Pathology

Welcome to the Barts Health pathology service. Pathology is the branch of medicine concerned with the cause of disease and the study of disease processes. It is an integral part of clinical practice and essential for the diagnosis, management and treatment of disease.

We are one of the largest pathology departments in the UK, with over 600 pathology staff. The various laboratory sections have been co-located since 2006 in the custom-designed, state of the art Pathology and Pharmacy Building. 

We provide a comprehensive diagnostic service for hospitals within the Barts Health including The Royal London, St Bartholomew’s, Whipps Cross, Newham and Mile End as well as GPs and referrals from within the London region and wider regions.

Our service maintains strong links with the Medical School at Queen Mary, University of London as well as various universities teaching healthcare scientists. This ensures we are involved in the latest research and development and have a key role in teaching the healthcare staff of the future.

We are patient focused, clinically relevant and cost-effective – with a suitably efficient turnaround to support our high quality clinical services and applied research projects. Our evidence driven service is delivered in accordance with legislation and guidelines set out by appropriate professional governing bodies and associations.

We provide pathology services from:

  • Mile End Hospital
  • Newham University Hospital
  • St Bartholomew’s Hospital
  • The Royal London Hospital
  • Whipps Cross University Hospital

For information about clinical haematology, visit our clinical haematology service page.

For patients

We offer a range of high quality pathology services that have received national recognition.

We are patient focused, clinically relevant and cost-effective – with a suitably efficient turnaround to support our high quality clinical services and applied research projects.

Our evidence driven service is delivered in accordance with legislation and guidelines set out by appropriate professional governing bodies and associations. Our evidence driven service is delivered in accordance with legislation and guidelines set out by appropriate professional governing bodies and associations.

The following services are available at our hospitals:

Cellular pathology

Our cellular pathology department is one of the largest and most versatile departments in the country. We offer a range of specialised histology and cytology reporting including:

  • breast pathology
  • endocrine pathology 
  • genitourinary pathology
  • gynaecological histopathology and cervical cytology
  • head and neck pathology
  • lymphoreticular disease and oncology
  • neuropathology including musculoskeletal diseases
  • oral pathology
  • paediatric pathology
  • renal pathology
  • respiratory and chest pathology
  • skin pathology
  • upper and lower gastrointestinal pathology, with specialists in liver and pancreatic pathology

We have a large and very active paediatric pathology casebook and also provide peri-natal pathology. Our pathologists give comprehensive and sensitive autopsies for many Trusts throughout the country to help parents understand the reasons behind the loss of loved ones.

Skin pathology is covered by several pathologists including our Trust's lead dermatology consultant thus we provide a 'holistic' approach for skin patients. Find out more about our dermatology service.

A referral service is provided for other NHS trusts and pathology providers in many of these areas.

Clinical biochemistry

Our clinical biochemistry department is a joint service unit and academic encompassing many specialties. We provide routine and specialised analytical services. As well as supporting services in the Trust, we also provide specialist services to laboratories across the UK. Our department adds value to the health and wellbeing of patients, through our activities.

We cover clinical biochemistry, endocrinology, paediatric metabolic biochemistry, toxicology, point-of-care testing and clinical trials.

Clinical transplantation 

The clinical transplantation service based at The Royal London provides histocompatibility and immunogenetics (H&I) support to a variety of healthcare providers ranging from specialist transplant units to GPs. The laboratory is a specialist facility serving the City and east London, and surrounding counties.

The provision of high quality H&I services is critical to both solid organ and stem cell transplant programmes. Based in the laboratory, we provide human leukocyte antigen (HLA) typing, co-ordination of donor and recipient matching for kidney and bone marrow transplantation, transplant donor and recipient crossmatching, HLA antibody testing and definition, including a specialist flow cytometry facility. HLA associations such as HLA-B27 and B*5701 are also performed. In addition, the laboratory has developed integral working relationships with the clinicians and nursing staff directing the various transplantation programmes.

Cytogenetics

Our cytogenetics department provides a specialist diagnostic service for patients with haematological malignancies and other cancers. Samples of bone marrow, peripheral blood or other infiltrated tissue are processed and analysed using a range of cytogenetic and molecular cytogenetic tests to screen for acquired chromosomal abnormalities that establish the diagnosis and provide prognostic information. This impacts on patient management and allows treatment responses to be scientifically assessed.

Diagnostic virology

Our diagnostic virology department provides a fully CPA accredited service for the timely diagnosis of viral infections and their clinical management. We are the HPA lead laboratory for London, providing public health testing and services for the capital.

Virology processes approximately 720,000 tests annually and provides extensive diagnostics for the whole of north east London and beyond. We provide a full comprehensive range of diagnostic molecular, detection and serological assays in our state of the art pathology building. Diagnostic results are augmented by clinical advice which is readily accessible both in and out of working hours.

We aim to be responsive to the needs of our users and in partnership with them have recently implemented a programme of development to introduce new methodology and systems. With these, we aim to improve the timely diagnosis of newly emerging and established infectious diseases. This is particularly significant in the areas of molecular diagnostics and automated serology.

The laboratory is approved by the Health Professions Council and the Royal College of Pathologists to conduct staff training in accordance with statutory registration of professional and regulatory bodies.

