests This email address is being protected from spambots. You need JavaScript enabled to view it.

Transportation of Specimens

Specimens are collected at regular intervals from theatres and all relevant departments via portering services. Urgent and unfixed (dry/not in formalin) specimens should NOT be left until the next routine collection – telephone portering services and arrange for a member of staff to bring the sample(s) to the laboratory without delay.

Please note specimens must be despatched to the Department within a secondary bag or secure transport box with sufficient absorbent material to absorb/contain any potential spillage.  Formalin is a hazardous reagent with any leakages put portering, transport and laboratory staff at significant risk.  Please ensure containers are closed or sealed with appropriate fitting lids.  If in doubt please seek advice from the Department.

Urgent Reporting

Occasionally it may be necessary for a requesting clinician to highlight a specimen as clinically urgent. If an urgent report is required it should be clearly identified or indicated on the request form. Urgent requests should be sent to Cellular Pathology via the porters without delay.

To ensure that cases are not delayed within the laboratory please make sure that the request form is correctly completed and all sections are filled in properly. Once received urgent cases will be highlighted by the specimen reception and prioritised appropriately in the departmental workload.  

In addition to clinically urgent cases there are UHB wide @FDS@ or Faster Diagnosis Specification stamps to fast track these patient cancer samples.  This is to support end to pathways and prevent patient breaches where possible through prioritisation.

Service Background

The Department of Cellular Pathology provides a diagnostic histopathology, cytopathology, andrology, muscle biopsy, electron microscopy, Mohs, post mortem and mortuary service to internal users (other Trust departments e.g. surgery) as well as external users (GPs, dental and private practices). The Department also incorporates the Tissue services for the Trust; this Department is responsible for managing and ensuring compliance of the licensable activities which falls under the HTA Human Application Sector, this includes procurement, testing, storage, traceability, disposal and distribution of human tissue and cells for therapeutic use.

Cellular Pathology Department operates within the Quality Management System for Pathology Services and is led by a Clinical Service Lead Dr Bruce Tanchel.   A technical Service Manager, Head Biomedical Scientist, Martin Collard oversees the management of the Department. Cellular Pathology participates fully in UK NEQAS External Quality Assurance schemes where appropriate.  The Laboratory works to ISO 15189 requirements and is assessed by UKAS to evaluate compliance.  The vast majority of equipment, procedures and tests offered by the Department of Cellular Pathology are included in the UKAS scope of Accreditation seen here: https://www.ukas.com schedule 10141 .  Some non-accredited tests may also be used to support diagnostic tests and these are mainly reflected in stains, antibodies and associated platforms that are currently under assessment by UKAS for potential additions to the scope of laboratory testing. 

Some non-gynae cytology remains available at the QE Laboratory site but the majority of cytology samples across UHB are transferred to the Heartlands Hospital site for processing and staining.  The routine histopathology repertoire includes specialist renal, liver, muscle and nerve processing and reporting and a well established electron microscopy service.  During 2022/23 the former Musculoskeletal Pathology laboratory moved across to the QE Cellular Pathology site and details of this major service change will follow as part of the project planning process.  This specialty within Cellular Pathology is referred to as the Bone and Soft Tissue Unit.

The Department provides a comprehensive pathology service to the Trust, South Birmingham Community and Mental Health Trusts, Private Hospitals, General Practitioners and General Dental Practitioners.  The core laboratory sites are open Mon-Fri between 08:00 and 17:30 with QE Cell Path also open Sun 07:00-15:00 and Heartlands Cell Path Sat 09:00-12.45. A specialist/expert referral service is also provided to hospitals in the West Midlands, nationally and to international clients.

The Department operates within the Quality Management System of the Clinical Laboratory Services and is led by both a consultant medical Clinical Service Lead and a technical Service Manager. Cellular Pathology participates fully in UK NEQAS External Quality Assurance where appropriate.

Cellular Pathology currently employs 32 consultant pathologists who cover a broad spectrum of clinical specialities, MDTS and are also available to offer clinical advice and interpretation of results if required.  Consultants can be contacted for specialist clinical advice by contacting the Cellular Pathology Offices on the QE (0121 371 3326) and BHH (0121 424 3884) sites.


Contact the Cellular Pathology Department

Heartlands 0121 424 3190 =  This email address is being protected from spambots. You need JavaScript enabled to view it. 

QE 0121 371 5990 = This email address is being protected from spambots. You need JavaScript enabled to view it.

Bone and soft tissue tumour unit = This email address is being protected from spambots. You need JavaScript enabled to view it.

Clinical Service Lead - Cellular Pathology

Dr Bruce Tanchel

0121 424 2196 or This email address is being protected from spambots. You need JavaScript enabled to view it.

Human Tissue Authority Designated Individual

Dr Rachel Brown (Post Mortem Licence - QE)

Dr Gerald Langman (Post Mortem Licence - BHH/GH)


0121 371 3339  or This email address is being protected from spambots. You need JavaScript enabled to view it.

0121 424 3189 or This email address is being protected from spambots. You need JavaScript enabled to view it.

Cellular Pathology - Head Biomedical Scientist

Martin Collard


0121 371 3343  or This email address is being protected from spambots. You need JavaScript enabled to view it. 

8a Operational Managers /Deputy Head Biomedical Scientists  - cross site roles include:

Becci Taylor (Cytology Lead)

Saeeda Kauser (Digital Pathology Lead/ routine labs)

Gavin Rock (IHC/Special stains Lead)

Rizwan Qamar (Dissection/Bone & soft tissue tumours)

Bev Whitehouse (Electron Microscopy Lead)

 This email address is being protected from spambots. You need JavaScript enabled to view it. or specific contacts as below:


0121 371 3336  or This email address is being protected from spambots. You need JavaScript enabled to view it.

