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Test Information

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This is a searchable database of information about tests offered by Severn Pathology. You can browse the index, enter a test name, part of a test name, abbreviation or clinical indication below.

Information available depends on the type of assay and department, but generally consists of alternative names, clinical indications, patient preparation (where appropriate), special precautions, department responsible for the test and reference ranges (where applicable).

The containers listed refer to those used to collect samples from adults locally in GP practices and hospital wards/outpatients. Details of the containers used for neonates, children and in the emergency zone (ED, AAU, ITU) can be found here Tube Guide and Recommended Order of Draw.

You may also find Lab Tests Online UK useful an additional resource for help you understand the many clinical laboratory tests that are used in diagnosis, monitoring and treatment of disease.

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Tube type	Sample type	Test name	Ideal volume	Turnaround time	Discipline

24	Serum	1,25-Dihydroxy Vitamin D	5 mL	4 weeks	Clinical Biochemistry
24	Serum	11-deoxycortisol	1 mL	1 week	Clinical Biochemistry
20	Plasma	17 OHP	5 mL	14 days	Clinical Biochemistry
31	Blood spot	17 OHP	see notes	14 days	Clinical Biochemistry
17	Plasma (fluoride oxalate)	3-Hydroxybutyrate	5 mL	7 days	Clinical Biochemistry
24	Serum	5-Alpha Dihydrotestosterone	1 mL	28 days	Clinical Biochemistry
5	Urine - 24 hour	5-HIAA	n/a	7 days	Clinical Biochemistry
20	Plasma	7-dehydrocholesterol	2 mL	28 days	Clinical Biochemistry
34	CSF	ACE	500 uL	6 weeks	Clinical Biochemistry
24	Serum	ACE	5 mL	7 days	Clinical Biochemistry
24	Serum	Acetylcholine Receptor Antibody	2 mL	3 weeks	Immunology
24	Serum	Aciclovir/CMMG		<3 days	Antimicrobial Reference Laboratory
14	Plasma	ACTH	5 mL	5 days	Clinical Biochemistry
24	Serum	Active B12/HoloTC	1 mL	7 days	Clinical Biochemistry
20	Plasma	Acylcarnitines	2 mL	21 days	Clinical Biochemistry
9	Blood spot	Acylcarnitines	1x Spot	21 days	Clinical Biochemistry
13	Plasma	ADAMTS13		Urgent requests: 24 hours; Routine requests: 2 weeks.	Haematology
34	Fluid	Adenosine Deaminase in TB	1 mL	14 days	Clinical Biochemistry
43	Swabs (nose and throat)	Adenovirus Molecular assay (NAAT)	0.5	2 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Adenovirus Molecular assay (NAAT)	0.5	2 days	Virology
34	Bronchoalveolar lavage (BALs) and Sputums	Adenovirus Molecular assay (NAAT)	0.5	2 days	Virology
11	Faecal sample	Adenovirus PCR	pea sized amount	2 days	Microbiology
43	Swab (eye)	Adenovirus (qualitative) PCR (In house)	0.5	4 days	Virology
14	EDTA Blood sample	Adenovirus (quantitative) PCR (In house)	0.45	3 days	Virology
24	Serum	Adrenal Cortex Antibody	2 mL	14 working days	Immunology
24	Serum	AFP	5 mL	1 day	Clinical Biochemistry
34	CSF	AFP	2 mL	3 days	Clinical Biochemistry
24	Fluid	Albumin	5 mL	3 days	Clinical Biochemistry
24	Serum	Albumin	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
35	Urine - Random	Albumin / creatinine ratio	n/a	1 day	Clinical Biochemistry
14	Plasma	Aldosterone	5 mL	21 days	Clinical Biochemistry
24	Serum	Alk Phos Isoenzymes	5 mL	7 days	Immunology
24	Serum	Allergen specific IgE	2 mL	7 working days	Immunology
24	Serum	ALP	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Alpha 1 antitrypsin activity	5 mL	3 days	Immunology
24	Serum	Alpha 1 antitrypsin phenotype	5 mL	14 working days	Immunology
24	Serum	Alpha subunit	2 mL	5 weeks	Clinical Biochemistry
24	Serum	ALT	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
10	Whole Blood	Aluminium	5 mL	7 days	Clinical Biochemistry
24	Serum	AMH	2 mL	1 week	Clinical Biochemistry
24	Serum	Amikacin		<1 day	Antimicrobial Reference Laboratory
34	CSF	Amino Acids CSF	1 mL	14 days	Clinical Biochemistry
20	Plasma	Amino Acids Plasma	2 mL	21 days	Clinical Biochemistry
35	Urine - Random	Amino Acids Urine	5 mL	21 days	Clinical Biochemistry
14	Plasma	Amiodarone	5 mL	7 days	Clinical Biochemistry
14	Plasma	Ammonia	1 mL	2 hours	Clinical Biochemistry
24	Fluid	Amylase	5 mL	3 days	Clinical Biochemistry
35	Urine - Random	Amylase	5 mL	4 hours	Clinical Biochemistry
24	Serum	ANCA	2 mL	4 working days	Immunology
24	Serum	Androstenedione	5 mL	28 days	Clinical Biochemistry
24	Serum	Anion Gap	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
16	Whole Blood	Antenatal Blood Group and Antibody Screen	4 mL	1 day	Blood Transfusion
24	Clotted blood sample	Antenatal Screen - HBsAg, HIV and Syphilis Serology	0.5	3 days	Virology
24	Serum	Anti Cardiolipin Antibody	2ml	1 week	Immunology
24	Serum	Anti PLA2 R	2ml	2 weeks	Immunology
13	Whole Blood	Anti Thrombin	3 full tubes	21 days	Haematology
13	Plasma	Anti-Xa	2.7 mL	4 hours for UFH, 24 hours for all other tests. If result is required more urgently than 24 hours, please contact haematology laboratory and testing will be expedited if possible.	Haematology
16	Whole Blood	ANTIBODY Investigation (red cells)	6ml x 2	Up to 72 hours	Blood Transfusion
35	Urine	Antihypertensive Drug Assay	5mL random	2 weeks	Clinical Biochemistry
24	Serum	Antinuclear Antibody	2 mL	4 working days	Immunology
14	Whole Blood	Apo E genotyping	4 mL	28 days	Genetics
24	Serum	Apolipoprotein B	1 mL	1 week	Clinical Biochemistry
13	Whole Blood	APTT/APTT-R	2.7 mL	24 hours	Haematology
14	Whole blood	Arsenic	2 mL	2 weeks	Clinical Biochemistry
34	Urine	Arsenic (urine)	5 mL	2 weeks	Clinical Biochemistry
25	Fluid	Asialotransferrin	see notes	3 working days	Immunology
24	Clotted blood samples	Aspergillus Antigen	700µL	Mean 1 day	Mycology Reference Laboratory
34	Broncheolar lavage (BAL) samples	Aspergillus Antigen	700µL	Mean 1 day	Mycology Reference Laboratory
34	Broncheolar lavage (BAL) samples	Aspergillus Antigen	700µL	Mean 1 day	Mycology Reference Laboratory
24	Clotted blood samples	Aspergillus Antigen	700µL	Mean 1 day	Mycology Reference Laboratory
24	serum	Aspergillus IgG	2ml	1 week	Immunology
24	Clotted blood samples	Aspergillus Precipitins	200µL	Mean 3 days	Mycology Reference Laboratory
24	Clotted blood samples	Aspergillus Precipitins	200µL	Mean 3 days	Mycology Reference Laboratory
24	Serum	AST	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
11	Faecal sample	Astrovirus PCR	pea sized amount	2 days	Microbiology
24	Serum	Autoimmune Liver Disease Antibodies	2 mL	4 working days	Immunology
43	Swabs (nose and throat)	Avian Influenza A PCR Molecular assay (NAAT)	0.5	2 days	Virology
24	Serum	Avian proteins IgG	2ml	1 week	Immunology
34	BAL MCS	BAL MCS	3 mL	12 days	Microbiology
35	Urine - Random	Barbiturates	5 mL	3 days	Clinical Biochemistry
24	Serum	Benzylpenicillin (Penicillin G)		<3 days	Antimicrobial Reference Laboratory
24	Serum	Beta 2 Glycoprotein 1	2 mL	7 working days	Immunology
24	Serum	Beta 2 microglobulin	2 mL	7 working days	Immunology
24	Clotted blood samples	Beta D Glucan	200µL	Mean <1 day	Mycology Reference Laboratory
24	Clotted blood samples	Beta D Glucan	200µL	Mean <1 day	Mycology Reference Laboratory
24	Serum	Bicarbonate	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Bilirubin	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
	Plasma	Bilirubin - infants	1 full paediatric lithium heparin tube	4 hours	Clinical Biochemistry
24	Serum	Bilirubin-(Conjugated fraction)	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
9	Blood spot	Biopterins	6x Spots	28 days	Clinical Biochemistry
14	Plasma	Biotinidase	1 mL	7 days	Clinical Biochemistry
34	Urine	BK virus (quantitative) PCR (In house)	0.5	3 days	Virology
14	EDTA Blood sample	BK virus (quantitative) PCR (In house)	0.45	3 days	Virology
14	Whole Blood	Blood Film		24 hours	Haematology
18	Whole Blood	Blood Gases	see notes	n/a	Clinical Biochemistry
	Bone Marrow	Bone Marrow Aspirate or Trephine			Haematology
24	Serum	Bone profile	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
43	Pernasal swabs	Bordetella parapertussis Molecular assay (NAAT)	0.5	3 days	Virology
43	Pernasal swabs	Bordetella pertussis Molecular assay (NAAT)	0.5	3 days	Virology
24	Clotted blood sample	Bordetella pertussis antibodies IgG	0.17	5 days	Virology
24	Clotted blood sample	Borrelia burgdorferi (Lyme) antibodies IgG and IgM	0.38	4 days	Virology
28	Urine - Random	C-peptide : creatinine ratio	2 mL	1 week	Clinical Biochemistry
14	Plasma	C-Peptide (plasma)	5ml	1 week	Clinical Biochemistry
11	Faeces	C.difficile toxin	Pot should be at least 1/3 full	24 hours	Microbiology
24	Serum	C1 Esterase Inhibitor	2 mL	14 working days	Immunology
14	Whole Blood	C3 Degradation Products	3 mL	5 working days	Immunology
24	Serum	C3 Nephritic Factor	2 mL	7 working days	Immunology
24	Serum	CA 125	5 mL	1 day	Clinical Biochemistry
24	Serum	CA 15-3	5 mL	1 day	Clinical Biochemistry
24	Serum	CA 19-9	5 mL	1 day	Clinical Biochemistry
35	Urine - Random	Cadmium	5 mL	14 days	Clinical Biochemistry
14	Whole Blood	Cadmium	4 mL	14 days	Clinical Biochemistry
24	Serum	Caeruloplasmin	5 mL	4 days	Clinical Biochemistry
24	Serum	Calcitonin	5 mL	14 days	Clinical Biochemistry
24	Serum	Calcium	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
4	Urine - 24 hour	Calcium	n/a	3 days	Clinical Biochemistry
27	Serum and Urine	Calcium excretion index	5 mL	3 days	Clinical Biochemistry
11	Faeces	Calprotectin	5 g	7 working days	Immunology
24	Clotted blood samples	Candida Antigen	300µL	Mean 1.6 days	Mycology Reference Laboratory
35	Urine - Random	Cannabinoids	5 mL	3 days	Clinical Biochemistry
24	Serum	Carbamazepine	5 mL	1 day	Clinical Biochemistry
18	Whole Blood	Carboxyhaemoglobin	full tube	n/a	Clinical Biochemistry
24	Serum	Cardiac Muscle Antibody	2 mL	21 working days	Immunology
35	Urine - Random	Carnitine,	5 mL	14 days	Clinical Biochemistry
	Urine - 24 hour	Catecholamines
14	Whole Blood	CD 4 Counts	3 mL	1 working day	Immunology
24	Serum	CDT	5 mL	14 days	Clinical Biochemistry
24	Serum	CEA	5 mL	4 days (due to batching of the assay)	Clinical Biochemistry
24	Serum	Centromere Antibody	2 mL	7 working days	Immunology
38	Aptima Urine	Chlamydia trachomatis NAAT	1 tube	3 days	Virology
1	Aptima Swab	Chlamydia trachomatis NAAT	1 tube	3 days	Virology
24	Clotted blood sample	Chlamydia trachomatis antibodies IgG	0.17	4 days	Virology
1	Swab (eye)	Chlamydia trachomatis/Neisseria gonorrhoeae NAAT	1 tube	3 days	Virology
37	See Notes	Chlamydia/ GC other swabs	n/a	10 days	Microbiology
38	Urine - Random	Chlamydia/ GC urine	n/a	10 days	Microbiology
1	See Notes	Chlamydia/ GC vaginal swabs	n/a	10 days	Microbiology
24	Serum	Chloramphenicol		<3 days	Antimicrobial Reference Laboratory
24	Serum	Chloride	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
20	Plasma	Cholestanol	1 mL	21 days	Clinical Biochemistry
24	Serum	Cholesterol	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Fluid	Cholesterol	2 mL	3 days	Clinical Biochemistry
14	Whole Blood	Cholinesterase Genotype	4 mL	10 - 12 weeks	Clinical Biochemistry
14	EDTA (whole blood)	Cholinesterase Studies	5 mL	3 - 4 weeks	Clinical Biochemistry
14	Whole Blood	Chromium	4 mL	14 days	Clinical Biochemistry
14	Plasma	Chromogranin A	5 mL	21 days	Clinical Biochemistry
24	Serum	Ciprofloxacin		<3 days	Antimicrobial Reference Laboratory
4	Urine - 24 hour	Citrate	n/a	7 days	Clinical Biochemistry
20	Plasma	Citrulline	1 mL		Clinical Biochemistry
24	Serum	CK	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
13	Whole Blood	Clauss Fibrinogen	2.7 mL	24 hours	Haematology
13	Whole Blood	Clotting Screen	2.7 mL	24 hours	Haematology
14	Plasma	Clozapine Level	2.7 mL	10 days
34	Urine	CMV PCR (In house)	0.5	3 days	Virology
24	Clotted blood sample	CMV IgG	CMV IgG and IgM 0.190, CMV IgG 0.17	4 days	Virology