Haematology and blood transfusion

We are committed to providing a haematology and blood transfusion service of the highest quality taking into consideration the needs and requirements of our users. In addition to providing diagnostics tests and therapeutic blood transfusion within the Trust, we also respond to requests from NHS Tower Hamlets and other users.

We provide:

  • routine haematology diagnosis
  • blood transfusions
  • haemoglobinopathy
  • haemostasis diagnosis
  • point-of-care testing
  • clinical trials

Immunology

Our immunology laboratory provides a full consultant-led service for the diagnosis and monitoring of patients with immunodeficiencies, autoimmune diseases and allergic conditions. Our staff provide a 24 hour consultative service for clinical and laboratory enquiries. If required, patients may be referred where specialised inpatient, outpatient, day-care and home therapy immunology services are available. Find out more about our immunology service.

The department is particularly well-equipped with a flow cytometry suite in order to diagnose and monitor immunodeficiency disorders. The immunology laboratory at The Royal London is also a referral centre for routine and specialist tests including those for systemic lupus erythematosus (SLE) and hereditary angioedema investigations.

Immunophenotyping

Our haematological malignancy diagnostic department provides a range of integrated testing, classifying, diagnosing, reporting and management of haematological malignancies including acute and chronic leukaemias, lymphomas, myeloproliferative disorders and myelodysplasia. We also provide monitoring of minimal residual disease.

Microbiology

Our microbiology department is home to one of the largest laboratories in the UK, processing over 500,000 samples per year and is the Lead Health Protection Agency laboratory for London. We provide comprehensive diagnosis, management and control of microbial disease. Clinical advice and laboratory diagnostic facilities are available 24 hours a day. We give routine and emergency diagnostics to inpatients and outpatients as well as a routine service to GP patients.

Biomedical scientists in our department examine specimens for the presence and effects of bacteria, fungi and parasites, and carry out appropriate antimicrobial sensitivity tests. Blood samples are tested for the presence of antigens and antibodies produced to a wide range of infectious agents, for example, legionella. Our specialist registrars, infection control nurses and consultant microbiologists advise on the therapy of patients with infection.

In collaboration with the infection control team and the national Health Protection Agency, we help in the surveillance, control and prevention of nosocomial infection and cross infection in the hospitals and local community.

Retinoblastoma genetic screening

Our Retinoblastoma Genetic Screening Unit is one of only two genetics centres for retinoblastoma (a rare form of eye cancer) in England and Wales. We provide patients and their relatives with a variety services from molecular genetic tests for predisposition to retinoblastoma. We also work closely with our colleagues at the Barts Health eye centre, which is a designated provider of retinoblastoma care in the south of England. Find out more about our retinoblastoma genetic screening service here.

Stem cell laboratory

The stem cell laboratory at St Bartholomew’s is licensed with the Human Tissue Authority and accredited with the Joint Accreditation Committee-ISCT Europe (JACIE) as a tissue processing and storage facility. Stem cells for therapeutic use are cryopreserved and stored long term at temperatures less than -140C. All processing takes place in Grade B rooms in accordance with Good Manufacturing Practice and in dedicated clean rooms.

Cells are analysed using flow cytometry for CD3 and CD34 using Ischage method.  Preparation of Peripheral Blood Samples for Split Chimerism is carried out using Automacs.

If the use of therapeutic stem cells is recommended as a treatment by your consultant, the procedure will be thoroughly explained to you by clinical staff before commencement. The cells will be treated in accordance with current legislation and guidelines and processed in a state of the art facility. All tissues are kept for long term storage in monitored conditions.

Useful information

If you are having a test done at one of our hospitals and have a preference for male or female staff please telephone us as soon as possible. We will try to accommodate your wishes but can not guarantee that we can. If you wish you may bring a chaperone. 

Patients that require a translator or require patient transport please visit the advice and support section of our website.

For clinicians

For urgent and non-urgent advice, please use the relevant contact details for each service area.

Completion of request forms

In hospital, tests are requested electronically: using CRS. In primary care, T-Quest should be used for electronic requesting if available. Paper request forms may be used where electronic requesting is unavailable. 

Clinical details must be provided on test request forms to allow interpretation of results, the addition of any further tests required and to enable the laboratory to decide on the most appropriate action to be taken with the results. Clinicians making referrals are responsible for providing these details. The person performing the blood test is not made responsible for this.

Sample identification

Three points of identification are required to enable the sample to be processed. The patient’s full name, date of birth and identification number are suitable but please be aware that many of our patients have similar names and if an identification number is not available please give a further identifier such as address. Due to the risks associated with inaccurate identification of a patient’s sample, laboratory staff are instructed not to take responsibility for processing samples that do not have this information and it is likely that the referrer will need to provide a further, appropriately labelled sample.

Specimen transport

All samples must be presented to the person undertaking transport in a safe and suitable manner that complies with necessary regulations. It is the responsibility of the sender that samples are collected and packaged safely.

Results

Electronic access to results is available to most of our regional GP practices and can be arranged if not. If you no longer wish to receive paper reports please contact the relevant service. 

If you would like to set up electronic reporting, or if you are experiencing issues with your electronic reports from Barts Health Pathology, please contact the Pathology IT department onbhnt.pathologyit@nhs.net.

Quality assurance and clinical governance

We aim to give the highest quality of service. Our laboratories participate in appropriate internal quality control and recognised external quality assurance schemes. We are CPA accredited and will seek UKAS accreditation in the next inspection cycle. We investigate any incidents and complaints thoroughly so that relevant actions are taken and our processes are improved.