0121 371 3352  or This email address is being protected from spambots. You need JavaScript enabled to view it.

0121 424 0189  or This email address is being protected from spambots. You need JavaScript enabled to view it.

0121 371 3352  or rizwan.QamarThis email address is being protected from spambots. You need JavaScript enabled to view it.

0121 371 5720 or  beverley.whitehouse.uhb.nhs.uk

Mortuary Manager

David Budding retiring during Summer 2024

QEHB 0121 371 2520/2523 or BHH 0121 424 2197

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Tissue Services (Human Applications)

Julie Dulson

0121 371 6838 (DDI:16838) or This email address is being protected from spambots. You need JavaScript enabled to view it.,uk

Quality Lead

Alexandra Martin (QE Based)

Joanne Small (BHH Based)

0121 371 5968 or This email address is being protected from spambots. You need JavaScript enabled to view it.

0121 424 0193 or This email address is being protected from spambots. You need JavaScript enabled to view it.

Training Lead

Tracy Bright (QE Based)

Olukemi A Johnson (Heartlands based)


0121 371 3314  or This email address is being protected from spambots. You need JavaScript enabled to view it.This email address is being protected from spambots. You need JavaScript enabled to view it.

0121 424 1191 or This email address is being protected from spambots. You need JavaScript enabled to view it.

Health and Safety Lead

Rizwan Qamar

Joanne Small


0121 371 3314 This email address is being protected from spambots. You need JavaScript enabled to view it.

0121 424 0193 or This email address is being protected from spambots. You need JavaScript enabled to view it. 

Muscle Service

Ferhana Maqsood


0121 371 5720 This email address is being protected from spambots. You need JavaScript enabled to view it.


Specimen requirements

Due to the wide range of cellular pathology specimens several key container types exist as below.  The size of the specimen container must be appropriate to the size of the specimen.

Specimen Type


Small specimens

Yellow Topped 60 mL Containers for biopsies and small resection e.g. skin ellipses, appendicies.

Routine specimens

350 mL White Topped “Honey Pots” - Suitable for larger specimens e.g. gall bladders, larger skin resections femoral heads These pots are also suitable for biopsy specimens where the tissue is adhered to glass microscope slides. 

Large resection specimens

Specimen buckets without fixative / dry - Fixative is supplied to theatres from pharmacy and is added to the container with the specimen prior to sending to the histology laboratory.  e.g. bowel, heart, breast tissue.

“Mega” Specimen Buckets

The buckets should be collected from cellular pathology in advance of the surgery taking place. Specimens MUST NOT be placed into yellow clinical waste bags or Griff Bins as these WILL NOT be opened by laboratory staff and should ONLY be used for the incineration of clinical waste. Large anatomical or specimen resections e.g. large sarcomas.

Dry Samples (Within Lab hours only)

Specimen buckets, 60ml pots / Theatre Tissue Safe system.  Dry samples sent to the lab e.g.  frozen sections; MOHS samples: lymph nodes; Research projects/biobank samples

Cytopathology Specimens


A universal container. 

Smears kits

Microscope slides; slide carriers; spray fix and cytorich red needle wash containers.

Serous Fluids/ Sputum/ respiratory fluids/CSFs

Universal Containers.  Do not use glass containers.

To ensure that cases are not delayed within the laboratories please make sure that the request form is correctly completed and all sections are filled in properly. Once received urgent cases will be highlighted by the specimen reception and prioritised appropriately in the departmental workload. 

Please note many of the technical preparation aspects of cytology may take place at the Heartlands Hospital Cell Path Laboratory.

Intra-operative Frozen Sections

The department provides a rapid diagnostic service for intra-operative tissue specimens. Requests for frozen section should be telephoned to the histopathology laboratory (at QE site 0121 371 13314 and at BHH site 0121 424 3188 ) in advance of the procedure being undertaken, preferably on the day prior to surgery. Where this is not possible, e.g. an incidental finding during surgery, the request should still be telephoned to the laboratory prior to the sample leaving theatre. When calling the laboratory please ensure that you have the following information available as it will be asked for by the person receiving the call: 

  • Patient’s full name.

  • Registration number.

  • Date of birth.

  • Contact number or bleep number.

  • Patient’s consultant.

  • Tissue type / nature of specimen.

  • Expected date and time of delivery to the Lab.

Tissue taken for frozen section should be placed into a suitably sized container without any form of fixative (i.e. dry) and sent in a secondary bag/container to Cellular Pathology without delay.  The transport of the fresh material is arranged by the requesting clinical team, typically using a UHB Hospital porter.  Theatre books should be used to record the audit trail from theatre and safe receipt in the laboratory.  The process from specimen receipt in the laboratory to verbal report issued takes 15 to 30  minutes however this time may be shortened or lengthened slightly based on the nature of the sample received.  High risk biohazardous tissues are not suitable for frozen sectioning unless absolutely clinically required. Examples of these include tuberculous lesions, specimens from patients with viral hepatitis and specimens from patients who are HIV positive. If there is any doubt as to whether the specimen is suitable or not please contact the laboratory and ask for the advice of a Consultant Pathologist.


Mohs, is microscopically controlled surgery used to treat common types of skin cancer. During the surgery, after each removal of tissue and while the patient waits, the fresh tissue is snap frozen and sectioned for microscopic examination. The examination informs the decision for additional tissue removal.

