Test information

Many of our tests have specific request forms and storage and transportation requirements so we suggest you revert to the individual test page in the first instance.

If the relevant request for is not supplied on the test page, please contact Customer Services or the relevant Central Specimen Reception for assistance.

Request forms must contain the following information:

• Patient’s first and family name
• Patient’s date of birth
• Patient’s gender
• Requestor’s name and location -Internal Request - location (ward code) and clinician details/code -External Request - address label/surgery and GP details.
• NHS and/or Hospital number
• Type of specimen
• Date/time of specimen collection
• Test(s) required
• Relevant clinical information
• Request forms should be dated and signed by those taking the specimen.

Errors made when completing the form may result in delays in processing.

Each request accepted by the laboratory for examination(s) shall be deemed to be an agreement by the Users of the service.

If a test is not available to be ordered electronically (e.g. using EMIS tQuest / NPEx) – users must use a separate manual request form for that test request.

Do not handwrite examinations/tests requested onto  the electronic request forms - these will not be processed.
Do not indicate tests requested in the clinical details section - these will not be processed. Clinical Details section of request forms are only for “clinically relevant information about the patient and the request, for examination performance and result interpretation purposes”

On manual request forms, tests requested should only be indicated in the relevant section (e.g. by ticking the test box or writing in the ‘Other Tests’ box [or equivalently named section]). If tests are noted outside these areas (e.g. in the clinical details section only) – they may not be processed.

All samples must be clearly labelled with sufficient information that unequivocally links the sample to an individual patient.

Samples will not be processed if important patient details are not included, or if samples cannot be matched unequivocally to request forms.

ALL samples must include:

• Patient’s full name
• Date of birth (DOB)
• NHS/hospital number
• Date sample was taken
• The requestor's name or location

In order to provide and accurate and reliable result, samples for the laboratory must be sent in accordance with guidelines to ensure they arrive in a fit condition to be analysed.

World Health Organisation Guidance (2005) states that: "Shippers of infectious substances must ensure that packages are prepared in such a manner that they arrive at their destination in good condition and present no hazard to others during transport."

Similarly, under various dangerous goods transport/carriage regulations (see below *), it is the responsibility of the consignor (sender/requester) to ensure that all dangerous goods, including diagnostic specimens, are correctly classified and packaged into suitable containers that are correctly marked and labelled. 

* The various Carriage Regulations consist of the European Agreement concerning the International Carriage of Dangerous Goods by Road 2015 (ADR 2015), The Carriage of Dangerous Goods and Use of Transportable Pressure Equipment Regulations 2009 and The Carriage of Dangerous Goods and Use of Transportable Pressure Equipment (Amendment) Regulations 2009, as amended 2011.

It is therefore the responsibility of the requestor to ensure that all samples are sent to Synnovis in accordance with the following instructions.

Packaging requirements 

Potentially infectious samples from GPs transported by designated vehicles provided by Synnovis or the local NHS Trust must be carried in compliance with the UK and European road transport regulations (*). 

Infectious substances include material that is known to contain, or is reasonably expected to contain, pathogens.  When being transported infectious substances must be packaged according to the UN standard P650 (Packing Instruction 650) as follows:

• All samples in containers (e.g. tube, pot known as the “primary”) must be placed in individual plastic ‘kangaroo’ type sample bags to avoid cross contamination.  Where the primary contains a liquid, then the primary container must be leak proof.  Where the primary contains a solid, then the primary container must be Sift proof (impermeable to dry contents).
• Individual sample bags should be placed into large, clear sealable, leak proof, plastic, sample bags (known as the “secondary”) that, where the specimen is a liquid, contains absorbent material sufficient to absorb the entire quantity of the liquid present in the specimen container (e.g. a sufficient amount of paper towelling to absorb any leakage).
• The large bag should be placed into a suitable rigid sample transport container that is capable of meeting the testing requirements of the regulations and that is correctly marked and labelled.
• Only rigid outer containers supplied by Synnovis or the local NHS Trust may be used to transport samples to the laboratory by road.
• There should be sufficient cushioning lining the outer rigid container to prevent samples becoming unstable.
• If the rigid outer container becomes contaminated it must be disinfected by wiping out with 1000 ppm chlorine solution or equivalent.
• For more information on P650 see the guidelines here.

For more information on P 650 see the guidelines here. 

Transport of samples in formalin 

Formalin is covered by the Control of Substances Hazardous to Health Regulations 2002 (COSHH). Before formalin is used in the workplace, risk assessments under COSHH must be carried out to ensure that people are not exposed to formaldehyde vapour. Formaldehyde has a short term (15 minutes) workplace exposure limit of two parts per million per mg.m-3 and is a potential carcinogen.

