Specimen acceptance

New referrals

If you do not have an established arrangement to refer samples for a test or procedure to the laboratory at Newcastle upon Tyne NHS Foundation Trust, please contact the laboratory business unit prior to sending any samples.

The laboratory may reject requests if capacity to test has not been sought prior to referral.

Sample Labelling (and patient identification)

Accurate patient identification details on laboratory samples are vital for patient safety. It is the responsibility of the person requesting a laboratory investigation (i.e., medical, nursing and phlebotomy staff etc). To ensure that samples are correctly labelled and request details (forms or electronic requests) are completed to the required standard. Sample and request details must be compatible.

Essential information for the sample label: 

• Patient’s Full Name 
• Date of birth 

It is also strongly recommended that sample label also includes:

• Hospital Number (MRN) or NHS number or another agreed unique identifier. 
• Referring laboratories identifier (i.e. specimen number)

If known biohazard a biohazard sticker or other alert must be attached to both request and sample

A single unique identifier is permitted only for specific services which must be pre-agreed with the laboratory.

Desirable information:

• Date and Time of sample is desirable; however, it is essential for certain dynamic tests, i.e., is one of a series
• Date and Time of sample is essential for Tissue Specimens and where the sample is perishable, or the analyte is unstable (e.g., serum potassium)
• The date and collection time is desirable for tissue samples so that the laboratory is fully informed about how long the sample has been in fixative as this will allow them to prioritise the processing of samples.

Please note if a referred test relates to a patient who has also attend Newcastle upon Tyne Hospitals NHS Foundation Trust (NUTH), test result information will be automatically shared with the NUTH EPR providing the required patient identifiers, relevant to the request type (paper or electronic), are available.

Sample Requests (Specimen Request forms)

Sample requests can be made electronically or with the correct paper request form (specimen request form). To ensure that the specimen is handled correctly, please ensure that the correct paper request form for the sample is used e.g., cytology samples must be sent on a cytology paper request form, Blood Sciences samples must be sent on a Blood Sciences paper request form.

Minimum Essential information for all paper requests:

• Patient’s Full Name 
• Date of birth 
• Investigations required
• Referring location
• Name of the requesting clinician (Contact Number desirable)

Essential information for all paper requests:

• Hospital Number or NHS number or another agreed unique identifier. 
• Referring laboratories reference (i.e. specimen number)
• Sex of patient 
• Date of sample 
• Clinical Information
• Essential requirements for Specific Sample type/test e.g., fasting 
• Time of sample: All cellular pathology requests. Selected dynamic function tests
• The exact official name of the investigation and /or the approved abbreviation should be written legibly

Sample rejection criteria

Samples may be rejected in the following circumstances:

• The minimum essential information is missing from the sample or request.
• The sample and request form information do not match.
• The sample is unlabelled or otherwise unsuitable (e.g., wrong tube type).

Samples Where the Minimum Essential Information Is Missing

Where essential information is missing from a sample or request form, the laboratory will attempt to contact the requesting medical officer/practitioner/referral organisation identified on the request using the contact number, where this is given.

If the laboratory is unable to contact the requesting medical officer/practitioner/referring organisation, the sample will be rejected, or analysis deferred until contact is made. The laboratory will make an assessment on the ease of repeating a test and how precious a sample is prior to rejection.

For specific contracts the laboratory may agree different criteria in relation to sample acceptance/rejection.

When samples are rejected due to insufficient information, a report will be issued through the laboratory information system as soon as practicable, stating that the sample has not been processed and giving details.

Where the missing information includes the location from which the sample originated and destination for report, a patient report will be unavailable. It is fully expected that in this scenario the service users local outstanding result process will identify missing results and instigate investigation.

Samples that have been rejected and not processed may be stored in the laboratory for up to one week to allow the requesting practitioner/organisation time to get in touch. This storage will be at the discretion of individual departments.

Samples which may be processed even if the essential information is missing.

Certain types of specimens are considered ‘precious’ or are extremely difficult to repeat (e.g., CSF samples, biopsies, aspirates, etc., or where the sample forms part of a series or dynamic test).

In such cases, a senior member of the laboratory staff will be responsible for deciding if the analysis is justified. The requesting medical officer/practitioner will be contacted and may be asked to come to the department to complete the details.

If samples are accepted under these circumstances, the details will be recorded on the form or in the computer. The report will include a clear disclaimer detailing the shortcomings of the sample and/or request.

The disclaimer will identify the requesting practitioner who has agreed to take responsibility for the results and for any action taken as a result of the report.

Cellular Pathology samples will not be rejected but will not be processed until any error has been corrected, and this may lead to a delay in diagnosis.

Terms of Business

Information on specimen acceptance and other terms of business is available in our Terms of Business document:

Internal Laboratory Users

Internal laboratory users can refer to the Trusts specimen acceptance policy available on the Trusts intranet.