The process from specimen receipt in the laboratory to verbal report issued takes no longer than 15 minutes per sample block however complex specimens with multiple samples will take additional time.

Mohs clinics are booked with the Department to ensure that there are clinical and technical staff are available to complete the test.  Mohs surgery is carried out at Solihull and QE Hospital sites.

Neuropathological Smears

The Department provides a rapid diagnostic service for intra-operative brain tissue specimens. Requests for neuro smears should be telephoned to the laboratory in advance as per intra-operative frozen sections.

Tissue taken for neuropathological smears should be placed into a sterile universal container (UC) without any form of fixative (i.e. dry) and sent to Cellular Pathology without delay. These specimens are often tiny and so any delay in receipt may lead to artefactual damage which can be detrimental to any further laboratory processing.

The process from specimen receipt in the laboratory to verbal report issued takes  15 - 30  minutes however this time may be shortened or lengthened slightly based on the nature of the sample received.

Small Biopsy Specimens

The Department provides both a routine and urgent diagnostic service for small biopsy specimens.

Specimens should be placed into 60 mL pre-filled containers of neutral buffered formalin.

  • Wherever possible small or endoscopic biopsies should be placed into mini biopsy or microcassettes cassettes (small yellow cassettes) before being placed into the neutral buffered formalin pots. Supplies of cellsafe cassettes can be sourced from the Cellular Pathology Specimen Reception.

  • Breast or other fine cores may be placed onto white cards before being placed into neutral buffered formalin pots. Please ensure the cores are stretched out linearly prior to fixation as knotted cores are not easy to separate out in the laboratory.

Please note that biopsies are delicate and should be handled with care, avoid the use of forceps wherever possible to prevent trauma artefact to the tissue.

Urgent Biopsy Specimens (Rapid Paraffin Service)

The Department provides a rapid paraffin service for clinically urgent biopsy specimens; a report can be issued on the same day that the specimen arrives in the department.  It should be noted however that not all specimens are suitable for rapid processing. In general terms only liver, renal and cardiac biopsies are processed in this way. Other specimens may be suitable however advice should be sought from the Histopathology Manager (0121 371 3352) or a trimming room senior Biomedical Scientist (0121 371 3314) prior to sending other tissue types.

Tissues for the rapid paraffin service must be received by the department no later than 13:30. Please ensure that the name and bleep number of the requesting clinician is clearly indicated on the request form to allow for the verbal report to be issued.

Specimens received after 13:30 will not be processed urgently and will be placed onto the “normal” biopsy run later in the day thus same day reporting will not be possible.

Resection Specimens

The department provides a routine and urgent diagnostic histopathology service for larger surgical resection specimens. Tissue should be placed into appropriately sized containers which will allow for the specimen and at least ten times its volume in fixative (i.e. neutral buffered formalin) to be contained.

DO NOT use containers which are too small to allow for this volume of fixative to be used or squash specimens into small pots. Specimens should be free-floating in fixative not pressed up against the sides of the container as this leads to distortion of the tissue and may make further processing unnecessarily difficult.


The Department provides the diagnostic cytopathology services for the Trust including fine needle aspirations, endoscopic brushings and washings, EUS-FNAs , serous fluids urines and CSF.  Routine specimens should reach the laboratory before 16:30 so that they can be processed within normal working hours. Specimens collected out of laboratory hours should be stored refrigerated until the next morning on which the laboratory is open.  Cytology sample that do not meet the minimum data requirements on request form or sample, are processed, to ensure that sample integrate is maintained. Details of missing data are added to the report.  Request for Consumables and Request Forms

Sample containers for use in cytology and request forms can be order by contacting the Cytology Department; they can be collected from the Cellular Pathology reception at Heatlands or QEHB sites.  Cytology samples which do not meet the MDS will not be returned.  They will be processed in order to preserve the diagnostic material while attempts are made to contact the sender.  These samples will not be reported until adequate labelling of specimen and request form has been undertaken.Minimal delay between collection and receipt by the laboratory is necessary in order to prevent degeneration of cellular components and consequent loss of diagnostic value. All cytological specimens are potentially biohazardous and must be transported in leak proof containers enclosed in sealed bags. Specimens sent to the laboratory via the SDS should be placed in specimen bags and lids on the all containers should be securely closed. 

Specimens from patients with known or suspected tuberculosis, HIV, viral hepatitis or other transmissible disease should be labelled clearly.  Cytology DO NOT except or handle any specimens that are ? prion disease or CJD.

Specimens should be received as either pre-prepared slides, fresh unfixed samples in white- topped universal containers, or suspended in CRR.  Equipment used to collect the specimen such as brushes or drains are inappropriate.

Sputum - A series of three early morning ‘deep cough’ specimens should be collected on three consecutive days for maximum sensitivity. Post physiotherapy and post bronchoscopy specimens are suitable but should be clearly identified as such.

Serous Fluids - 50mls or the whole volume if less is aspirated should be sent in sterile universal containers. Include any tissue fragments or clots. Do not add fixative of anticoagulant. Drain bags are not suitable for transporting specimens and should NOT be sent.

Cerebrospinal Fluid (CSF) - Rapid processing is essential to preserve cells in CSF. These specimens should be sent to the laboratory within one hour.  ALL CSF SPECIMENS SHOULD REACH THE LABORATORY BY 16:30 AT THE LATEST TO ALLOW PREPARATION.

Urine - A representative aliquot of a maximum of 25ml of urine is sufficient for cytology processing, Ensure that this is not the first sample of the day.  Catheter urine and bladder washings are also acceptable but please mention this on the request form. Mid-stream urine samples are not suitable for cytology because they contain few cells.

