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Samples sent to the laboratory must be accompanied with the appropriate completed request form, to ensure specimens are processed correctly and results are sent back to the appropriate Requestor for acknowledgement. 

Secondary Care requests

UHCW
All inpatient and outpatient requests for Biochemistry, Immunology, Haematology, Virology and Microbiology MUST be requested electronically using the e-requesting facility on CRRS. Request form labels should then be printed on the ward/clinic and attached to the plastic specimen bag. The date and time of collection should be written on the request label when the sample is collected. Please contact ICT at UHCW if e-requesting training is required.  

SWUFT
All inpatient and outpatient requests for Biochemistry, Immunology, Haematology, Virology and Microbiology MUST be requested electronically using the e-requesting facility on Lorenzo. Request form labels should then be printed on the ward/clinic and attached to the plastic specimen bag. The date and time of collection should be written on the request label when the sample is collected.

GEH
All inpatient and outpatient requests for Biochemistry, Immunology, Haematology, Virology and Microbiology MUST be requested electronically using the e-requesting facility on T-Quest. Request form labels should then be printed on the ward/clinic and attached to the plastic specimen bag and blood tubes. The date and time of collection should be written on the request label when the sample is collected.

Primary care requests
All GPs in Coventry and Warwickshire should have access to T-Quest electronic order communications which should be used for all Pathology requests. For further information or any GP order comms issues please contact Ruth Hallett or Pathology Order communication facilitators Charlene.OKane@uhcw.nhs.uk (07468702110) or gregory.tindall@uhcw.nhs.uk (07557 566390).

Please see below with details of essential labelling requirements for both request forms and samples for all Pathology requests. Please see below separate section below for Blood Transfusion sample requirements

Request Form

Please ensure all the essential information is provided on the request form. The identification criterion applies to both paper and electronic formats.    

• NHS Number
• Patient’s full name (or coded identifier)
• Date of birth
• Hospital number (only if patient's name given)
• Patient’s location (or destination of final report)
• Patient’s consultant, GP or name of requesting practitioner
• Patient’s address (& post code)
• Requesting practitioners contact number
• Investigations clearly indicated
• Date and time of sample collection and collector’s details (i.e. phlebotomist name)
• Clinical details
• Where appropriate - Nature/site of sample, e.g. distal, left etc
• Gender

Please ensure that the location and consultant/GP details are correct, as this information is necessary for the correct delivery of reports and result acknowledgement. In Histology if the requesting Consultant is not supplied, then the sample will not be processed until this information is available. In addition, the date and time of sample collection are important as some parameters are affected by the introduction of an extended time before processing.

Pathology samples

Please ensure all the essential information is provided on the sample.
The laboratory will not process unlabelled or mislabelled repeatable patient samples but will refer back to the requestor. 
Label tubes clearly by hand or using small printed labels, in the presence of the patient using:

• Surname,
• Forename, 
• Date of Birth 
• Hospital or NHS number, 
• Date and time of specimen
• Identification of blood taker

If patient’s ID label is used on the sample, please ONLY use the small patient ID labels that are designed specifically for specimen tubes. These must be stuck length ways on the tube not sticking at right angles as this interferes with the processing of the sample. 

Large Addressograph labels MUST NOT be used on any specimens

Please note Blood transfusion have different minimum labelling requirements and the Laboratory will refuse samples which do not meet the minimum labelling requirements listed below.

MINIMUM REQUIREMENTS ON BLOOD TRANSFUSION SPECIMENS (SAMPLE TUBE) 

• Surname (correctly spelt)
• Forename (in full and correctly spelt) 
• Date of birth (not age or year of birth)
• Hospital number (NHS number acceptable only for antenatal/CRM samples and Myton Hospice patients)
• Gender (and/or on the request form)
• Identification of blood taker
• Date and Time specimen collected 

The laboratory reserves the right to refuse to process any samples that are not fully labelled.

*NB. Do NOT use labels on Blood Transfusion tubes; these tubes are to be completed by hand.

Samples must be sent sealed in a transport bag, and where appropriate ensure the container caps are screwed on tight. Do not send leaking samples to the laboratory – the requests will be rejected and a repeat requested. The request form should NOT be placed in the sealable part of the bag with the specimen.

It is important to indicate fluid type when samples other than blood are sent.

High Risk Specimens

All staff are required by the Health and Safety at Work Act to take reasonable care for their own safety and that of other people who may be affected by their actions.

All specimens are potentially an infection risk and must be handled carefully. 

Specimens from patients suspected of suffering from a Category 4 infection, e.g. a suspected viral haemorrhagic fever case must be discussed with the Virology laboratory before samples are collected.

From Wards

N.B. All specimens should be placed and sealed in plastic transport bags prior to transportation.

Where a pneumatic air tube system exists, it must be used to deliver specimens to the laboratory as this is the most efficient way to transport samples to the laboratory for testing. All URGENT sample should be delivered in this way to support the rapid turnaround of results.

