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Worcestershire Acute Hospitals NHS Trust
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Cellular pathology

Our cellular pathology service is based at Worcestershire Royal Hospital. All specimens should be sent directly to the laboratory at the Worcestershire Royal hospital.

We provide a comprehensive histology and cytology (including a consultant led FNA service), together with an operating mortuary.

The laboratory at the Alexandra Hospital provides a pre-booked frozen section service and an operating mortuary.

We have a consultant pathologist as our designated Human Tissue Act (HTA) individual for the trust.

Who's who and contact details

Interim Laboratory Manager  (countywide)

Mrs Susan Lovelock 

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Consultant Pathologists - Worcestershire Royal Hospital

Dr C Allen 

Dr T Jones

Dr K Romain

Dr R Vaziri

Dr J Xureb 

Dr S Littleford

Dr B Sethi

Dr N Nair

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Advanced Practitioners - 
Specimen Dissection:

Cytology:
 
S. Clarke

K. Williams

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Medical Secretaries - Worcestershire Royal Hospital

Sandra Green

Sally Palmer

Julie Creese

Tina Denton

Sandra Williams

Catrin Price

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01905 760199

Appointments for Fine Needle Aspiration   x 39625 
     

Mortuary Manager

 

Deputy Mortuary Manager

Mrs Sheryl Thomas

Mr Tim Maccormac

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DDI 01905 760343
Fax 01905 760312   

     
   

 

Coroner's Office   03003 333000
 Coroners Officers   01527 586186
01527 586103


Lab locations and opening times

River level
Worcestershire Royal Hospital - Main Lab. 
Charles Hastings Way
Worcester
WR5 1DD

Core hours
Monday to Friday: 8.00am - 5.00pm
Saturdays: 9.00am - 11.00am (restricted service only)
Closed Bank Holidays and Sundays

There is no routine on-call service. Contact can usually be
established with staff in an emergency via switchboard.

Alexandra Hospital - Satellite Lab.
Woodrow Drive
Redditch
Worcestershire
B98 7UB

This laboratory is now closed And only functions to provide a pre-booked frozen section service. All other specimens should be sent directly to the WRH laboratory.


Tests available

Surgical Histopathology

The majority of cases are reported by pathologists within the trust but the high workload in the laboratory sometimes requires us to send work out to an external source for reporting to enable turnaround times to be achieved. The work is either sent to Hereford Histopathology Department (UKAS Acredited) or to an agency known as Backlogs (currently non UKAS accredited). The laboratory sends routine, non-urgent work only. Reports issued will state where the cases were reported. Cases referred for molecular testing are sent to The Molecular Diagnostics Department at QEH Birmingham. This department is currently non UKAS accredited. Additionally, HER-2 testing is now carried out in-house. This test is in the process of gaining accreditation.

Please see the A-Z directory of tests.

Autopsy

We provide an autopsy service for the Alexandra and Worcestershire Royal Hospitals, and H M Coroner. These are performed at the Worcestershire Royal Hospital mortuary. Please ensure that the correct procedures are followed in obtaining permission for autopsy and transfer of the body to the mortuary. 

Clinical cytology

Sputum, urine, pleural fluid, ascitic fluid, fine needle aspirations, CSF(for tumour cytology). See test directory for further test information. If cytology is required from material from another origin it is advisable to discuss the case beforehand with the Cytology Laboratory to ensure optimal collection of the specimen. Any cytology specimens collected outside of routine laboratory hours should be refrigerated until they can be delivered to the laboratory during its normal operating hours and must be received within 48 hours of collection.


Fine needle aspiration cytology

There is a consultant led FNA service located within the laboratory at WRH. Ward visits for the purpose of FNA can also be arranged.

Andrology Service (Fertility and post vasectomy semen analysis)

Worcestershire Acute Hospitals NHS Trust no longer accept samples for this service. All documents pertaining to the new service provider can be be downloaded using the following links:

BWH Pathway for Semen Analysis and Post Vasectomy Referrals

BWH Semen Analysis Referral Form

BWH Post Vasectomy Referral Form

Semen Analysis Patient Information Leaflet

Post Vasectomy Patient Information Leaflet


Frozen Sections Requests

These must always be arranged in advance with the WRH laboratory to ensure that staff and equipment are available. Frozen section specimens should NOT be placed in formalin but transported to the laboratory as soon as possible in a sealed and appropriately sized sterile container.

Biopsies for Immunofluorescence

Containers with the transport medium are available from the WRH laboratory.
Please place the specimen into special transport medium for immunofluorescence studies and send directly to the WRH laboratory.