Endoscopic Brushing - Immediate fixation is important and all slides must be labelled with PENCIL with the patient’s name and hospital number before the smears are made.

Fine needle aspiration - Unless the clinician is experienced in this procedure, including making good quality smears, it is recommended that they contact the laboratory for advice before beginning the procedure. Smears should be made and the needle rinsed out in cytorich red fluid. For ENT specimens in particular it is important that smears are sent as well as needle washings. Only prepared smears and needle washings are accepted. The sending of needles sheathed or otherwise is strictly forbidden.

EUS-FNAs - Please send all the specimen in cytorich red fluid

Cervical Smears - Cervical smears are NOT accepted in nor prepared by cytopathology at QEHB. Please send any cervical smear specimens to the Cytopathology Laboratory at Wolverhampton's Black Country Partnership Laboratories.


Once specimens are reported and authorised by the laboratory they can be accessed on the intranet by appropriate staff. In addition a typed copy will be sent to the destination specified on the request form (FOR EXTERNAL USERS ONLY). If the specimen is needed for a particular MDT or clinic, then please state this on the request form. Urgent reports can be issued verbally if necessary to a suitable member of medical staff. Please put a mobile telephone number or a bleep number (that will be answered immediately) on the request form. Telephone reports will only be issued on request via telephone.

Muscle Biopsy Service - specific requirements

Muscle biopsies are performed as part of the investigation of a clinically suspected neuromuscular disorder when other less invasive tests have not provided a firm diagnosis.  The Muscle Biopsy Service receives muscle and nerve samples from the whole of the West Midlands region and occasionally from elsewhere in the UK.

This Department offers the following investigative techniques:

  • Muscle Histochemistry methods on frozen sections
  • Muscle immunocytochemistry on frozen sections.
  • Electron Microscopy.
  • Histology and Muscle immunocytochemistry on paraffin wax sections.
  • Arrangements can be made to send tissue away for DNA analysis.

 If required samples can be referred to specialist centres for further investigation

  • Metabolic tests.
  • Mitochondrial Assays and MtDNA.
  • Protein analysis for adult Limb Girdle Muscular Dystrophies.
  • Rare paediatric dystrophies

If a member of the muscle biopsy team is required to collect a nerve or muscle biopsy from QEHB theatres there should be a delay of no longer than 30 minutes between the biopsy being taken and the sample are being placed into fixative for electron microscopy.

For QEHB service users - Please call the lab to request collection as soon as possible once the specimen is available.  Prior to collection muscle should be kept in a dry universal container on water ice (ice can be supplied by the Muscle Lab) and the nerve should be kept in a dry universal container at room temperature.  A copy of the Muscle Biopsy request form noting the time the biopsy was taken should be completed by the requesting clinician. 

For external service users - Medical or secretarial staff from the requesting centre liaises directly with the Muscle Lab to book a biopsy.   A Senior Biomedical Scientist will travel to the hospital to collect the biopsy which is received fresh.  Clinical details are preferably received in advance of the biopsy from the requesting medical staff but relevant information may be transcribed from the patient’s notes onto the Muscle Biopsy Request Form by the Scientist collecting the biopsy.  The Scientist decides which tests will be required on the basis of this information.  The biopsy is cut up and fixed for certain tests on site, the rest of the specimen is brought back to the lab on ice and some is frozen in liquid nitrogen and the remainder allocated for further tests. 

Muscle Biopsy Service :

Cases can be requested as urgent at the time of the biopsy or by email/telephone; the pathologist will relay results back to the clinician via email/telephone.  

  • Muscle report  – 4 weeks from receipt to report authorisation.
  • Nerve reports – 4 weeks from receipt to report authorisation.
  • The current turnaround time for cases referred by the Department to specialist centres is 2-3 months depending on tests requested.

Electron Microscopy Service - specific requirements

The Electron Microscope Unit is used routinely at magnifications of between 1500 and 70,000 times to examine the ultrastructure of cells and their surroundings.  The EM unit receives approx. 800 samples a year, the majority of which are renal, but about 100 muscle and 30 nerve biopsies are also collected.  Other specimens include cardiac biopsies, occasional skin biopsies and tumour samples.

Specimens from outside the department requiring EM should be sent in a small sample container (e.g. bijou or Eppendorf tube) containing at least 2 mL of an EM fixative.  A glutaraldehyde based fixative such as 2.5% glutaraldehyde in phosphate buffer is ideal but 10% buffered formalin is also acceptable.  In larger tissue samples individual pieces should be no larger than 3 mm cubed and should be completely submersed in fixative.  The optimal size of diagnostic tissue requiring processing for electron microscopy is as follows: the largest dimension should be no greater than 5mm and the smallest dimension no less than 1mm. Any specimen with the smallest dimension less than 1mm may not survive tissue processing.

For QEHB service users - Renal biopsies are delivered to the Cellular Pathology Specimen Reception and EM samples are taken in the EM Lab. 

For External service users - package specimens for EM in firmly closed leak proof containers, together with sufficient absorbent material to contain any liquid, in sealed bags. The sealed bags are placed securely in a small padded envelope with the address label as given above under key information.  The EM unit makes use of the Histology request form for both internal and external users.   A copy of the light microscopy report is also required.  

Please note that we support the service by outsourcing when required to the specialist EM facility at Leicester Royal Infirmary.  It is fully accredited by United Kingdom Accreditation Services (UKAS) ISO 15189, reference number 8608.

Advice on the service or requirements can be obtained from the EM lead biomedical scientist This email address is being protected from spambots. You need JavaScript enabled to view it. or from the electron microscopy laboratory team on 0121 371 5720.



