Pathology

The Pathology department at Homerton University Hospital NHS Foundation Trust provides laboratory services for a wide variety of service users, providing diagnostic and clinical advice to surgeons and clinicians from within the Trust as well as local GP surgeries and local employers.

Our full list of UKAS accreditaed tests can be found on each laboratory's schedule of accreditation which can be viewed via the accreditation page.

Guidance covering the range of testing available through the Homerton Pathology service and specific test requirements necessary for a given assay may be found by means of clicking on the Pathology Test Directory A-Z link box below.

If you are unable to find the test you are looking for please contact the laboratory concerned for further advice.

See below for discipline test directories.

 

Pathology

Please use the Department listing (above) to navigate to the required test and click on the individual test link for further information.

The Pathology department at Homerton University Hospital comprises a comprehensive Clinical Biochemistry, Microbiology, Haematology and Blood Transfusion service in addition to an infectious serology screening programme with off-site confirmation provided by the either The Royal London Hospital or another accredited external Reference laboratory.

In addition there is a full Immunology service managed by an external provider.

We are accredited to train biomedical scientists, and support junior doctors in training.

Our Quality team ensures the whole department operates under a rigorous quality management system to provide diagnostic laboratory services of the highest quality to meet the requirements of our users and those set by regulators and accreditors alike.

Here you can find information for patients coming for various tests and for healthcare professionals, including a searchable test directory and guidance on completion of request forms and labelling of samples.

You may be referred to the Pathology department by your GP for a blood test, or a variety of other tests to help with diagnosing and monitoring certain medical conditions.

This section contains useful information about pathology, including specimen reception location and routine opening times that will ensure you are adequately prepared and can provide a suitable specimen for analysis when you attend clinic. Additionally, here you will find background information as to the purpose of the test(s) you have been requested to have taken, or deliver. 

 

The Pathology Department at Homerton University Hospital NHS Foundation Trust is a well-equipped facility located on the ground and first floors in the Green Zone of the main Hospital Building. 
Visitors to Pathology should report to the Pathology Reception, on the first floor, which can be found via the Main Hospital entrance and following the signs for Pathology.

The Pathology laboratories operate 24 hours a day, 7 days a week, and 365 days a year, and are open for receipt and processing of routine specimens during the hours stated below. 

 

Please write the date and time when you produce the sample onto the container provided by your GP (on each sample container and any forms you are submitting for testing). 

If you have been referred to the pathology department by your GP for a blood test, please see Phlebotomy for opening hours and contact details.

Pathology departments availability and services provided

 
Department
Monday - Friday
Saturday & Sunday
Bank Holiday 
Out of Hours service (OOH) 
(Emergency work) 
Pathology Reception  08:00–20:00  09:00–17:00 09:00– 13:00        Not Available
Clinical Biochemistry  09:00–20:00  09:00–17:30 09:00–20:00 17:30 - 09:00           Bleep 233 (24hrs)
Haematology & Blood Transfusion  09:00–20:00  09:00–20:00 09:00–20:00 20:00 - 09:00           Bleep 234 (24Hrs)
Microbiology  08:00–20:00                  09:00–17:30                 09:00–17:30 Contact out of hrs staff via switch board

Please note: Verbal reports via Telephone, or by Fax are never given to patients.

Patients are asked to contact their clinician / GP for laboratory results at the time specified by the surgery and not to phone the laboratory where the tests were carried out.

This follows strict guidance and control by local SOP's and the guidance given by the Institute of Biomedical Science (IBMS)

Telephoned communication of results will only be given to recognised medical staff, out-of-hours call handlers, ward sisters, staff nurses, midwives or other designated healthcare professionals. 

Homerton University Hospital NHS Foundation Trust is committed to ensuring that the confidentiality of those who give information, and those who are the subject of information, is respected and that their rights in relation to identifiable information are protected.

The Pathology Department follows the Homerton University Hospital NHS Foundation Trust policy on Data Protection and Information Governance, further information can be found here.

Specimen Storage prior to arrival at Pathology:

To increase the sensitivity of diagnostic testing all specimens should be delivered to the pathology reception as soon as possible, however if storage at home is required (e.g overnight) then after collection they may be stored refrigerated at 4oC until they are dropped off, or if unsure check with your GP surgery for guidance and advice.

 

Information for Patients

Information for Patients

You may be referred to the Pathology department by your GP for a blood test, or a variety of other tests to help with diagnosing and monitoring certain medical conditions.

This section contains useful information about pathology, including specimen reception location and routine opening times that will ensure you are adequately prepared and can provide a suitable specimen for analysis when you attend clinic. Additionally, here you will find background information as to the purpose of the test(s) you have been requested to have taken, or deliver. 

