Specimen requirements and referring samples

Samples at high risk of being infected with hazardous biological agents must be labelled, and certain high risk samples cannot be processed by the laboratory.

When requesting test activations, including using existing samples stored in the laboratory, all requests must be submitted in writing on our request form (see request forms), proforma (see request forms), email (see contact us) or letter.

Any request made verbally should be confirmed in writing.

Samples are normally referred by hospital consultants. Certain test requests are only accepted from the Regional Genetics Service (details available on request).

GP referrals are not encouraged for specialist tests, though are permitted for some karyotyping, haemato-oncology and non-malignant haematology referrals.

Sample labelling and request forms

• Samples must be labelled with:
  • patient's full name (surname / family name and given / individual name)
  • date of birth and unique NHS / hospital number
  • date of collection
• A fully completed request form should accompany each sample and some requests also require a pre-request form. See request forms.
• Request forms must be legible and provide:
  • patient's full name
  • date of birth and NHS / hospital number
  • patient's postcode
  • name and address for invoicing for non-NHS referrals
  • full name and address of referring clinician
  • referral reason and test/s required.
  • information regarding any known or suspected infection risks (e.g. HIV / Hep B & C / TB) must be clearly documented - see below

Specific sample requirements

Details of specific sample requirements are provided on the following pages:

• Specimen requirements - cytogenetics
• Specimen requirements - molecular genetics - constitutional analysis
• Specimen requirements - molecular haematology - acquired cancer

High risk samples (hazardous biological agents)

For samples known / likely to be infected with hazardous biological agents (hazard group 3 or above, e.g. HIV, Hepatitis B/C, prions):

• the nature of the risk must be clearly marked on the request form
• the sample tube should be clearly labelled, e.g. Danger of Infection tape, to indicate the high risk nature
• samples known/likely to be infected with hazard group 3 biological agents that are not listed in Annex 1 (may be handled at less than the minimum containment conditions) of the ACDP Approved List of biological agents, e.g. Mycobacterium tuberculosis (TB), cannot be processed by the laboratory
• if information regarding hazardous biological agents becomes available after a sample is referred to the laboratory, then the laboratory must be informed immediately.

Sample handling, packaging and storage

• All samples should be sent directly to the laboratory to arrive as soon as possible after collection, i.e. hospital transport, first class post, courier service etc.
• All samples, with the exception of NIPD samples and muscle/liver biopsies for mitochondrial genetic analysis, can be stored overnight at +4°C if there is an unavoidable delay between sample collection and dispatch. NIPD samples should be kept at room temperature. Muscle/liver biopsies for mitochondrial genetic analysis should be stored at -80°C.
• Please do not freeze blood samples or bone marrow aspirates.
• Samples sent by post or courier must be packaged to comply with appropriate regulations, generally those for Category B Infectious Substances, or, for DNA samples, regulations for Exempt Patient Specimens. See transporting infectious substances on the Royal Mail website for further details.

Inappropriate samples

The following samples will not be accepted by the Oxford Genetics Laboratories:

• clotted blood samples
• lithium heparin samples for Molecular Genetics analysis - this is due to risk of failure or false positive results for some analyses: lithium heparin samples are requested for karyotype analysis
• inadequately labelled samples - when it has not been possible to confirm the patient of origin
• inadequately packaged samples, including damaged or leaking samples.

Consent

In submitting samples, the referring clinician confirms that consent for testing has been obtained.

Material may be stored (where applicable) from all patients referred unless consent for this is specifically denied and recorded on the request form.

Service agreement

By sending a sample, accompanied by a completed laboratory request form, the user enters into an agreement for the Oxford Genetics Laboratories to provide the service or test requested and agrees to the terms and conditions.