The Transfusion Laboratory at the Norfolk and Norwich University Hospital provides blood components for transfusion at the Norfolk and Norwich University Hospital, Cromer Hospital, Priscilla Bacon Lodge, Norfolk Community Health and Care Trust (NCHC), Spire Norwich, Bowthorpe Kidney service and Health Care at Home.
They are also responsible for the supply of routine and prophylactic Anti-D, Prothrombin Complex Concentrate (Beriplex) and clotting factors.
The Transfusion Laboratory at the James Paget Hospital provides blood components for transfusion at the James Paget Hospital and Beccles Community Hospital.
They are also responsible for the supply of routine and prophylactic Anti-D, Prothrombin Complex Concentrate (Beriplex) and clotting factors.
The Transfusion Laboratory at the Queen Elizabeth Hospital provides blood components for transfusion at the Queen Elizabeth Hospital and North Cambridgeshire Hospital in Wisbech.
They are also responsible for the supply of routine and prophylactic Anti-D.
The Blood Transfusion Departments at NNUH, QEH and JPUH are accredited by the United Kingdom Accreditation Service (UKAS) to ISO 15189:2012. The defined schedule of tests for which the laboratories are accredited can be found by clicking on the links below.
20492 (NNUH)
21363 (JPUH)
20494 (QEH)
Please note that the EPA transfusion services at NNUH, JPUH and QEH are currently in the process of completing a planned refresh of their equipment and a review of the related test methods. As a result, all tests performed by the transfusion departments on these sites, with the exception of the Kleihauer test, have been temporarily removed from their scope of UKAS accreditation until the new equipment and tests can be assessed by UKAS.
For a list of abbreviations please click here
Samples
One 6 mL pink top EDTA sample is usually acceptable for the majority of transfusion testing. On occasions the laboratory may ask for additional samples.
Refer to local Trust policies.
If you suspect a transfusion reaction, stop the infusion and assess the patient. Call a Dr to see the patient, who can take advice from the clinical haematology team.
Each hospital will have their own Trust policies to follow, which are available on the staff intranet. You must inform the laboratory on the relevant site of the suspected transfusion reaction.
NNUH – Trust Guideline for the Management of Reactions to Blood and Blood Products (Trust docs ID 1281).
JPUH – Supplement 5: Transfusion Reactions/Complications: SUPP5/TWD/JJ0106/02
QEH – Trust Transfusion procedures and Managing reactions – B04.5 Procedure for managing and reporting adverse events in transfusion.
Massive blood loss is defined as ≥40% loss of total blood volume, blood loss of 4000mls within a 24hr period, blood loss of 2000mls in a 3hr period, or blood loss at a rate of >150mls/min. In recent years a more practical approach is that patients suspected of bleeding (especially if it is internal) will demonstrate a pulse of >110 bpm and a systolic blood pressure of < 90 mmHg.
NNUH – The NNUH uses the treatment algorithm developed by the East of England Trauma Network and agreed by the East of England Transfusion Committee.
To activate the protocol, phone the transfusion lab on ext. 2905/2906 and state “I want to trigger the massive blood loss protocol”. Patient details are required; if the patient is unknown (out of hospital) then a generic trauma name must be provided.
All subsequent communications between the clinical area and the laboratory staff should be started with “This call relates to the massive blood loss protocol”. A specific member of the clinical team should be nominated to co-ordinate communication with the transfusion laboratory.
Full details can be found in the Guideline for the Management of: Massive Blood Loss in Adults (MBL) (Trust Docs ID: 1175) and Massive blood loss in children (Document ID 9960 and Flow chart ID 10828)
JPUH – The JPUH uses the treatment algorithm developed by the East of England Trauma Network and agreed by the East of England Transfusion Committee.
Full details can be found in the Transfusion Policy Supplement 6: Major Haemorrhage: SUPP6/POL/TWD/JJ1220/02.1
You will need to call the laboratory on ext 2443 or 2050 and inform them you wish to Activate the Massive Blood Loss Protocol (if out of hours, a bleep is carried by the laboratory haematologist)
QEH – The QEH uses the treatment algorithm developed by the East of England Trauma Network and agreed by the East of England Transfusion Committee.
