Haematology

Our Haematology service is involved in the diagnosis and monitoring of patients with disorders of the blood and bone marrow, such as: sickle cell disease, anaemia, leukaemia and related blood cancers, clotting disorders and bleeding problems such as haemophilia.

Using our state of the art technology we offer the following routine investigations:

  • Full blood count
  • Reticulocyte Count
  • Erythrocyte Sedimentation Rate (ESR)

Other routine investigations include:

  • Blood Film Examination
  • Malaria
  • Infectious Mononucleosis (I.M) also known as a Paul Bunnell (PB) test

 

Haemostasis/ Coagulation

Our Haemostasis department analyses samples for assessment of anticoagulant therapy or to investigate possible disorders of the clotting system.

It provides a 24-hour full diagnostic interpretive service:

  • Routine screen (INR & APTTR)

Significant abnormalities in the above investigations will automatically have the following added as appropriate:

  • Fibrinogen
  • 50/50 Corrections

Coagulation section provides a comprehensive service for the diagnosis and management of haemophilia and thrombophilia. Routine testing includes:

  • Clotting Screen
  • D-Dimers
  • International Normalised Ratio (INR)

We also offer more specialised factor assays including those for the monitoring of various anticoagulant therapies.

 

Haemoglobinopathy screening and investigations

The Haemoglobinopathy service focuses on the identification of disorders of haemoglobin production such as G6PD deficiency, sickle cell disease, thalassaemia and other haemoglobin variants.

See the full list of haematology tests

 

Turnaround times

Many of the haematology tests have a turnaround time of less than 24 hours, but some are batched and may take a week or more. Haematinic assays are now performed everyday on site.

Most tests can be performed more quickly than usual if there is a clinical reason. Please telephone the laboratory if you wish a request to be treated urgently.

 

Reference ranges

The basis of the reference ranges are determined from manufacturers recommendation and testing a normal set of patient samples (either from a commercial company or from collection of normal patients from the local population). Reference values will take into account age, sex and environment (please refer to Dacie & Lewis (2016). Practical Haematology, 12th Edition).

 

Out of hours at St Helier Hospital and Epsom Hospital

Out of hours, runs will be performed approximately every hour. It is not necessary to phone the on-call person unless results are imminently life threatening, when the person on duty should be contacted via bleep 572 for the St Helier site and bleep 897 for the Epsom site.

All requests within the out of hours repertoire will be processed, but please note not all tests are available out of hours. 

The following investigations are available out of hours:

  • Full blood count
  • ESR
  • Glandular fever screen
  • Blood film
  • Reticulocytes
  • Direct antiglobulin test
  • Sickle screening test.

The requesting clinician must contact the on-call laboratory scientist if the request is life-threateningly urgent and in all cases is responsible for reviewing the results. We will, however, endeavour to contact the requestor if results are found to be markedly abnormal.

There is a member of the haematology medical staff available for advice at all times, contactable via the hospital switchboard.

Saturday and Sunday mornings: urgent requests only, please. Anticoagulant samples and blood counts should be in the laboratory by 12pm.

Bone marrow investigations may be performed but only by agreement of the consultant haematologist. 

Regional Newborn bloodspot screening service

The department also includes the South West Thames Newborn Bloodspot Screening laboratory. This provides screening for sickle cell on the bloodspot sample. The laboratory follows guidelines produced by the UK Newborn Screening Programme Centre. 

Find out more about the NHS Newborn Blood Spot Screening Programme.  

 

Key staff

Dr Caroline Ebdon, Consultant Haematologist & Joint Clinical Lead, St Helier Hospital
Tel: 020 8296 2214/2216

Dr Simon Stern, Consultant Haematologist, St Helier Hospital
Tel 020 8296 2214/2216

Dr Jenny Bosworth Consultant Haematologist, St Helier Hospital
Tel 020 8296 2214/2216

Dr James Croft Consultant Haematologist, St Helier Hospital
Tel 020 8296 2214/2216

Dr Sneha Muthalali, Lead Consultant Haematologist, Epsom Hospital
Tel: 01372 735348

Dr Stella Appiahcubi, Consultant Haematologist, Both sites
Tel: 01372 735348

Karen Cook (Cross site) Lead Scientist for Automated Haematology
Tel: 020 8296 2203 (St Helier)
Tel: 01372 73 5735 ext 6091 (Epsom)

Sarah Brown (St Helier), Lead Scientist for Special Haematology
Tel: 020 8296 2812 (St Helier)

Hugh Boothe, Blood sciences Hub Manager (Cross site)

Tel: 02082962286 (St helier) or 01372735 ext 6105 (Epsom) 

email: Hugh.boothe@nhs.net

 

Location

St Helier Hospital: second floor, D block

Epsom Hospital: first floor, Headley wing

Opening hours

Monday to Friday from 9am to 5.30pm and Saturdays from 9am to 12pm

An out-of-hours service operates outside of these hours.

Contact details

St Helier Hospital

Tel: 020 8296 2214

Epsom Hospital 

Tel: 01372 73 5735 Ext 6091

A member of haematology medical staff is available for advice at all times, contactable via our hospital swtichboard - 020 8296 2000 (St Helier) or 01372 735735 (Epsom).

 

More information

Please follow our detailed guidance on the completion of request forms and labelling of samples and transport of diagnostic specimens.

 

Coagulation

Instructions for sample collection:

Please ensure that there is no possibility of sample contamination with heparin or other IV fluids, e.g. flushed from venflons, etc.

Please collect coagulation samples before all other sample types with a minimum of stasis or delay. Do not top up coagulation tubes from other samples.

Please ensure each tube is correctly filled - under-filled samples give unreliable results and will not be tested.  Small volume tubes for neonatal testing are available.

All coagulation samples must be received and assayed or frozen within four hours of collection. Samples will be separated and prepared out of hours where indicated clinically and with agreement from a haematology consultant, eg for thrombophilia studies

Please discuss with a consultant haematologist before requesting any of the following investigations:

  • Platelet function studies
  • Investigation of a possible bleeding disorder
  • Investigation of a possible thrombophilia

For all coagulation tests, four citrates is the maximum requirement (although other sample types may be required).   

Other coagulation studies

Please remember to state any current anticoagulation therapy and request appropriately on ICM.

Control of anticoagulant therapy INR & APTTR.  Note that newer oral anticoagulant drugs cannot be reliably monitored with coagulation screening. Please seek advice prior to invasive procedures.

Coagulation factor assays may be performed by prior consultation with the haematology consultant on call.

Regular hospital and community based anticoagulant clinics are held with clinical advice given by pharmacists or anticoagulant nurses.

Blood sample assays for private contracts and clinical trials also form part of the service.

Contact details

Coagulation laboratory


Tel: St Helier- 020 8296 2814/Epsom – 01372 735286.

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