Abbott Alinity analysers are now in place on the Birmingham Heartlands site to provide biochemistry and serology services.  Assays provided on this site now lie outside our scope of accreditation as assessed by UKAS.  UKAS have been informed and will assess the assays on the new instrumentation as an extension to scope of our accreditation in Autumn 2020. 

In line with changes to guidelines for reporting and monitoring HbA1c levels, from the 1st June 2021, the HbA1c DCCT % result will no longer be reported, only the IFCC  mmol/mol result. This applies to any HbA1c test being processed at Heartlands, Good Hope or Solihull laboratories and will standardise reporting across the UHB laboratory network.

Direct Oral Anticoagulants (DOACs) are a relatively new class of anticoagulants that have several advantages over traditional anticoagulation agents such as Warfarin. This includes rapid onset of action, few drug interactions and predictable pharmacokinetics which result in no requirement for routine laboratory monitoring. As a result, the use of DOAC’s in clinical practice has grown. The DOAC’s are problematic for the laboratory as they have been reported to interfere with most coagulation tests to varying degrees.

Currently when testing a patient for a thrombophilia a patient is required to be free from anticoagulation to obtain a valid result, however due to the risk of thrombosis these patients are also required to be anticoagulated. This paradox is problematic for both the laboratory and the clinician.

DOAC-Stop tablets can be used to efficiently remove all types of DOACs including dabigatran, apixaban, rivaroxaban and edoxaban, from test plasmas with minimal effect on plasma proteins involved in the clotting mechanism. This will allow clinicians to get an accurate result while the patient is anticoagulated with a DOAC, preventing the need for cessation for an accurate result and therefore reducing the risk of thrombosis.

If you are requesting a thrombophilia or lupus anticoagulant screen and your patient is on a DOAC, please state clearly on the request form, together with which anticoagulant, so DOAC Stop can be applied.

From Monday 17^th June the Biochemistry phone limits at Heartlands/Good Hope and Solihull will change (see table below).  The new limits are already in place on the Queen Elizabeth site and so we will now be phoning the same results across all sites.   The new limits reflect changes to the Royal College of Pathologists guidance.