Renal Biopsy

Tumour samples are processed in the lab. Electron microscopy biopsies are referred by the clinician to the Cellular Pathology Department at the University of Birmingham Medical School (0121 414 4001). Advice and instructions for taking, preservation and transport of the biopsy may be obtained from the medical school.

Early pregnancy loss

Products of conception – any tissue which may contain foetal parts, including ectopic pregnancies. The specimen and request form must be accompanied by a completed ‘Consent for Pathological Examination and Disposal of Tissue following early Pregnancy Loss’ form. Specimens received without a correctly completed consent form will not be examined.The link below will allow you to download a copy of the required consent form.

Products of Conception Consent Form.

To ensure adequate fixation, the specimen bag must be opened before immersion in formalin.

Placenta

Worcestershire Royal Hospital - The department does not offer a diagnostic service for placental tissue. These specialist investigations are undertaken at the Pathology Department, Birmingham Women’s Hospital. The requesting clinician is responsible for ensuring that arrangements are made to transport the specimen.

Alexandra Hospital - If the baby has died, the placenta goes with it to the Mortuary and accompanies it to Birmingham Women’s Hospital if a post mortem is requested. With live births, if histology is required on the placenta, it is sent to the WRH laboratory as per any other surgical specimen.

Fetuses

Worcestershire Royal Hospital - The department does not offer an autopsy service for fetuses, or a diagnostic service for fetal tissue. These specialist investigations are undertaken at the Pathology Department, Birmingham Women’s Hospital. The requesting clinician is responsible for ensuring that arrangements are made to transport the specimen. The Bereavement Office arranges transport for the fetus to BWH via the Mortuary at WRH using a contracted Funeral Directors.  It is expected that the Clinician has completed all the necessary paperwork and made arrangements at BWH for the autopsy.

Alexandra Hospital - The Mortuary will arrange transport of a fetus but expect the Clinician to complete all the necessary paperwork and make arrangements with Birmingham Women’s Hospital for the autopsy.  All requests for post mortem require both:- 

  • A Birmingham Women’s Hospital Consent Form for Fetal and Perinatal Autopsies. 

  • A request for Pathological Examination of the Fetus/Neonate (form 2).

 

The above should both be sent to the Mortuary.

The WRH laboratory will investigate products of conception if an histology request form and consent form has been completed appropriately. 

Cytogenetics

For information about the requirements for genetic testing (type of specimen, etc) please contact the Regional Genetics Laboratory Service tel:  0121 627 2710. This laboratory acts ONLY as a postal service for specimens.

Specimens should be sent without delay to the Histopathology laboratory with a Cytogenetics Request Form (DO NOT USE A GENERAL PATHOLOGY REQUEST FORM). These are obtainable from either the Regional Genetics Laboratory, Outpatients, Ward 14, SCBU or the Delivery Suite.

The form should be completed with all relevant medical history and clearly state where the specimen originated (e.g. Ward 14, Alexandra Hospital, Redditch – Ward 14, Alexandra Hospital alone is obviously not sufficient).  Also state to whom the report should be sent.

Weekends/Out of Hours - requesting Clinicians must arrange for transport (by taxi) of specimens to the Regional Genetics Laboratory at the Birmingham Women’s Hospital. Please contact their on-call technician before sending the specimen (DL 0121 627 2710 or #6 104).

REPORTS ARE ONLY AVAILABLE FROM THE REGIONAL GENETICS LABORATORY.


Specimen Transport

All specimens must be packaged in a sealed bag together with the appropriate request card or ICE order form. If specimens are sent from outside the trust they must be packaged in a sealed bag and then transported in a sealed box conforming to UN3373.

There must be no interference with the specimen from source to the laboratory. 


Request forms

All cellular pathology requests can now be made on ICE.

Clinicians should ensure that the appropriate request card and specimen container are available before undertaking
any biopsy procedures.

Worcestershire Royal Hospital request cards - White A5 card, entitled Histopathology Worcestershire Royal Hospital (Code R573, obtained from Service Point, River Level, WRH)

Alexandra Hospital request cards - Pink A5 histology request form (Code AW547), obtained via a printed stationary stock requisition.

Request forms for Cytology

Worcester – Yellow A5 card, entitled CYTOLOGY (other than gynaecological) Worcestershire Royal Hospital. (Code WR1139, obtained from Service Point, River Level, WRH).  Pink card for private patients.

Alexandra Hospital – Green A5 Non-Gynaecological Request form (Code AW541), obtained via printed stationary stock requisition.

