Haematology and Blood Transfusion
The Haematology laboratory processes approximately 90000 samples per year, acting as a regional diagnostic centre covering the
The Haematology department is staffed by a team of medical, technical and support staff who provide an interactive clinical and analytical service. The majority of the staff are members of professional associations which have an important role in the setting of professional standards and standards of analytical performance. Continuing Medical Education and Continuing Professional Development is supported by membership of professional bodies and learned societies including the Royal College of Pathologists and the
The clinical service is led by 3 Consultant Haematologists and includes the Regional Leukaemia and Oncology Unit, the Regional Paediatric Haemophilia Comprehensive Care Centre and General Haematology.
The department undertakes all aspects of paediatric haematology and acts as a regional referral centre for haemophilia, leukaemia and oncology. The department also provides analytical and clinical support to the regional Neonatal Intensive Care Unit located at the Liverpool Women’s Hospital.
Based on the ground floor of the main building of the
Haematology test repertoire and sample requirements
List of referral laboratories used by the Haematology department
Opening Hours
A laboratory service is provided 24 hours per day, seven days per week. The service is however, divided into periods where the full repertoire of tests is available (normal working hours service), and periods where a restricted range of tests are available.
Normal working hours are Monday to Friday, 9.00 am to 5.30 pm (with the exception of public holidays),
Outside normal working hours a restricted range of services are available, requests should limited to those where there is a reasonable likelihood that the results will affect the immediate management of the patient, or where regular monitoring is required for unstable patients.
Where to find us
The Haematology departments are situated on the ground floor of the main hospital building and can be accessed during normal working hours from the main hospital corridor on the ground floor opposite B1 clinic. Outside normal working hours the department can be accessed when required using the coded entry doors.
Making requests
All URGENT requests should be preceded by a telephone call to the haematology department on 0151-252-5490 (internal extension 2490 for Haematology, 2942 for Transfusion)
Requests for services should be made using the Trust’s Meditech System.
Requests from GP surgeries should be printed or hand written using the specific Alder Hey Pathology request forms, ensuring that details entered on the request form are legible. It is important that the information provided includes:
- Full name of patient
- Date of Birth
- NHS Number/Hospital number /Address
- Location of patient
- Date of sample
- Type of specimen
- Name and contact details of requesting doctor
- Name of consultant
- Tests required
- Clinical details including any medication
Please note that for transfusion requests it is essential that patient details on the sample are hand written with the patient’s full name, date of birth, case sheet number, date of the sample, and is signed by the member of staff collecting it. Inadequately labelled samples will not be accepted for analysis. Please refer to the Trust Blood and Blood Product Transfusion Policy for further information.
Clinical information and the patient’s date of birth are particularly important in paediatric requesting, so that the laboratory staff may
- Understand the reason for the request and consider the need for further investigation.
- Interpret the results against an appropriate age specific reference range.
The Department reserves the right to decline to analyse samples with incomplete information, particularly if there is doubt about the identity of the patient or sample. The results may also be misleading in the absence of relevant clinical details.
Enquiring about sample types and amounts
See link for test repertoire or contact the laboratory on 0151 252 5490 (internal extension 2490). The sample volumes indicated are the minimum required but it is helpful if larger volumes can be supplied to enable repeat testing if required. If inadequate sample volumes are provided, it may be necessary to delete those tests from the profile that require large amounts of sample. If there are clinical reasons for giving preference to specific analytes, please telephone the department.
Additional investigations.
If additional investigations are required on specimens already sent to the laboratory, please contact the laboratory to establish if sufficient sample remains and it is suitable for analysis.
Key Contacts
| Medical staff | ||
| Consultant (Head of Department) | Dr Mark Caswell | Ext 3680 |
| Consultant | Dr Russell Keenan | Ext 2073 |
| Consultant | Dr Helen Campbell | Ext 2183 |
| Biomedical Scientists (BMS) | ||
| Laboratory Manager | Mr Ray Billington | Ext 2263 |
| Senior BMS Coagulation | Janice Wilkinson | Ext 2260 |
| Senior BMS Routine Haemoatology | Mr Dennis Fath | Ext 2490 |
| Senior BMS Special Haematology | Mr Paul Walsh | Ext 2559 |
| Senior BMS Blood Transfusion | Mrs Margaret Slade | Ext 2492 |
| Transfusion Specialist | Mrs Tracey Hall | Ext 3732 |
Clinical Advice
Clinical advice on the planning and interpretation of haematological investigations is available at all times. The laboratory can be contacted at any time for technical advice on 0151 252 5940 (internal extension 2490) and the duty Haematologist can be contacted for clinical advice and result interpretation via the hospital switchboard (0151 228 4811)
Routine Haematology
This section provides full blood counts including visual white cell differential counts, ESR, Glandular fever screening tests and Sickle screens. The section also assists in the collection, preparation and staining of bone marrow samples.
Our aim here is to provide:
- A timely and accurate screening service.
- Diagnosis of anaemias and other cytopenias.
- The diagnosis of primary haematological disorders.
- Some help for the clinician in highlighting where significant non-haematological disease is present and manifest in either an abnormal blood count or ESR.
- Monitoring of treatment particularly in areas where the blood count may be affected, such as chemotherapy.
- Biomedical scientists regularly review blood films as an aid to diagnosis of disease, including leukaemia, sepsis anaemia and malaria.
Coagulation screens and specific clotting factor assays are performed in this section.
The following services are provided:
- Routine Coagulation screens as part of pre and post-op assessment, and investigation of patients suspected of having an increased tendency to bruise or bleed.
- Monitoring Warfarin treatment using the INR (Near Patient testing and remote laboratory testing).