Our laboratories adheres to Caldicott principles and confirms with the Data Protection Act.

Referring to Pathology

Completion of request forms

In hospital, tests are requested electronically: using CRS. In primary care, T-Quest should be used for electronic requesting if available. Paper request forms may be used where electronic requesting is unavailable.

Clinical details must be provided on test request forms to allow interpretation of results, the addition of any further tests required and to enable the laboratory to decide on the most appropriate action to be taken with the results. Clinicians making referrals are responsible for providing these details. The person performing the blood test is not made responsible for this.

Sample identification

Three points of identification are required to enable the sample to be processed. The patient’s full name, date of birth and identification number are suitable but please be aware that many of our patients have similar names and if an identification number is not available please give a further identifier such as address. Due to the risks associated with inaccurate identification of a patient’s sample, laboratory staff are instructed not to take responsibility for processing samples that do not have this information and it is likely that the referrer will need to provide a further, appropriately labelled sample.

Specimen transport

All samples must be presented to the person undertaking transport in a safe and suitable manner that complies with necessary regulations. It is the responsibility of the sender that samples are collected and packaged safely.

Results

Electronic access to results is available to most of our regional GP practices and can be arranged if not. If you no longer wish to receive paper reports please contact the relevant service.

Results are also available via our secure online results viewer Cyberlab here.

If you have problems obtaining results contact the pathology IT team at BHNT.PathologyIT@nhs.net or call 020 3246 0116.

Quality assurance and clinical governance

We aim to give the highest quality of service. Our laboratories participate in appropriate internal quality control and recognised external quality assurance schemes. We are CPA accredited and will seek UKAS accreditation in the next inspection cycle. We investigate any incidents and complaints thoroughly so that relevant actions are taken and our processes are improved.

Our laboratories adheres to Caldicott principles and confirms with the Data Protection Act.

Retinoblastoma Genetic Screening

We work closely with our colleagues in the retinoblastoma service, which is a designated provider of retinoblastoma care in England and Wales.

This information is for physicians, ophthalmologists and oncologists offering information and guidance about the services of the Retinoblastoma Genetic Screening Unit.

The Unit participates in the external quality assessment scheme organised by the European Molecular Genetics Quality Network (EMQN), is fully accredited by Clinical Pathology Accreditation (UK) Ltd (CPA) and is a diagnostic member of the UK Genetic Testing Network (UKGTN).

Our user manual contains all the information needed for genetic counsellors and physicians to submit specimens to the Unit. Please ensure you have the parent/guardian's consent before making a request.

The disease

Retinoblastoma (OMIM reference number 180200) is a rare form of eye cancer that occurs in children (it makes up 3% of all childhood cancers) that develops in the cells of the retina, the light sensitive lining of the eye. It often occurs before the age of five with an incidence of approximately one in every 20,000 births.

The majority of retinoblastoma patients (85%) have no family history of the disease. In 15% of cases, however, a blood relative has also had retinoblastoma.

In about two thirds of children only one eye is affected (known as unilateral retinoblastoma) while the remainder develop tumours in both eyes (known as bilateral retinoblastoma). When retinoblastoma is passed from parent to child, the disease is often bilateral. The mean age of diagnosis of unilateral retinoblastoma is 28 months while that for bilateral retinoblastoma is eight months. With early detection and modern medical care, the survival rate for children with retinoblastoma is more than 95%. Ongoing research and new treatment developments are saving an increasing number of affected eyes from enucleation (removal), and are maximizing the visual outcome and quality of life for each affected child.

Genetic testing for this disease allows the monitoring of children known to carry a predisposing mutation, so that tumours can be detected and treated promptly. Conversely, it excludes children who are not carriers from frequent examinations. Additionally, the knowledge gained can be used by affected families in family planning, with pre-natal testing of carrier status being made possible. In some cases, preimplantation diagnosis may also be possible. Adults who are aware of being carriers of disease susceptibility should also be vigilant in later life as they are prone to other types of cancer (e.g. lung, skin, breast and bone).

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The genetics

The retinoblastoma susceptibility gene, RB1 (Genbank sequence accession number L11910.1; NCBI RefSeq NM_000321.2), is located on chromosome 13q14 and is a tumour suppressor gene. Mutations in both copies (alleles) of the RB1 gene are necessary for the development of retinoblastoma. 

In about 50% of affected children, both mutations occur in a single retinal cell by chance and cannot be passed to offspring. These children have unilateral (one eye), unifocal (one tumour) disease. In the remaining patients one ‘predisposing’ mutation is present in germ line cells (sperm or ova) and can be transmitted to offspring. This is genetic/hereditary retinoblastoma which generally affects both eyes (bilateral disease) when inherited. Somatic and/or germ line mosaicism, where some but not all cells contain the predisposing mutation, is observed in some founders of new mutation lineages. 

In the sporadic (no family history) unilateral form of retinoblastoma, it is not possible to know without genetic testing whether the disease will be heritable unless the patient has affected offspring. It is estimated that around 15% of such sporadic cases do carry germ line mutations. Early identification of these cases requires genetic testing which is most efficiently done using tumour tissue from an enucleated eye.