24	Clotted blood sample	CMV IgM	CMV IgG and IgM 0.19, CMV IgM 0.17	4 days	Virology
14	Whole Blood	Cobalt	4 mL	14 days	Clinical Biochemistry
24	Serum	Colistin		<3 days	Antimicrobial Reference Laboratory
24	Serum	Complement C3 + C4	2 mL	4 working days	Immunology
24	Serum	Complement Function	5 mL	28 working days	Immunology
24	Serum	Copeptin	5 mL	14 days	Clinical Biochemistry
24	Serum	Copper	5 mL	7 days	Clinical Biochemistry
5	Urine - 24 hour	Copper	n/a	7 days	Clinical Biochemistry
24	Serum	Cortisol	5 mL	1 day	Clinical Biochemistry
34	Bronchoalveolar lavage (BALs) and Sputums	COVID-19 Molecular assay (NAAT)	0.5	1 day	Virology
43	Swabs (nose and throat)	COVID-19 Molecular assay (NAAT)	0.5	1 day	Virology
34	Nasopharayngeal aspirates (NPAs)	COVID-19 Molecular assay (NAAT)	0.5	1 day	Virology
35	Urine - Random	Creatine Studies	5 mL	14 days	Clinical Biochemistry
20	Plasma	Creatine Studies	2 mL	21 days	Clinical Biochemistry
24	Serum	Creatinine	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
34	Dialysate	Creatinine	2 mL	1 day	Clinical Biochemistry
24	Fluid	Creatinine	2 mL	3 days	Clinical Biochemistry
26	Serum and Urine	Creatinine clearance	n/a	8 hours	Clinical Biochemistry
24	Serum	Crithidia for dsDNA antibodies	2ml	14 working days	Immunology
0	Whole Blood	Crossmatch - (Lymphocyte) for Renal Transplantation Immunology	see "sample required"	Live donor typing and crossmatch = 28 working days	Immunology
16	Whole Blood	Crossmatch - Blood Transfusion	4 mL	See Notes	Blood Transfusion
24	Serum	CRP	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Cryoglobulin	Discuss with Laboratory	10 working days	Immunology
	CSF	CSF neurodegenerative markers	0.5mL in each tube	10 working days	Clinical Biochemistry
14	Plasma	CTx	2 mL	21 days	Clinical Biochemistry
24	Serum	Cyclic Citrullinated Peptide Antibodies	2 mL	14 Working days	Immunology
24	Serum	Cycloserine		<3 days	Antimicrobial Reference Laboratory
14	Whole Blood	Cyclosporin	4 mL	3 days	Clinical Biochemistry
24	Serum	Cystatin C	2mL	7 days	Clinical Biochemistry
4	Urine - 24 hour	Cystine 24 hour excretion	n/a	21 days	Clinical Biochemistry
33	Urine - timed	Cystine day/night	n/a	21 days	Clinical Biochemistry
35	Urine - Random	Cystine Random Urine	5 mL	21 days	Clinical Biochemistry
34	CSF	Cytomegalovirus CMV (quantitative) PCR (In house)	0.2	3 days	Virology
34	Amniotic fluid	Cytomegalovirus CMV (quantitative) PCR (In house)	0.2	3 days	Virology
14	EDTA Blood sample	Cytomegalovirus CMV (quantitative) PCR (In house)	0.45	3 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Cytomegalovirus CMV(qualitative) PCR (In house)	0.5	3 days	Virology
24	Clotted blood sample	Cytomegalovirus IgG avidity	0.17	4 days	Virology
34	Bronchoalveolar lavage (BALs) and Sputums	Cytomegaloviurs CMV (qualitative) PCR (In house)	0.5	3 days	Virology
13	Whole Blood	D-Dimer	2.7 mL	24 hours	Haematology
24	Serum	Daptomycin		<3 days	Antimicrobial Reference Laboratory
14	Whole Blood	DAT	3 mL	24 hours	Blood Transfusion
24	Serum	DHEAS	5 mL	10 days	Clinical Biochemistry
24	Serum	Diabetes Autoantibodies (ZnT8, GAD, IA2)	2 mL	28 working days	Immunology
24	Serum	Digoxin	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Down's Syndrome Screening	5 mL	7 days	Clinical Biochemistry
14	Whole Blood	DQ6(DQB1*06:02)	3 mL	14 working days	Immunology
35	Urine - Random	Drug (Overdose) Screen	5 mL	3 days	Clinical Biochemistry
35	Urine - Random	Drugs of Abuse	5 mL	4 days	Clinical Biochemistry
24	Serum	ds-DNA antibodies	2 mL	7 working days	Immunology
14	EDTA Blood sample	EBV (quantitative) PCR (In house)	0.45	3 days	Virology
24	Serum	eGFR	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Fluid	Electrolytes	2 mL	3 days	Clinical Biochemistry
24	Serum	ELF	5 mL	10 days	Clinical Biochemistry
24	Serum	Endomysium Antibody	2 mL		Immunology
14	EDTA Blood sample	Enterovirus PCR (In house)	0.45	3 days	Virology
34	Vesicle fluid	Enterovirus PCR (In house)	0.5	3 days	Virology
43	Swabs Throat swab	Enterovirus PCR (In house)	0.5	3 days	Virology
43	Vesicle swab	Enterovirus PCR (In house)	0.5	4 days	Virology
34	CSF	Enterovirus PCR (In house)	0.2	3 days	Virology
43	Vesicle Swab	Enterovirus PCR (In house)	0.5	4 days	Virology
11	Faecal sample	Enterovirus PCR (In house)	pea sized amount	3 days	Virology
24	Whole Blood	EPO	5 mL	10 days	Clinical Biochemistry
24	Clotted blood sample	Epstein Barr Virus (EBV) IgG	0.17	4 days	Virology
24	Clotted blood sample	Epstein Barr Virus (EBV) serology EBNA VCA IgG and IgM	0.42	4 days	Virology
34	CSF	Epstein Barr Virus EBV (qualitative) PCR (In house)	0.2	3 days	Virology
24	Serum	Ethambutol		<3 days	Antimicrobial Reference Laboratory
35	Urine - Random	Ethanol	2 mL	1 day	Clinical Biochemistry
17	Plasma	Ethanol	5 mL	4 hours	Clinical Biochemistry
17	Plasma	Ethylene glycol	5 mL	1 day	Clinical Biochemistry
24	Serum	Extractable Nuclear Antigen	2 mL	7 working days	Immunology
14	Whole Blood	Fabry Screen	4 mL	2-3 weeks	Clinical Biochemistry
13	Plasma	Factor II	2 full tubes	2 weeks	Haematology
13	Whole Blood	Factor IX Assay	2.7 mL	10 days	Haematology
13	Plasma	Factor V	2 full tubes	2 weeks	Haematology
13	Whole Blood	Factor V Leiden	2.7 mL	1 month	Haematology
13	Plasma	Factor VII	2 full tubes	2 weeks	Haematology
13	Whole Blood	Factor VIII Assay	2.7 mL	10 days	Haematology
13	Plasma	Factor VIII Inhibitor	2 full tubes	2 weeks, urgents will be processed as required following discussion with Haematologist	Haematology
13	Plasma	Factor X	2 full tubes	10 days	Haematology
13	Plasma	Factor XI	2 full tubes	10 days	Haematology
13	Plasma	Factor XII	2 full tubes	10 days	Haematology
13	Plasma	Factor XIII	2 full tubes	10 days	Haematology
11	Faeces	Faecal Elastase	5 g	16 working days	Immunology
		Faecal reducing substances
		Fat Globules
24	Serum	Ferritin	5 mL	24 hours	Clinical Biochemistry
14	Plasma	FGF-23	2 mL	4 weeks	Clinical Biochemistry
24	Plasma AND Serum	FIB-4	5 mL	24 hours	Clinical Biochemistry
	Faecal	FIT		2 working days	Immunology
24	Serum	Flucloxacillin		<3 days	Antimicrobial Reference Laboratory
	Serum	Fluconazole		< 2 days	Antimicrobial Reference Laboratory
	Serum	Flucytosine		< 2 days	Antimicrobial Reference Laboratory
16	Whole Blood	Foetal leak investigation	4 mL	1 day	Blood Transfusion
24	Serum	Folate	5 mL	24 hours	Clinical Biochemistry
24	Serum	Free androgen index	5 mL	7 days	Clinical Biochemistry
17	Plasma (fluoride oxalate)	Free Fatty Acids	2 mL	7 days	Clinical Biochemistry
16	Whole Blood	Free fetal DNA for fetal Rh typing	4 mL	15 days	Blood Transfusion
24	Serum	Free Light Chains	2 mL	7 working days	Immunology
24	Serum	Free Testosterone	5 mL	7 days	Clinical Biochemistry
24	Serum	Fructosamine	5 mL	7 days	Clinical Biochemistry
24	Serum	FSH	5 mL	1 day	Clinical Biochemistry
14	Whole Blood	Full Blood Count	4 mL	24 hours	Haematology
35	Urine - Random	Galactitol	5 mL	28 days	Clinical Biochemistry
20	Whole Blood	Galactokinase	1 mL	14 days	Clinical Biochemistry
20	Whole Blood	Galactosaemia screen	1 mL	7 days	Clinical Biochemistry
20	Whole Blood	Galactose-1-phosphate	0.5 mL	28 days	Clinical Biochemistry
20	Whole Blood	Galactose-1-phosphate uridyl transferase (quantitative)	1 mL	28 days	Clinical Biochemistry
24	Serum	Gamma GT	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Ganciclovir		<3 days	Antimicrobial Reference Laboratory
24	Serum	Ganglioside Antibodies	2 mL	21 working days	Immunology
24	Serum	Gastric Parietal Cell Antibody	2 mL	4 working days	Immunology
14	Plasma	Gastrin	5 mL	28 days	Clinical Biochemistry
24	Serum	GBM Antibody	2 mL	7 working days	Immunology
24	Serum	Gentamicin	5mL	Hospital patients 4 hours	Clinical Biochemistry
14	Plasma	Glucagon	5 mL	28 days	Clinical Biochemistry
17	CSF	Glucose	2 mL	4 hours	Clinical Biochemistry
17	Fluid	Glucose	2 mL	3 days	Clinical Biochemistry
24	Serum	Glucose (inpatients only)	5 mL	4 hours	Clinical Biochemistry
17	Plasma	Glucose (outpatients/General practice)	2 mL	1 day	Clinical Biochemistry
14	Whole Blood	Glucose 6 Phosphate Dehydrogenase	4 mL	5 working days, 10 working days if sent to referral laboratory for quantitative testing	Haematology
17	Plasma	Glucose tolerance test	2 mL	8 hours	Clinical Biochemistry
17	Plasma	Glucose tolerance test in Pregnancy	2 mL	1 day	Clinical Biochemistry
16	Whole Blood	Group and Hold	4 mL	24 hours	Blood Transfusion
24	Serum	Growth Hormone	5 mL	7 days	Clinical Biochemistry
14	Plasma	Gut Hormones	10 mL	28 days	Clinical Biochemistry
11	Faeces	H.pylori	1/3 full/10ml minimum	3 days	Microbiology
14	Whole Blood	Haematocrit	4 mL	24 hours	Haematology
14	Whole Blood	Haemoglobin	4 mL	24 hours	Haematology
14	Whole Blood	Haemoglobinopathy screen	4 mL	3 days	Haematology
24	Serum	Haemophilus B Antibodies (HIB)	2 mL	14 days	Immunology
34	Urine - Random and Bone Marrow	Haemosiderin	2 mL	7 days	Haematology
24	Serum	Haptoglobin	5 mL	7 working days	Clinical Biochemistry
14	Whole Blood	HbA1c	4 mL	3 working days	Haematology
34	CSF	hCG	2 mL	3 days	Clinical Biochemistry
24	Serum	hCG	5 mL	1 day (2 hours for urgent requests)	Clinical Biochemistry
	See Notes	hCG (Molar)			Clinical Biochemistry
24	Serum	HDL Cholesterol	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Clotted blood sample	Helicobacter pylori antibodies IgG	0.16	4 days	Virology
24	Clotted blood sample	Hepatitis A IgM and IgG	Anti-HAV 0.24 HAVIgM 0.17	3 days	Virology
14	EDTA Blood sample	Hepatitis B (quantitative) Molecular assay	1mL	5 days	Virology
24	Clotted blood sample	Hepatitis B Surface Antibody Anti-HBs (Quantitative)	0.3	3 days	Virology
24	Clotted blood sample	Hepatitis B Surface Antigen (HBsAG)	0.5	3 days - Screen 7 days - Confirmations	Virology
14	EDTA Blood sample	Hepatitis C (genotype) PCR (In house)	0.2	14 days	Virology
14	EDTA Blood sample	Hepatitis C (quantitative) PCR (In house)	1mL	5 days	Virology
24	Clotted blood sample	Hepatitis C antibody Total antibody screening & confirmation testing	0.5	3 days - Screen 7 days - Confirmations	Virology
24	Clotted blood sample	Hepatitis E IgM & IgG	0.5	4 days	Virology
24	Clotted blood sample	Hepatits B core antibody	0.26	3 days	Virology
34	CSF	Herpes Simplex HSV 1 and 2 PCR (In house)	0.2	3 days	Virology
43	Vesicle Swab	Herpes simplex HSV 1 and 2 PCR (In house)	0.5	4 days	Virology
43	Swab (eye)	Herpes simplex HSV 1 and 2 PCR (In house)	0.5	4 days	Virology
24	Clotted blood samples	Herpes Simplex HSV 1 and 2 specific serology IgG	0.19	4 days	Virology
14	EDTA blood sample	Herpes Simplex HSV 1and 2 PCR (In house)	0.45	3 days	Virology
14	EDTA (whole blood)	HGA - HFE Gene Analysis	1-5 ml		Genetics (Exeter lab)
14	EDTA Blood sample	HHV6 - Blood PCR (In house)	0.45	3 days	Virology
34	CSF	HHV6 - CSF PCR	0.45	3 days	Virology
24	Serum	Histone antibodies	2 mL	21 working days	Immunology
24	Serum	HIT		1 day for urgent requests, otherwise 5 days.	Haematology
14	EDTA Blood sample	HIV (quantitative) Molecular assay	1mL	7 days	Virology
24	Clotted blood sample	HIV 1 and 2 antigen/antibody Confirmation	0.5	7 days - Confirmations	Virology
24	Clotted blood sample	HIV 1 and 2 antigen/antibody Total antibody/antigen	0.35	3 days - Screen 4 days - confirmations	Virology
24	Serum	HLA antibody screen	8 mL	14 working days	Immunology
15	Whole Blood	HLA type (DR,DQ,DP)Class II	8 mL	28 working days	Immunology
15	Whole Blood	HLA type(A,B,C)Class I	8 mL	28 working days	Immunology
14	Whole Blood	HLA-A29	3 mL	14 working days	Immunology
14	Whole Blood	HLA-B27	3 mL	14 working days	Immunology
14	Whole Blood	HLA-B51(5)	3 mL	14 working days	Immunology
14	Whole Blood	HLA-B57(B*57:01)	3 mL	10 working days	Immunology
14	Whole Blood	HLA-DQ2+DQ8(3)	3 mL	14 working days	Immunology
14	Plasma	Homocysteine (Total)	2 mL	7 days	Clinical Biochemistry
24	Clotted blood sample	HTLV antibody Total Antibody screening	0.25	3 days	Virology