For Healthcare Professionals

for Healthcare Professionals

These pages contain general information relating to transport of specimens, diagnostic protocols (e.g. dynamic function tests,) special specimen requirements and guidance for making test orders.

For advice on the communication of urgent pathology data please consult the Urgent results section of this guide. 

Blood Transfusion

Blood Transfusion

The blood transfusion service provides a range of blood and blood products, performs antenatal screening and other specialist testing for the Trust and external healthcare professionals and advises clinicians on the appropriate use of this limited resource. 

  • Blood Transfusion
  • Blood products
  • Antenatal screening

Haematology

Haematology

The haematology department provides a 24-hour quality diagnostic and advisory service to the hospital clinical staff and general practitioners which encompasses a comprehensive haemoglobinopathy screening and HbA1c monitoring service in addition to an established haemostasis laboratory for the routine diagnosis and treatment of clotting disorders (inclusive of thrombophilia screening.) 

  • Coagulation
  • Haemaglobinopathy / Sickle cell screening
  • Blood Film
  • Malaria screening 

Clinical Biochemistry

Clinical Biochemistry

The department of clinical biochemistry offers a diagnostic and advisory service to clinical staff throughout the Trust and wider environs in addition to providing a tertiary service to other Trusts through its busy drugs of abuse, specific proteins and Liquid chromatography–mass spectrometry (LCMS) laboratories.

In addition, clinical ciochemistry operates an infectious serology screening service with subsequent referral to an off-site provider for confirmation and specialist virology analyses, and an antimicrobial therapeutic drug monitoring service (TDM).

  • Routine Chemistry
  • Drugs of Abuse screening
  • Electrophoresis and Special Chemistry
  • Infectious serology screening (inc. Occupational Health screens)
  • Chromatography laboratory

Immunology

The Clinical Biochemistry department processes requests for immunology investigations via an external provider which in turn provides a full diagnostic and interpretive service to healthcare professionals throughout the Trust and commissioning PCT. Further details may be found at the TDL website

Immunology

Immunology specialises in investigating abnormalities and disturbances of the immune system associated with bacterial and viral infections, parasitic infestations, allergy, malignant and autoimmune diseases and immunological deficiencies.

Tests are also performed to assess responses to vaccination or treatment, and in transplant recipients measure the function of their immune system.

Test repertoire

We provide a comprehensive range of tests for the immunological investigation of patients. We aim to provide the highest quality of service with prompt delivery of accurate results, backed up by specialist medical and scientific expertise.

Where specific tests are not available locally, we will refer samples on to colleagues in other centres. The quality of all our work is regularly and frequently monitored in National Quality Control Schemes (UKNEQAS).

Microbiology

Microbiology

The microbiology laboratories at Homerton provide a 24-hour quality diagnostic, interpretative and clinical Microbiology service which includes screening for Chlamydia trachomatis and Neisseria gonorrhoeae by molecular assays (NAATs), diagnosis and monitoring of TB by Interferon-gamma release (Quantiferon) ELISA in addition to the normal compliment of assays and testing necessary for identifying specific infections and their corresponding (antibiotic) sensitivities.

  • Bacteriology
  • MRSA screening
  • Mycology
  • Virology
  • Serology
  • Molecular
  • Antigen detection

Histopathology and Cytology

These services are currently contracted through Barts Health NHS Trust Hospital's. 

If you experience any difficulty with access to results, please contact the RLH Histopathology Office for Reports: 020 3246 0172
Laboratory: 020 3246 0180
or email pramudi.kosgodage@nhs.net

Routine Specimens

The tissue must be placed in an adequate sized container with at least five times its volume of fixative. Specimens should be labelled with the following details:

  • Patient’s Family Name
  • Patient’s First Name
  • Hospital Number
  • Specimen Type

The specimen(s) must be accompanied by an accurately completed request form. Failure to provide adequate clinical information may mean that the Histopathologist reporting may find it necessary to contact you, which will delay the issuing of a report.

Please note: formalin-fixed tissue is unsuitable for bacteriological examination.

If this is required please either send two separate pots or send fresh tissue but contact the laboratory immediately so that appropriate arrangements can be made to divide the specimen.

Routine Turnaround Times (TAT)

80% of non-urgent histology is reported within 7 working days although cases requiring longer fixation or special investigation may take longer. 

If results are required sooner, please contact a senior member of the Royal London Histology laboratory staff giving the clinical reasons for the urgency.

