NOTE: All procedures and investigations carried out on a patient need the informed consent of the patient.

For most routine laboratory procedures, consent can be inferred when the patient presents themselves at a phlebotomy clinic, laboratory, or other suitable area, within a primary or secondary care setting, with a request form and willingly submits to the usual collecting procedure.

The laboratory infers informed consent has been obtained when samples are received. It is the responsibility of the clinician requesting the test to ensure that informed consent has been obtained.

For guidance on blood sample centrifugation and storage prior to transport to specimen reception at the Norfolk and Norwich University Hospital, click here.

Samples are a potential source of infection and should be treated accordingly. Samples must be placed into the appropriate container and be securely fastened; leaking samples with gross contamination of contents and containers are discarded. Samples should be placed into a marsupial bag (a clear, re-sealable plastic bag with a pocket), and be accompanied by a request form placed in the side pouch. 

The transport of samples from GP surgeries or other primary care locations is carried out by the Logistics Service staff who will collect all samples from dedicated collection points.

Samples from within the hospital can be transported to Pathology either by the Pneumatic Tube System (PTS), if suitable, or by a porter. For urgent samples ward staff are required to arrange delivery to the laboratory. Samples must first be placed in the plastic sample bags together with the completed request form.

The safe transport of specimens to the laboratory is the responsibility of the requesting doctor or carrier. Laboratory responsibility for the sample begins when it has arrived at the laboratory. 

The Pneumatic Tube System is for the transport of Blood Sciences specimens to the laboratories only.

• All items MUST be sent in the carriers provided.
• Samples MUST NOT be placed directly into the carriers.
• ALL Pathology samples MUST be placed in specimen bags and the lids of all items with the potential to leak (fluids etc.) tightly secured BEFORE placing them in the carriers.
• Do not cram samples/items into the carrier as this may lead to breakage/leakage and system failure.
• Only one carrier at a time should be placed in a delivery station.
• Ensure that carriers are closed securely at both ends to avoid them jamming in the tube network.
• If any defect is noticed with the operation of the air-tube systems, please notify the laboratory at the earliest opportunity.
• The system must not be used for sending consumables and other “forbidden items” around the hospital.

The air-tube system should NOT be used for:

• Danger of Infection samples
• Blood gases
• Blood cultures
• Unrepeatable samples
• CSFs (for culture, protein, glucose, xanthochromia, etc.)

SEE INDIVIDUAL TRUST POLICIES

Forms can now be requested on Web ICE

• ICE forms must be requested on Web ICE by 06:00 for that day’s phlebotomy round.
• Extra forms will not be accepted by the phlebotomists during the ward round.
• Requests marked ‘URGENT’ WILL NOT be taken by the Phlebotomist – these must be taken by the requesting clinician.
• Request forms which have the incorrect location on the request form will be sent to the correct location (if identified) via the pneumatic air tube system. If the phlebotomist on the correct location has already completed their ward round, the request form will become the responsibility of the ward staff to obtain blood sample collection for their patient.
• If the phlebotomist is unable to obtain blood sample collection the request form will be returned to the clinician.

Forms can now be requested on Web ICE 

Medical officers responsible for the care of patients have a duty of care towards other members of staff – therefore all samples from patients who are known to have, or strongly suspected of having the conditions noted below must be identified. 

• Creutzfeldt-Jakob disease (CJD).
• Viral haemorrhagic fever (VHF) of any type.
• Microorganisms, (biological agents) in Hazard Group 3 or 4.
• Pyrexia of unknown origin (PUO) recently returned from Africa.

Medical staff should ensure that appropriate information, including relevant travel history, is provided in order to alert laboratory staff of potential dangers. Clinical details supplied on sample request forms must contain clear information regarding the nature of the test being requested and sufficient detail to inform laboratory staff upon the safety precautions they need to take in order to process the sample without risk of infection.

If, during patient intervention, further information becomes available that has implications for the safety of laboratory staff this must be communicated immediately to the laboratory so that appropriate steps regarding containment can be taken.