43	Swabs (nose and throat)	Human metapneumovirus Molecular assay (NAAT)	0.5	2 days	Virology
34	Bronchoalveolar lavage (BALs) and Sputums	Human metapneumovirus Molecular assay (NAAT)	0.5	2 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Human metapneumovirus Molecular assay (NAAT)	0.5	2 days	Virology
35	Urine - Random	HVA	5 mL	7 days	Clinical Biochemistry
24	Serum	IgE	2 mL	7 working days	Immunology
24	Serum	IGF-1	5 mL	5 days	Clinical Biochemistry
24	Serum	IGFBP-3	5 mL	14 days	Clinical Biochemistry
24	Serum	IgG Subclasses	2 mL	7 working days	Immunology
14	Whole Blood	Immunodeficiency (Immunophenotyping)	3 mL	2 working days	Immunology
	n/a	Immunodeficiency Investigations			Immunology
24	Serum	Immunoglobulins	2 mL	3 working days	Immunology
7	Rectal Swab	Infection screen – VRE		3 days	Microbiology
7	Various	Infection screen Carbapenemase screen (rectal swab)	n/a	3 days	Microbiology
	Various	Infection screen MRC MRC screen for ESBL-producing Enterobacterales	n/a	3 days	Microbiology
	Various	Infection screen MRSA Screen	n/a	2days	Microbiology
	Various	Infection screen MSSA Screening (Renal/ Spinal)	n/a	3 days	Microbiology
7	Various	Infection screen Pseudomonas Screening (NICU)	n/a	3 days	Microbiology
14	Plasma	Infectious Mononucleosis	3 mL	72 hours	Haematology
34	Nasopharayngeal aspirates (NPAs)	Influenza A Virus Molecular assay (NAAT)	0.5	2 days	Virology
43	Swabs (nose and throat)	Influenza A Virus Molecular assay (NAAT)	0.5	2 days	Virology
34	Bronchoalveolar lavage (BALs) and Sputums	Influenza A virus Molecular assay (NAAT)	0.5	2 days	Virology
43	Swabs (nose and throat)	Influenza B Virus Molecular assay (NAAT)	0.5	2 days	Virology
34	Bronchoalveolar lavage (BALs) and Sputums	Influenza B virus Molecular assay (NAAT)	0.5	2 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Influenza B Virus Molecular assay (NAAT)	0.5	2 days	Virology
13	Whole Blood	INR	2.7 mL	24 hours	Haematology
44	Plasma	Insulin (Paediatric)	1 mL	1 working day	Clinical Biochemistry
24	Serum	Insulin and C-peptide	5 mL	14 days	Clinical Biochemistry
24	Serum	Insulin Antibodies	2 mL	21 working days	Immunology
24	Serum	Intrinsic Factor Antibodies	5 mL	10 days	Clinical Biochemistry
24	Serum	Iohexol GFR	2ml	7 days	Clinical Biochemistry
24	Serum	Iron	5 mL	<4 hours	Clinical Biochemistry
24	Serum	Iron and Transferrin Saturation	5 mL	1 day	Clinical Biochemistry
	Serum	Isavuconazole		< 2 days	Antimicrobial Reference Laboratory
17	Whole Blood Collected in Fluoride Oxalate (Fx) Tube	Isoniazid (+ N-Acetyl-Isoniazid)	1-2 ml	<3 days (from day of receipt)	Antimicrobial Reference Laboratory
	n/a	Issue of Albumin Solution	n/a		Blood Transfusion
	n/a	Issue of Fresh Frozen Plasma	n/a		Blood Transfusion
	n/a	Issue of Platelets	n/a		Blood Transfusion
	Serum	Itraconazole		< 2 days	Antimicrobial Reference Laboratory
35	Urine - Random	Ketones	5 mL	n/a	Clinical Biochemistry
17	CSF	Lactate	2 mL	4 hours	Clinical Biochemistry
17	Plasma	Lactate (Laboratory analysis)	2 mL	4 hours	Clinical Biochemistry
18	Whole Blood	Lactate (Point of Care Testing)	n/a	n/a	Clinical Biochemistry
14	Plasma	Lamotrigine	5 mL	1 - 2 weeks	Clinical Biochemistry
34	CSF	LDH	0.5 mL	3 days	Clinical Biochemistry
24	Fluid	LDH	2 mL	3 days	Clinical Biochemistry
24	Serum	LDH	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	LDL Cholesterol	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
35	Urine - Random	Lead	5 mL	7 days	Clinical Biochemistry
14	Whole Blood	Lead	1 mL	7 days	Clinical Biochemistry
34	Urine	Legionella antigen		1 day	Microbiology
34	Lymph Nodes	Leukaemial/Lymphoma Immunophenotyping	see notes	1 working day	Immunology
14	Bone Marrow	Leukaemial/Lymphoma Immunophenotyping	0.5 mL	1 working day	Immunology
14	Whole Blood	Leukaemial/Lymphoma Immunophenotyping	3 mL	1 working day	Immunology
34	Other fluids	Leukaemial/Lymphoma Immunophenotyping	see notes	1 working day	Immunology
20	Whole Blood	Leukocyte Cystine	4 mL	28 days	Clinical Biochemistry
24	Serum	Levofloxacin		<3 days	Antimicrobial Reference Laboratory
24	Serum	LFT	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	LH	5 mL	1 day	Clinical Biochemistry
24	Serum	Linezolid		<3 days	Antimicrobial Reference Laboratory
24	Serum	Lipase	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Lipid Profile	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Lipoprotein (a)	5 mL	21 days	Clinical Biochemistry
24	Serum	Lipoprotein Electrophoresis	5 mL	14 days	Clinical Biochemistry
24	Serum	Lithium	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Liver Kidney Microsomal	2 mL	4 working days	Immunology
24	Serum	Liver line blot	2ml	2 weeks	Immunology
13	Whole Blood	Lupus Anticoagulant	3 full tubes	10 days	Haematology
20	Whole Blood	Lymphocyte Function Tests	7 mL	7 working days	Immunology
24	Serum	Macro CK	5 mL	4-6 weeks	Clinical Biochemistry
24	Serum	Macroprolactin	5 mL	14 days	Clinical Biochemistry
24	Serum	Macroprolactin confirmation	2 mL	3 weeks	Clinical Biochemistry
4	Urine - 24 hour	Magnesium	n/a	3 days	Clinical Biochemistry
24	Serum	Magnesium	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
14	Whole Blood	Malaria Parasites	4 mL	24 hours, 7 working days if sent to Referral Laboratory for confirmation	Haematology
10	Whole Blood	Manganese	5 mL	14 days	Clinical Biochemistry
24	Serum	Mannose Binding Lectin	2 mL	14 working days	Immunology
14	Whole Blood	Manual Blood Film including White Cell differential		24 hours	Haematology
24	Serum	Mast Cell Tryptase	2 mL	9 working days	Immunology
14	Whole Blood	MCH	4 mL	24 hours	Haematology
14	Whole Blood	MCHC	4 mL	24 hours	Haematology
8	Whole Blood	MCS (Blood Culture)	Adults: 8-10mL blood per blood culture bottle; Paeds: 1-3mL blood. Wherever possible, please ensure that each bottle of the blood culture set is inoculated with the correct volume of blood. Smaller volumes adversely affect the sensitivity of the assay.	6 days	Microbiology
34	CSF	MCS (Cerebrospinal fluid)	3 mL	4 hours Microscopy 4 days Culture & sensitivities	Microbiology
	Corneal Scrapes	MCS (Corneal Scrapes)		10 days	Microbiology
7	Swab	MCS (Ear / left / right)	n/a	4 days	Microbiology
7	Swab	MCS (Eye / left / right)	n/a	4 days	Microbiology
11	Faeces	MCS (Faeces)	1/3 full/10ml minimum	4 days	Microbiology
34	Fluid	MCS (Fluids)	3 mL	8 days	Microbiology
7	Swab	MCS (Genital Swabs)	n/a	4 days	Microbiology
7	Mouth	MCS (Mouth Swab)	n/a	4 days	Microbiology
7		MCS (Nose swab)	n/a	4 days	Microbiology
41	Penile / Urethral	MCS (Penile / Urethral swab)	n/a	4 days	Microbiology
34	Peritoneal fluid	MCS (Peritoneal Dialysis fluid)	n/a	8 days	Microbiology
34	Pus	MCS (Pus)	n/a	10 days	Microbiology
7	Swab	MCS (Skin swab)	n/a	4 days	Microbiology
34	Sputum	MCS (Sputum)	n/a	5 days	Microbiology
7	Swab	MCS (Throat swab)	n/a	4 days	Microbiology
34	Tip	MCS (Tip)	n/a	4 days	Microbiology
34	Tissue	MCS (Tissues)	n/a	10 days	Microbiology
34	Trachael aspirate	MCS (Tracheal aspirate)	n/a	4 days	Microbiology
28	Urine	MCS (Urine Catheter)	> 3 ml	3 days	Microbiology
28	Urine	MCS (Urine)	> 3 ml	3 days	Microbiology
7	Swab	MCS (Wound Swab)	n/a	4 days	Microbiology
14	Whole Blood	MCV	4 mL	24 hours	Haematology
24	Clotted blood sample	Measles IgG	0.17	4 days	Virology
24	Clotted blood samples	Measles IgG and IgM	0.19	4 days	Virology
43	Swabs (nose and throat)	Measles PCR PCR (In house)	0.5	3 days	Virology
35	Urine - Random	Mercury	1 mL	14 days	Clinical Biochemistry
14	Whole Blood	Mercury	1 mL	14 days	Clinical Biochemistry
24	Serum	Meropenem		<3 days	Antimicrobial Reference Laboratory
43	Swabs (nose and throat)	MERS-CoV Molecular assay (NAAT) Biofire Film array RP2	0.5	4 hours from receipt for initial screening.	Virology
24	Serum	Mesothelin	2 ml	Please note this test is not currently available. For further information or enquires please contact the Immunology laboratory 0117 4148366	Immunology
4	Urine - 24 hour	Metadrenalines	n/a	7 days	Clinical Biochemistry
14	Whole Blood	Metadrenalines (Plasma)	4 mL	2 weeks	Clinical Biochemistry
17	Plasma	Methanol	5 mL	1 day	Clinical Biochemistry
34	Fluids - e.g. CSF, vitreous	Microscopy and Culture	200µL	Microscopy mean 1 day	Mycology Reference Laboratory
34	Bronchoalveolar lavage (BALs) and Sputums	Microscopy and Culture	300µL	Microscopy mean 1 day	Mycology Reference Laboratory
34	Tissue - e.g. lung biopsy, corneal scraping	Microscopy and Culture		Microscopy mean 1 day	Mycology Reference Laboratory
34	Fluids - e.g. CSF, vitreous	Microscopy and Culture	200µL	Microscopy mean 1 day	Mycology Reference Laboratory
34	Bronchoalveolar lavage (BALs) and Sputums	Microscopy and Culture	300µL	Microscopy mean 1 day	Mycology Reference Laboratory
34	Tissue - e.g. lung biopsy, corneal scraping	Microscopy and Culture		Microscopy mean 1 day	Mycology Reference Laboratory
		Microscopy for Crystals			Cytology
24	Serum	Mitochondrial antibody	2 mL	4 working days	Immunology
35	Urine - Random	MMA	5 mL	28 days	Clinical Biochemistry
24	Serum	MMA	2 mL	20 days	Clinical Biochemistry
43	Swabs (nose and throat)	Molecular assay (NAAT) Biofire Film array RP2	0.5	4 hours from receipt.	Virology
24	Serum	Moxifloxacin		<3 days	Antimicrobial Reference Laboratory
14	Bone Marrow	MRD Flow Cytometry	0.5 mL	1 working day	Immunology
35	Urine - Random	Mucopolysaccharide screen	5 mL	14 days	Clinical Biochemistry
24	Clotted blood sample	Mumps IgG	0.17	4 days	Virology
23	Skin	Mycology Skin Scrapings	n/a	15 days	Microbiology
23	Hair	Mycology Hair	n/a	15 days	Microbiology
23	Nail clippings	Mycology Nail	n/a	15 days	Microbiology
14	Whole Blood	Mycophenolate	4 mL	14 days	Clinical Biochemistry
45	Aptima Swab or urine with a Copan or virocult swab	Mycoplasma Genitalium	1 tube	3 days	Virology
43	Swabs (nose and throat)	Mycoplasma pneumoniae Molecular assay (NAAT) Biofire Film array RP2	0.5	4 hours from receipt.	Virology
		Myoglobin - Urine
24	Serum	Myositis line blot	2ml	2 weeks	Immunology
34	Urine - Random	NAG: Creatinine ratio	1 mL	4 weeks	Clinical Biochemistry
38	Aptima Urine	Neisseria gonorrhoeae NAAT	1 tube	3 days	Virology
1	Aptima Swab	Neisseria gonorrhoeae NAAT	1 tube	3 days	Virology
44	Whole Blood	Neonatal Blood Group	1 mL	24 hours	Blood Transfusion
44	Whole Blood	Neonatal Crossmatch - Blood Transfusion	1 mL	See Notes	Blood Transfusion
44	Whole Blood	Neonatal DAT	1 mL	24 hours	Blood Transfusion
24	Serum	Neuron Specific Enolase	5 mL	3 days	Clinical Biochemistry
24	Serum	Neuronal Antibody (Purkinje)	2 mL	14 working days	Immunology
14	Plasma	Neurotensin	5 mL	28 days	Clinical Biochemistry
32	CSF	Neurotransmitters	see notes	4 - 6 weeks	Clinical Biochemistry
20	Whole Blood	Neutrophil Function Tests	7 mL	2 working days	Immunology
9	Blood spot	Newborn Screen	4x Spots		Clinical Biochemistry
11	Faecal sample	Norovirus PCR	pea sized amount	2 days	Microbiology
24	Serum	NT-Pro-BNP	5 mL	1 day	Clinical Biochemistry
24	Serum	Oestradiol	5 mL	1 day	Clinical Biochemistry
25	Serum and CSF	Oligoclonal bands	200ul CSF, 200ul Serum	5 working days	Immunology
34	CSF	Orexin	2mL	42 days	Clinical Biochemistry
35	Urine - Random	Organic acids	5 mL	14 days	Clinical Biochemistry
35	Urine - Random	Orotic acid	5 mL	14 days	Clinical Biochemistry
35	Urine - Random	Osmolality	5 mL	Hospital patients 8 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Osmolality	5 mL	Hospital patients 8 hours; GP patients 24 hours	Clinical Biochemistry
11	Faeces/ Urine	Ova Cysts & Parasites Faeces/ Urine - Concentrate	Minimum volume: 1/3 full/10ml minimum	4 days	Microbiology
24	Serum	Ovarian Antibody	2 mL	21 working days	Immunology
14	Plasma	Oxalate	5 mL	14 days	Clinical Biochemistry
4	Urine - 24 hour	Oxalate	n/a	7 days	Clinical Biochemistry
24	Serum	Pancreatic Islet Cell Antibody	2 mL	14 working days	Immunology