Frozen Sections

Requests for frozen sections should be booked as early as possible. This is especially important if a particular consultant is required to examine the specimen. Contact the pathology reception team leader or supervisor to pre-book a courier.

Cytology

Specimens should be taken during normal working hours if possible. Specimens left in refrigerators overnight are not satisfactory. Where possible take specimens early in the morning. Pleural and ascetic fluids (if available, at least 50ml) must be added to a container with sodium citrate to prevent clotting, since clotted specimens make unsatisfactory preparations. These containers can be obtained from Pathology.

The turnaround time for routine gynaecological cytology varies with workload but slides are normally reported within 12 working days.

Quality department

Homerton Pathology laboratories (Biochemistry, Microbiology, Haematology & Blood transfusion) are now accredited by United Kingdom Accreditation Service (UKAS) to internationally recognised standard ISO 15189:2012 (medical laboratories).

 

 
UKAS 8700 UKAS 8702 UKAS 8701
8700
Microbiology
8702
Haematology & 
Blood Transfustion
8701
Biochemistry

All tests accredited by UKAS are listed in our schedule of accreditation for each laboratory, which can be found by clicking the UKAS symbols above.

ANY TESTS NOT LISTED IN THE SCHEDULES ARE NOT CURRENTLY ACCREDITED BY UKAS. 

 

 

Please contact the laboratory manager for more information.

Clinical Biochemistry Ext 7235
Haematology Ext 7213
Blood Transfusion Ext 7213
Medical Microbiology Ext 7184

 

Pathology News

Feb 2019
Pathology services at Homerton

The Trust has now entered into exploratory talks with Barts Health NHS Trust about a potential collaboration between the two Trusts for the future provision of pathology services. Here we answer some of your questions about this.

Frequently asked questions

Why do you need to talk about changing pathology services at Homerton?
What have you done?
Would this collaborative arrangement mean no pathology services at Homerton in future?
What happens next?

Why do you need to talk about changing pathology services at Homerton?
Our pathology teams provide a high quality service to the hospital and to colleagues in primary care. But it is becoming difficult to work in the current location in the hospital because of demands on space and ageing equipment. The space issue restricts the ability of the teams to expand further to take on additional capacity. There are also stringent accreditation standards set by independent bodies which we must continue to meet. The current arrangements will make the service’s ability to meet these standards increasingly difficult.

What have you done?
In the spring of 2016, we commissioned independent consultants to review the options available to us in developing our pathology services in the future. The findings of that review were put before the Trust Board of Directors November of that year and the Board decided to pursue two options:

  • transferring the bulk of services to another provider
  • or the preferred option of  going into a collaborative arrangement with another NHS Trust.

Consolidating the provision of services has been a growing feature of pathology working in the UK over the last decade. It is a development which is in line with the main drive of Sustainability and Transformation Plans (STPs) being drawn up across the country and is strongly supported by NHS Improvement.

In London alone, multiple examples exist of NHS trusts pooling their pathology services in pursuit of mutual financial and quality benefits as well as attracting skilled staff.

This is one of the key reasons the Trust Board favours the idea of a close alliance with another NHS provider.

Would this collaborative arrangement mean no pathology services at Homerton in future?
We will have to retain some pathology services on the hospital site if we are to continue providing a full range of acute hospital services.

Parts of each of the main components of our pathology service provide vital support to key areas such as A&E. These could be described as ‘hot services’ and need to be available on site. But other parts of pathology offer ‘cold services’ such as routine testing which could be outsourced without affecting hospital services. For instance, we already have an agreement with Barts Health to provide much of the histopathology testing for the Trust.

If the collaboration was to go ahead, any hot services would be retained at Homerton in an Essential Services Laboratory (ESL), sometimes called a blood sciences lab, along with some services supporting areas such as maternity. Other services and staff might transfer to Barts.

What happens next?
Discussions with Barts Health about a potential collaborative arrangement have been going on for some time at a Chief Executive level but a full appraisal of the details around any future arrangements must be carried out to explore its viability.

A programme director will be appointed to look at these details and whether a collaborative arrangement is feasible; then set out a case for collaboration for both Trust Boards to consider. This work will be carried out over the next six months.

The Trust Board would then need to sign off on any agreement with Barts before a process of setting up the new service began. This process may take up to eight months to complete including any formal consultation with the staff affected, so we are not expecting any changes till late autumn 2019 at the earliest.

Pathology staff, and their staff side representatives, will be kept informed about this work as it progresses with face-to-face meetings. The Trust will give regular updates to other staff along with other interested groups and individuals.

This list of questions and answers will be adapted and changed as we become clearer on the direction of travel of this process and whether or not the alliance with Barts is viable going forward.