Formalin spillage control granules should be available wherever formalin is used or stored and staff trained in their use. Granules are available here. 

Advice on the safe use of formalin may be obtained from the local Synnovis Histopathology department.

Samples for histology, and liquid based cytology, should be sent via designated vehicles organised by Synnovis or the local NHS Trust as follows:

• Ensure the cap of the primary container is securely fastened.
• Wrap the primary container in absorbent material and place into a sample bag.
• Place the sample bag into a large plastic bag or cardboard box and place into the transport box. Ensure the sample remains upright in the transport box.
• The surgery must keep a log of all samples for Cytopathology and Histopathology sent to the laboratory. The patient’s name, type of sample and the date and time the sample was sent to the laboratory must be recorded, as well as the signature of the person who packaged and sent the sample.
• Under the Carriage Regulations, Formaldehyde solutions, non-flammable with less than 25% formaldehyde are not subject to the requirements of ADR. 
• The Carriage Regulations permit the packaging 30ml or less of dangerous goods in the primary receptacle containing infectious substances with no additional requirements of the Carriage Regulations having to be met.
• As such, no additional special packaging is required there is no requirement for specialist marking & labeling of the package where it contains formalin. The P650 packaging, marking and labelling requirements must still be met.

Samples sent on dry ice

Samples on dry ice must not be sent in outer containers with a sealed lid as there is a risk of explosion during transport from the build up of carbon dioxide gas.

If dry ice is used to transport samples the outer packaging or over pack shall permit the release of carbon dioxide gas. The primary and the secondary packaging shall maintain their integrity at the temperature of the refrigerant used as well as the temperatures and the pressures which could result if refrigeration were lost. For more information see page 57 of the guidelines here.  

When dry ice (solid carbon dioxide) is used as a coolant to keep specimens cold, the following requirements must be met: 

• The dry ice must be placed outside the secondary packaging or in the outer packaging or an over pack.
• Interior supports must be provided to secure the secondary packaging in the original position after the ice or dry ice has dissipated.
• Packages containing dry ice for cooling shall be marked with the following wording on the outside of the package in addition to the P650 requirements:CARBON DIOXIDE, SOLID, AS COOLANT
• The markings shall be durable, legible and placed in such a location and of such a size relative to the package as to be readily visible.

Samples sent via Royal Mail 

Packaging for samples sent via Royal Mail must also comply with P650 for Category B substances.  P650 requires that the primary sample container must be leak-proof and wrapped in sufficient absorbent material to absorb any spillage (see information on sample packaging above). The primary container and absorbent material must be placed into a single sample bag with the request form in the pouch.

The sample bag should be placed into a suitable rigid container that is correctly marked and labelled. This product must be fully compliant with both Packing Instruction 650 and UN3373 requirements.

Labelling of packages

Packages containing infectious substances sent by post must be marked with: 

• The sender’s name and address.
• The telephone number of a responsible person, with knowledge of the shipment.
• The receiver’s name and address.
• The proper shipping name Biological Substance, Category B”.
• The appropriate warning label for infectious substances should be used  
• The outer packaging must always be suitably marked / labelled with the UN3373 contained within a diamond shape with minimum dimensions of 50 mm by 50 mm; the width of the line shall be at least 2 mm and the letters and numbers at least 6 mm high.
• The Proper shipping name “Biological Substance, Category B’’ must be marked on the outer packaging adjacent to the diamond shaped mark in letters at least 6 mm high.
• Labels shall be displayed on a background of contrasting colour, or shall have either a dotted or solid outer boundary line. The dotted outer boundary is not required when the label is applied on a background of contrasting colour
• The label must be affixed to the surface of the package and, if the dimensions allow, must be placed on the package so that it is not covered or obscured by any part or attachment to the packaging or any other label or marking. Where the package is of such an irregular size or small shape that the label cannot be satisfactorily affixed, the label may be attached to the package by a securely affixed tag or other suitable means.
• If the size of the package so requires, the dimensions of the labels may be reduced, provided that they remain clearly visible.

Warning labels

The HSE recommend the use of ‘high risk’ or ‘danger of infection’ stickers attached to samples and request forms from patients that pose a high risk of exposure to agents such as HIV, HBV, HCV, TB, Typhoid, Brucella, CJD. Care must be taken to protect the confidentiality of the patient when these stickers are used. See HSE Guidance Safe working and the prevention of infection in clinical laboratories and similar facilities ISBN 0-7176-2513-3.

Please send your specimens to the appropriate Laboratory or Central Specimen Reception. If you are in any doubt, please contact our Customer Services Team or the laboratory directly.