Contact details for the Infection Protection and Control Nurses:

James Paget University Hospital

Mon–Fri 08:00–18:00

Tel 01493 452612

Email: [email protected]

Norfolk and Norwich University Hospital

Mon–Fri 09:00–17:00

Tel 01603 289847 (Ext: 5847)

Email: [email protected]

Queen Elizabeth Hospital

Mon–Fri 08:00–17:00

Tel (via switchboard 01553 613613) Ext: 2596

Email: [email protected]

Some specialised or low volume assays are referred to external laboratories for analysis; these may take weeks for a result to become available. Please contact the laboratory if there is any urgency for these investigations. Information regarding specimen type for referred tests can be obtained by contacting the laboratory.

In line with accreditation requirements, we endeavour to use accredited laboratories whenever possible. Further information on the reference laboratories we use can be obtained from the Quality Manager if required.

Only those tests in the agreed list are authorised for add-ons. Additionally, only add-on requests from certain locations will be accepted (see information for individual hospitals below).

 View Full list of agreed Add on Tests (PDF)

If other investigations are required, or for locations outside of those listed below, they will have to be discussed with the Duty Biochemist who is contactable via NNUH switchboard. 

An ‘Additional Test Request Form’ must be filled and sent to the laboratory. You can also contact the lab on 01493 452846 (or internal ext. 2846).

Download Additional Test Request Form (PDF) (for use at JPUH & QEH only)

Only add-on requests from the following locations will be accepted, unless the sample cannot be repeated:

• Accident and Emergency
• Emergency Assessment and Discharge Unit (EADU)
• Ambulatory
• Intensive Treatment Unit
• Paediatrics Ward 10
• Special Care Baby Unit

Telephone the laboratory on 01603 286929 (or internal ext. 2929) to request an add-on. Only add-on requests from the following locations will be accepted, unless the sample cannot be repeated:

• Emergency Medicine – Emergency Department (ED) Admissions Units Medical and Surgical (AMUL/M, EAUS)  Aylsham suite
• Critical Care
• All Paediatric Locations including Buxton, Children’s Assessment Unit (CAU), Children’s Day Ward (CDW)
• Urgent Care Centre
• Delivery Suite

An ‘Additional Test Request Form’ must be filled and sent to the laboratory. You can also contact the lab on 01553 613490 (or internal ext. 3490).

Download Additional Test Request Form (PDF) (for use at JPUH & QEH only)

Only add-on requests from the following locations will be accepted, unless the sample cannot be repeated:

• Accident and Emergency (AE)
• Medical Assessment Unit (MAU)
• Ambulatory Emergency Care (AEC)
• Surgical Assessment Unit (SAU)
• Central Delivery Suite (CDS)
• The Appleton Unit
• Intensive Treatment Unit (ITU)
• Critical Care Unit (CCU)
• Neonatal Intensive Care Unit (NICU)

Only those tests in the agreed list are authorised for add-ons. If other investigations are required, they will have to be discussed with the Duty Biochemist who is contactable via NNUH switchboard. 

View Full list of agreed Add on Tests (PDF)

Telephone the laboratory on 01603 286929 (or internal ext. 2929) to request an add-on, or NNUH switchboard on 01603 286286 to speak to the Duty Biochemist.

Authorised results are available on the ICE system, which is updated in real time throughout the day. If a result is needed urgently and/or cannot be found via the ICE system, the laboratory may be contacted on the phone numbers below. Note: Primary Care users should contact the NNUH laboratory.

James Paget University Hospital:              01493 452846 (or internal ext. 2846)

Norfolk and Norwich University Hospital: 01603 286929 (or internal ext. 2929)

Queen Elizabeth Hospital:                          01553 613490 (or internal ext. 3490)

Critical test results will be telephoned or sent via Alertive (NNUH secondary care only) in line with the Critical and Escalation Protocols for Telephoning Critical Results in Clinical Biochemistry and Immunology.

In the event that the laboratory is unable to deliver the required service due to equipment failure we will endeavour to contact all relevant users.

For Clinical Biochemistry telephone limits please click here

For Acute Kidney Injury algorithm click here

For guidance on the reporting of estimated GFR (eGFR) click here

For guidance for the interpretation of elevated serum potassium in primary care click here

For information about key factors that are known to affect test performance and result interpretation click here