Pathology

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NORMAL WORKING HOURS

Royal Stoke and County hospitals

Monday‒Friday	0830‒1730 hr Histology 0900‒1730 hr
Saturday	Histology no service Biochemistry 0830‒1300 hr for advice, contact BMS (bleep 389) contact on-call clinical scientist via Rotawatch Haematology 0900‒1300 hr Microbiology 0830‒1700 hr Virology 0830‒1300 hr
Contact microbiology if sending an urgent sample
Clinical scientist holds biochemistry hospital bleep (389) for specialist advice

URGENT OUT-OF-HOURS SERVICE

Specimens

Clearly mark all urgent requests 'urgent'
Include patient’s name (or emergency ID), date of birth, unit number, consultant, ward and time of specimen
- essential for electronic reporting of results
All requests must contain clinical information relevant to investigation requested
Where request form or sample containers are inadequately completed/ labelled or illegible, this may result in investigation(s) not being performed

Request: request form or phone?

If sending an urgent microbiology sample, contact microbiology
Otherwise, do not bleep biomedical scientist (BMS) unless results are clinically very urgent and need to be telephoned

Results: Electronic systems or phone?

Results will be phoned only if:
- delay likely in transmitting results to electronic systems
- BMS has already agreed to phone
- results alert BMS to possibility that immediate action may be required

Transfer of samples to pathology

For urgent and out-of-hours specimens, use pneumatic tube for transfer of policy-compliant samples, or contact hospital portering helpdesks for samples that cannot be transferred via pneumatic tube

Table 1: Investigations available out-of-hours via request form

Department	Investigations available out-of-hours by request form
Blood transfusion	Group and save Crossmatch of red cells Direct Coombs test
Haematology	Full blood count (FBC) including differential WBC International normalised ratio (INR) Activated partial thromboplastin time (APTT) D-dimer for screening patients with suspected DVT or PE ESR Blood films for morphology Malarial parasites Infectious mononucleosis screen D-dimer with fibrinogen for assessment of DIC Fibrinogen
Biochemistry	Under normal operational circumstances, most biochemistry investigations required urgently are available 24/7, e.g. Amylase Cardiac troponin Liver function tests (LFT) Creatine kinase (CK) Uric acid Serum or plasma U&E, osmolality Bone Thyroid function tests (TFT) Urine U&E, osmolality CRP NTproBNP HCG Magnesium CSF protein and CSF glucose Therapeutic drug monitoring e.g. digoxin, phenytoin, carbamazepine, theophylline, valproic acid, lithium. Toxicology investigations e.g. paracetamol, salicylate, iron, ethanol See Table 2 below for investigations requiring clinical approval
Microbiology	Limited routine service available Weekdays 1730‒1930 hr Saturday 0900‒1700 hr Sunday 0900‒1700 hr antimicrobial monitoring assays are batched and run at approximately 1100 and 1530 hr on Saturday, Sunday and Bank holidays contact laboratory during these times At all times, send samples (especially MRSA swabs) to laboratory promptly to ensure processing as soon as possible

INVESTIGATIONS AVAILABLE OUT-OF-HOURS

Be certain that investigation will influence immediate clinical management
- if BMS is in any doubt about relevance of request, they will ask SpR or more senior doctor to contact duty biochemist or on-call laboratory clinician for agreement to proceed

Table 2

Department	Investigation available out-of-hours requiring clinical approval
Blood transfusion	If urgent transfusion required phone If massive haemorrhage activate MHP see Massive haemorrhage protocol Unless discussed antenatal samples and direct antiglobulin test (DAT) processed during routine working hours
Haematology	Sickle cell screen in appropriate patients requiring urgent general anaesthesia, sickle cell screen – require 1 hr prior notification ESR – for patients with suspected temporal arteritis or for paediatrics
Biochemistry	CSF Xanthochromia Ammonia Ethanol Hypoglycaemia screen SUDIC samples Urinary PBG Specialised toxicology requests for the Regional Toxicology Laboratory e.g. drugs of abuse, ethylene glycol, methanol for transport, phone. Requesting department will be charged
Microbiology	Contact BMS on phone for all requests until 2230 and after 2230 only for: CSF samples intra-operative specimens taken in theatre where a microscopy is urgently required joint aspirates ascitic fluids if spontaneous bacterial peritonitis suspected After 2230 hr, refer all other requests to on-call consultant medical microbiologist
Histology	No out-of-hours service available

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Last reviewed: 2025-07-18