EXCELLING IN SCIENCE AND SERVICE
Microbiology – Changes to Sample Processing during Covid-19
COVID-19 Update for Genomics Laboratory
CYTOLOGY CELEBRATION AND RAFFLE FOR JO’S CERVICAL CANCER TRUST
COVID-19 Laboratory Testing Update
CHANGES TO THE CERVICAL SCREENING PROGRAMME
Microbiology Newsletter January 2020
SENIOR BIOMEDICAL SCIENTIST SECURES A PLACE ON CLINICAL DOCTORAL RESEARCH FELLOWSHIP SCHEME
CELLULAR PATHOLOGY USER SURVEY 2019
Specialist Rapid Exome Sequencing Service coming 1st Oct 2019
Exeter molecular genetics laboratory are recruiting!
Follow @Exeter_Lab
April 7th, 2020
Clear Urine During the COVID pandemic, clear urine samples are not being processed. Infection is unlikely when the urine appears clear. Consider repeat sample or empirical treatment following NICE guidelines.
Sputum samples Non-mucoid samples will not be processed as poor quality samples. Consider repeat sample if clinically indicated.
Superficial wound swabs Specimens will not processed if there is a lack of clinical details. Please consider if this sample is clinically required and would change management. Promote good wound care and only consider antimicrobial therapy for superficial wounds when there is spreading cellulitis.
Mycology testing During the COVID pandemic, mycology samples are not being processed. Repeat samples should not be sent until the laboratory can confirm they will be processed.
Faecal samples During the COVID pandemic, non-bloody faecal samples will not be processed. Most cases of infectious gastroenteritis are self-limiting and do not require treatment. If there are specific concerns in an immunocompromised patient, please discuss case directly with microbiologist via email rde-tr.MicroConsultants@nhs.net
Please note, faecal sample processing is limited to direct culture for Salmonella, enrichment culture will not take place. If high clinical concern of Salmonella, please consider sending a repeat sample if initial sample negative.
MRSA MRSA testing is restricted to admission to high risk in-patient areas – ITU, NNU, vascular surgery, elective orthopaedic surgery, renal and haematology/oncology. Please do not send swabs from patients in other areas unless previously positive.
March 30th, 2020
For information regarding important changes to genomic laboratory services in accordance with national recommendations from NHSE, please read the COVID-19 Update here.
March 24th, 2020
The Cytology department hosted a farewell party on Friday 13th March at Buckerell Lodge, Exeter. We would like to thank everyone who attended, it was a wonderful evening.
We held a raffle with NINE fantastic prizes, all proceeds going towards Jo’s cervical cancer trust, the UK’s leading cervical cancer charity.
We would like to thank everyone for their generous donations and congratulations to those who won prizes… we raised £226 !!!
The Cytology department would like to thank all those involved with cervical screening for their dedication and professionalism over the years. We wish you all the best of luck for the future.
March 13th, 2020
COVID-19 testing is performed using PCR technology (i.e. to detect the viral RNA). Test sensitivity is dictated by the amount of virus on the swab and is therefore influenced by (1) the timing of the test in relation to the symptoms and (ii) the quality of the sample (operator-dependent). A test should be interpreted in light of the pre-test probability (severity of symptoms, their level of exposure, the disease in the contact); no test is 100% sensitive or specific.
Serological testing is NOT available currently (27th March 2020).
• COVID19 RNA is detected on a Nasopharyngeal swab (Red COPAN or Yellow COBAS) by PCR (or BAL if on ITU) • Follow Trust guidelines as on HUB • All samples need to be requested on Medway using the “COVID-19” request • Do not send repeat swabs unless agreed by Micro • If unable to use Medway, use Virology form (we would rather you didn’t) • If Flu testing is also required, please write this in clinical details • Place swab into clear bag and then blue bag (i.e. DOUBLE bagged) • Place sample into rigid red transport boxes (at present on ITU, AMU, MTU, Torridge, Bramble and ED) • Porters will collect swabs from above wards every two hours starting from 6:00am (this is a 24 hour service) and take directly to Old Path Lab • No need to telephone Porters for Virology samples (though urgent blood samples will need portering to Blood Sciences in A template) • All other samples from patients need to have ?COVID in clinical details as they need to be handled separately in the lab • There is no need to telephone the lab in advance if the patient meets the case definition (the case definition may change so check HUB) • Samples are processed daily 7 days a week, so expect a result the same day if the sample arrives before 1800 • Positive results will be telephoned; negative results will NOT be telephoned and you need to check Medway or IPS • Please do not ring for results – we are inundated with telephone calls
February 26th, 2020
FOR PRACTICE MANAGERS AND CERVICAL SCREENING SAMPLE TAKERS: CHANGES TO THE CERVICAL SCREENING PROGRAMME
Devon and Cornwall
Communications were sent out on the 3rd of September 2019 by the Head of Public Health Commissioning, NHS England and NHS Improvement – South West to confirm that the processing and reporting of all cervical screening samples taken in your practice will transfer to Severn Pathology, North Bristol NHS Trust.
