Specimens, requests, reports

Mpox

Specimens from suspected or confirmed Mpox cases must be double bagged and clearly labelled. DO NOT send via pneumatic air tube system.

Sample requirements
Request forms and specimen labelling
Minimum requesting intervals
Handling and transport of specimens, including via pneumatic air tubes
The acceptance and rejection of samples
Factors affecting the validity of tests
Reports

 

Sample requirements

Blood samples should be collected using the Greiner Vacuette® system. If collecting more than one sample please use the recommended order of draw to avoid contamination.

Download Greiner Draw Order poster

Greiner draw order chart shows correct order and gives useful information on taking blood samples.

 

Details of sample requirements can be found on this site - use the A to Z index or search function to check the listings.

For urine, faeces and other samples please check the listings if in doubt, as requirements vary depending on the test.

For CSF please refer to the CSF collection page.

Request forms and specimen labelling

All specimens must be labelled with full patient identification and be accompanied by a request form giving full clinical details and signed by a doctor, in accordance with UHSPE Pathology Sample and Request Form Labelling Requirements.

Download specimen and form labelling requirements

Pathology Sample and Request Form Labelling Standards (GDc-PAT-SpecLab, revision 6, active 1.11.2021)

To allow us to process your request efficiently please use ICE requesting or the correct type of manual request form.

Information on how to access ICE Desktop.

Completing manual forms.

Please note that due to the automated handling of many requests, instructions in clinical details fields on ICE forms (e.g. to add extra tests) will not be registered as test requests.

Minimum retesting intervals

From July 2024 systems will be introduced in ICE to limit inappropriate repeat testing according to the Royal College of Pathologists guidelines (G147 National Minimum Retesting Intervals in Pathology, March 2021).

Handling and transport of specimens

Mpox

Specimens from suspected or confirmed Mpox cases must be double bagged and clearly labelled. DO NOT send via pneumatic air tube system.

Specimens must be transported to the laboratory in sealed plastic transport bags, with the request form in the open pocket.

Larger specimens, such as some histology specimens or 24h urine collections, should be enclosed in individual plastic bags and sealed to prevent leakage.

Specimens collected in the hospital should be transported in plastic containers that are capable of retaining spillages and can be cleaned and disinfected.

All GP surgery specimens are to be labelled and transported to the laboratory sealed in the plastic bag attached to the request form.

Download Model Rules for porters

Model Rules for Laboratory Porters, Couriers and Messengers. (GDc-PAT-MODRULCOUR, revision 5, last updated 13/8/2021)

 

Use of pneumatic air tube system (pods)

Download Model Rules for porters

Pneumatic Air Tube Transport System (PATTS) – User Guide.  (SIc-PAT-PneuTrans, revision 2, last updated 27/6/2023)

 

Samples being transported in air-tube carriers must be packed into a sealed plastic bag. Note that samples for some tests should NOT be transported by pod. A full list of items that must never be transported by pod is listed in the user guide.

Biochemistry and Haematology:

Specimens for tests that may be affected by acceleration/ deceleration, e.g. CSF samples for xanthochromia scanning (risk of red cell lysis, which can compromise results), platelet function tests.

Samples that are being sent on ice (e.g. ACTH, gut hormone profile, insulin/C-peptide). These samples should be brought to lab in person.

Samples that must be kept warm, e.g. Cold agglutinins and cryoglobulins (must be brought to lab at 37°C).

Microbiology:

Blood culture bottles.

Cellular pathology:

Specimens containing formaldehyde (formalin) e.g. histology specimens.

Tissue samples for frozen sections.

High-risk samples:

High-risk samples include specimens from patients known or suspected to have certain infectious diseases MUST NOT be submitted via the pneumatic air tube system. They must be delivered by hand directly to Pathology (contact Trust Porters on ext.63250):

  • Anthrax (Bacillus anthracis)
  • Brucellosis (Brucella spp.)
  • CJD / Creutzfeld-Jakob disease and other Prion diseases / TSE agents
  • Coccidioides / paracoccidioides and other dimorphic fungi
  • Coronaviruses (Novel), including COVID-19 - see info box above.
  • Dysentery (caused by Shigella dysenteriae)
  • Enteric fever - see Typhoid / Paratyphoid fever
  • Faecal samples from patients with Haemolytic Uraemic Syndrome, VTEC (e.g. E.coli O157) etc.
  • Melioidosis (Burkholderia mallei or pseudomallei)
  • MERS / Middle East Respiratory Syndrome
  • Plague (Yersinia pestis)
  • Monkeypox
  • Pleural and respiratory fluid samples from patients with TB (Mycobacterium tuberculosis)
  • SARS / Severe Acute Respiratory Syndrome
  • Typhoid / Paratyphoid fever (Salmonella Typhi or Paratyphi A, B or C)
  • Tularaemia (Francisella tularaemia)
  • VHF / Viral haemorrhagic fever (e.g. Ebola, Lassa, Marburg etc.)  - DO NOT SEND. DO NOT submit VHF samples to Pathology - contact the Consultant Virologist or duty Microbiologist, collection will be arranged.

The acceptance and rejection of samples

Samples submitted to the laboratory must be:

  • labelled in accordance with the specimen labelling policy.
  • submitted in a laboratory approved container with the required anticoagulant or preservative (if any).
  • received with time to process (e.g. centrifuge and separate serum/ plasma) before the validity of the sample is compromised by the extra time required,
  • transported under conditions which do not affect the validity of the results. Effects of heat/cold may not be evident until the sample has been processed. Samples should be transported at room temperature unless stated otherwise (refer to individual test information in this guide).
  • filled correctly. Some tests can be run provided a minimum sample volume is achieved but others (primarily coagulation tests) contain a precise volume of anticoagulant and must be filled within the indicator line on the bottle.
  • collected in a sample container which has not exceeded its expiry date.
  • adequately contained during transport (see handling and transport of specimens).


Samples may not be processed if they are not required, for example a group and screen request where the patient already has two recent results which are valid for issue of blood and blood products. The lab will book in all samples received and state a reason if a sample is not processed. Very occasionally, e.g. where a sample is received entirely unlabelled with no request form, this may be impossible.

Key factors which may affect the validity of a test

General factors which affect the validity of a test include:

  • correct patient identification
  • sample age,
  • sample storage and transport conditions
  • presence of contaminant (e.g. from drip, or where a patient is on anticoagulants and is being investigated for a coagulation disorder),
  • use of sample bottles with the wrong anticoagulant or with anticoagulant whenclotted blood is required,
  • contamination of sample with anticoagulant from another sample (observe draw order),
  • use of non-standard sample bottles for which the lab test has not been validated,
  • haemolysis, lipaemia, excessively icteric samples*
  • Drug and antibody interferences*.

*known interferences are listed on individual test pages - please use the A-Z listings or search function.

Reports

Results are viewable on ICE Desktop or on GP systems as soon as they are available. Please use the enquiry system before contacting the laboratories. Telephoning for results should be avoided because of the risk of transcription errors.

Information on how to access ICE Desktop.

Paper reports, for destinations that still require them, are sent out to wards at 1.30 pm and 4.30 pm via the portering system. Results for outpatients and other departments are sent daily via the internal mail. Results for General Practitioners are sent out daily by post, or returned on specimen runs.

All histology and cytology reports are sent to the requesting clinician's secretary or to the GP as appropriate.

Results can NOT be accessed through this site.