14	Plasma	Pancreatic Polypeptide	5 mL	28 days	Clinical Biochemistry
24	Serum	Paracetamol	5 mL	4 hours	Clinical Biochemistry
34	Bronchoalveolar lavage (BALs) and Sputums	Paraflu 1 Molecular assay (NAAT)	0.5	2 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Paraflu 1 Molecular assay (NAAT)	0.5	2 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Paraflu 2 Molecular assay (NAAT)	0.5	2 days	Virology
34	Bronchoalveolar lavage (BALs) and Sputums	Paraflu 2 Molecular assay (NAAT)	0.5	2 days	Virology
43	Swabs (nose and throat)	Paraflu 2 Molecular assay (NAAT)	0.5	2 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Paraflu 3 Molecular assay (NAAT)	0.5	2 days	Virology
34	Bronchoalveolar lavage (BALs) and Sputums	Paraflu 3 Molecular assay (NAAT)	0.5	2 days	Virology
43	Swabs (nose and throat)	Paraflu 3 Molecular assay (NAAT)	0.5	2 days	Virology
34	Bronchoalveolar lavage (BALs) and Sputums	Paraflu 4 Molecular assay (NAAT)	0.5	2 days	Virology
43	Swabs (nose and throat)	Paraflu 4 Molecular assay (NAAT)	0.5	2 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Paraflu 4 Molecular assay (NAAT)	0.5	2 days	Virology
43	Swabs (nose and throat)	Paraflu1 Molecular assay (NAAT)	0.5	2 days	Virology
24	Serum	Paraneoplastic line blot	2ml	2 weeks	Immunology
14	EDTA Blood sample	Parvovirus PCR (In house)	0.45	3 days	Virology
34	Amniotic fluid	Parvovirus PCR (In house)	0.2	3 days	Virology
24	Clotted blood samples	Parvovirus IgG and IgM	Parvovirus IgG 0.17mL, Parvovirus IgG and IgM 0.19mL	4 days	Virology
24	Serum	Phenobarbitone	5 mL	1 day	Clinical Biochemistry
9	Blood spot	Phenylalanine	2x Spots	5 days	Clinical Biochemistry
24	Serum	Phenytoin	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
4	Urine - 24 hour	Phosphate	n/a	3 days	Clinical Biochemistry
24	Serum	Phosphate	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
20	Plasma	Phytanic acid	2 mL	21 days	Clinical Biochemistry
24	Serum	PIIINP	2 mL	4-6 weeks	Clinical Biochemistry
24	Serum	Piperacillin		<3 days	Antimicrobial Reference Laboratory
13	Plasma	PIVKA II		10 days	Haematology
14	Whole Blood	Plasma Viscosity	4 mL	3 days	Haematology
14	Whole Blood	Platelet count (EDTA & Citrate)	4 mL	24 hours	Haematology
14	See Notes	PNH Immunophenotyping	3 mL	4 working days	Immunology
14	Whole Blood	Porphyrin Enzyme/DNA analysis	4 mL	28 days	Clinical Biochemistry
14	Whole Blood	Porphyrins	5-10 mL	15 days	Clinical Biochemistry
11	Faeces	Porphyrins	5 g	15 days	Clinical Biochemistry
34	Urine - Random	Porphyrins	10 mL	15 days	Clinical Biochemistry
	Serum	Posaconazole		< 2 days	Antimicrobial Reference Laboratory
5	Urine	Potassium	n/a	1 day	Clinical Biochemistry
24	Serum	Potassium	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Prednisolone	5 mL	21 days	Clinical Biochemistry
24	Serum	Progesterone	5 mL	1 day	Clinical Biochemistry
24	Serum	Prolactin	5 mL	1 day	Clinical Biochemistry
35	Urine - Random	Protein	5 mL	1 day	Clinical Biochemistry
34	CSF	Protein	2 mL	4 hours	Clinical Biochemistry
34	Dialysate	Protein	5 mL	8 hours	Clinical Biochemistry
24	Serum	Protein	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Fluid	Protein	5 mL	3 days	Clinical Biochemistry
13	Whole Blood	Protein C	3 full tubes	21 days	Haematology
13	Whole Blood	Protein S	3 full tubes	21 days	Haematology
13	Whole Blood	Prothrombin Gene Mutation	3 full tubes	1 month	Haematology
24	Serum	PSA	5 mL	1 day	Clinical Biochemistry
14	Plasma	PTH	5 mL	1 day	Clinical Biochemistry
32		PTH-related peptide			Clinical Biochemistry
35	Urine - Random	Purine / Pyrimidine Screen	5 mL	21 days	Clinical Biochemistry
14	Plasma	Pyruvate Kinase		21 days	Haematology
32	See Notes	Quantiferon		7 working days	Immunology
24	Serum	RAST	2 mL		Immunology
14	Whole Blood	Red Blood Count	4 mL	24 hours	Haematology
		Red cell Transketolase
14	Plasma	Renin	5 mL	28 days	Clinical Biochemistry
34	Bronchoalveolar lavage (BALs) and Sputums	Respiratory Syncytial Virus Molecular assay (NAAT)	0.5	2 days	Virology
43	Swabs (nose and throat)	Respiratory Syncytial Virus Molecular assay (NAAT)	0.5	2 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Respiratory syncytial virus Molecular assay (NAAT)	0.5	2 days	Virology
14	Whole Blood	Reticulocytes	4 mL	24 hours	Haematology
34	Urine - Random	Retinol Binding Protein	20 mL	14 days	Clinical Biochemistry
24	Serum	Rheumatoid Factor	2 mL	3 working days	Immunology
34	Bronchoalveolar lavage (BALs) and Sputums	Rhinovirus Molecular assay (NAAT)	0.5	2 days	Virology
43	Swabs (nose and throat)	Rhinovirus Molecular assay (NAAT)	0.5	2 days	Virology
34	Nasopharayngeal aspirates (NPAs)	Rhinoviurs Molecular assay (NAAT)	0.5	2 days	Virology
24	Serum	Rifabutin		<3 days	Antimicrobial Reference Laboratory
24	Serum	Rifampicin		<3 days	Antimicrobial Reference Laboratory
13	Whole Blood	Ristocetin Co Factor.	2.7 mL	21 days	Haematology
14	Whole blood	Rituximab	3ml	2 working days	Immunology
11	Faecal sample	Rotavirus PCR	pea sized amount	2 days	Microbiology
24	Clotted blood samples	Rubella IgG and IgM	Parvovirus IgG 0.17mL, Parvovirus IgG and IgM 0.19mL	4 days	Virology
24	Serum	Salicylate	5 mL	4 hours	Clinical Biochemistry
24	Serum	Salivary Gland Antibodies	2 mL	21 working days	Immunology
11	Faecal sample	Sapovirus PCR	pea sized amount	2 days	Microbiology
24	Serum	Selenium	5 mL	7 days	Clinical Biochemistry
5	Urine - 24 hour	Selenium	n/a	14 days	Clinical Biochemistry
24	Serum	Serum Electrophoresis	2 mL	5 working days	Immunology
24	Serum	SHBG	5 mL	7 days	Clinical Biochemistry
24	Serum	Short Synacthen Test	5 mL	1 day	Clinical Biochemistry
35	Urine - Random	Sialic acid	5 mL	14 days	Clinical Biochemistry
14	Whole Blood	Sickle Cell Screen	4 mL	24 hours (confirmatory testing); 1 hour (urgent and request phoned through to lab)	Haematology
14	Whole Blood	Sirolimus	4 mL	3 days	Clinical Biochemistry
24	Serum	Skeletal Muscle Antibody	2 mL	21 working days	Immunology
24	Serum	Skin Antibody (Pemphigus/Pemphigoid)	2 mL	14 working days	Immunology
24	Serum	Smooth Muscle Antibody	2 mL	4 working days	Immunology
35	Urine - Random	Sodium	5 mL	1 day	Clinical Biochemistry
24	Serum	Sodium	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
14	Plasma	Somatostatin	5 mL	28 days	Clinical Biochemistry
5	Urine - 24 hour	Steroid Profile (urine)	n/a	14 days	Clinical Biochemistry
34	Stone	Stones - Renal Calculi	n/a	14 days	Clinical Biochemistry
24	Clotted blood sample	Streptococcus serology (antistreptolysin O) ASO	0.15	6 days	Virology
24	Serum	Streptomycin		<3 days	Antimicrobial Reference Laboratory
24	Serum	Sulphamethoxazole in Co-trimoxazole		<3 days	Antimicrobial Reference Laboratory
24	Serum	Sulphonylurea	5 mL	28 days	Clinical Biochemistry
24	Clotted blood samples	Syphilis RPR	0.5	4 days - Confirmations	Virology
24	Clotted blood samples	Syphilis confirmation testing - IgG and IgM; Treponemal serology	0.5	4 days - Confirmations	Virology
43	Copan swab	Syphilis PCR	1 tube	10 days	Virology
24	Clotted blood sample	Syphilis serology Total Antibody - Screening	0.5	3 days - Screen	Virology
24	Serum	Systemic Sclerosis line blot	2ml	2 weeks	Immunology
14	Whole Blood	T Cell Subsets (see CD4 Counts)	3 mL	1 working day	Immunology
14	Whole Blood	Tacrolimus	4 mL	3 days	Clinical Biochemistry
39	Whole Blood	TB (Mycobacterium Blood)	3-5 mL	70 days	Microbiology
6	Urine	TB (Mycobacterium Urine)	250 mL	70 days	Microbiology
34	Sputum/ Pus/ Tissue, NOT Swabs	TB (Mycobacterium) samples (other than Blood/ Urine)	n/a	70 days	Microbiology
24	Serum	Teicoplanin		<2 days	Antimicrobial Reference Laboratory
24	Serum	Testis Antibody	2 mL	21 working days	Immunology
24	Serum	Testosterone	5 mL	1 day	Clinical Biochemistry
24	Serum	Testosterone confirmation	1 mL	14 days	Clinical Biochemistry
24	Serum	Tetanus antibodies	2 mL	28 working days	Immunology
24	Serum	TFT confirmation	1 mL	3 weeks	Clinical Biochemistry
24	Serum	Theophylline	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
14	Whole Blood	Thiopurine Metabolites	4 mL	21 days	Clinical Biochemistry
14	Whole Blood	Thiopurine methyl transferase	4 mL	14 days	Clinical Biochemistry
0	Rectal suspension kit	Threadworm		4 days	Microbiology
13	Whole Blood	Thrombophilia Screen	3 full tubes	21 days	Haematology
24	Serum	Thyroglobulin	5 mL	7 days	Clinical Biochemistry
24	Serum	Thyroid Function Tests	5 mL	1 day	Clinical Biochemistry
24	Serum	Thyroid Peroxidase Antibody	2 mL	7 days	Clinical Biochemistry
24	Serum	Tissue Transglutaminase Antibody	2 mL	7 working days	Immunology
24	Serum	Tobramycin		<1 day	Antimicrobial Reference Laboratory
24	Serum	Total Bile Acids	5 mL	1 day	Clinical Biochemistry
24	Serum	Total Protein	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Clotted blood samples	Toxoplasma Total antibody & IgM	0.5	5 days	Virology
24	Serum	Transferrin Glycoforms	5 mL	14 days	Clinical Biochemistry
16	Whole Blood	Transfusion Reaction	6ml	24 hours	Blood Transfusion
1	Aptima Swab	Trichomonas vaginalis NAAT	1 tube	3 days	Virology
24	Serum	Triglycerides	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Trimethoprim in Co-trimoxazole		<3 days	Antimicrobial Reference Laboratory
4	Urine - 24 hour	Trimethylamine	n/a	8 weeks	Clinical Biochemistry
24	Serum	Troponin I	5 mL	4 hours	Clinical Biochemistry
9	Blood spot	TSH	2x Spots	7 days	Clinical Biochemistry
24	Serum	TSH Receptor Antibodies	2ml	8 working days	Immunology
24	Serum	U/E (Urea and Electrolytes)	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
24	Serum	Urate	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
3	Urine - 24 hour	Urate	n/a	1 day	Clinical Biochemistry
24	Serum	Urea	5 mL	Hospital patients 4 hours; GP patients 24 hours	Clinical Biochemistry
5	Urine	Urine Electrolytes	n/a	1 day	Clinical Biochemistry
35	Urine - Random	Urine Electrophoresis	1 mL	5 working days	Immunology
5	Urine - 24 hour	Urine Free Cortisol	n/a	2-3 weeks	Clinical Biochemistry
		Urine reducing substances
5	Urine	Urine Urea	n/a	1 day	Clinical Biochemistry
5	Urine - 24 hour	Urine volume	n/a	2 days	Clinical Biochemistry
24	Serum	Valproate	5 mL	7 days	Clinical Biochemistry
24	Serum	Vancomycin	5mL	Hospital patients 4 hours	Clinical Biochemistry
34	Lesion/vesicle fluid	Varicella zoster PCR (In house)	0.5	3 days	Virology
43	Vesicle Swab	Varicella zoster PCR (In house)	0.5	4 days	Virology
14	EDTA Blood sample	Varicella zoster PCR (In house)	0.45	3 days	Virology
34	CSF	Varicella Zoster PCR (In house)	0.2	3 days	Virology
24	Clotted blood samples	Varicella zoster IgG	0.17	3 days	Virology
24	Serum	VEGF	2 mL	21 days	Clinical Biochemistry
20	Plasma	Very long chain fatty acids	2 mL	21 days	Clinical Biochemistry
14	Plasma	VIP	5 mL	28 days	Clinical Biochemistry
	Whole Blood	Viral Haemorrhagic Fever	7 mL	1 day	Virology
0	Various	Virology/ Serology (referred tests)	n/a	10 days	Virology
24	Serum	Vitamin A	2 mL	14 days	Clinical Biochemistry
14	Whole Blood	Vitamin B1	4 mL	2 weeks	Clinical Biochemistry
24	Serum	Vitamin B12	5 mL	3 days	Clinical Biochemistry
14	Whole blood	Vitamin B6	4 mL	3 weeks	Clinical Biochemistry
20	Plasma	Vitamin C	2 mL	4 weeks	Clinical Biochemistry
24	Serum	Vitamin D	5 mL	7 days	Clinical Biochemistry
24	Serum	Vitamin E	2 mL	14 days	Clinical Biochemistry
35	Urine - Random	VMA	5 mL	7 days	Clinical Biochemistry
13	Whole Blood	Von Willebrand's Disease	2.7 mL	3 weeks	Haematology
	Serum	Voriconazole		< 2 days	Antimicrobial Reference Laboratory
13	Plasma	Warfarin levels		10 days	Haematology
27	Serum and Urine	Water Deprivation Test	see notes	1 day	Clinical Biochemistry
14	Whole Blood	White Blood Count	4 mL	24 hours	Haematology
14	Whole Blood	White Cell Enzymes	5 mL	3-4 weeks	Clinical Biochemistry
34	CSF	Xanthochromia	1 mL	4 hours	Clinical Biochemistry
10	Plasma	Zinc	5 mL	7 days	Clinical Biochemistry
		Zinc Protoporphyrin