Massive Blood Loss Flow Chart on The Trust Transfusion policy – B07.2 Massive Blood loss and B10.5 MBL in children protocol EoE RTC
To activate the protocol, the transfusion laboratory must be contacted on ext 2330 or 3782 ask Transfusion to ‘’Initiate Massive Blood Loss Protocol’’
The transfusion laboratories use the reference services of the NHS Blood and Transplant (NHSBT). The EPA laboratories hold the specialist request forms for these investigations, and some require haematology consultant advice before referring.
Referral laboratory sample requirements are varied and stated on the reverse of the NHSBT request forms, please check before bleeding the patient.
Red Cell Immunohaematology (RCI): for blood grouping and antibody investigations that cannot be resolved in the laboratory.
Histocompatibilty and Immunogenetics (H&I): for investigations of platelet refractoriness, Transfusion Related Acute Lung Injury (TRALI), Neonatal Auto Immune Thrombocytopenia (NAIT).
International Blood Group Reference Laboratory (IBGRL): samples for cell free fetal DNA (cffDNA) to guide antenatal anti D prophylaxis.
Authorised results are available on the ICE system, which is updated regularly throughout the day.
Results of urgent requests, if ICE access or electronic delivery is not available, and unexpected results, which may aid immediate patient management, will be telephoned.
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.
Clinicians
Clinicians may contact the duty consultant covering blood transfusion for clinical advice at any time via switchboard.
Details of national guidelines and local polices for blood transfusion can be found in Trust Docs via ‘The Beat’
The laboratory can also contact staff at NHSBT for advice, if required
Patients
Patients already under the care of the NNUH Haematology Team should contact their consultant for any advice regarding their transfusion care. For other patients or members of the public, please contact the clinician involved with your care or your GP for any clinical queries related to blood transfusion. If required, your clinician will liaise with any relevant transfusion specialists.
Please note laboratory staff are not authorised to give results or provide advice to patients.
Each Trust has a Hospital Transfusion Committee (HTC), which is a multi-disciplinary team which meets 4 times a year and is made up of a variety of specialities with an interest in transfusion. The HTC is Chaired by a senior consultant from the group who is not a haematology consultant.
The Hospital Transfusion Team (HTT) meets more frequently and is comprised of representatives from the Medical staff, BMS staff and the Transfusion Practitioner team. The HTT is a subcommittee of the HTC and issues can be feedback to the full committee when required.
All 3 laboratories participate in the external quality assurance scheme run by UK NEQAS (National External Quality Assurance Scheme).
All 3 laboratories are UKAS accredited to ISO 15189 standards.
All 3 laboratories comply with the Blood Safety and Quality Regulations 2005/50, under the guidance of the Medicines and Healthcare products Regulatory Agency (MHRA). As part of the MHRA compliance all laboratory incidents, errors and near misses are reported via the Serious Adverse Blood Reportable Events (SABRE) website.
All 3 laboratories report to the UK’s independent, professionally-led haemovigilance scheme SHOT (Serious Hazards Of Transfusion)
EPA Network Blood Transfusion Manager: Eleanor Byworth
NNUH – Tracey McConnell or Sandra Ellis 01603 286906
JPUH – Marie Smith 01493 452102
QEH – Sandra Faloye 01553 613782
JPUH
The Transfusion laboratory is available 24 hours a day
For Urgent samples the laboratory can be contacted internally on 2443. Outside hours contact the Haematology BMS via the Switchboard.
The laboratory can be found at the rear of the building on the ground floor sign posted ‘Pathology – Blood Tests’
NNUH
The Transfusion laboratory is available 24 hours a day and can be contacted on Ext 2905/2906.
The laboratory can be found in East Block Level 1 at the rear of the building on the ground floor sign posted ‘Pathology – Blood Tests’
QEH
The Transfusion Laboratory is open 24 hours a day.
For Urgent samples the laboratory can be contacted internally on 3782. Outside hours contact Haematology by bleep 2475.
The laboratory can be found at the rear of the building on the ground floor, in area 4, the green section sign posted “Pathology & Blood Tests”. Urgent samples should be handed to a member of laboratory staff after contacting them by telephone. It is a locked department and so can only be contacted in this way.
EWT-D-001 Last updated 05/04/2024 (6)