The spectrum of predisposing RB1 gene mutations includes large structural changes (about 10-20%) some of which are also detectable by cytogenetic analysis. Other changes include single base substitutions (about 50-60% of mutations) and small insertions/deletions (about 30%). 60-70% of tumours exhibit loss of heterozygosity (loss of one copy/allele) with a mutation in the remaining copy. Finally, hypermethylation at the RB1 gene promoter, which inhibits the levels of retinoblastoma protein made by the cell rather than its function, is observed in around 10% of tumours.

Variable penetrance (the probability that a specific mutation will lead to cancer development) and expressivity (the number of tumours occurring) is a feature of retinoblastoma. Much of this variation is due to the different types of RB1 mutation. Mutations that result in premature termination (truncated protein) are most often associated with almost complete penetrance and bilateral retinoblastoma. However, milder disease with incomplete penetrance and reduced expressivity is usually found in families with missense mutations, some splice site changes, small in-frame deletions and promoter region mutations.

The risk of other members of the family being affected depends upon whether or not the affected child (proband) has a germline RB1 mutation. 

Bilateral retinoblastoma is considered to be hereditary. Whether a sporadic unilateral retinoblastoma is heritable can only be known by identification of both RB1 mutations in the retinoblastoma tumour. A blood sample must then be examined for the same pair of mutations. Finding one of the candidate mutations in blood indicates heritable retinoblastoma. The absence of RB1 mutations in blood suggests non-heritable retinoblastoma, although a small risk of mosaicism remains where the mutation is present in too few blood cells to be reliably detected. 

Once a heritable mutation is identified, molecular testing can determine which members of a family are at risk of developing retinoblastoma. Children who do not carry the family's RB1 mutation are not at increased risk. Children who do carry the mutation can be examined frequently for tumours and treated early if any are detected. The children of germ line mutation carriers have a 50% risk of inheriting the parent’s RB1 mutation (lower if the parent is mosaic) and developing retinoblastoma. However, in certain families with incompletely penetrant RB1 mutations the risk of developing retinoblastoma is lower. 

In cases where a mutation can not be identified, linkage analysis using polymorphic markers within and adjacent to the RB1 gene can be used (exclusion testing) to modify the risk of other family members. 

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Detection of retinoblastoma

Our sensitivity for detection of unknown mutations is shown below, based on over 500 families analysed between April 2005 to March 2013.

In familial/bilateral cases and tumours, our detection rate is >95%.  In unilateral sporadic cases the expected germline mutation figure is 15-20%.  Our unilateral sporadic tumour data shows that one of the tumour mutations is present in the blood of 18% of these patients (24 mutations in 172 unilateral sporadic bloods represents 77% of this expected figure).

Sensitivity for detection
RB sample type Tested Mutation found Sensitivity
Familial and bilateral sporadic blood 165 157 95.2%
Tumour 179 271/281 expected mutations 96.4%
Unilateral sporadic blood 172 24 14%

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Tests

Linkage analysis

Intragenic RB1 and chromosome 13 polymorphisms are investigated for linkage exclusion and loss of heterozygosity (LOH) in the absence of mutation information. 99% of cases are informative for at least one polymorphism.

Exclusion testing using blood DNA

Carried out to exclude siblings of sporadic cases from unnecessary examination under anaesthetic (EUA). 25% can be excluded through linkage analysis.  

Loss of Heterozygosity (LOH)

LOH (when only the initially mutated allele is left in the tumour - occurs in 60-70% of Rb tumours) is useful to exclude siblings or offspring of sporadic cases. Test cases can be excluded when the RB1 allele that is left in the probands tumour is not present in the test case. The overall chance of exclusion is 35% when tumour is available and polymorphisms are informative.

Screening for unknown RB1 gene mutations

Current mutation detection rates in familial cases, sporadic bilateral cases and in fresh tumours of sporadic unilateral cases are around 95%. Expected mutation detection rates in blood samples of unilateral cases are 10-12%.

Testing for known RB1 mutations

Gene carrier testing can be carried out pre- (before birth) or peri-natally (first six weeks of life). Pre-natal and peri-natal testing are available for previously defined cases (mutation known, linkage informative) with prior notice.

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Limitations of tests

The genetic screening provided is based on current knowledge of the RB1 gene, but the techniques used are not 100% sensitive and mutation(s) in any given sample could be missed. Therefore, when full mutation screening is negative, it does not mean that the sample is free of RB1 mutations. Furthermore, identification of a RB1 mutation in an individual does not exclude the remote possibility of the presence of a second unidentified RB1 mutation. It is possible for two relatives to have different RB1 mutations.

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Specimen requirements and turnaround times

The Retinoblastoma Genetic Screening Unit uses a series of different molecular tests to identify RB1 gene mutations. In cases where mutation identification is not possible, indirect testing using linkage analysis is performed.

Select from the list below the table of the different tests available, specimens required and our turnaround times:

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Submitting specimens

Please prepare samples as detailed in the specimen collection instructions (see below) and complete a request form (see below) for each patient. Complete all parts of the form. If sending samples for a family complete one form for each family member and state the relationship to the proband. 

Please note: wrong information on relationship to proband could result in an incorrect diagnosis.

Each sample or group of samples must be accompanied by an appropriately signed consent form. The details of the form must be explained to the patient or parent by a genetic counsellor and/or informed medical personnel. In addition, patients should be informed about the turnaround times of retinoblastoma screening.

