Haematology

Haematology

The Black Country Pathology Service offers a comprehensive Haematology service for both hospital and primary care users.

The tests offered include:

  • Routine & Specialist Haematology
  • Routine & Specialist Coagulation
  • Haemoglobinopathy
  • Haematinics & Erythropoietin

All haematology laboratories in the Black Country Pathology Service utilises the latest analytical equipment and are UKAS approved. This allows these departments to offer a safe and comprehensive service for clinical haematology users. All laboratories operate a 24-hour emergency service across all trusts. Consultant haematologists are available across all sites to also offer further advice and testing strategies when required.

The Haematology department provides a comprehensive laboratory service for routine and specialised Haematology testing of blood and body fluids using state of the art equipment. The Black Country Pathology Services network is a hub and spoke model – with each hospital having a haematology service covering the acute work for each of the partner Trusts 24/7. Additionally, the GP and specialised haematology testing is site based at the hub site at New Cross Hospital, Wolverhampton. The other haematology laboratories are classed as essential services laboratories (ESLs) and perform routine Full Blood Count analysis, routine coagulation, and blood morphology.

The BCPS Haematology service offers:

  • A high quality clinical and analytical service fully accredited by UKAS (ISO15189:2022) and supported through extensive internal quality control and external quality assurance.
  • Active involvement in clinical audit, research, and development.
  • Training accredited by the HCPC and IBMS for registration and specialist portfolios.
  • A 24-hour clinical advisory service.
  • Rapid turnaround time of results with real time monitoring
  • Electronic requesting and reporting for both acute and primary care settings.

The laboratories perform over 7500 FBC’s per day and over 1600 coagulation requests. The department performs testing for routine coagulation (including tests to monitor standard and novel anticoagulants) and specialised haemostasis and thrombosis testing (including testing for haemophilia, von Willebrand Disease screening and full thrombophilia screening, including molecular genetics).

The department has a substantive haemoglobinopathy section, screening for the presence of variant Haemoglobins e.g. HbS in sickle cell patients and thalassaemia. The laboratory also performs work for the Antenatal and Newborn screening service and is a referral centre, providing a confirmation service to other hospitals.

A full list of the tests available can be found by clicking on the Pathology Test directory link.

Full Blood Count tests and blood film screening

Full Blood Count tests and blood film screening help identify the presence of infection, anaemia, to help monitor response to therapy or assist in the diagnosis of disease e.g. leukaemia. Other common testing includes screening for malaria parasite infection, glandular fever, and enzyme deficiencies such as G6PD.

Each of the haematology laboratories across the BCPS use the same equipment provided by the same supplier under a single contract:

  • Sysmex CT-90 Track System
  • Sysmex XN FBC Analysers (FBC’s)
  • Sysmex SP Stainers (PBF’s)
  • Sysmex DI‐60 or DM1200 Digital Morphology (PBF’s)
  • Starrsed RL, ST & SR ESR Analysers (ESR’s)

The laboratories across the Black Country Pathology Service have the capacity to process over 1500 Full Blood Counts per hour and provides haematology testing to a population of just under one million people.

Blood films (morphology)

The Black Country Pathology Service use the latest Digital imaging technology to process peripheral blood films in a more effective and efficient manner, when compared to manual morphology. Its use allows for a standardization and consistency of white cells identification, while also providing an excellent learning and training tool. The technology uses a neural network database which improves the accuracy of white cells identification, with each classification that is made. As the data is electronically stored, it is available when ever required and can also be used to track any morphological changes that may have taken place, which can potentially improve the quality of patient care.

There are two systems used for digital imaging. Two DI60 that are fully tracked at the RWT/hub laboratory, and a DM1200 at each of the ESL sites. The main aim of using digital imaging across all sites was to be able to network across the BCPS. Multiple DI instruments across the 4 BCPS sites can be linked and share a common image database. This would mean blood films can be signed off from another location and more challenging slides that require a second opinion can be reviewed remotely by a morphology expert or referred to a consultant haematologist.

Each laboratory still retains a microscope for any films that require a traditional, manual review.

Currently, the film rate across the BCPS is 4-7% of the total number of FBCs received.