Fri 8 May 2026 - 12:00

Medical Same Day Emergency Care (SDEC)

Read more about Medical Same Day Emergency Care (SDEC)

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Medical Same Day Emergency Care (SDEC)

Medical Same Day Emergency care (SDEC) is situated at Gate 36, Level 1, within the Emergency Zone, Brunel building.

The Same Day Emergency Care Unit provides:

assessment
investigation
diagnosis
management of patients with an acute illness within 1 day.

The Same Day Emergency Care team consists of consultants, nurses, pharmacists, junior doctors, advanced practitioners, and physician associates. Support is provided to the team by specialist nurses and doctors in other specialties.

Contact the Medical SDEC team

Medical Same Day Emergency Care
Gate 36
Level 1
Brunel building
Southmead Hospital
BS10 5NB

Phone: 0117 414 7408

Analytes

Read more about Analytes

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Gentamicin

As of 2nd December 2024, this test will be provided on the Clinical Biochemistry analytical platform, however clinical advice will still be offered by the Microbiology service 0117 4146222. Please see updated test information Gentamicin test page link.

Isavuconazole

Isavuconazole test page link

Isoniazid (+ N-Acetyl-Isoniazid)

Isoniazid (+ N-Acetyl-Isoniazid) link

Itraconazole

Itraconazole test page link

Levofloxacin

Levofloxacin test page link

Linezolid

Linezolid test page link

Meropenem

Meropenem test page link

Moxifloxacin

Moxifloxacin test page link

Posaconazole

Posazonazole test page link

Rifabutin

Rifabutin test page link

Rifampicin

Rifampicin test page link

Streptomycin

Streptomycin test page link

Sulphamethoxazole in (Co-trimoxazole)

Sulphamethoxazole in (Co-trimoxazole) test page link

Teicoplanin

Teicoplanin test page link

Tobramycin

Tobramycin test page link

Trimethoprim in (Co-trimoxazole)

Trimethoprim in (Co-trimoxazole) test page link

Vancomycin

Voriconazole

Voriconazole test page link

Antimicrobial Reference Laboratory Contact Details

Antimicrobial Reference Laboratory
Level 2, Phase 1, Pathology Sciences Building
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB

For General Enquiries and Results:

Telephone: 0117 4146269 or 0117 4146220
For Clinical Advice: 07802 720900
Email: arlenquiries@nbt.nhs.uk

Laboratory Hours

Monday to Friday 09:00 - 17:15

Saturday 09:00 - 12:00

Wed 29 Apr 2026 - 12:00

Idiopathic Pulmonary Fibrosis (IPF)

Read more about Idiopathic Pulmonary Fibrosis (IPF)

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What is pulmonary fibrosis?

Pulmonary fibrosis is when normal lung tissue is replaced by scar tissue and/or inflammation. This makes the lungs stiff and not work as well.

Pulmonary is the medical term for your lungs.
Fibrosis means scarring.

We know what causes some types of pulmonary fibrosis. But sometimes we cannot find a cause, including in Idiopathic Pulmonary Fibrosis (IPF). We do know that it is not a form of cancer or cystic fibrosis, and it is not contagious.

How common is IPF?

IPF is rare - only around 14 to 43 people out of 100,000 have IPF. It can affect anyone but is much more common in older people.

What are the symptoms?

At first, people with IPF can have no or only mild symptoms. If the pulmonary fibrosis worsens then you may have:

Difficulty breathing.
Dry cough.
Feeling tired.
Poor appetite.

IPF can cause weight loss. You should weigh yourself regularly and speak to your GP or team if you are losing weight over time.

What tests will I have?

The doctors will take a detailed medical history from you and do a physical exam. You may also have the following tests:

Chest X-ray.
Lung function tests – to see how well your lungs work. They can also monitor how your condition is progressing. This may include a walking test to see how breathless you get.
CT scan – this will give us a detailed picture of your lungs including any scarring or inflammation.
Blood tests – to rule out other causes of pulmonary fibrosis.
If the diagnosis is still unclear, you might have surgery to take a lung biopsy (sample).

Will my lungs get worse?

In the past we thought all patients with IPF would get worse quickly. Now we know that some patients get worse more slowly, and some can stay the same for some time.

Unfortunately we cannot tell which patients will get worse and how quickly. This is an important area of research so we can understand this more and find better treatments.

If your symptoms change, that might mean your condition is getting worse. Speak to your respiratory team and mention any changes you have noticed.

If your symptoms suddenly get worse, speak to your GP.

How is IPF treated?

The fibrosis in IPF is permanent and cannot be cured but treatment can help slow progression or manage symptoms.

Medication

Your specialist might suggest you try medications to slow the scarring - antifibrotic medications.
They may suggest advise different medications to help your symptoms.

Pulmonary rehabilitation

Pulmonary rehabilitation is a supervised exercise and education programme.
- It helps you manage breathlessness, stay active, and improve strength and energy.
- The team may include physiotherapists, nurses, dietitians, and doctors.

Supplemental oxygen

Lung scarring can reduce the amount of oxygen that can get into your blood.
Some people may need oxygen therapy if oxygen levels in the blood are low.
This can improve breathlessness and help you stay active.

Clinical trials

You can ask about clinical trials which test new treatments. Joining is voluntary.

Lung transplants

A small number of patients may be referred for lung transplant assessment.

How can I help myself?

Have your seasonal vaccinations (COVID-19 and flu) and the pneumonia vaccination (only once).
You may be eligible for benefits like PIP (Personal Independence Payment) if you need help with personal care or getting about.
Our specialist nurses runs a regular Pulmonary Fibrosis Support Group which is a space for discussion with other patients with similar lung conditions. Here we also aim to have presentations from a variety of guest speakers and charities.
Keep active and do what you enjoy!

Resources and how to contact us

Resources

How to contact us

For ILD related queries:

Bristol Interstitial Disease Service
- Respiratory admin: 0117 414 7762
- ILD@nbt.nhs.uk

Endoscopic Sleeve Gastroscopy (ESG)

Read more about Endoscopic Sleeve Gastroscopy (ESG)

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Welcome to the North Bristol Weight Management Service

This information is to help you prepare for your procedure. Take time to read it carefully, and we can answer any questions you have.

Important information:

We are here to help you on your weight loss journey and think surgery will help your health and wellbeing.
It is a big step, and we can help you make long-term habits to maintain your progress. We can support you for 2 years after surgery.
We cannot offer this procedure to anyone who smokes or vapes – nicotine causes complications.
We welcome your feedback and suggestions to improve our service.

Endoscopic Sleeve Gastroplasty (ESG)

ESG is an endoscopy procedure to reduce the size of the stomach.
We place stitches (sutures) on the inside of the stomach and pulling them tight to fold the stomach in on itself.
This means your stomach holds less food, and you will feel full more quickly after eating.
You will lose about 10-15% of your body weight usually in the first year.
Your change in appetite means you can start new eating habits along with help getting the right nutrition.
Endoscopic means we put a flexible tube down your throat to do the procedure. We won’t do any external incisions (cuts) so there are less complications than other types of weight loss surgery.

Complications

The risk of serious complications like these is small:

Bleeding.
Infection.
Tears in the stomach.
Abscess (a pocket of infection).
Leaking of stomach contents into the chest or abdominal cavity.
Pulmonary Embolism (a blood clot in the lung).
Pneumothorax (collapsed lung).

Diet before ESG

Many people who live with obesity have an enlarged liver. This can make the procedure more difficult and increase the risk of complications.

It is important you follow a low calorie and carbohydrate diet for 2 weeks before your operation. The diet helps shrink the size of the liver making the procedure easier and safer. It is sometimes called the Liver Reducing Diet.

This diet will encourage your body to use up its stores of glycogen (a form of stored sugar in the liver and muscles). This causes the liver to shrink rapidly.

This diet designed to reduce your risks from the surgery and should not be followed long term.

What does the diet involve?

Each day aim to stick to between 800-1000 calories. This should include at least 60-80g protein.
The diet is low calorie, low fat, low sugar, and low carbohydrate.
You can choose to use food, shakes or a combination of both.
We suggest you include at least 1 meal per day of normal food. This is so you can practice chewing your food thoroughly. You should chew each bite at least 20 times until it is soft/like a paste before swallowing.. This is an important part of eating after your surgery to make sure you get the best outcome.

Option 1: food

Protein: try to include a protein food at every meal. Aim for 60-80g protein each day. Focus on low-fat protein sources such as chicken, fish, turkey, beans, lentils, tofu, or low-fat dairy.

Fats: limit the amount of oil, butter or margarine you use. Cooking sprays are a good alternative. Try to avoid high-fat foods such as cakes, biscuits, or crisps.

Carbohydrate: Limit carbohydrates with lots of starch. Try to have 1-2 meals per day which do not include starchy carbohydrates. Choose wholegrain options if you do eat them. Aim for less than 120g per day.

Sugars: Avoid adding any type of sugar, honey, or syrup to foods. Artificial sweeteners are ok to use. Aim to avoid eating any foods high in sugar e.g. cake, chocolate, sweets, fruit juice.

You will need to start taking a multivitamin and mineral supplementation as this diet is won’t give you all the nutrients you need. This can be either tablet or chewable/gummy. There is more information about vitamins later in this booklet.

Meal ideas

Breakfast	Lunch	Dinner	Snacks
High protein yoghurt	Soup with meat/beans/ lentils	Chicken breast (no skin) with vegetables and 1-2 new potatoes	Boiled egg Egg muffin Babybel light High-protein yoghurt Veg sticks Fruit (1 portion) like 1 apple, 1 small banana, 2 satsuma/kiwi/ plum, 80g of chopped fruit
Poached/ boiled eggs on 1 slice seeded bread	1-2 oatcakes with cottage cheese and salad	Homemade turkey burger with salad and low-fat coleslaw
150-200g Low-fat natural yoghurt with berries	Tuna/chicken/tofu salad with low-fat salad dressing	White fish or tuna steak with ratatouille
Scrambled eggs/tofu with mushrooms and tomatoes	1 slice seeded bread with tuna/ chicken/tofu and sweetcorn mixed with low-fat mayo	Turkey mince chilli with veg and 1-2 tablespoons of cooked brown rice
Protein shake	Hummus or bean dip with vegetable sticks	Shakshuka - baked eggs in a tomato stew

Nutrient tracking options

Where to find recipes

Low-carb diet and meal plan | Eating with diabetes | Diabetes UK
Low-carb meals - BBC Food
Low calorie recipes and diet information - BBC Food
Easy Low Calorie Meals | olivemagazine
Books:
- Pinch of Nom
- Carbs and Cal: Very Low Calorie Recipes and Meal Plan
- The Fast 800 Recipe Book

Option 2: meal replacement shakes

You can have low-sugar, high-protein, meal-replacement shakes to provide 800-1000 calories in total each day. Many of these shakes are low in fibre so it can be helpful to include 1-2 portions of vegetable or salad each day (fibre in these helps prevent constipation).

Look for shakes with 200-300 kcals and 20-30g protein per serving. Aim for a low sugar option - about 5g of sugar per 100g/100ml.

Some suitable options

Product	Preparation	Nutrition per serving	Servings per day
High-protein milk	2 tbsps of skimmed milk powder to 300ml milk	Skimmed milk: 215kcals and 21g protein Semi-skimmed: 250kcals and 21g protein	3-4
Huel*	40g Huel black edition powder mixed with 500ml water Huel black edition pre-made (500ml)	400kcals and 40g protein 400kcals and 35g protein	2-2.5
Grenade Carb Killa	Pre-made shakes (330ml) Bar (60g)	210kcals and 25g protein 240kcals and 20g protein	3-4
My Protein	60g Impact diet whey powder mixed with 300ml water Pre-made Impact shake (330ml)	220kcals and 35g protein 200kcals and 25g protein	3-4
PhD Smart protein Plant*	25g powder in 250ml water	240kcals and 20g protein 220kcals and 21g protein	3-4

* vegan options

Option 3: combination of food and shakes

Meal	Food/shake	Calories (Kcal) per portion
Breakfast	Meal replacement shake	200-250 Kcals
Lunch	Meal replacement shake	200-250 Kcals
Evening meal	Lunch/dinner option from meal ideas table above	300-400 Kcals
Snacks	Vegetable sticks/sugar free jelly	5-100 Kcals

Diabetes

If you have diabetes treated with tablet medication and/or insulin you will probably need to change these medications. Your diet before and after surgery will have very little carbohydrate and can increase your risk of hypoglycaemia.