All samples should be addressed to:

Retinoblastoma Genetic Screening Unit
Molecular Pathology Suite
3rd Floor, Pathology and Pharmacy Building
Barts Health NHS Trust
80 Newark Street
Whitechapel
London, E1 2ES

Tel: 020 3246 0265

Cost

This is a National Commissioning Group (NCG) funded service for England and Wales. Prices for private testing are available from the Unit.

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Cellular pathology

Our department is made up of

  • histopathology
  • cytopathology
  • mortuary services
  • a Human Tissue Resource Centre (Tissue Bank)

Our cellular pathology laboratories are located on The Royal London Hospital site. Satellite laboratories providing a frozen section services are located at St Bartholomew’s and Whipps Cross.

We have a large workload reporting on over 56,000 histology, 11,000 diagnostic cytology and 84,000 cervical cytology specimens in the last year, we also undertook over 500 autopsies. We are CPA accredited and an approved training centre for histopathologists, biomedical scientists, and allied health professionals.

What is cellular pathology?

Cellular pathology is the study of disease in organs, tissues and cells. Histopathology and cytopathology are key diagnostic tests in the initial detection and diagnosis of cancer and other diseases supported by modern molecular techniques. Consultant histopathologists are able to provide information on prognosis and help to appropriately direct therapies in post diagnostic treatment.

The cervical cytology screening program detects latent disease in well women and plays an important part in cancer prevention.

If you have any questions about the tests we do visit Lab Tests Online-UK, a patient-centred website written by practicing laboratory doctors and scientists to help members of the public understand the many clinical laboratory tests that are used in the diagnosis, monitoring and treatment of disease.

Clinical services provided

The range of specialised histology and cytology reporting we offer includes:

  • Breast pathology
  • Endocrine pathology
  • Genitourinary pathology
  • Gynaecological histopathology and cervical cytology
  • Head and neck pathology
  • Lymphoreticular disease and oncology
  • Neuropathology including musculoskeletal diseases
  • Oral pathology
  • Paediatric pathology
  • Renal pathology
  • Respiratory and chest pathology
  • Skin pathology
  • Upper and lower gastrointestinal pathology, with specialists in liver and pancreatic pathology

We also provide a referral service in many of these specialisms for other NHS trusts and pathology providers.

Paediatric pathology

We have a large and very active paediatric pathology casebook and also provide a peri-natal pathology service. Our peri-natal and paediatric pathologists offer a comprehensive and sensitive autopsy service for trusts across the country to help parents understand the reasons behind the loss of loved ones.

Skin pathology

Several pathologists including the Trust's lead dermatology consultant cover skin pathology enabling us to provide a 'holistic' approach for skin patients.

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Specialist laboratory services

  • Rapid Intra-operative Diagnosis
  • Support for Moh’s micrographic surgery
  • Her-2 testing
  • Fine needle aspirations
  • Liquid based cytology
  • HPV testing
  • Immunocytochemisty
  • Immunofluorescence
  • Fluorescence in-situ hybridisation
  • Muscle enzyme histochemistry
  • Electron Microscopy
  • Tissue bank sourcing a wide range of tissue for research
  • Specialist Integrated Haematological Malignancy Diagnostic Service (SIHMDS)

Any changes made to existing examinations such that results or their interpretation could be significantly different will be explained to users before the changes are implemented.

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Contact us

Contact our services using the key contacts below.

Key contacts
Job title Name Contact details
Lead clinician Deirdre Ryan Tel: 020 3246 0263
Email: deirdre.ryan@bartshealth.nhs.uk
Service manager Steve Jones Tel: 020 3246 0185
Email: steve.jones@bartshealth.nhs.uk
Reception manager Dean McDonald Tel: 020 3246 0168
Email: dean.mcdonald2@bartshealth.nhs.uk
Histology manager Lee Jeffries Tel: 020 3246 0218
Email: lee.jeffries@bartshealth.nhs.uk
Cytology manager Geoffrey Curran Tel: 020 3246 0166
Email: Geoffrey.curran@bartshealth.nhs.uk
Mortuary manager Lynne Pulham Tel: 020 3246 0190
Email: lynne.pulham@bartshealth.nhs.uk

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Location of our laboratories

The Royal London

Floor 2, Pathology and Pharmacy Building
80 Newark Street
London, E1 2ES

Opening hours
Monday to Fridays, 8am - 5.30pm
Saturday and Sundays are closed for the receipt of specimens

St Bartholomew’s

Human Tissue Resource Centre and frozen sections only:
Pathology Laboratory
2nd Floor
North Wing
St Bartholomew’s Hospital
West Smithfield, EC1A 7BE

Whipps Cross

Cellular Pathology Reception
Junction 2 first floor
Whipps Cross University Hospital
Whipps Cross Road
Leytonstone
London, E11 1NR

Tel: 020 3416 5000 option 2, ext 5162

A pre-booked frozen section service is available.
Specimen reception is manned from 9am – 5.30pm

User guide

Download our user guide for details of examinations, second opinions referred to other laboratories and a full list of our key contacts.

Immunology

We provide a consultative service for clinical and laboratory questions. Our department diagnoses and monitors immunodeficiency disorders and provides specialist investigations in this area.

