Clinical Chemistry

The Clinical Chemistry department delivers a high-quality, clinically-led, analytical service. A comprehensive clinical and interpretative advice service is also provided by our highly trained clinical scientists and medical staff.

Clinical Chemistry input is critical to all aspects of the patient care pathway, including screening, diagnosis and monitoring of many conditions. We process between 5,000 and 6,000 samples per day and receive 6 to 7 million test requests per year. These samples come from:

  • Newborns to elderly patients
  • Acutely ill patients on the Neonatal Unit (NNU), the Critical Care Unit and the Emergency Department (ED)
  • Patients at outpatient clinics including Oncology and Renal Dialysis
  • General Practice (GP) clinics
  • Research and Clinical Trials

Type of samples we handle

  • Blood
  • Urine
  • Cerebrospinal Fluid (CSF)
  • Pleural and Other Fluids
  • Sweat Testing Samples
  • Dried Blood Spots
  • Renal Stones

The Automated Laboratory & STAT Area

The Automated Laboratory handles all our hospital, outpatient and GP work, and is therefore responsible for producing the majority of Clinical Chemistry results. The STAT area within it is where urgent samples are prioritised and quickly processed so results are available within one hour. Also the very small samples we receive on babies from NNU and children are also handled here as they require extra care to maximise testing from the small samples.

Routine tests include:

  • Renal, liver or bone function
  • Hormones (Thyroid, Testosterone, LH, FSH, Progesterone, Prolactin)
  • Haematinics (Ferritin, Folate and Vitamin B12)
  • Blood Gases

Specialist tests include:

  • hsTNT
  • NT-proBNP
  • Oestradiol
  • Tumour markers (CA125, CEA, AFP, HCG)
  • Alcohol
  • Drugs (e.g. Digoxin, Lithium, Phenytoin) and Antibiotics (e.g.Gentamicin, Vancomycin)

Manual Laboratory/Specialist Techniques

As the name suggests any test performed here requires more laboratory staff input and specialist methods. These include:

  • Ion Exchange Chromatography: HbA1c
  • ELISA: Faecal Calprotectin & Faecal Elastase
  • Spectrophotometry: CSF samples
  • High Performance Liquid Chromatography (HPLC): 24hr Urinary Metanephrines – 24hr Urinary 5HIAA
  • Chloride Meter: Chloride in sweat samples

We also send samples to other NHS laboratories for any specialist tests that we are unable to perform locally.

Behind The Scenes – Computer Algorithms

As well as testing patient samples, we can take results and further process them via our Pathology computer to extract more information that can be used in patient care.

Acute Kidney Injury (AKI)

AKI reporting is part of a national campaign to reduce short-term and long-term complications from deterioration in renal function, including death.

eGFR (estimated Glomerular Function) and Chronic Kidney Disease (CKD)

Using the eGFR the patient is then categorised as per national guidelines into a CKD stage, which the GPs particularly use in the management of their patients.

ASSIST-CKD (A programme to Spread eGFR graph Surveillance for the early Identification, Support and Treatment of people with progressive Chronic Kidney Disease.)

The Clinical Chemistry laboratory at RCH was the first in the country to initiate this quality improvement program. The Clinical Biochemists look at 5years of eGFR results and flag patients that potentially in the future will require dialysis. Reporting aims to either prevent the need for dialysis, delay the time to start dialysis and to provide adequate time to allow for patient preparation for dialysis or transplantation.

Key Clinical Chemistry Contacts

Head of Department

Dr Anthea Patterson (Consultant Clinical Biochemist)
01872 252546
antheapatterson@nhs.net

Consultant Chemical Pathologist

Dr Simon Fleming
01872 252541
simon.fleming2@nhs.net

Principal Clinical Biochemist and Down’s Screening Service Lead

Dr Angela Mallard
01872 252564
angela.mallard@nhs.net

Principal Clinical Biochemist

Miss Anna Barton
01872 252566
anna.barton3@nhs.net

Lead Biomedical Scientist for Clinical Chemistry

Alan Bromley
01872 252542
alan.bromley1@nhs.net

Specialist Registrar

Dr Rachel Cooper
01875 252567
rachel.cooper6@nhs.net

Joint reception manager & private patient billing

Jo Walsh
01872 252554
jowalsh@nhs.net

On-call Clinical Chemistry Consultant (out of hours)

Please call the Royal Cornwall Hospital switchboard on 01872 250000.

On-call Biomedical Scientist (out of hours)

Please bleep 3001 or call switchboard on 01872 250000.

More information about Clinical Chemistry