We will help you make a plan in your pre-operative assessment appointment. You will need to monitor your diabetes control more closely during this time.

Reintroducing food after ESG

What is the aim of the diet after ESG (post-procedure diet)?

After your procedure you will reintroduce food over 6 weeks. You will slowly move from liquids to solid food. This is to reduce pressure in the gastric pouch, give the stitches time to heal, and optimise your weight loss.

Aim to:

Take small mouthfuls of food and drink.
Stop eating before you feel full - 1-2 mouthfuls of food extra may make you feel discomfort, nausea or make you vomit.
Learn what the early signs of fullness feel like to you and stop here.
Chew your food thoroughly – about 20 times per mouthful.
Sip fluids slowly.

If you do not follow these recommendations, there is a risk of loosening the stitches, becoming unwell, or not achieving significant weight loss.

The post-procedure diet involves 4 stages:

Thin liquids: 2 days days 1-2)
Liquid diet: 12 days (week 1-2)
Puree diet: 2 weeks (week 3-4)
Soft diet: 2 weeks (week 5-6)
Normal texture food: week 7 onwards

Stage 1: thin liquids (2 days)

Following surgery, you will need to drink thin liquids (drinks) only for 2 days such water, squash, protein water, tea and coffee, and semi-skimmed milk.

Have small amounts of fluid (no more than 50mls) every 10-15 minutes.
Aim for least 2 litres of fluids each day.
Even if you feel thirsty it is important you drink small quantities at a time
Avoid fizzy or high sugar drinks such as juices.
If you have stomach pain or nausea whilst drinking stop until the feeling has passed.

Stage 2: liquid diet (12 days)

Aim to have high protein drinks, shakes, or soups which are smooth (with no lumps) regularly through the day. The liquids should be able to run off the back of a spoon like thin yoghurts, tinned soups, or runny custard.

Portion sizes are approximately 100-300ml.
Take small mouthfuls one at a time and give yourself a break in between mouthfuls so you can recognise the early signs of fullness and stop.
If you feel pain, stop immediately.
You will need to drink other fluids (water, tea, squash) to get your 2 litres fluids per day.
It can be difficult to get enough nutrients while you are following a liquid diet.
Aim to include as many liquids with lots of protein as possible. Protein is important for your general health including maintaining your muscle mass while you are losing weight. This will help your overall weight loss.
Aim for 60g protein.

High protein liquids

‘Fortified milk’ - 1 pint semi-skimmed or skimmed milk with 4 tbsps of dried skimmed milk powder.
Smoothies – fruit or vegetables blended with fortified milk, natural yoghurt or protein powder. (Avoid shop bought smoothies as these are low in protein and high in sugar).
Smooth Soup (homemade or tinned). Add 1-2 tbsp of skimmed milk powder, protein powder or quark.
Meritene or Complan shakes or soups – available in Supermarkets or pharmacies.
Meal replacement shakes e.g. Slimfast, Tesco Slim, Asda Great Shape, Exante or Lighter Life.
High protein milkshakes e.g. UFit, Arla, For Goodness Shakes, Urban Active
Protein Water e.g. Vieve, Upbeat or +PW
Whey, soya, or pea protein powders

Recipes

Option	Ingredients	Method
High protein milk	4 tbsp (60g) skimmed milk powder 1 pint (570ml) skimmed or semi-skimmed milk Optional vanilla extract/ unsweetened cocoa powder/coffee	Mix milk powder with a little milk to form a paste. Stir in the rest of the milk.
Fruit smoothie	Half a pint (250ml) high protein milk One quarter of a pint (100ml) low fat yoghurt 3 oz (100g) fresh fruit like banana, strawberries (fresh or frozen)	Combine all ingredients in a blender and blend until smooth. Serve chilled

Option

Ingredients

Method

High protein milk

4 tbsp (60g) skimmed milk powder

1 pint (570ml) skimmed or semi-skimmed milk

Optional vanilla extract/ unsweetened cocoa powder/coffee

Mix milk powder with a little milk to form a paste.

Stir in the rest of the milk.

Fruit smoothie

Half a pint (250ml) high protein milk

One quarter of a pint (100ml) low fat yoghurt

3 oz (100g) fresh fruit like banana, strawberries (fresh or frozen)

Combine all ingredients in a blender and blend until smooth.

Serve chilled

Stage 3: puree diet (2 weeks)

After 10 days of a liquid diet, you can progress to foods with a thicker, puree consistency. You will need to use a food blender, processor or liquidiser.

Start with 1 tsp of food at a time and check how you feel after. Each meal should have around 2- 4 tbsp. Aim to eat the protein part of the food first. It may be helpful at this stage to cook and freeze foods, as portions will be small.

See the example menu plan on the next page.

Tips:

Eat protein food first, then vegetables and finally carbohydrates. P.V.C (Protein, Vegetable, Carbohydrate). In the early days, you may only manage the protein.
Use high-protein milk in/with foods such as cereal, scrambled eggs etc.
Try one new food at a time. If you feel sick, gas, or bloated, it may be the case you are not ready for this type of food, try again in a few days.
Food can be liquidised in bulk and frozen. You can use an ice cube tray and take a few ice cubes out per meal.
Slow cook or casserole meat in plenty of liquid to make it easier to blend.
Adjust your portion sizes as you feel necessary. Listen to your body and stop before you feel full.

Sample meal plan

Meal	Options
Breakfast	Half or 1 whole Weetabix with high protein milk or 1 pot yoghurt of fromage frais or 2 tbsp of porridge or Ready Brek made with high protein milk
Mid morning	200 ml high protein drink
Lunch	1 cupful of soup made with fish/meat/beans/ pulses and potato or 1 scrambled egg or 1-2 tbsp pureed fish/pulses/ chicken/meat or 1-2 tbsp mashed cottage cheese or with 1/2 tbsp pureed vegetables and 1/2 tbsp mashed potato/sweet potato/winter squash
Mid afternoon	150ml yoghurt with or without pureed fruit or 150ml fruit smoothie or 200ml skimmed or semi-skimmed milk or 2 tablespoons low fat custard or
Evening meal	1-2 tbsp pureed fish/pulses/chicken/meat, with ½ -1 tbsp blended vegetables, and ½ -1 tbsp mashed potato/sweet potato/winter squash
Evening snack	200ml high protein drink

Stage 4: soft diet (2 weeks)

You no longer need to blend food. Gradually introduce foods which are soft in consistency, that is they fall apart easily with a fork. Foods which are naturally moist are good at this stage or add sauce/gravy to dishes.

You can also include crunchy foods in this stage such as cereal, crackers or toast. Make sure you chew these foods thoroughly. Start with a small portion e.g. 3 tablespoons as a meal and increase gradually depending on how you feel.

Tips:

Aim to grill or air fry and use herbs/spices to flavour foods.
If using oil, measure out a small amount (1-2 tsp).
Try 1 tbsp (tablespoon) of a new food every 1-2 days. If you feel nauseated or bloated after eating, then you may not be ready for this food. Wait a few days before trying this food again.

Sample meal plan

Meal	Options
Breakfast	1 Weetabix/25g porridge oats/All Bran/Branflakes with skimmed or semi-skimmed milk or Scrambled egg with 2 wholegrain crispbreads/ crackers with 1 tsp butter/margarine/low fat cheese spread
Mid morning	150ml light natural yoghurt/fruit yoghurt or 200ml semi-skimmed milk or 200 ml high protein drink
Lunch	200ml high protein soup for example chicken/lentil/ bean/fish or Small jacket potato without skin with 40g cottage or low fat cheese or Macaroni cheese/cauliflower cheese
Evening meal	50g fish/chicken/turkey/ground beef with half a cup soft cooked vegetables and half a cup mashed potato/sweet potato/winter squash/risotto/4-6 wholegrain crackers/1 slice wholegrain toast
Evening snack	150ml low fat natural or low sugar fruit yoghurt or 1/2 cup pureed/stewed/soft/tinned fruit or 1 scoop sorbet or 200 ml high protein drink

Stage 5: healthy normal textured diet (week 7 onwards)

You are now ready to progress onto your long-term healthy diet.

This can be challenging as you learn how much you can eat of certain foods and the importance of paying attention to your body as you eat. Continue to add new foods in slowly. Aim to eat 3 small meals per day with 1-2 snacks as necessary. Focus each meal and snack on protein-rich foods. Keep portions small by using a side plate. Aim to eat 60-80g protein per day.

Cooking tips:

Remove fat and skin from meat before cooking.
Use low fat cooking methods such as grilling, baking (wrap in foil to keep things moist), steaming or boiling.
Limit oil or butter added to vegetables or salads. If you need extra flavour, add seasoning, low-calorie dressing or vinegar.
If you need to use oil to stop food from sticking, use a spray oil.
Add flavour using herbs, spices, seasonings, lemon juice, ginger, onions, and garlic.
Aim to avoid adding oil or butter to carbohydrates.
Choose high fibre (wholegrain) carbohydrate foods where possible like wholegrain bread, brown pasta, brown rice, wholegrain / seeded crackers or oatcakes and keep skins on potato.

Sample meal plan

Meal	Options
Breakfast	Wholegrain cereal/porridge/Ready Brek made with milk or Wholegrain toast/crackers/crispbread with 1 tbsp of low fat cheese spread/peanut butter/hoummous or Scrambled egg on toast or Baked beans on toast
Mid morning	Fruit, tea/coffee or Cracker with low fat spreadable cheese/peanut butter
Lunch	200ml high protein soup like chicken/lentil/bean or Baked beans / sardines / poached egg on toast or Bean and rice salad or Small jacket potato with baked beans/tuna/cottage cheese
Dessert	150ml light natural or fruit yoghurt or Half a cup soft/pureed/stewed fruit or 1 scoop sorbet
Mid afternoon	Tea/coffee/vegetable juice Fruit/low fat yoghurt
Evening meal	Small serving of lean meat/fish/egg/beans/lentils/tofu/ quorn with a serving of vegetables or salad and small serving of potatoes/brown rice/brown pasta/ chapatti/yam/plantain/cassava
Dessert	Fruit/low fat yoghurt/low fat puddings

Snack ideas - 100 calories with high protein

Small handful nuts
Slice of smoked salmon or ham with cucumber sticks
Trail mix of nuts/seeds with dark choc chips
1 pot of high protein natural yoghurt (Icelandic or low fat Greek style)
1 pot Greek style Soya yoghurt
1 boiled or Devilled egg
1 oatcake or rye crispbread with 1 tbsp cottage cheese or low fat cream cheese
1 egg muffin
Veg sticks with 1 tbsp of hummus or bean dip
2 tbsp roasted pumpkin/ sunflower seeds
Slice smoked salmon with 1 teaspoon cream cheese
Nice cream – frozen banana whizzed with peanut butter
1 pot of fruit flavoured high protein yoghurt
2 tbsp low fat Greek yoghurt with handful of berries
80g soya/edamame beans
80g Spicy chickpeas – try roasting with cumin and smoked paprika
Slice of ham with low fat cheese spread* or cottage cheese
1 mini cheese or Babybel
1 stalk of celery or 2-3 slices of apple with 2 tsp of almond butter
1 pack of chicken bites

Complications after the procedure

Constipation

It is common to have constipation in the early days after these operations because you are not having much food and drink

To help manage constipation:

Drink plenty of fluids – aim for 2 litres a day a day.
Add in a laxative such as sodium docusate or senna.
Add in some high fibre foods where able e.g. vegetables, wholegrain carbohydrates, beans and pulses.
Keep as active as you can.

Please contact the Bariatric Team or the Bariatric Clinical Nurse Specialist if the above does not work.

Nausea, vomiting, and indigestion

If you have any of these, it may be because you are:

Eating too quickly.
Not chewing enough.
Eating too much.
Drinking with the meal or within half an hour after eating.
Lying down too soon after eating.

If you suddenly feel unwell with symptoms such as shortness of breath, worsening abdominal pain, fever, limb swelling, unable to tolerate food/fluids, nausea and vomiting please go to the Emergency Department, contact Bariatric Team or GP.

Feeling tired

It is common for people to feel tired and to have low energy levels in the early weeks after the procedure. This is usually because it is difficult to get enough calories and protein, also the fact you are losing weight.

Aim to consume at least 60g protein and 800 calories each day. If you are struggling to do this, it can be helpful to include protein shakes to help meet this target.

Tiredness can also, but less commonly, be due to a vitamin or mineral deficiency, so please do ensure you take your multivitamin and mineral supplement once a day.

Hair loss

In the first 6-9 months, it is common to have some hair loss. This also is usually due to not enough calories and protein. Once your weight loss has stopped, this problem usually goes away.

Vitamin and mineral deficiencies

After your procedure you will be eating much smaller portions of food and it can be hard to get all the vitamins and minerals your body needs. Please take the following vitamins and minerals. You can buy these in most supermarkets, chemists, or online.

1 A-Z multivitamin tablet once a day.
1 vitamin D tablet once a day.

For first 6 weeks these need to be in a chewable form. Once you are on a normal textured diet you can take a tablet form.

Suitable options are:

Chewable: Superdrug chewable, Centrum chewable
Tablet: Tesco A-Z, Superdrug A-Z or Aldi A-Z

Dumping syndrome

Dumping syndrome is a less common side effect after ESG. It happens when the lower end of the small intestine (the jejunum) fills too quickly with undigested food from the stomach. There are two types of dumping:

Early dumping - happens during or right after a meal. Symptoms of early dumping include nausea, vomiting, bloating, cramping, diarrhoea, dizziness and fatigue
Late dumping - happens 1-3 hours after eating and is usually due to a low blood sugar. Symptoms of late dumping include weakness, sweating and dizziness .

Managing dumping syndrome

Early dumping syndrome: lie down as soon as you have symptoms, you are likely to feel better after around 30 minutes.
Late dumping syndrome: have a snack that includes both carbohydrate and protein like a cracker with soft cheese. If you feel very unwell you may need a small glass of orange juice before the cracker to bring your blood sugar back to normal.