This change will be effective for all samples taken on and after the 18th March 2020 onwards for all practices in Devon and Cornwall.
All cervical samples sent to Severn Pathology will undergo testing for Human Papilloma Virus (HPV) in the first instance (HPV primary screening). The result of the HPV test determines whether or not cytology testing is also carried out.
Cervical Screening Requests – Open Exeter
Please be aware of the following changes in the requesting process which may require action for your practice:
Electronic requesting systems (including ICE and other order communications platforms) will no longer be used for cervical screening samples. Any practices currently using electronic requesting for cervical screening requests will have this functionality switched off from the date of service transfer. Any electronic requesting currently used for other pathology requests will remain unchanged.
All sample takers will require access to Open Exeter and should request access from their practice manager if they do not currently have it.
A guide to using Open Exeter for this purpose is attached to this communication.
Electronic Reporting of Cervical Screening Results
Cervical screening results will be sent electronically from Severn Pathology, North Bristol NHS Trust to all GP practice clinical systems.
There may be a period of a few days where you will receive reports from both the new and previous provider on different patients.
Direct Referrals from the Laboratory to Colposcopy
Direct referrals will be made from the laboratory at Severn Pathology, North Bristol NHS Trust following the service transfer but practices will not notice any change in the referral process. Your patients will continue to be referred to the same colposcopy clinic as previously.
Sample Taker Consumables
Severn Pathology will be requesting that all cervical screening samples be transported in new bags which will have orange swirls with a white outline. The bags will be provided with the sample taker consumable kits. Existing kits and bags can be used up before switching over. The current arrangements in place for requesting sample taker kits will remain unchanged until further notice.
Sample Transport
Existing arrangements are expected to remain for the collection of cervical screening samples from practices for onward delivery to Bristol from a network of local hubs which will be a mixture of existing and newly created collection points. You will be notified if this changes.
For more information please see:
https://www.gov.uk/government/collections/cervical-screening-professional-guidance
Or speak to your cervical screening sample taker training lead.
For ALL laboratory queries please contact the Cytology department at Severn Pathology on 0117 414 9810.
Katherine Hunt, Lead Biomedical Scientist, Cytology
Dr Karin Denton, Lead Cytopathologist
Website: https://www.nbt.nhs.uk/severn-pathology/pathology-services/cellular-pathology/cytology
CERVICAL SCREENING REQUESTS – OPEN EXETER GUIDE
All cervical screening sample requests will need to be made via Open Exeter using the pre-populated HMR101 (editable) printed request form.
Sample taker PIN codes and clinical details should be typed into the relevant boxes, which will eliminate issues for the laboratory with hand-written forms.
Once the HMR101 request form is complete, please ensure you print the A4 PDF version directly from Open Exeter.
1.Enter patient’s NHS number:
2. On top left hand corner click on HMR101 editable form:
3. Type sample taker PIN code and enter clinical details:
4. Select A4 PDF:
5. Click Open and a PDF version of the pre-populated request form with typed sample taker PIN code and clinical history will open.
6. Click print from the Open Exeter form menu
There will be no changes to sample taker PIN ID’s – please continue to use existing PINs when requested cervical screening tests.
Please obtain new PIN IDs from your usual source.
January 31st, 2020
Microbiology Newsletter Jan 2020
January 29th, 2020
The Exeter Clinical Laboratory team based in the The Royal Devon and Exeter Hospital are celebrating the fact that Rachel Nice, Senior Biomedical Scientist has recently secured a place on the highly prestigious Clinical Doctoral Research Fellowship (CDRF) scheme, which encourages research in clinical settings.