The laboratory's priority is to provide a comprehensive semen analysis service for Consultants, Urologists and General Practitioners from the Birmingham and Solihull area. This includes semen analysis (Diagnostic Semen Analysis), post-operative analysis of semen following a vasectomy operation (Post Vasectomy Semen Analysis) and Retrograde analysis of urine.

The laboratory operates on a clinic based service and has a maximum capacity of 2000 appointments available per annum. This covers the annual workload of routine diagnostic semen analysis, post-vasectomy samples and retrograde ejaculation analysis. Routinely patients will be given an appointment to attend the Andrology Department for on-site sample production in a designated private clinic room, however in exceptional circumstances samples may be produced off site if then able to be delivered to the laboratory within an appropriate time interval. 

The UHB Andrology Laboratory has fully trained scientists who are highly proficient in performing quality diagnostic semen analysis in line with World Health Organisation (2021) and the 2016 Laboratory Guidelines for post vasectomy semen analysis. The laboratory regularly performs internal quality control, participates in the UK National External Quality Assurance Reproductive scheme for Andrology (UKNEQAS) and liaises with other accredited laboratories for comparison of tests not covered within the UKNEQAS scope.

A laboratory referral can be made via:

Paper copy referral forms sent to Appointment Centre via post/e-mail

Electronic Referral Service (e-RS) with an attached referral form 

A copy of the referral form can be obtained by;

Contacting the laboratory directly on 0121 424 9717
Or by downloading from here Andrology Referral Form
Or by GP’s accessing the word version at: https://www.uhb.nhs.uk/gps/referrals/andrology.htm

Off-site production can be arranged by the patient by telephoning the laboratory on 0121 424 9717 or by e-mailing This email address is being protected from spambots. You need JavaScript enabled to view it. (if you e-mail you are accepting that the connection is not secure and potentially not confidential – laboratory staff will minimise data transmission but cannot guarantee security). Please note that retrograde urine production must be on-site at Good Hope Hospital.


Turnaround Time: 7-10 days (electronic reporting may be more rapid). Paper copies sent out following result authorisation.

Anti-sperm antibodies (ASAB) are not tested at this laboratory. Agglutination is described if noted.

Please see user handbook for additional information including contact details.

Accreditation information can be found under Cellular Pathology (UKAS 10141): https://www.ukas.com/find-an-organisation/?q=&type%5B%5D=275&orgname%5B%5D=3073

 Post-vasectomy Semen Analysis (PVSA)

The laboratory undertakes examination procedures in line with the following guidelines: 2016 PVSA Guidelines. This will give clinicians information regarding clearance criteria. 

 Results are available to Hospital clinicians via PICS, Clinical Portal, and ICE.

 GP’s can access patient results through their own electronic result systems.

 Key details of the service:

Operates Monday to Friday 08:00am to 16:00pm
Undertakes Diagnostic semen analysis, Post vasectomy semen analysis and Retrograde examination (urine)
Appointment based with on-site private room for sample production
7-10 day turnaround time (electronic and paper copy reporting)
Patients are booked within 7 weeks from referral, unless clinically indicated or by patient choice
The User Handbook can be accessed here: Andrology User Handbook

Andrology Clinical Advice

The Andrology department has a team of HCPC registered Scientists to support interpretation of diagnostic results.

A FRCPath registered Clinical Embryologist acts as the Clinical Advisor for the Andrology service and can be contacted via the Andrology department if required.

Please contact the department for further information via telephone or Email.

If you require any further information, please contact Emma Whitehouse - Andrology Lead Scientist on 0121 424 9717 or Email This email address is being protected from spambots. You need JavaScript enabled to view it.

Laboratory Turnaround Times

The Department monitors turnaround times on a regular basis and reviews significant delays or service issues within the Trust's Divisional Diagnostic Performance monthly meetings.  7, 10 and 14 day Cellular Pathology turnaround target reporting times are reported to Trust service users, broken down by clinical specialty for biopsies and for cancer tracking cases for each month.  Specific turnaround data is available to service users upon request in addition to UHB internally available histopathology intranet dashboards.  The agreed routine TATs for each specialty is 14 days to first reported for greater than or equal to 90% of cases, within tolerance = 75% - 90% reported in 14 days.  Targets for reporting are not consistantly met, but of note is some more complex haematopathology and urology cases  may require additional work e.g.  immunohistochemistry or molecular pathology and this does add to reporting times for complex cases.  

Cancer tracking patient TATs are also tracked and reviewed with service user representatives and the Trust's FDS or Faster Diagnosis Specification group.  For example breast cancer tracking patient samples for Cellular Pathology remained strong at 90-100% reported within 10  days.  Urgent cytology is typically reported the same day where IHC is not required.  Routine cytology reporting such as urine cytology may be reported outside of the 14 day target but within 28 days.  Urgent renal biopsy samples for example are routinely processed and reported on the same day.  There are delays in non-urgent work currently and this is reflected in 50% of work reported within 14 days.  Frozen sections/neuro smears are reported within approx. 15-30 minutes from receipt.

In addition the Department actively monitors outstanding cases, notifying reporting pathologists that cases are still unreported.  This and actions to increase lab and consultant capacity continue to support the delivery of improved TATs for service users.

Muscle Biopsy Service :

  • Histochemistry results is 7 days
  • The current turnaround time for cases referred to specialist centres is 2-3 months depending on tests requested.

Electron Microscopy :

  • Renal and cardiac turnaround times are approx. 10 to 14 days, TATs may be longer with a small specialist EM team
  • Muscle and nerve biopsies approx. 10 to 14 weeks.