To avoid dumping symptoms:

Avoid chocolate, biscuits, cakes, sweets, desserts, high sugar drinks, high glycaemic index (GI) carbohydrates such as white bread.
Aim to eat at least 3 times per day (rather than 1 big meal).
Avoid eating and drinking at the same time – wait 20 minutes.

Increased fertility

Losing weight can increase fertility and we strongly recommend that you do not become pregnant for at least 18 months following the procedure. Weight loss can have negative effects on the pregnancy.

After this surgery your oral contraceptives (the pill) may not work. You should use alternative methods of contraception, for example, barrier methods (condoms/cups) if this is a concern.

If you become pregnant following the procedure it is important to let your GP, Obstetrician, Midwife, and Bariatric Team know as soon as possible. You may need extra monitoring during the pregnancy to make sure that you and the baby get enough nutrients to keep healthy.

Long term tips for the best outcome

Focus on protein-rich foods every time you eat. Include vegetables, salads, wholegrain carbohydrates, unsalted nuts and fruit.
Eat three meals a a day and choose healthy snacks if you are hungry in between meals.
Think PVC – protein first, then vegetables, then carbohydrates.
Limit foods high in fat, saturated fat and sugar such as biscuits, cakes, muffins, sweets, confectionary, chocolate and crisps
Aim to follow the ‘Rule of 20’:
Cut your food up to the size of a 20 pence piece size
Chew 20 times
Wait for 20 seconds after swallowing before taking a second mouthful.
Stop eating after 20 minutes (if you haven’t already stopped).
Avoid drinking 20 minutes before and after eating
Sip fluids often throughout the day; aiming for 2 litres a day
Avoid carbonated and sugary drinks.
Avoid alcohol for the first 6 months and drink within recommended a day limits thereafter.
Monitor your weight and food intake if you find this helps you keep on track.
Move your body in ways that your body allows, and you enjoy such as exercise classes, walking or dancing in the kitchen.
Take your vitamin and mineral supplements.

You will have Specialist Dietician support for 2 years following the procedure. Your first review will be approximately 4 weeks after your operation.

How to contact us

Bariatric Coordinators: 0117 414 0855/54
Bariatric Waiting List Coordinator: 0117 414 8826
Bariatric Surgery Senior Enhanced Practitioner: 0117 414 2085 or 0755 7312784

Urine Flow Clinic (at Weston General Hospital)

Read more about Urine Flow Clinic (at Weston General Hospital)

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Flow tests

On the day of your appointment, drink approximately 2 pints of fluid before you come to the clinic, in order to have a successful test. If you cannot manage this, arrive around 20 minutes early for your appointment, and water/ squash will be provided for you to drink.

If you normally take diuretics (water tablets), please take them as normal on the day of the clinic. If this is likely to cause you problems, bring them with you. You can take them when you arrive at the clinic.

The clinic nurse will then ask you to do some urine flow tests. The flow test involves passing urine (peeing) into a special toilet that measures the flow. You will be left in private to do this.

After you have passed urine into the flow toilet, the clinic nurse will do a bladder scan to find out whether you have completely emptied your bladder. This is painless, and involves passing an ultrasound probe over your tummy to get a reading.

Due to the nature of the appointment, if you would like a chaperone present please tell the clinic nurse.

Some patients will need a further test, so will need to stay longer in the department.

Other appointments

You may have an appointment booked to see a Urology doctor on the same day as your appointment for your flow test. This will be in Quantock Outpatients department, on the ground floor.

If you do have an outpatient appointment on the same day, Quantock Outpatients will be aware of this. They know that flow tests can sometimes take a while to complete, so will not worry if you are late for the doctor’s appointment.

Transport

You will be able to drive both before and after the appointment. If you cannot use your own or public transport, please ask a relative or a friend to bring you. Your GP can only order hospital transport for medical reasons.

How to find us

Follow the signs from the main entrance of the hospital to the first floor of the Jackson-Barstow Wing. There are signs to the Urology Department within the wing.

General information

Parking and public transport

Parking for Blue Badge holders is free; other spaces are pay-on-exit. Please ensure you have a valid payment card or plenty of change with you.

A regular bus service runs to Weston General Hospital.

Infection control

Help us prevent the spread of infection while in the hospital. Please make sure your hands are clean. Wash and dry them thoroughly, and/or use the hand gel provided.

If you have been unwell in the last 48 hours, please consider whether your visit is essential.

Other means of communication

If you need this leaflet in another format, please contact the Patient Advice and Liaison Service (PALS) on 0117 414 4569.

Hernia prevention and core exercise

Read more about Hernia prevention and core exercise

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Information for patients after abdominal and stoma surgery

Around 7 in 10 people who have stoma surgery will get a parastomal hernia. This is when there is a bulge near the stoma. This can develop gradually, increasing in size over time. The hernia happens because the tummy muscles are made weaker during surgery when the bowel is brought through the muscle to make a stoma.

Parastomal hernias can make managing the stoma tricky. They can cause:

The stoma to not work as well.
Pain around the stoma.
Discomfort when moving about.
Difficulty fitting the stoma pouch because of the shape of the stoma - this may mean the pouch is not secure.

What to do before surgery to prevent hernias

Do gentle abdominal exercises like the ‘Core 4.’ Even if you do not already do regular exercise these will soon feel comfortable.
Maintain a healthy weight and reduce tummy fat - this will put less pressure on the abdominal muscles.

How to help prevent hernias after surgery

Avoid driving for at least 4 weeks after laparoscopic (keyhole) surgery. After open surgery avoid driving for at least 6 weeks, if your wounds have healed. You should also check with your insurance company.
Avoid strenuous (very physical) activity for 8 weeks. This includes heavy lifting, pulling, pushing, or awkward movements like stretching and twisting.
Support your stoma when you sneeze or cough.
Use the bed roll method to get out of bed.

From 8 weeks after surgery

You can start doing more strenuous activity while using a support belt:
- You will discuss this and be measured for it during your post-surgery clinic review.
- You should still avoid very heavy lifting and awkward movements.
- When moving smaller items follow correct manual handling advice.
Continue your abdominal exercises to build your strength:
- We advise you not to wear the support belt when doing this so you can feel your core muscles engage.

Health factors that contribute to hernias developing

Smoking (4x greater risk of developing a parastomal hernia).
Persistent coughing due to COPD or asthma.
Being overweight or having a large abdominal girth (measurement around your waist), particularly greater than 100cm.
Being generally unfit.
Lifting heavy items with poor manual handling technique.

Breathing to reduce intra-abdominal pressure

Intra-abdominal pressure (IAP) is the pressure inside the abdomen (tummy). Reducing IAP can help reduce the risk of hernia developing. Using safe ways to lift and move things (manual handling), and learning how to breathe well can help lower IAP.

Deep breathing can help your core muscles to work more efficiently by engaging the core.

Take a slow deep breath in through your nose.
Expanding your abdomen and ribcage out.
Exhale slowly out through your mouth, feeling your ribs move back inwards.
Repeat 5-6 times.

Do not hold your breath when doing an exercise or lifting task. When exerting effort, breathe out to lower your IAP.

If the abdomen domes/pushes out during exercise (or lifting) and you can feel a raise in pressure, this is a sign of increased IAP. Stop doing any movement or exercise that causes this. Move into a better position and adjust your breathing to reduce the increase in IAP.

Try to avoid anything that may raise IAP including:
Preventing nausea and vomiting.
Managing long term coughing and by seeking support from your GP or respiratory team.
Urostomy and colostomy patients should maintain good diet and hydration to prevent constipation.
Support your abdomen/stoma with a rolled-up towel/pillow/hand when coughing, sneezing, or blowing your nose.

The benefits of protein

Proteins are made up of amino acids. These give your body energy and help cells renew; this helps build and heal muscles. Increasing how much protein you have before surgery will help to build supplies and condition your body. Keeping this up after surgery will help with healing and strength.

High protein foods include:

Fortified yogurt and drinks.
Protein powders you can add to soups and smoothies.
Foods like fish, turkey, and chicken.
Dairy.
These all help repair and regain muscle tissue.

Log roll technique to get in and out of bed

To avoid putting strain on your abdomen in the first stages of recovery (up to 2-3 months post-surgery), use the log roll technique to get in and out of bed. Please ask your stoma nurse or physiotherapist about this.

This is important immediately after surgery

Getting out of bed

Raise one knee at a time and roll onto your side, moving your entire body in one movement.
Lower your legs over the side of the bed.
Use your arm furthest away from the bed to push yourself up into a sitting position.

Getting into bed

Sit on the side of the bed with the back of your knees against the bed.
Lower your body to the bed surface with use of your arm, furthest away from the side of the bed you are going to lay on.
Slowly lift both legs onto the bed to meet your body, keeping your knees bent.
Roll onto your back and slowly lower one leg at a time.

Exercises

From 3-4 days post-surgery up to 8 weeks

Tummy tightening breathing deep core-back

Lie on your back, on the bed, or floor with your knees bent.
Take a deep breath in.
As you exhale, draw your abdominal muscles down towards your spine and ribs towards your pelvis.
Hold this contraction for 2-3 seconds while still breathing. Then release and repeat 5 times.
Slowly build up to holding the contraction for 10-15 seconds and repeat 5-10 times.

Line drawing of person lying on floor with arrows indicating breathing in and out

Deep core side

Lie on your side with knees bent.
Allow your stomach to drop toward the floor.
Take a deep breath in and exhale, drawing your abdominal muscles in and towards your back, pulling your ribs toward your pelvis, and lifting your tummy away from the floor.
Hold the contraction for 2-3 seconds then release and repeat 5 times.
Slowly build up to holding the contraction for 10-15 seconds and repeat 5-10 times.

Pelvic tilt

Lie on your back, on the bed/floor with your knees bent.
Press your lower back into the bed or floor.
Rock your pelvis up towards your head, feeling a tightening in your tummy and bottom muscles, slightly pulling your ribs and pelvis together.
Hold the contraction for a second and return to the neutral position. Repeat 5 times - build to 20 repetitions.

Line drawing of person lying on back with knees bent and arms folded, arrows indicating tilting pelvis

From 7 days post-surgery

Knee rolls

Lie on your back on the bed or floor with your knees bent.
Keep your knees and thighs together, exhale. Slowly drop your knees as far as is comfortable, rotating your pelvis and hips to one side.
Keep your shoulders fixed to the floor as you roll. Inhale and breathe normally, and hold the position for a few seconds. Drop your knees a little to start with, and work on increasing this over time.
Exhale and return your knees up to the starting position, use your core muscles to draw them up slowly. Repeat on alternate side 10-15 times.

Person lying on back with arms outstretched, legs together with knees bent and turned to the right

Seated knee lifts

Sit toward the edge of a chair with your back straight and unsupported (not leaning back).
Engage your deep core, pulling your tummy toward your spine and breathe normally. Lift one foot from the floor a short distance, hold for 2 seconds
then return foot flat to the floor.
Repeat 10-20 times on alternate sides. You can increase the height you raise your foot from the floor over time.

Person sitting on chair with arms on foot on the floor and one leg lifted with knee bent

Hip bridge

Exhale and pull your tummy toward your spine, tilt your pelvis toward your head and lift your tailbone off the floor. Raise up a short way pushing from your heels, curling up through your spine.
Breathe in and normally, holding the position for 2 seconds.
Exhale and slowly lower yourself curling your spine back to the floor, relax and repeat 10-15 times.

Person lying on back with knees and hips lifted up

From 6-16 weeks

Leg slides

Lie on your back on the bed/floor with knees bent up and core pulled toward your spine.
Exhale and slide one foot slowly away from you straightening your leg and breathe in. Exhale and slowly draw your foot back to the starting position. Keep control of the core by pulling it towards your spine. Repeat on alternate sides 10-20 times.
As you get stronger you could increase the intensity by raising the opposite arm to leg up, and rotating it back past your head to your ear. Move the arm and opposite leg at the same time.

Person lying flat on floor with one hand under head, one knee bent with heel touching floor

Knee circles

Lie on the bed/floor or sit in a chair with your back straight and unsupported, exhale, pull your core towards your spine to engage your deep core, breathe normally.
Exhale and lift one knee to 90 degrees (right angle), breathe normally keeping the core engaged.
Circle the leg making a clear movement to one side, towards the chest, towards the opposite knee and to the back completing a full circle.
Lower the foot back to the floor and repeat on the opposite side, alternating 10-20 times.

Person lying flat on back, one leg bent at knee with foot on floor, one leg raised

Hip bridge and inner thigh squeeze

Lie on the bed/floor with your knees bent up and place a small ball or rolled up towel between your knees and hold firmly.
Exhale and pull your tummy towards your spine, tilt your pelvis towards your head and lift your tailbone off the floor. Raise your body up, curling your spine off the surface, pushing from your heels until your body runs straight from your head to your knees.
Breathe in and normally, holding the position for 2-5 seconds. Exhale and lower your body back to the floor curling your spine flat. Repeat 15-20 times.

Half superman with arms

Start on your hands and knees, making sure hands are positioned under your shoulders, and hips over your knees.
Pull your core to your spine to engage your deep abdominal muscles.
Slide one hand away from you, keeping your arm stretched out, until your hand just leaves the floor. Hold the position for 2-5 seconds and slowly return your hand to the starting position. Always keep control of your core.
Repeat on alternate sides 15-20 times.

Person kneeling on floor resting forward on hand with other arm raised in front

Half superman with legs

Start on your hands and knees, making sure hands are positioned under your shoulders, and hips over your knees.
Pull your core to your spine to engage your deep abdominal muscles.
Slowly slide your foot away from you until your leg is straight and your foot lifts away from the floor. Hold this position for 2-5 seconds keeping your core engaged. Slowly return your foot back to the starting position.
Repeat on alternate legs 15-20 times.

Person on knees on the floor resting forward on hands with one leg raised behind them

Standing knee lifts

Stand tall with your back straight and core pulled towards your spine. Hold onto the back of a chair with one or both hands for stability if needed.
Exhale and slowly lift one knee up as far as is comfortable, breathe out and normally while holding the position for 2-5 seconds, maintaining control of your core. Exhale and lower your foot to the floor.
Repeat on alternate legs 15-20 times.
To make this a little harder and if your balance is good – raise both arms above your head and proceed to lift one knee at a time alternately.