- Monitoring Heparin therapy using the APTT or specific Heparin assay for patients receiving Low Molecular Weight Heparin (LMWH).
- The diagnosis and management of congenital or acquired bleeding disorders; the former includes haemophilia, the latter the bleeding problems in the critically ill.
- Platelet function tests including platelet aggregometry are available following discussion with the Consultant Haematologist and Senior BMS in Coagulation.
- Thrombophilia screen, including the lupus anticoagulant, anti-thrombin III, protein S, protein C, resistance to activated protein C, anti-cardiolipin antibody, factor V Leiden and factor II mutations are referred to a local referral laboratory for analysis. (These tests cannot be fully performed if the patient is either on Heparin or Warfarin.
Other than in the acute situation (i.e. prior to commencement of heparin) the Consultant Haematologist must be contacted prior to requesting Thrombophilia screens to ensure that the correct investigations are carried out.
This section offers the following services:
- Routine blood grouping and antibody screen with identification of antibodies. Any atypical antibodies identified are referred to the Regional Blood Transfusion Service for confirmation.
- Provision of compatible Red Blood Cells, for routine and emergency cases, for surgery, bleeding patients and some cases of anaemia.
- Provision of compatible Blood Products including Platelets, Fresh Frozen Plasma and Cryoprecipitate as required for the appropriate treatment of bleeding disorders, congenital or acquired.
N.B. Always inform the laboratory of Urgent or Emergency cross-match and Blood product requests by telephone 0151-252-5490 (internal extension 2492/2490)
- Direct and indirect antiglobulin test.
- Kleihauer test to guide appropriate administration of anti-D during or following pregnancy to both general practice and hospital depts.
- The investigation of cold agglutinins.
Immunosuppressant drug monitoring is performed in support of the renal unit and bone marrow transplantation.
The regional leukaemia and oncology unit is supported with a rapid diagnostic service comprising of immunophenotyping and cytochemical staining techniques.
The service provided includes;
- Provision of the Regional Neonatal Sickle Cell Screening service, haemoglobin studies such as sickle tests, haemoglobin electrophoresis and thalassaemia screen. If a haemoglobinopathy is diagnosed, follow up clinical support is provided by the Consultant Haematologist and clinical team.
- Cell surface markers in the investigation and diagnosis of leukaemia and immune disorders.
- Other special investigations include special stains for haematological malignancies, Ham's test.
- Assays for anti rejection drugs including Cyclosporin and Tacrolimus.
These special tests are probably best discussed with laboratory staff before samples are sent.
The results of most non-specialist routine tests will be available on Meditech within 2 hours. Significantly abnormal results that require clinical action are telephoned to the requesting doctor.
All incoming work is classified as routine unless the requesting clinician contacts a member of laboratory staff to inform them that the work is to be undertaken urgently or out of hours. Typical turnaround times are dependent on the complexity of the requested test. Some tests are referred to external laboratories and additional time therefore has to be allowed for appropriate transport of specimens. Please contact the Haematology laboratory for more detailed information.
It is important to understand that reference ranges are age (and in some instances sex) related and appertain to particular methodology. The reference ranges quoted in these pages and with printed and electronic results therefore are only applicable to analyses performed at the Haematology Department of Alder Hey Children’s NHS Foundation Trust. Reference ranges are displayed with all results on both computer screen and printed reports. For further clinical interpretation of laboratory results please contact the duty Haematologist. To view the reference ranges follow the link ranges.
Quality Control
The quality of results is controlled by internal quality control procedures and monitored by external quality assessment. The Haematology department participates in external quality assurance and proficiency schemes from the UK (UKNEQAS). Common interferences
Users should be aware that samples collected by capillary puncture from children are more prone to interference than samples collected by venepuncture in adults. The most common interferences are haemolysis, lipaemia and jaundice. All our samples are routinely checked for the common interferences and the affected tests are indicated on the final report. Heparin and other contaminating fluids from venous line samples will interfere with coagulation test results (especially APTT, TT and Factor assays) and other analytes.
Delays of more than a few hours in sample transport to the laboratory can also result in erroneous results for some analytes, e.g. PT, APTT. For more detailed information on interferences please contact the Haematology laboratory ext 2490.
Turnaround times
The department classifies its work as routine, urgent or out of hours work. All incoming work is classified as routine unless the requesting clinician contacts a member of staff in the department to inform them that work is to be undertaken urgently. The processing of the different categories of work is described below.
Routine Work
Routine requests within each work section are processed on a first in, first out basis.
Urgent Work
The turnaround time given under the ‘urgent’ category is the minimum time needed to analyse a sample if we change the order of work on our work list. Requests for urgent work should be made only if the patient is unstable and results are needed to decide on the immediate clinical management.
Work will be prioritised according to clinical urgency.
Out of Hours Work
The department provides a continuous 24 hour service with a restricted repertoire of tests available outside normal working hours. Outside normal working hours one member of the Haematology BMS staff provides cover for all Haematology and Blood Transfusion requests and can be contacted on extension 2490 or bleep via switchboard.
The turnaround times quoted below are measured from the time of the receipt of the specimen in the laboratory to reporting of the result and cover the common investigations. If information is required for the turn around time of investigations not listed below please contact the Haematology laboratory on 0151 252 5490 or the internal extension 2490. The department operates a system for regular review of turnaround times.
Provision of blood products
Turn around time for the provision of blood products are approximate and are timed from the receipt of a correctly labelled specimen in the appropriate container with sufficient blood volume. If there are special requirements e.g. irradiated products, or there are complicating factors e.g. red cell antibodies there may be a delay in provision of appropriate blood products.
Authorised by: Ray Billington, Haematology Lab Manager
Version 2
Review date: November 2013