Referral Laboratories and second opionons

For some complex cases outside, second opinions may be requested  internally within UHB but also externally to support the diagnostic report and this may add to the number of days before a final diagnostic report is issued.   List of key contacts we currently use for specialist second opinions and referral labs used for testing. 

Lymphomas Dr Stefan Dojcinov University Hospital of Wales (Cardiff and Vale University Health Board) 16/04/2021
Lymphomas Dr Danial Royston John Radcliffe Hospital Oxford 06/04/2021
Lymphoma (skin) Dr John Robert Goodlad Greater Glasgow and Clyde. 04/04/2023
Dermatopathology Dr Catherine Stefanato St Thomas's Hospital London (Viapath Analytics LLP) 05/04/2023
Dermatopathology Dr Alan Evans Ninewells Hospital Dundee (NHS Tayside) 25/01/2022
Dermatopathology Dr David Slater Royal Hallamshire Hospital, Sheffield (Sheffield Teaching Hospital NHS FT) 13/01/2023
Dermatopathology Dr R Carr Warwick 10/06/2022
Thyroid Dr Lia Menasce Christie Hospital Manchester (Central Manchester University Hospitals NHS FT 06/09/2021
Breast   Dr Andrew Lee University Hospital Nottingham (Nottingham University Hospitals NHS Trust Queens Medical Centre 22/03/2022
Gastro-Intestinal Prof. Neil Shepherd Cheltenham General Hospital (Gloucestershire Hospitals NHS FT) 04/01/2023
Bowel Screening Dr Adrian Bateman Southampton General Hospital 30/09/2022
Neural Prof Tuomo Polvikoski Royal Victoria Infirmary (Newcastle). (Newcastle Upon Tyne NHS Foundation Trust) 13/08/2021
Hydatidiform mole Dr Neil Sebire Charing Cross Hospital (UCL Hospitals NHS Foundation Trust) 03/03/2023
Lung Prof Andrew Nicholson Brompton Hospital London 09/03/2023
Haematopathology  Dr Alan Ramsay University College London NHS foundation Trust 06/06/2022
Haematopathology and Gynaecological pathology Dr Jayashree Pawade Southmead Hospital, Bristol  26/06/2019
Gynaecological pathology Dr Glenn McCLuggage ROYAL GROUP OF HOSPITALS Belfast 11/03/2022
Haematopathology  Dr Dogan NY USA Ahmet Dogan, MD, PhD
Chief, Hematopathology Service, Departments of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center
1275 York Avenue, Dept of Pathology, Suite C-563
Attn: Ahmet Dogan, Jeeyeon Baik, New York, NY 10065
Dermatopathology Dr David Cundell  Royal Wolverhampton NHS Trust 16/02/2022
lower GI/bowel screening. Prof Marco Novelli UCL University college London 06/06/2022
Dermatopathology Eduardo Calonje St Johns Institute of Dermatology, St Thomas' Hospital 05/04/2023
Referal for Second opinion  Department of Histopathology Charing Cross Hospital LONDON 03/03/2023
BMT histology reporting Dr Andrew Jack HMDS St James Institute of OncologyBexley WingSt James University Hospital (leeds teaching Hospitals NHS Trsut) 03/02/2023
Muscle pathology Dr Chris Kettle Newcastle upon Tyne Dental HospitalRichardson Road 24/05/2021
Referal for Second opinion  Dr Madhuri Deolekar  Deartment of Histopathology Royal Blackburn Hospital Blackburn VV2 3HH 21/03/2023
Renal Histology  Dr Ian Roberts Oxford University Hospitals NHS TrustJohn Radcliffe HospitalHeadley Way 20/03/2023
Muscle histology Dr Lucy Feng Dubowitz Neuromuscular Centre, Dept of Neuropathology, Institute of Neurology, Queen Square, London WC1N 3BG Acadamic
Dental Histology Dr Paul Matthews University Hospitals Coventry and Warwick NHS TrustClifford Bridge Road 10/06/2022
Dental histology (slide reporting) Dr Phil Sloan Newcastle Royal Victoria InfirmaryQueen Victoria Road 13/08/2021
ENT histology Dr Richard Allibone Nottingham University Hospitals NHS TrustQueens Medical Centre CampusDerby Road 22/03/2022
Skin Dr Richard Carr Coventry and Warwickshire Pathology Network, Department of Histopathology, Warwick Hospita, Warwick CV34 5BW 10/06/2022
Referal for Second opinion  Dr Candice Roufosse
Histology Department 
North West London Pathology Charing Cross Hospital 03/03/2023
Referal for Second opinion  Prof Emad Rakha Nottingham City Hospital Campus 22/03/2022
Dental histology  Prof Paul Speight Emeritus Professor in oral and maxillofacial pathology School of Clinical DentistryUniversity of Sheffield19 Claremount Crescent  
Referral for second opinion (Neuropathology) Profesor Safa-Al-Sarraj  King's College Hospital, Denmark Hill, London
 SE5 9RS
Paediatric Neuropathology  Prof Thomas Jacques Great Ormond street hospital  19/12/2022
Gynae Raji Ganesan Birmingham Women's hospital 22/11/2022
Referral for second opinion (Neuropathology) federico Roncaroli Salford Royal Hospital 20/10/2022
Referral for second opinion (Neuropathology) Professor Sebastian Bradner UCL Institute of Neurology 06/06/2022
Referral for second opinion (Neuropathology) Dr Zane Jaunmuktane UCL Institute of Neurology 06/06/2022
Referral for second opinion (Neuropathology) Prof Marai thom UCL Institute of Neurology 06/06/2022

Unaccredited testing

The Department regularly reviews testing to reflect clinical service needs and advances in technology.  Consequently, some testing and equipment has not yet been reviewed at UKAS assessment visit.  The following testing and aspects of Cellular Pathology are not covered by UKAS 15189 accreditation:

Sputum Analysis - Differential cell count performed on induced and non-induced sputum samples. A developmental diagnostic tool to deliver accurate severe asthma diagnosis and phenotyping.  This will be a step towards patient tailored medicine delivery in severe asthma and will enhance our Trust position as a leading national centre in the management of severe asthma.