Labratory opening times: 8.30am – 5pm, Monday to Friday. For urgent immunology enquiries outside normal working hours contact the Duty Consultant Immunologist via the main switchboard.

If you have any questions about the tests we do visit Lab Tests Online-UK, a patient-centred website written by practicing laboratory doctors and scientists to help members of the public understand the many clinical laboratory tests that are used in the diagnosis, monitoring and treatment of disease.

If you have any questions about Immunodeficiencies that we help diagnose visit the PID UK website here.

For details of specimen requirements and a full list of the tests we perform download our immunology user guide. We participate in a comprehensive quality assurance programme, monitoring all aspects of the service. All investigations, laboratory and clerical procedures are governed by external quality requirements and in house validated standard operating procedures in addition to periodic laboratory and clinical audit.

Our department is approved by the Health Professions Council as a training department for registered and specialist biomedical scientists.

Standards of testing are maintained by the use of internal quality control and external UK National External Quality Assessment Schemes (UK NEQAS) schemes.

Contact us

GPs that have general enquiries should contact us by using the following details:

Tel: 020 3246 0282
Fax: 020 3246 0283
Email: bhnt.immunology@nhs.net

Key contacts
Name Job title Email Tel
Dr Matthew Buckland Consultant Immunologist matthew.buckland@bartshealth.nhs.uk 020 3246 0264
Dr Sofia Grigoriadou Consultant Immunologist sofia.grigoriadou@bartshealth.nhs.uk 0203 246 0285
Dr Hilary Longhurst Consultant Immunologist hilary.longhurst@bartshealth.nhs.uk 0203 246 0286
Chris Scott Laboratory Manager chris.scott@bartshealth.nhs.uk 0203 246 0287
Diane Macdonald Lead, Autoimmunity diane.macdonald@bartshealth.nhs.uk 0203 246 0281
Alaco Hickey

Lead, Immunodeficiency and Allergy

alaco.hickey@bartshealth.nhs.uk
0203 246 0322
Dr Mike Stevens Senior Clinical Scientist mike.stevens@bartshealth.nhs.uk 0203 246 0279

SIHMDS

As part of the care package we provide we consider the whole patient journey taking account of our patients needs right from the beginning of their journey with us.

Patients with a haematological malignancy can require a complex care package, which involves multiple healthcare professionals, sometimes across a range of healthcare providers.  We are committed to providing integrated care, working across organisations to improve our patients’ outcomes. To maintain our focus, we are driven by one overriding value:

The Barts Health SIHMDS will put the patient at the heart of the diagnostic pathway.

We provide a range of integrated testing, classifying, diagnosing, reporting and management of haematological malignancies including acute and chronic leukaemias, lymphomas, myeloproliferative neoplasms and myelodysplasia. Our service is provided by a highly-skilled team of dedicated doctors, scientists and technologists who offer a timely, efficient and cost-effective service to our users.

Testing

We believe that an important means of reducing premature mortality from cancer is by raising public awareness to improve early diagnosis of cancer. If you have any questions about the tests we do visit Lab Tests Online-UK, a patient-centred website written by practicing laboratory doctors and scientists to help members of the public understand the many clinical laboratory tests that are used in the diagnosis, monitoring and treatment of disease.

If you have any questions about the blood cancers (haematological malignancies) that we help diagnose, visit the Barts Health Cancer Service and the Macmillan Cancer Care website.

Download the SIHMDS request form [pdf] 196KB

We provide all investigational modalities:

Haematology

All SIHMDS cytopathology of peripheral blood films, cerebrospinal fluids, other fluids and bone marrow aspirates are processed in the haematology laboratories on the fourth floor.

Histopathology

Lymph node biopsies, Trephine biopsies and biopsies from other sites for suspected haematological malignancies are processed within cellular pathology on the second floor.

Immunophenotyping

We provide a full diagnostic and prognostic leukaemia and lymphoma Immunophenotyping Service. We also carry out Minimal residual disease analysis (including high resolution MRD detection) and Paroxysmal Nocturnal Haemoglobinuria (PNH) testing.

Cytogenetics and molecular haematology

We process samples of bone marrow (BM), peripheral blood (PB) or other infiltrated tissue for acquired cytogenetic and molecular abnormalities. These are analysed using conventional cytogenetic and molecular cytogenetic tests to screen for abnormalities that establish the diagnosis, monitor treatment and provide prognostic information.

Other tests for non-haematological cancers are performed within each SIHMDS laboratory, which are not part of the core activity of the SIHMDS. Contact the appropriate team for specific enquiries.

If you have a clinical suspicion of a previously undiagnosed haematological malignancy, diagnostic tissue and blood specimens should be sent direct to the SIHMDS rather than the local pathology services for diagnosis.

For details of specimen requirements and a list of the full range of tests we perform, download our SIHMDS user guide.

Quality assurance

Quality assurance is provided by the SIHMDS operating according to the principles of total quality management and we seek evidence of quality from multiple sources. We are a large training centre and the SIHMDS is committed to creating a learning climate conducive to training the haematopathologists of the future. With decades of experience training doctors and healthcare scientists, we are driven by a belief that excellent training goes hand in hand with high quality and sustainable diagnostics. We are also involved in research. We have extensive experience working with a diversity of academic, NHS and industry organisations to facilitate research and development and translate the latest research into clinical diagnostics.

