From the 1st October 2021 the Public Health England (PHE) Public Health Laboratory, Birmingham based at Heartlands Hospital will be incorporated into the United Kingdom Health Security Agency (UKHSA). There will be no change to our clinical diagnostic or public health microbiology services.

Over the next few months we will update our user facing information and request forms etc. to reflect the change so please do not be concerned about a mixture of PHE and UKHSA branding during this time.

Please be advised that due to a recent supplier issue there is no availability of the current Glandular Fever test kits used by the Haematology laboratories at Heartlands, Good Hope and Solihull Hospital’s for a possible 8 to 12 weeks. In an effort to minimise any disruption to our users we will be verifying a different Glandular Fever screen currently in use at the laboratory in QEH and therefore standardise testing across UHB.  An extension to scope will be submitted for this change in assay with a view to be accredited during the next UKAS assessment in October 2021.

Due to the reconfiguration of Clinical Haematology all Haematology malignancy flow cytometry work will be transferred over the Midlands Integrated Reporting for Haemato-Oncology (MIHRO) based at the University of Birmingham Medical School. This change is expected to commence June 2021. The service at Heartlands will continue to run non-malignant flow work  such as FMH, PNH and CD34 count requests.

The laboratory at Heartlands will facilitate the transfer of samples to the MIHRO service. All samples must arrive in the laboratory by 3.00 p.m. on the day of sampling accompanied by clinical details. Any urgent samples must be prearranged with MIHRO laboratory in advance and the Heartlands laboratory informed on extension 40704.

Please contact the laboratory for further information.

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.

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. 

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.