Pathology Service Update Bulletin 1
SWLP is working tirelessly to maintain a comprehensive pathology service to all sites and disciplines. The pandemic is dramatically changing the makeup of the work we receive, including elective work, outpatients and community work.
Our strategy is to target key services and direct resources to the areas these areas, which will have an impact on some levels of service and turnaround times.
We hope you understand why we need to make these changes and appreciate your support.
We will continue to send out bulletins when we have to make changes to our services and have created a dedicated web page which will include all of the service changes in one place. This page can be accessed using the link below:
South West London Pathology (SWLP) Microbiology is now acting as the sole south west London hub laboratory for Covid-19 testing, serving four acute hospital trusts and population of approximately 1.5 million. We have been working very hard to develop testing and test as many samples as we can.
As a part of this we have tested over 4,000 SARS-CoV-2 tests for suspected Covid-19. Given this increase in testing for SARS-CoV-2 we are unfortunately unable to continue our full repertoire of normal tests as we are using the equipment to test for SARS-CoV-2 or staff are needed to run the coronavirus assays.
As such, we have taken the difficult decision that there will be a reduction in services for the following tests:
- Chlamydia and gonorrhoea NAT testing will be done three times a week instead of Monday to Saturday
- HIV and hepatitis virus loads will be done twice a week instead of Monday to Friday
- Viral skin PCR (vesicular rash PCR) will be done once a week
- Viral eye PCR (for keratoconjunctivitis investigation) will be done once a week.
For all microbial serology (including virology and syphilis) – normal testing will continue however we will be unable to add on tests to samples already tested (note – testing of stored antenatal booking samples is excluded).
There may also be extended turnaround times, reduced storage of previously tested samples, and a restriction in add on testing.
Urine microscopy will now only be performed on the following samples:
- children under six years old
- renal transplant patients (where clearly stated on the request)
- nephrostomy urine (where clearly stated on the request).
Faecal elastase and calprotectin
Faecal elastase and calprotectin testing has been suspended for the time being so we can devote resources to more critical aspects of the service, and due to some concerns around health and safety.
There are a number of changes to our immunology services.
Routine analysis of faecal samples for alpha-1 antitrypsin
Routine analysis of faecal samples for alpha-1 antitrypsin, or urine samples for protein electrophoresis are not currently being carried out. Any requests received will be reported with a standard comment explaining why these tests are not being run.
The faecal samples will be stored indefinitely. The urine samples will be discarded after one month, but we will instead analyse serum free light chains if we have an appropriate serum sample.
If any of these tests are considered essential for a patient’s care, please call the Immunology
Consultants on 020 8725 5106 to discuss whether arrangements can be made to analyse a specific sample.
Tau protein (asialotrasferrin) for suspected CSF leak
The Immunology laboratory is unable to analyse samples for Tau protein (asialotrasferrin) for suspected CSF leak if the sample is taken from the respiratory tract, eg nasal leak, unless the patient is confirmed as being Covid-19 negative. Samples taken from other sites, eg ears or surgical wounds, will be analysed.
Restriction in the collection of cryoprotein samples
Collection of cryoprotein samples from St George’s Hospital are being restricted. If you require collection of a cryoprotein sample, please call the Immunology Consultants on 020 8725 5106 to discuss the case first.