Urgent Requests – If this is required the requesting doctor should discuss with a Consultant Pathologist beforehand.
All specimens should be clearly marked Urgent for the laboratory to fast track.

Urgent Reports - WRH - If results are required urgently, the Consultant Pathologist should be contacted BEFORE the specimen is sent to the laboratory. Urgent results may be obtained by telephone from the Consultant Pathologist.

ALX forms – Tick the urgent box and provide the date/time by which the report is required.  However, if a telephoned report is required, then the name of the Clinician and his/her bleep number must be included; there is a box on the form for this.


Private Patient Request Cards

WRH - request forms for private patients are available from the laboratory (these are pink A5 forms).
ALEX - use the normal histology form with a tick in the box to indicate pp.


Completion of Request Forms

All requests can now be made on ICE using the cellular pathology page or by using the options that have been added to your speciality page. Please ensure all essential fields are filled out correctly.

Request forms should bear the following minimum essential information:

  • Patient’s full name or unique coded identifier
    This information is normally provided for in-patients by the larger printed sticky labels generated by PAS. If these are not available, then all the data fields shown should be completed.

  • Address and postcode; POST CODES are now essential so that cross-boundary flow can be identified. Care is needed to ensure that obsolete labels are not used.

  • Date of birth

  • Sex

  • NHS number (preferable) and/or hospital number

  • Patient’s location or destination for report i.e. Ward/Dept.

  • Patient’s Consultant, GP or name of requesting Practitioner
    It is not acceptable to put the name of the requester if they are not a Consultant, as the laboratory computer system will not recognise the information and the report may not reach its intended recipient.

  • Specimen type
    This should be an adequate concise description of what the specimen represents. If multiple specimens obtained from different sites are collected at the same procedure then the origin of each should be indicated on the request card and specimen container.

  • Relevant clinical details
    It is essential that each specimen be accompanied by an appropriate clinical history. More detailed information may be required for specific specimen types and some of the more common are outlined below. Complex cases often benefit from discussion and the Pathologists are always happy to be consulted in advance.

  • Previous operations and biopsies
    All previous requests for Histopathology should be listed even when their relevance to the current investigation is unclear. Such previous investigations are often crucial and are easily overlooked. The dates of these investigations should be given accurately together with the Laboratory number whenever possible.

  • Extra Copy to - The Laboratory will provide extra copies of reports to any destination indicated here where these are necessary due to shared care by Consultants. The Laboratory will not be responsible for communication with GPs regarding the results of Hospital Investigations, this remains the duty of the Clinician.

 

The specimen must be clearly identified, in line with above criteria. Where a multi-part specimen (for example, endoscopic biopsies) are received with a single request card, individual specimens must be clearly labelled, to indicate the site from which each biopsy was taken.

Criteria for non-compliant specimens are as follows:

  • Request card and specimen container details do not correlate

  • Patients name on request form does not correspond with name on specimen container

  • The specimens received do not correspond to those stated on the request card

  • Insufficient clinical/specimen information on request form / specimen container

  • Specimen container leaking

  • Specimen received without a request card

  • Request card received without a specimen

  • Specimen container empty

 

If the information on the request form and/or specimen is inconsistent or incomplete, the specimen WILL NOT BE examined and the sender advised.


Turn Around Time

The aim of the department is to report diagnostic biopsies within 5 days of receipt but major resections, complex cases and specimens requiring special techniques will take longer. Some cases require external referral to specialist centres which necessarily increases turnaround time; the department will endeavour to issue a provisional report in these circumstances as soon as possible.

If delays are anticipated, an interim/provisional report will be issued or the lead clinician contacted by telephone.

It is the departments aim to report at least 80% of all cases within 10 working days.

High risk cases may take longer due to a delay in processing as they are left to fix for a further 24 hours upon receipt.

 

Protection of Personal Information

Worcestershire Acute Hospitals NHS Trust takes the security of personal information very seriously. Everyone working for the NHS has a legal duty to keep information about patients confidential.

Patients’ health information is protected through a number of measures; all Trust staff are required to:

a. Record patient information accurately and consistently

b. Keep patient information private

c. Keep patient information physically secure

d. Disclose and use information with appropriate care

Any breaches of security or incidents relating to Information Governance are investigated, actioned and reported via the Trust’s Governance Structure.

In order to support our staff in ensuring personal information is kept securely the Trust have a number of policies which set out the requirements staff must fulfil when accessing or sharing personal information. Furthermore, all staff receive Information Governance Training which includes topics such as information security, confidentiality and data protection.

Page last updated: 26 September 2018