About EPA Immunology

The Clinical Immunology Department at the Norfolk and Norwich University Hospital is part of Eastern Pathology Alliance (EPA), a network also involving the James Paget University Hospital, Gorleston and the Queen Elizabeth Hospital, King’s Lynn. These pages cover Clinical Immunology services at NNUH.

In order to maintain high standards of analysis this Department participates in national external quality assessment schemes (EQA) including General Autoimmune, Specialist Proteins and Allergy, and maintains its own internal system of quality control checks (IQC), routine validation and daily calibrations on all assays where appropriate. Full details of EQA scheme participation are available on request.

The Immunology Department at NNUH is accredited by the United Kingdom Accreditation Service (UKAS) to ISO 15189:2012. The defined schedule of tests for which the laboratory is accredited can be found by clicking on the following link for schedule no.21365

These pages contain information about how users can access our services, who to contact for advice, which tests we perform, sample requirements, normal ranges and turnaround times. The information provided is accurate at time of issue and is reviewed and updated regularly.

For patients using this website, please note that any information provided should not be used for self-diagnosis and should you have any concerns about your health please consult your GP.

If you find any errors within this information or would like to make any comments and/or suggestions for improvement, please contact Diane Murley, EPA Quality Manager on 01603 286900 or email [email protected]

Test Samples

General Sample Guidelines can be downloaded here.

Sample Acceptance/Rejection Criteria can be downloaded here

A guide to changing internet explorer margins for all ICE forms can be found here

Patient consent:

• NOTE – All procedures 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 himself or herself at a 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.

This consent includes notification to third parties where required by law for example under
the Health Protection (Notification) Regulations 2010: we are required to notify any infection
of public health significance to local public health department as mandated by the regulation.
Please ensure your patient is aware of this before submission of samples for testing.

Packaging and Transport of Samples

Samples are a potential source of infection and should be treated accordingly. Please fill all sample bottles with the correct volume of blood to ensure correct anticoagulation, and all containers must be securely closed. Leaking samples with gross contamination of contents and containers are discarded. Pocket bags are available for sample transport. Samples should be placed in the appropriate container, which must be securely fastened. This must be placed in a clear plastic bag and sealed. Samples accompanied by forms without specimen bags must be put into marsupial bags with the request form being placed in the side pouch.

Refer to local Trust policies.

Contact details for the Infection Protection and Control Nurses:

Mon-Fri 09:00 – 17:00
Tel 01603 289847 (Ext: 5847)

Email: IP&[email protected]

Out of hours: First contact the relevant site practitioner. 

Add on Tests

There are occasions when extra tests are required to be added to existing samples for patient management. Follow this link to view information about add-on tests

Add-on investigations from within the Trust

NOTE – Only Add-On requests from the following locations will be accepted, unless the sample cannot be repeated:

Emergency Medicine A&E, AMUL/M, EAUS
Critical Care
NICU
CCC

• The clinician must phone into the laboratory if add-on investigation(s) required.
• Only those on the agreed list are added on. If other investigations are required they will have to be discussed with the Haematology Consultant who is contactable via switchboard.
• If Add-On test is accepted then transfer information relating to patient and sample to Add-on Request Slip and send to the laboratory.
• If samples are insufficient or inappropriate it is the responsibility of the laboratory to inform the requesting clinician of the problem.

Outside normal laboratory hours the following procedure will be followed:

• The BMS will take the telephone call from the requesting clinician and use the add-on sheet available.
• While requester is on the phone the following message will be read out to the requesting clinician:

“If we can find the sample it will be processed but this may take a while. Also if you are intending to take another sample at any time in the near future this may be the quicker route.”

• If there is any doubt regarding the request the BMS may refer the call to either the on-call Consultant or the Duty Manager, whichever is felt more appropriate.
• Sample is then assayed as appropriate.
• If insufficient or inappropriate sample then it is the responsibility of the relevant section to inform requesting clinician of problem.

Procedure for requesting add-on investigation(s) from outside the Trust

• The clinician must phone into the laboratory if add-on investigation(s) required.
• Only those on the agreed list are added on. If other investigations are required they will have to be discussed with the Haematology Consultant who is contactable via switchboard.
• While requester is on the phone the following message will be read out to the requesting clinician:

“If we can find the sample it will be processed but this may take a while. Also if you are intending to take another sample at any time in the near future this may be the quicker route.”

• If insufficient or inappropriate sample then it is the responsibility of the relevant section to inform requesting clinician of problem.

Referred Tests

Some specialised or low volume assays are referred to external laboratories for analysis; these may take up to 4 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 Individual Head of Section or from the Quality Manager if required.

Results

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 01603 286929/286932 (Ext 2929/2932).

Critical test results will be telephoned in line to 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 criteria for telephoning results click here

Due to IG compliance requirements, results cannot be communicated directly to patients. 

Guidance

For Key factors known to affect test performance and result interpretation click here