Please ensure staff are fully trained in the use of the air-tube system prior to sending samples.

The air tube system must not be used for the following samples:

• CSF samples for Xanthochromia
• Histology/non-gynae Cytology samples
• Cryoglobulins and cold agglutinins samples
• Samples with ice
• Samples that are difficult to repeat
• Samples of an infectious nature

All samples not sent through the air tube should be brought to specimen reception and handed to a member of staff or placed in the appropriate box at University Hospital.

If a sample delivered by hand to any CWPS laboratory is URGENT or has special handling requirements, please hand to a member of staff at specimen reception and do NOT place in the box with routine samples.

There is regular transport of samples between all sites for centralised tests: Hospital of St Cross Rugby, George Eliot Hospital, Warwick Hospital, University Hospital and City of Coventry Health Centre.  

From GP Surgeries
Ensure that all samples are sealed in the clear transport bag. All samples must be sealed in the secondary plastic bag before placing in the transport box.

GP Specimens are delivered to the City of Coventry Heath Centre, Hospital of St Cross Rugby or George Eliot Hospital specimen reception by QE Facilities Ltd (QEF), our Transport partner. Samples are then forwarded for analysis to George Eliot Hospital for Blood Sciences or University Hospital for Microbiology. Times of these collections should be available locally, if in doubt please consult Specimen Reception staff at these sites or QEF.

QE Facilities Contact Numbers    
QE Facilities Main Number 024 7661 9174 (Monday -Friday 08:30 - 17:00)
QE Facilities Duty Phone             07943 083 110 
QE Facilities Supervisor Phone         07973 973 274
QE Facilities Pathology Orders 
(GPs and Pharmacy sites only)        ghnt.qefstockcwps@nhs.net

Spillage of body substances/fluids

Spillages should be dealt with immediately. Wearing disposable gloves, plastic aprons and eye protection if splashing is likely to occur.  Blood spillages should be cleaned up using chlorine-releasing agents such as hypochlorite granules, which will inactivate BBVs.  High levels of available chlorine are recommended (10,000 parts per million) because microbial activity is reduced in the presence of organic material.

The granules should be left in contact for sufficient time to ensure the virus is    inactivated, i.e. two minutes.

Disposable paper towels should be used to clean up the spillage and placed in yellow clinical waste bags.  The area should then be cleaned with detergent solution and dried thoroughly.

Body fluid spillage should be cleaned up using disposable paper towels, hot detergent solution and thoroughly dried.  The area may then be wiped over with a 70% methylated spirit wipe.

Blood spillage on surfaces that cannot be treated with hypochlorite should be covered with disposable paper towels to soak up excess debris treated as clinical waste and the area washed with detergent and dried.  Disposable gloves and aprons should be worn.

NB. PLEASE DO NOT MARK TESTS AS “URGENT” IF THEY ARE ROUTINE. Most routine ward results for Blood Sciences are available within 4 hours of receipt in the laboratory.

UHCW
Samples from ED and critical care units are automatically treated as urgent. All other urgent samples must be clearly marked as urgent and sent in the air tube.

The laboratory has a policy for telephoning results outside critical limits. Please note urgent results are not phoned unless they are outside these limits, this is because they are immediately available on CRRS.

George Eliot Hospital
When making an emergency request please phone the relevant departments and clearly mark the form “URGENT”, together with your contact details. As soon as the results are available they can be accessed on all ward terminals, or a surgery representative will be contacted.

Warwick Hospital
Urgent samples from wards must be placed in red bags. ITU, A+E and Admissions use an air tube system to send samples to the laboratory. Other wards must contact porters on Ext. 4107 to organise urgent transport to the laboratory. Between the hours of 9am to 5pm Mon to Fri, the laboratory does not require phoning; outside these hours, the laboratory must be contacted on Ext. 4198, in addition to the porters, to alert the laboratory staff.

Blood Sciences
The Blood sciences laboratories have a night shift providing a reduced routine service at night and weekends. 

Microbiology
Microbiology provides an on-call service after 9pm, 7 days a week for out-of-hour requests.

Cellular Pathology
There is no ‘out of hours’ service for, Cellular Pathology.

Rejection by the Laboratory of Specimens Submitted for Analysis

The laboratory may, on occasions, reject samples that are submitted for testing. 

Rejection can be for the following reasons:

• The patient details on the specimen and request form do not match.
• Insufficient information is provided on the request form to determine the investigation(s) required. 
• The sample type is incorrect.
• The specimen has leaked or fails to comply with health and safety policy.
• The quality of the sample is inadequate (too old, haemolysed, insufficient etc).
• Sample and/or request form are not labelled. 

The laboratory will endeavour to contact the requestor, and a report will be issued with a statement explaining why the request has been rejected.