Central Specimen Reception at Princess Royal University Hospital 

01689 01689 864266
Princess Royal University Hospital
Farnborough Common
Orpington
Kent
BR6 8ND

Central Specimen Reception at Guy's Hospital

020 7188 1168
Central Specimen Reception
Guy's Hospital
Southwark Wing - 4th Floor
Great Maze Pond
London SE1 9RT

Central Specimen Reception at King's College Hospital

020 3299 4109
Central Specimen Reception
Blood Sciences Laboratory
King's College Hospital
Bessemer Wing - Ground Floor
Denmark Hill
London SE5 9RS

Central Specimen Reception at St Thomas' Hospital

Laboratory enquiries: 020 7188 1167
Central Specimen Reception
North Wing - 5th Floor
St Thomas' Hospital
Westminster Bridge Road
London SE1 7EH

Clinical Transplantation at Guy's Hospital

Clinical Transplantation Laboratory
3rd Floor Borough Wing
Guy's Hospital
Southwark Wing
Great Maze Pond
London SE1 9RT

Oncology Cytogenetics at Guy's Hospital

Oncology Cytogenetics
5th Floor Tower Wing
Guy's Hospital
Southwark Wing
Great Maze Pond
London SE1 9RT

DX delivery to King's College Hospital

Please use the following address when sending samples to KingsPath via DX:
Kingspath, DX6570200,
Peckham 90SE
Details of the DX service can be found at their website.

Histology/ Histopathology Laboratory at Kings' College Hospital

Advanced Diagnostics, 2nd Floor Bessemer Wing, King's College Hospital, Denmark Hill, London, SE5 9RS

Department of Clinical Immunology and Allergy at Kings' College Hospital

1st Floor, Bessemer Wing, King's College Hospital, Denmark Hill, London, SE5 9RS

SE-HMDS Cytogenetics Laboratory at Kings' College Hospital

Cytogenetics Department, Haematological Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS

Molecular Diagnostics Laboratory at Kings' College Hospital

Department of Haematological Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS

Red Cell Laboratory at Kings' College Hospital

Haematology Department, King's College Hospital, Denmark Hill, London, SE5 9RS

Toxicology Department at Kings' College Hospital

Top Floor, Bessemer Wing, King's College Hospital, Denmark Hill, London, SE5 9RS

• Correct labelling.
• Correctly filled citrate samples. (e.g. not under or over-filled)
• Please package carefully, to avoid leakage/breakage, and note appropriate postal regulations (where applicable).
• Some samples will deteriorate with time therefore they should be sent to the laboratory without delay.
• Appropriate transport conditions: e.g. frozen specimens transported in a way that avoids allowing them to thaw.
• Requesting clinicians will be notified if a specimen has not been accepted due to any of the conditions listed.
• As enzymes are affected by delays in transit, samples for enzyme analysis must be received within 24 hours of collection. Therefore further investigations can only be requested within this time period. Further testing usually requires a fresh specimen.
• Please ensure transcription between request form and sample  are correct.

We appreciate there are times when you need to call the laboratory to request additional tests to a sample we have already received or have stored. Please be aware that as some laboratories store samples in the short, medium and long term, it can take time to locate the specimen, add the test and re-sample.

Not all specimens will be suitable for additional tests or retesting due to sample age or quality (certain tests are time critical) but please contact the individual laboratory for further information.

• Personal data shall be processed fairly and lawfully.
• Personal data shall be obtained only for one or more specified and lawful purposes, and shall not be further processed in any manner incompatible with that purpose or those purposes.
• Personal data shall be adequate, relevant and not excessive in relation to the purpose or purposes for which they are processed.
• Personal data shall be accurate and, where necessary, kept up to date.
• Personal data processed for any purpose or purposes shall not be kept for longer than is necessary for that purpose or those purposes.
• Personal data shall be processed in accordance with the rights of data subjects under this Act.
• Appropriate technical and organisational measures shall be taken against unauthorised or unlawful processing of personal data and against accidental loss or destruction of, or damage to, personal data.
• Personal data shall not be transferred to a country or territory outside the European Economic Area unless that country or territory ensures an adequate level of protection for the rights and freedoms of data subjects in relation to the processing of personal data.
• The Blood Science laboratories does not provide results directly to patients, relatives or carers: all results are communicated via the healthcare provider that has requested the test.

View our Privacy, data protection and cookie policy.

Measurement uncertainty is determined for each measurement procedure in the laboratory and these estimates are available to users on request. Please contact the named laboratory contact if information on measurement uncertainty is required.

For qualitative tests, factors affecting the final result are considered and steps taken to minimise the effect of any variables to ensure a standardised, consistent approach is maintained.