Person standing behind chair with one leg raised

From 14+ weeks

Continue the previous exercises alongside these.

Toe tap

Lie on the bed/floor or with your knees bent up and engage your core, pulling your tummy to the spine. Exhale and pull one knee up to 90 degrees (right angle) followed by the second knee.
Breathe in, and on exhale tap one foot down to the floor while keeping the opposite leg still. Breathe in as you bring the leg back up and repeat on the opposite side.
Repeat 5 to 20 times on each side.

Full superman

Start on your hands and knees, making sure hands are positioned under your shoulders, and hips over your knees. Pull your core to your spine to engage your deep abdominal muscles.
Slowly straighten out your right leg and left arm until both your foot and hand are off the floor. Start by raising a short distance off the floor and increasing this over time, if not able to lift parallel with the body to start with. Control your pose keeping the core engaged and not overextending the arm or leg.
Hold the pose for a few seconds, increasing this over time.
Return your arm and leg slowly to the start position and repeat on the opposite side.
Repeat 20 times.

Person kneeling on floor with one arm and opposite leg outstretched

Further information and support

Sarcoidosis

Read more about Sarcoidosis

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What is sarcoidosis?

Sarcoidosis is a condition where lumps cause granulomas develop in different areas in the body. Granulomas are made up of clusters or cells involved in inflammation. If lots of granulomas form in an organ, they can stop the organ from working properly.

What causes sarcoidosis?

The exact cause of sarcoidosis is not known but it probably involves a mixture of genetic and environmental factors. It can run in some families. So far, a single cause of sarcoidosis has not been found.

What parts of the body can be affected?

Sarcoidosis can affect many different parts of the body.
The lungs and lymph glands in the chest are most commonly involved, affecting 9 in 10 patients with sarcoidosis.
Other parts of the body that are often involved are the skin, eyes, and lymph glands elsewhere in the body.
Joints, muscles, and bones are involved in 1 in 5 patients.
The nerves and nervous system are involved in about 1 in 20 patients.
The heart is involved in about 1 in 50 patients.

What are the symptoms of sarcoidosis?

The symptoms of sarcoidosis depend on which part of the body is affected.

They can include:

cough
feeling breathless
red or painful eyes
swollen glands
skin rashes
pain in joints, muscles or bones
numbness or weakness of the face, arms, or legs

Patients with sarcoidosis may feel tired and lethargic (fatigued), lose weight, or have fevers and night sweats.

Sometimes, the symptoms of sarcoidosis start suddenly and don’t last long. In other patients, the symptoms may develop gradually and last for many years. Some people don’t have any symptoms at all and are told they have sarcoidosis after having a routine chest X-ray or other investigations.

How is sarcoidosis diagnosed?

There is no one specific test to diagnose sarcoidosis. The doctors will take a detailed medical history from you and do a physical exam. You may also have the following tests:

Blood tests – to check your liver and kidney function, and calcium levels. We may also check a marker in your blood called Angiotestin-Converting Enzyme (ACE) - this is sometimes higher in patients with sarcoidosis.
ECG - a tracing of the electrical activity in your heart.
Chest X-ray
Lung function tests – to see how well your lungs work. They can also monitor how your condition is progressing.
CT scan – this will give us a detailed picture of your lungs. The patterns on these pictures
helps us work out if the disease is active or quiet.
PET-CT scan – this scan can look for areas affected by sarcoidosis that might not be causing any symptoms.
Biopsy – we may wish to remove a small piece of tissue to confirm the diagnosis. Where the biopsy will be depends on the area of your body affected; we will discuss this with you.
Sarcoidosis can affect many different parts of the body, so your doctor may ask other specialists (who specialise in the part of your body affected by sarcoidosis) to look after you as well.

The outlook

Sarcoidosis gets better without treatment in most patients (around 60%). In others, the condition persists and may require some treatment. A small group of patients develop a more serious form of the disease which is more aggressive. This may need long term treatment.

Sometimes symptoms may suddenly get worse - this is known as a ‘flare-up’. This may be triggered by stress, infections, a change in environment, or often something unknown.

A much smaller group of patients develop permanent scarring of their lungs (called pulmonary fibrosis).

How is sarcoidosis treated?

Treatment may be required for patients whose sarcoidosis is causing severe symptoms or is preventing the affected organ(s) from working normally.

Medications

Steroids are produced naturally in the body by the adrenal gland. An additional steroid in the form of prednisolone can be given by your specialist to attempt to treat your sarcoid.

They are usually given in tablet form but may be given by injection into a vein. If you take steroid tablets on a long-term basis, you should not stop them suddenly.

You will be given a ‘steroid emergency card’ which you should always carry with you.
Your specialist may also check if you need treatment against some side effects of steroids such as bone protection medication and anti-reflux treatment.

Sometimes steroids may not be completely effective, or cause side effects. Other medications may be used, either alone or in combination, to help reduce the steroid dose. These are often called ‘immunosuppressive’ or ‘steroid- sparing’ medications. Methotrexate, Mycophenolate mofetil, and azathioprine are commonly used. We may use methotrexate on its own (without steroids) as a first treatment for some patients too.

Whilst you are taking immunosuppressant medication you will require regular blood tests to monitor your response to the treatment.

Clinical trials

You can ask about clinical trials which test new treatments. Joining is voluntary.

How can I help myself?

Have your seasonal vaccinations (COVID-19 and flu) and the pneumonia vaccination (only once).
You may be eligible for benefits like PIP (Personal Independence Payment) if you need help with personal care or getting about.
Our specialist nurses runs a regular Pulmonary Fibrosis Support Group which is a space for discussion with other patients with similar lung conditions. Here we also aim to have presentations from a variety of guest speakers and charities.
Keep active and do what you enjoy!

Resources

Sarcoidosis UK charity
SarcoidosisUK - Information, Support, Awareness & Research

Asthma and Lung UK
Asthma + Lung UK

Action for pulmonary fibrosis
www.actionpf.Home

Date published: 11 June 2026 Review due: 30 June 2029 PI number: BFT002701

Haematology

Read more about Haematology

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The clinical service is staffed with 8 Consultant Haematologists for interpretation and advice. The technical and clinical service is provided by Biomedical Scientists (BMS), Clinical Scientists (CS), Associate Practitioners (AP) and Medical Laboratory Assistants (MLA). In 2024 the laboratory processed 600,000 full blood counts, 250, 000 HbA1Cs & 100,000 clotting requests, with 10% growth each year. Haemoglobinopathy testing is also undertaken, including sickle cell and thalassaemia (SCT) screening for the antenatal and newborn programmes.

The Blood Transfusion laboratory issued over 13,000 blood components and processed 50,000 group and save samples. It also supports the Adult Major Trauma Centre at NBT and provides blood components to two air ambulances for the prehospital setting.

The department has been approved for BMS training by the IBMS and our Trainee BMS staff are trained in accordance with the IBMS and HCPC regulations. Our qualified staff (CS and BMS) are required to be registered with HCPC. The department is also accredited to train staff undertaking the STP and HSST programmes with the National Science Healthcare school. There is active encouragement for staff to follow further education courses, such as MSc (Haematology) and management qualifications.

The Department has a dedicated Quality Manager who is responsible for maintaining accreditation and compliance to ISO 15189 and BSQR (https://www.nbt.nhs.uk/severn-pathology/quality/pathology-accreditation-status) . The department participates in all appropriate External Quality Assurance Schemes accredited to ISO 17043 (https://www.nbt.nhs.uk/severn-pathology/quality/external-quality-assurance) for which performance is closely monitored.

Clinical Head of Service
Dr Alastair Whiteway

Blood Sciences Services Manager
Mr Alan Noel

Blood Sciences Operations Manager
Mrs Ellen Roberts

Haematology & Transfusion Laboratory Hours

Monday-Sunday including bank holidays: 8am - 10pm

Specimens received outside these normal opening times are classified as “out of hours”. Out of hours blood product requests must be discussed with the Biomedical Scientist on call. The Biomedical Scientists should always be informed of urgent analytical requests.

Test Information

Includes details of sample types, volumes, special precautions, turnaround times & reference ranges.

Haematology Wed 10 Jun 2026 - 12:00

Sickle and Thalassaemia Screening

Read more about Sickle and Thalassaemia Screening

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Antenatal and Newborn Screening for Sickle and Thalassaemia (SCT)

Background:

Haemoglobinopathies are a group of inherited blood disorders that fall into two main categories: haemoglobin variants, such as sickle cell, and thalassaemias. If a person is a carrier of the sickle cell or thalassaemia gene it can be passed onto the baby. All pregnant people in England who have accepted screening will have laboratory testing for haemoglobin variants and thalassaemia. If the mother is found to be a carrier, screening may also be offered to the father.

Haematology Department:

The department of Haematology provides a Sickle Cell and Thalassaemia (SCT) Screening service for antenatal patients in North Bristol and offers a confirmatory service for the newborn screening provided by Clinical Biochemistry. For further information on newborn blood spot testing please see the following page (newborn-screening).

The SCT screening provided by the laboratory follows the government’s published handbook for antenatal laboratories and handbook for newborn laboratories which set out interpretation and reporting guidelines, including which types of sickle and thalassaemia carrier states to report.
SCT testing on antenatal patients is undertaken on whole blood samples taken at booking, preferably before 10 weeks gestation. This allows for prenatal diagnosis (PND) to be offered to at risk women and couples by 12 weeks + 6 days of pregnancy. Early detection of SCT through screening allows for personal informed choice, timely counselling, clinical monitoring and preparation for those patients identified as having an “at risk” pregnancy.

As well as the general sample labelling requirements, it’s also necessary for the patients’ family origin questionnaire (FOQ) to be completed either on the reverse of the antenatal form or by following prompts when requesting on ICE. Our UKAS accredited laboratory currently screens approximately 7,000 pregnant people each year and confirms results for approximately 500 babies for the newborn screening laboratory.

The SCT screening programme is provided in close collaboration with health care professionals throughout the region

Analysis:

Initial screening is performed on our primary analyser using capillary electrophoresis (CE).

Sebia Analyser used for Sickle Cell and Thalassaemia Screening

Abnormal samples are then reanalysed using isoelectric focussing (IEF). IEF separates the proteins into bands allowing our skilled biomedical scientists to identify the types of haemoglobins.

Isoelectric Focussing Gel separates the proteins into bands.

Quality Assurance:

Turnaround times (TATs), standards and key performance indicators (KPIs) are used to continually monitor the performance of the laboratory service.

The laboratory is accredited by UKAS under ISO15189 registration number 8066 and participates in UK NEQAS Quality Assurance Scheme.

Screening laboratories must be able to release > 90% of antenatal results, interim reports and requests for repeat tests in < 3 working days in accordance with SCT screening standards.

Developments:

We report our rare, affected babies (those with suspected severe disease) on a named patient basis, and this is to the newborn outcomes solution (which reports to NCARDRS)

https://www.gov.uk/government/publications/sickle-cell-and-thalassaemia-screening-newborn-outcomes-system/sct-newborn-outcomes-system-overview#national-congenital-anomaly-and-rare-disease-registration-service-ncardrs
https://nww.mdsas.nhs.uk/Newborn/

All patient leaflets are held centrally and are available on the government website:
https://www.gov.uk/government/collections/screening-in-pregnancy-information-leaflets#sickle-cell-and-thalassaemia

Laboratory Visits:

We offer half-day training sessions to midwives, health visitors, nurses, doctors and other allied healthcare professionals involved in the collection of samples. Please contact us to arrange a visit.

Please see below for responses to our most recent survey

SCT user survey report 2023.pdf187.55 KB

Key Contacts for Haematology Laboratory

Dr Sophie Otton
Clinical Lead for SCT & Consultant Haematologist
Via Haematology secretaries - Telephone: 0117 414 8401

Reginah Visser
Principal Clinical Scientist

Jemma Cable
Clinical Scientist

Grace Van Der Mee
Lead Biomedical Scientist

Helen Izzard
Senior Biomedical Scientist

Pathology Sciences Laboratory
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB
Email: NBTHaemoglobinopathyService@nbt.nhs.uk
Telephone: 0117 414 7121 / 0117 414 8356

Opening times: 9am - 5pm Monday - Friday excluding bank holidays.

Clinical advice & interpretation is available during working hours.

Q-Pulse Ref HA/WE/008 V3

Tue 24 Mar 2026 - 12:00

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Medical Same Day Emergency Care (SDEC)

Related links

Related links for clinicians

Contact the Medical SDEC team

Aciclovir

Amikacin

Benzylpenicilin (Penicillin G)

Chloramphenicol

Ciprofloxacin

Colistin

Cycloserine

Daptomycin

Ethambutol

Flucloxacillin

Fluconazole

Flucytosine

Ganciclovir

Gentamicin

Isavuconazole

Isoniazid (+ N-Acetyl-Isoniazid)

Itraconazole

Levofloxacin

Linezolid

Meropenem

Moxifloxacin

Posaconazole

Rifabutin

Rifampicin

Streptomycin

Sulphamethoxazole in (Co-trimoxazole)

Teicoplanin

Tobramycin

Trimethoprim in (Co-trimoxazole)

Vancomycin

Voriconazole

Antimicrobial Reference Laboratory Contact Details

What is pulmonary fibrosis?

How common is IPF?

What are the symptoms?

What tests will I have?

Will my lungs get worse?

How is IPF treated?

Medication

Pulmonary rehabilitation

Supplemental oxygen

Clinical trials

Lung transplants

How can I help myself?

Resources and how to contact us

Resources

How to contact us

Welcome to the North Bristol Weight Management Service

Important information:

Endoscopic Sleeve Gastroplasty (ESG)

Complications

Diet before ESG

What does the diet involve?

Option 1: food

Meal ideas

Nutrient tracking options

Where to find recipes

Option 2: meal replacement shakes

Some suitable options

Option 3: combination of food and shakes

Diabetes

Reintroducing food after ESG

What is the aim of the diet after ESG (post-procedure diet)?

Stage 1: thin liquids (2 days)

Stage 2: liquid diet (12 days)

High protein liquids

Recipes

Stage 3: puree diet (2 weeks)

Tips:

Sample meal plan

Stage 4: soft diet (2 weeks)

Tips:

Sample meal plan

Stage 5: healthy normal textured diet (week 7 onwards)

Cooking tips:

Sample meal plan