Routine Haematology Testing
The department processes around 2,000 full blood counts (FBCs) per day, including reticulocyte counts, using Sysmex XN analysers. Acute results are available within 1 hour, and routine results within 6 hours.
Haemoglobin and Red Cell Indices
Haemoglobin is the oxygen-carrying protein within red blood cells. Red cell indices (MCV, MCH and MCHC) describe the size and haemoglobin content of those cells. These parameters form part of a standard FBC and support the investigation of anaemia, including potential iron, B12 or folate deficiency.
Abnormal indices can also be seen in conditions such as sickle cell disease, thalassaemia, haemolysis, liver disease and renal disease.
White Blood Cells
White blood cells help defend the body against infection and are also affected by stress, inflammation and malignant disease. The total white cell count and the five-part differential (neutrophils, lymphocytes, monocytes, eosinophils, basophils) provide valuable information about possible infection, inflammation or haematological disorders. White cell and platelet counts are often monitored closely in patients receiving chemotherapy or other cytotoxic treatments.
Blood Film Morphology
Blood films are examined on approximately 5% of FBCs. The turnaround time is around 3 working days.
A thin layer of blood is stained and examined microscopically to assess the size, shape and colour of cells. Blood film review can assist in diagnosing conditions such as anaemia, haemoglobinopathies, infections (including malaria), glandular fever, haematological malignancy and metabolic deficiencies.
Routine Coagulation Screening
The department processes around 300 coagulation screens per day using Sysmex CN analysers. Results are available within 1 hour for acute testing and 4 hours for routine samples.
Coagulation Screen
The basic screen includes prothrombin time (PT) and activated partial thromboplastin time (APTT). A fibrinogen level is measured when indicated. These tests assess clotting time and help identify abnormalities in haemostasis — whether impaired clot formation (e.g., haemophilia) or increased clotting tendency (e.g., deep vein thrombosis).
The coagulation screen, alongside INR and anti-Xa assays, is used to monitor patients prescribed anticoagulants, ensuring correct dosage and treatment.
Specialist Coagulation Tests
Specialist investigations include:
Factor assays, used to assess coagulation factor levels and diagnose inherited bleeding disorders such as haemophilia. Turnaround times are 2 hours for acute samples (authorised by consultant haematologists) and 7 days for routine tests.
Lupus anticoagulant screening, performed to detect phospholipid-dependent antibodies that may prolong the APTT. The turnaround time is 14 days.
Other Specialist Tests
Screening for Sickle Cell Disease and Thalassaemia
Carried out for diagnostic purposes and for all pregnant patients as part of antenatal screening. Techniques include ion-exchange HPLC, gel electrophoresis, and sickle solubility testing.
Platelet Aggregation Studies
These tests assess how effectively platelets adhere and aggregate during clot formation. Light transmission aggregometry is used to investigate unexplained bruising or bleeding.
Heparin-Induced Thrombocytopenia (HIT) Screening
In some patients receiving UFH or LMWH, antibodies may develop against platelet factor 4 (PF4), causing a fall in platelet count. When the 4T score suggests possible HIT, specialist immunological testing can be performed to confirm or exclude HIT and guide safe anticoagulant choice.
Quality Assurance
The department is committed to continuous improvement and the delivery of a high-quality service.
We participate in NEQAS external quality assurance schemes where available, allowing ongoing comparison of our performance with other UK laboratories.
Internal quality assurance includes the use of validated IQC materials, appropriate calibration, a robust audit programme, and a strong culture of safety, learning and transparency, with encouragement of incident reporting and follow-up through corrective and preventive actions.
Our aim is to provide a test repertoire that meets clinical need and produces results that are accurate, timely and meaningful to patient care.