The Biochemistry Department is split into several sections, as detailed below:
The majority of samples entering the department pass through Specimen Reception. Samples are received in person (porters or ward staff), via the pneumatic pod system, or transported from GP surgeries by couriers. Once in the department, MLAs unpack individual samples, check that the patient details are correct and the correct samples have been received, and enter the requests onto the IT system. A unique barcode sticker is attached to both sample and request – these are permanently linked, allowing us to track samples throughout the laboratory. Once samples are ‘booked in’, they are loaded onto the analysers, and begin processing.
Specimen reception has a dedicated Urgent Desk for samples from the Emergency Department, etc. and any samples that are brought in person as urgent. These samples are processed as a priority. Please do not mark samples as urgent unless they are required for the immediate clinical management of the patient. Otherwise, analysis of genuinely urgent samples may be delayed.
The Help Desk is also located in Specimen Reception. Staff members are able to assist with general enquiries, provide results to GP surgeries and clinicians, and are responsible for telephoning abnormal results throughout the day, as directed by the Duty Biochemist.
Most routine tests are performed by automated chemistry analysers, which in this laboratory are supplied by Siemens. The Department has a track-based system. Each sample is loaded onto a conveyer belt, and travels around the laboratory. The unique barcode is read at regular intervals, and the sample is transported to the most appropriate analyser for analysis. For routine analysis, this means that results can be generated without the need for human intervention, vastly increasing the speed and capacity of analysis. Once analysis is complete, samples are automatically stored in a refrigerated storage module for at least 48 hours.
The automated chemistry section is staffed by Biomedical Scientists who are responsible for ensuring that the equipment is working correctly, performing calibration and quality control measures throughout the day, and checking that the results generated are technically correct.
The automated chemistry section operates 24 hours a day, with core hours of 9 am – 8 pm. Outside these hours, the section operates with reduced staff numbers, and vital maintenance is performed. Urgent test requests are processed as usual, but routine requests may take longer.
Routine tests include:
- Electrolytes
- Renal function tests
- Liver function tests
- Cardiac markers
- Bone profile
- Haematinics
- Glucose
- Hormone profiles
Manual Chemistry
The Manual Chemistry section is responsible for performing tests which require a significant component of manual work. These tests require significant staff time and expertise to perform, thus turnaround times are greater than for routine analysis. Examples include:
The Manual Chemistry Section is also responsible for dispatching referred work to external laboratories for analysis.
Specialist chemistry tests require significant staff expertise to perform tests and interpret results.
The department has a tandem mass spectrometer (Waters), which is configured to perform analysis of:
- Tacrolimus/cyclosporin (Tuesday and Friday)
- Urine metanephrines (Wednesday)
These analyses are performed in batches, with a turnaround time of approximately 2 weeks. Samples require a great deal of preparation before analysis, thus it is not possible to perform ‘urgent’ analysis of any of these tests. Furthermore, the volume of test requests for certain analytes means that a backlog is often present.
The Department performs protein electrophoresis and immunofixation of blood and urine samples for diagnosis and monitoring of patients with myeloma. These are complex analyses, which require a great deal of experience to interpret; and may require further testing. As a result, turnaround time of at least 2 weeks is expected.
The Molecular Diagnostics section is based at the Clinical Biochemistry Department and currently provides genetic testing for:
- thrombophilia risk factors (Factor V Leiden and prothrombin c.20210G>A variants)
- alpha-1-antitrypsin deficiency (Z and S mutations)
- genetic haemochromatosis (C282Y and H63D variants)
- HLA-B27
- cytochrome P450 CYP2D6*4 genotype
Please see individual test request pages for details.
A range of other genetic analyses are available from other laboratories. Contact the laboratory before sending sample(s). For specialist molecular tests, please use the dedicated molecular genetics request form and ensure that all fields have been completed, clearly indicating that the patient has given consent for the testing to be carried out. It should also be noted that invoices for such specialised tests will be forwarded to the requestor.