Contact us

Immunophenotyping

Tel: 020 3246 0226
Email: BHNT.immunophenotyping@nhs.net

Cytogenetics

Tel: 020 3246 0427
Email: BHNT.cytogenetics@nhs.net

Molecular haematology

Tel: 020 3246 0115
Email: BHNT.molecularhaem@nhs.net 

General enquiries

Tel: 020 3246 0224
Email: BHNT.SIHMDS@nhs.net

Clinical biochemistry

As well as supporting services in the Trust, we also provide specialist services to laboratories across the UK. Our department adds value to the health and wellbeing of patients, through our activities.

We cover clinical biochemistry, endocrinology, paediatric metabolic biochemistry, toxicology, point-of-care testing and clinical trials.

What is clinical biochemistry?

Clinical Biochemistry is the branch of Pathology concerned with the biochemical basis of disease and the use of biochemical tests for diagnosis and management.

If you have any questions about the tests we do visit Lab Tests Online-UK, a patient-centred website written by practicing laboratory doctors and scientists to help members of the public understand the many clinical laboratory tests that are used in the diagnosis, monitoring and treatment of disease.

Our laboratory is equipped with:

  • Roche automated analysers for core biochemistry
  • routine endocrinology and measurement of troponin
  • haematinics
  • tumour markers
  • four Biorad variant Turbos for HbA1c measurement

We carry out more complicated clinical biochemistry investigations including specialised endocrine tests, analysis of trace metals, protein electrophoresis and measurement of drugs of abuse and immunosuppressants. Some tests are provided for other hospitals within the local area and some are offered to other hospitals in the UK.

For the majority of tests the result is available the same day, often within an hour or two of receipt of the specimen. Some investigations are carried out less frequently. Some highly specialised, non-urgent tests may be analysed in laboratories elsewhere in the UK. Due to the complex nature of these investigations results may sometimes not be available for several weeks.

Clinical advice

A duty biochemist is available for advice and enquiries about interpretation of results and follow-up tests and can be contacted during the routine working day, ideally by email. A consultant is available at all times for advice and can be contacted via switchboard out-of-hours.

Download our clinical biochemistry user handbook

Point of care testing (POCT)

Biochemistry testing is increasingly required at the point of care in preference to sending samples to the laboratory e.g. using blood glucose meters, urine dipsticks, blood gas machines and pregnancy testing kits.

Any POCT testing is performed to the same standard of safety and quality as testing in a traditional laboratory setting. The POCT team assists and supports the introduction and monitoring of POCT equipment within the Trust.

Contact us

Non-urgent advice and guidance

For nom-urgent advice and guidance contact us by email at bhnt.ClinBiochemAdvice-barts@nhs.net

Laboratory enquiries

Newham
Tel:
020 7363 8121

St Bartholomew's
Switchboard tel:
020 7377 7000 ext 55362

The Royal London
Switchboard tel: 020 7377 7000 ext 61011 or bleep 1221

Whipps Cross
Tel: 020 8535 6831

Clinical scientists

Tel: 020 3246 0379 (ext 60379) or 020 3246 0377 (ext 60377) or 020 3246 0380 (ext 60380)

Consultant chemical pathologist

Tel: 020 3246 0386 (ext 60386)
Email: Ruth.ayling@bartshealth.nhs.uk

Point of care Testing (POCT)

Newham
Tel: 020 7476 4000 ext 8428

The Royal London
Tel:
020 7377 7000 ext ext 60376

Whipps Cross
Tel: 020 8539 5522 ext 5385
 

Microbiology

Biomedical scientists in our department examine specimens for the presence and effects of bacteria, fungi and parasites, and carry out appropriate antimicrobial sensitivity tests. Blood samples are tested for the presence of antigens and antibodies produced to a wide range of infectious agents.

Our specialist registrars, infection control nurses and consultant microbiologists advise on the therapy of patients with infection.

In collaboration with the infection control team we help in the surveillance, control and prevention of nosocomial infection and cross infection in the hospitals and local community.

If you have any questions about the tests we do visit Lab Tests Online-UK, a patient-centred website written by practicing laboratory doctors and scientists to help members of the public understand the many clinical laboratory tests that are used in the diagnosis, monitoring and treatment of disease.

Contact us

Microbiology laboratory

  • Main laboratory and general enquiries: 020 3246 0320
  • Departmental fax: 020 3246 0367
  • PHE enquiries: 020 3246 0311
  • Clinical advice: via switchboard to contact the SpR for the relevant hospital site 020 3416 5000.

Availability of clinical advice on ordering of tests and interpretation

Clinical advice is available 24 hours a day 7 days a week.

From 9.30am to 5.30pm, Monday to Friday contact the relevant Specialist Registrar for each site through the main switchboard on 0203 416 5000.

Out of hours and at the weekend

Contact an on call microbiology registrar or an on call consultant via switchboard on 0203 416 5000.

Please note: there are separate consultant and registrar on call for Whipps Cross.

The on call microbiology biomedical scientist for all sites is at The Royal London. Call 0203 416 5000 and bleep 1274 via switchboard if necessary.

Microbiology user guide

Download our microbiology user guide

Stem cell

Stem cells for therapeutic use are cryopreserved and stored long term at temperatures less than -140C. All processing takes place in Grade B rooms in accordance with Good Manufacturing Practice and in dedicated clean rooms.