Digital Pathology - the Department is performing extensive clinical validation towards going live with digital pathology during 2024.  Hamamtsu S60 and S360 slide scanners are used as part of a Sectra IDS7 software solution for viewing and reporting digital images.  This will be subject to a UKAS 'Extention to accredited scope' application later in 2024.



Coagulation Laboratory Introduction

Routine Coagulation Testing:

The Coagulation section offers a 24 hour service for all routine coagulation testing, which includes Prothrombin time (PT/INR) Partial Thromboplastin Time (PTT), Fibrinogen level and D-Dimer assay. For urgent requests during core hours (08:00-20:00) please contact the laboratory on ext 15986 or 0121 3715986 to obtain an urgent reference number.


Special Coagulation Testing:

The coagulation section also offers a comprehensive range of specialist coagulation assays which are performed by prior arrangement. These include Factor Assays, Inhibitor Assays, Anti-Xa Assays, Thrombophilia screening, von Willebrand screening, Lupus screening, Heparin induced thrombocytopenia (HIT) screening, ADAMTS13 Activity/Inhibitor Assays and Platelet function testing. This service operates a 5 day working week from Monday to Friday 09:00-17:30. In certain circumstances urgent assays may be performed out of hours by prior arrangement. Refer to the information in the individual test database for sample requirements and for copies of the appropriate request form (external requests only). Please contact Haematology medical staff for further advice on any special coagulation requests. 

Special coagulation assays are complex to perform and are batch processed within 21 days of receipt, however urgent requests can usually be processed within 24 hours. Please contact the specialist coagulation laboratory on ext 15988 or 0121 3715988 to discuss any urgent requests.

Investigation of Coagulation Disorders request forms:

ADAMTS13 Activity/Inhibitor Click Here

All other specialist coagulation assays: Click Here

(links to these request forms can also be found in the test database) 

Sample collection notes:

The ratio of citrate anticoagulant to blood in the coagulation test tubes is critical and therefore these tubes must be filled to the black fill line indicated on the tube. It is important to ensure that the anticoagulant is mixed adequately with the blood as inadequate mixing may result in a degree of coagulation activation, which may cause abnormal laboratory results. It is also important to avoid tube contamination, for example do not tip blood from EDTA tubes into citrate tubes as this will interfere with coagulation test results. Blood should not be taken for coagulation studies via a line or indwelling catheter which has contained heparin. Even trace amounts of residual heparin will interfere with coagulation test results.

It is important that blood samples for coagulation tests are transported to the laboratory without delay, samples must not be refrigerated or stored overnight. Testing is most accurate if carried out within 4 hours of venepuncture. As the stability of coagulation factors varies, add on telephone requests will be performed at the discretion of the laboratory based on sample viability.

If tests are required on patients taking anticoagulant therapy, the anticoagulant must be stated clearly on the request form. This information ensures that tests are prioritised accordingly and also facilitates the interpretation of results. 

Common Factors Affecting Analysis

It is not practical to list all factors that may affect all analytes however but a guide to some of the more common factors are as follows:

  • Haemolysis, icteric and lipaemia interfere with certain analytes and as a consequence some analytes may not be reported. However, a comment will be included on the report to indicate why. Common analytes affected include: sodium, potassium, bilirubin, magnesium, phosphate, LDH, AST, ALT and cTnT hs.
  • Serum samples should be processed (centrifuged and serum separated from the cells) within 12 h of collection. Any undue delay, particularly more than 6 h, can influence the potassium and enzyme results.
  • Extreme temperatures (cold and hot) can cause abnormal levels of some analytes especially potassium.
  • Sodium is affected by abnormal levels of protein and lipids. A direct ISE measurement will be performed and this report (plus appropriate comment) will be issued.
  • A high platelet and white blood count can cause a falsely elevated potassium (a condition known as pseudohyperkalaemia). It is suggested that in these suspected cases blood is collected into both a lithium heparin tube and a yellow top serum tube and sent to the Biochemistry department as soon as possible for potassium analysis to confirm. There is a difference of approximately 0.3 mmol/L in plasma compared with serum potassium. Larger differences are consistent with blood abnormalities affecting the results.
  • It is important that blood is collected in the correct tubes and in the correct order to reduce the risk of anti-coagulant interference e.g. EDTA interference with calcium assays.
  • CSF samples for xanthochromia should be protected from light and should not transported to the laboratory using the SDS. Lumbar puncture for xanthochromia should not be performed until 12 hours post onset of symptoms in order to minimise false negative results.
  • HbA1c will not be reported on patients with known haemoglobinopathies. It is recommended that fructosamine is measured on these patients.

Coronary Heart Disease Risk Score

Standard 4 of the National Service Framework for Coronary Heart Disease states that:

“General Practitioners and Primary Health Care teams should identify all people at significant risk of cardiovascular disease (CVD) but who have not yet developed symptoms and offer them appropriate advice and treatment to reduce their risk”.