This is a fantastic achievement given the scheme is extremely competitive, with only a handful of places being offered each year through the NIHR (National Institute for Health Research). This will enable Rachel to undertake a fully funded PhD from September 2020, an incredibly exciting opportunity for her and the RD&E NHS Foundation Trust, as it enables Rachel to continue working in the Exeter Laboratory, retaining her vast knowledge and expertise in the hospital, whilst further embedding research into routine clinical care. This represents a new direction for the Trust who are jointly sponsoring the venture in collaboration with the University of Exeter Medical School.
Over the last 15 years, Rachel has developed a passion for diagnostic testing research. Her project will aim to benefit patients with Inflammatory Bowel Disease by investigating optimising laboratory methods for measuring antibodies to Anti-TNFα drugs, which help reduce inflammation. This is an exciting development in a highly specialist area of testing, of which Exeter Clinical Laboratory are leading experts in the UK and at the forefront of innovations in the field, really driving change to optimise how tests are used to benefit patient care and improve outcomes.
To find out more contact Rachel Nice Rachel.Nice@nhs.net
January 10th, 2020
Many thanks to those of you who took the time to complete the Cellular Pathology user survey in 2019
Overall Cellular Pathology service:
87.5% of responders would rate The Cellular Pathology Service either Good or Excellent
You said • Always approachable and helpful. • Feel that the department is under a lot of pressure, but works hard to get our results out quickly and accurately. In house HER2 would be awesome! • Out of hours pathology for oncologic emergencies not available. No ability to incorporate genomic data in the pathology. • Fabulous one stop clinic help from Cytology. We said • HER2 is centrally funded and therefore currently cannot be carried out on this site. • Unfortunately the Cell Path team are not responsible for reporting genomic results and so we have no control over the way genomic data is reported. • Many thanks – We always aim to provide an excellent ROSE service for all of our users.
Turnaround Times: You said • Sometimes turnaround times for Histology are reasonable for H&E 3-5 days, but often not. We said • We are working on recruiting more Pathologists to improve our turnaround times
Quality and clinical relevance of reports: You said • When slides go off to backlogs the reports are of varying quality and there is often an unacceptable delay in getting slides back. We said • We are working on recruiting more Pathologists to avoid sending slides away.
CERVICAL CYTOLOGY USER SURVEY 2019
Many thanks to those of you who took the time to complete the Cervical Cytology user survey in 2019.
94% of responders would rate The Cervical Cytology Service either Good or Excellent.
You Said Website • Have just had a look and added to my favourites – it looks good. • Very clear always found all the info I needed. • Just found it and accessed it without difficulty, very informative.
Availability and quality of technical and clinical advice • The advice and assistance I have received has been very helpful. • Not accessed it yet. • Rang the lab a few times and have always found them to be very helpful and efficient. • Always willing to answer queries in a timely fashion, really helpful.
Quality of sample taker training • I visited as part of my training. Extremely helpful staff and made to feel very welcome.
We said: • Many thanks for your comments – they are appreciated.
Transport of samples: You said: • As a Practice of 15,500 pts we only get a 1x daily courier collection. A further pm collection would be desirable. We said: • As the laboratory turnaround times are within the 14 days, it is not considered essential to increase the number of collections at this time. You said: • Slight confusion since the addition of the orange bags – it’s a lot of plastic – can more than one sample go into an orange bag at a time, and is anyone looking at more eco-friendly options? We said: • We will investigate the use of biodegradable bags as an alternative to plastic.
September 24th, 2019
The Rapid Exome Sequencing Service for acutely unwell children with a likely monogenic disorder (R14) run by our Exome team will be available from 1st October 2019.
Please contact the Exome team with any questions: karen.stals@nhs.net or julia.baptista@nhs.net.
June 13th, 2019
An exciting opportunity has arisen to join the Exeter Molecular Genetics Laboratory as a Band 7 Clinical Scientist.
The department of Molecular Genetics at the Royal Devon & Exeter NHS Foundation Trust is at the forefront of NHS Genomic Medicine, providing state-of-the-art diagnostic testing services that utilise specialist gene panel, exome and genome analyses to make diagnoses for the benefit of families with rare diseases across the UK and beyond.
Full details of the role and how to apply can be found here: https://www.jobs.nhs.uk/xi/vacancy/?vac_ref=915609104
Closing date is Thursday 27th June 2019.