Patients who wish to access our stem cell service should be referred to a consultant Haemato-oncologist within the Barts Cancer Centre.

If the use of therapeutic stem cells is recommended as a treatment by your consultant, the procedure will be thoroughly explained to you by clinical staff before it begins. The cells are treated in accordance with current legislation and guidelines and processed in a state-of the-art facility. All tissues are kept for long term storage in monitored conditions.

Important information

  • Peripheral blood samples should be taken into EDTA tubes, packaged securely and sent by courier directly to the stem cell lab
  • Harvest products should be collected into bags containing ACD-A, packaged into dedicated blood transport boxes and sent directly to the stem cell lab by courier
  • CD34 analysis results will be available after one hour
  • A full report for stem cell harvest will be available after 14 days

All samples should have an attached label with the stem cell lab address and telephone number.

Stem Cell Lab
5th Floor
Pathology and Pharmacy Building
80 Newark Street
London, E1 2ES

Tel: 020 3246 0606

Samples will be delivered to the pathology reception and collected from there by a member of the stem cell team. If you require clinical advice contact:

Dr Matthew Buckland, Laboratory Director  
Email: matthew.buckland@bartshealth.nhs.uk
Tel: 020 3246 0286

Clinical transplantation

For more information about transplantation visit the British Transplantation Society website here.

If you have any questions about the tests we do visit Lab Tests Online-UK, a patient-centred website written by practicing laboratory doctors and scientists to help members of the public understand the many clinical laboratory tests that are used in the diagnosis, monitoring and treatment of disease.

Our laboratory based service provides:

  • Human Leukocyte Antigen (HLA) typing,
  • co-ordination of donor
  • recipient matching and crossmatching for kidney
  • cardio-thoracic and stem cell transplantation
  • HLA antibody testing and definition
  • HLA associations such as HFE, HLA-B27 and B*57:01 are also performed.

In addition, the laboratory staff has an integral working relationship with the clinicians and nursing staff directing the various transplantation programmes.

We provide an out-of-hours service for solid organ transplant programmes which provides HLA typing of potential deceased organ donors, a virtual crossmatching service as well as pre-transplant antibody screening and crossmatching.

Currently, no additional services are offered outside of normal working hours. However, other urgent laboratory investigations are undertaken when considered appropriate.

Contact us

Clinical Transplantation Laboratory or the On Call "Transplant Immunologist"

Through the pager: 076 5913 2970
Mobile: 078 8050 0885
The Royal London switchboard: 020 7377 7000

For details of the full range of tests we perform, specimen requirements and transportation please download our user guide.

General enquiries

Email: tissue.typing@bartshealth.nhs.uk
Tel: 020 3246 0232

Clinical Transplantation Laboratory

Tel: 020 3246 0232

Location of our laboratory

Clinical Transplantation Laboratory,
Barts Health NHS Trust,
2nd Floor Pathology & Pharmacy Building,
The Royal London Hospital,
80 Newark Street,
Whitechapel,
London, E1 2ES

Opening hours
Monday to Friday, 8.30am -5pm

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Virology

We process approximately 890,000 virology tests annually and provide extensive diagnostics for the whole of north east London and beyond. We provide a full comprehensive range of diagnostic molecular, detection and serological assays in our state of the art pathology building. Diagnostic results are augmented by clinical advice which is readily accessible both in and out of working hours.

We aim to be responsive to the needs of our users and in partnership with them have recently implemented a programme of development to introduce new methodology and systems. With these, we aim to improve the timely diagnosis of newly emerging and established infectious diseases. This is particularly significant in the areas of molecular diagnostics and automated serology.

The laboratory is approved by the Health Professions Council and the Royal College of Pathologists to conduct staff training in accordance with statutory registration of professional and regulatory bodies.

The NHS choices website has information on a variety of conditions, including infections.

If you have any questions about the tests we do visit Lab Tests Online-UK, a patient-centred website written by practicing laboratory doctors and scientists to help members of the public understand the many clinical laboratory tests that are used in the diagnosis, monitoring and treatment of disease.

Contact us

Address

Diagnostic Virology
Barts Health NHS Trust
3rd Floor
Pathology and Pharmacy Building
80 Newark Street
Whitechapel
London E1 2ES

Dx address (for tracked deliveries using the DX company)

Dx account number: 6640602
Tower Hamlets 94E

Key contacts

For virology results, call our enquiry line (A)

Tel: 020 3246 0364

On call biomedical scientist (B)

For laboratory advice about the tests we perform

Opening times: Monday-Friday, 6pm to 8am, Saturday and Sunday, 5pm to 9am
Air call pager: 076 5981 0479 (via The Royal London switchboard 0207 377 7000)

For all clinical queries contact virology/microbiology registrar in first instance.

Daytime duty virology consultant

For clinical advice about patients or the tests we perform.

Opening times: Monday-Friday, 9am to 5pm

For out of hours contact the virology/microbiology registrar mobile: 077 1503 8336

Virology specialist registrar in hours (C)

For clinical advice about patients or the tests we perform contact the virology registrar between 9am to 5pm.

Mobile: 077 1503 8333

Virology specialist registrar out of hours (D)

For clinical advice about patients or the tests we perform contact the virology/microbiology registrar (out of hours).

Tel: 020 3416 5000 (aircall)

Virology user guide

Download the virology user handbook