Numerous risk calculators are available to calculate risk for coronary disease and these are all based on the Framingham model. The JBS III or the QRISK 2016 calculators are used for the calculation of cardiovascular disease risk. The South Birmingham PCT requires general practice to screen for CVD and any request for ‘CVD risk’ will generate a total cholesterol, HDL-cholesterol, creatinine and HbA1c (a yellow top and purple top bottle must be supplied). There are freely available calculators available to calculate a ‘CHD risk’ (Coronary heart disease risk) score (e.g. http://www.qintervention.org/)

Please note HDL-cholesterol is only measured when the CHD risk score is requested. We do not provide HDL-cholesterol otherwise on any request for a lipid profile.

Often we are asked to provide LDL-cholesterol calculations. For your convenience the calculation of LDL-cholesterol is provided below but you should recognise that this is only strictly valid where patients attend fasting for at least 12 hours in order to suppress triglyceride concentrations. Triglyceride concentrations >4.5 mmol/L negate the use of the calculation;

LDL cholesterol = Total cholesterol – HDL-cholesterol – (Triglyceride/2.19)

Diagnosis of Diabetes Mellitus

Conventionally diabetes mellitus was diagnosed by high fasting or random blood glucose concentrations, or an abnormal oral glucose tolerance test (OGTT) whilst haemoglobin A1c (HbA1c) was used to monitor longer term glycaemic control in patients with known diabetes mellitus.

In 2011, the World Health Organisation (WHO 2011) recommended that HbA1c measurements should also be used to diagnose diabetes in the majority of asymptomatic individuals, and this recommendation has been agreed in the UK (NHS Diabetes 2011).

An HbA1c of 48 mmol/mol or more is consistent with diabetes. If the patient has no symptoms then a second HbA1c result must be obtained within 2 weeks, and if it remains ≥48 mmol/mol diabetes mellitus is confirmed.

HbA1c values of 42 to 47 mmol/mol suggest a high risk of future diabetes. Such individuals should be offered structured lifestyle education and support to delay/prevent development of diabetes, and have an annual HbA1c test.

HbA1c must be measured in an accredited laboratory undertaking recommended quality assurance procedures. Near patient testing is not appropriate when HbA1c is used for the diagnosis of diabetes.

HbA1c is now the preferred method to diagnose diabetes, except in the following situations where this test would be unreliable, and in whom the traditional methods of diagnosis with blood glucose concentrations remain the method of choice:

  • Haemoglobinopathies
  • Increased red cell turnover
  • Anaemia (haemoglobin < 80 g/L)
  • ?Type 1 diabetes or acute onset of symptoms of diabetes
  • ?Gestational diabetes
  • Children and adolescents
  • Patients taking steroids and antipsychotic or other medications that cause a rapid rise in blood glucose

Despite this new approach, if an individual has abnormally high random or fasting blood glucose levels or abnormal OGTT, which would be consistent with diabetes on the traditional criteria, then that patient should be considered to have diabetes irrespective of their HbA1c value. Without symptoms of diabetes two abnormal tests of the same type (two high fasting/random blood glucoses or a diabetic OGTT) are required to confirm diabetes mellitus.

Glucose Tolerance Tests

Contact the duty biochemist on 0121 3716543 to discuss whether an oral glucose tolerance test (OGTT) is required for a particular patient and/or to book an OGTT. The OGTT is performed at the Diabetes Centre Laboratory in Nuffield House on the QEHB site. In addition, a protocol can be provided for performing an OGTT on wards or in the community.

Introduction to Clinical Laboratory Services at UHB


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 center 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.

Quality Management

Clinical Biochemistry, Laboratory Haematology, Blood Bank, Cellular Pathology, Molecular and Clinical Microbiology laboratories are subject to external accreditation by UKAS against ISO 15189.

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.

User Satisfaction

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.

Please feel free to email any of the Quality Team with any suggestions or feedback to This email address is being protected from spambots. You need JavaScript enabled to view it. or the individual department representatives.

Laboratory Haematology


Haematology and Transfusion Department

Click here for the list of Haematology and Transfusion UKAS accredited Assays


This section of the website provides information about the Trust’s Haematology laboratories and how to use the haematology laboratory service. It is by no means exhaustive and should further information, clinical advice or result interpretation be required, please contact a member of the haematology staff using the contact numbers listed below.

Urgent Samples

Should you require any urgent full blood count or coagulation specimens to be analysed in the laboratory during core hours at QEH, you must telephone the routine laboratory prior to dispatch of the sample to obtain a specimen reference number (0121 371 5986 or ext 15986). This ‘urgent specimen’ number must be written on the request form as must the correct location of the patient. This will facilitate its processing and ensure that the results are returned directly to the requesting source. It is important to do this in order that we identify urgent specimens and provide easy identification for the laboratory staff on arrival within the department.

The following tests are available out-of-hours:

  • Full Blood Count
  • PT, APTT, Fibrinogen and D-Dimer
  • Sickle cell solubility screening test
  • Malarial parasites
  • Blood film for diagnostic purposes

The following locations are already prioritised:


Turnaround time (from receipt of specimen)


WCCA, WCCB, WCCC, WCCD, WADM, WAMB, Oncology, W622, QCCU, QSSU,  St Mary’s Hospice and GP samples marked urgent.

1 hour


All Trust inpatients

4 Hours

All Turnaround times for inpatients are monitored for FBC, PT, APTT and D-Dimer.

Please note that at times of high demand or if there are instrument malfunctions we may not be able to achieve these turnaround times.

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General Information

General information about the website and its content

Location of Laboratories

Where the laboratories are located and information about the services offered at each laboratory