Behind the scenes

HIDDEN away in a maze of corridors and laboratories at the heart of Ipswich Hospital, is the pathology department which eight out of ten of us have benefited from at some point - sometimes without even realising.

HIDDEN away in a maze of corridors and laboratories at the heart of Ipswich Hospital, is the pathology department which eight out of ten of us have benefited from at some point - sometimes without even realising. SARAH GILLETT meets the back-room workers who help to keep the hospital going.

HIGH above the heads of patients at Ipswich Hospital, hidden above the ceilings, is a complex labyrinth of tubes.

They connect every major department, and flying along these pipes, 24 hours a day, is a steady stream of test tubes - all bound for the pathology department.

Doctors and nurses place the samples in the tube, they are sucked up in to the ceiling and in the corner of a laboratory deep in the heart of the hospital, stands a large pipe with a basket underneath.

Wait beside it for long enough and out pops the latest sample ready to be tested - like a medical version of one of Willy Wonka's wacky creations.

The complex technology which follows might seem like something out of a Roald Dahl novel but it demonstrates how the work of the team of scientists in the pathology labs reaches in to every area of the hospital.

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Bob Keeble, principal biomedical scientist, said: “We have an outpatients' area where people come to have their blood taken and, for most people, that's the extent of their knowledge of us. They don't realise what else is behind that clinic.

“In fact, studies show that between 70 and 80 per cent of all health care decisions have some input from the pathology department. We provide the science behind the medicine and everything we do is central to the diagnosis of different conditions.”

Around 50,000 outpatients pass through the department's drop-in clinic every year, but there are thousands of others throughout the whole of east Suffolk, not just the hospital itself, that will call upon the services of the department.

Mr Keeble said: “We offer pathology to the whole of the community, including GPs and the independent sector. We've got the technology here so it makes sense for us to offer our services to as many people as possible.”

In total, the pathology labs carry out 5.5 million tests each year.

Mr Keeble said: “It's a 24 hour service, 365 days a year. If someone needs an urgent blood transfusion there has to be someone here to assist with that.”

Around 190 people work in the department including 15 doctors, six nurses and 70 biomedical scientists, and the work is divided in to four main areas:

Every year more than 15,000 units (around 7,500 pints) of blood are used throughout the hospital, and every single one of those has to be carefully cross-matched by the haematology team.

Martin Bartlett, head biomedical scientist in haematology, said: “Between 7,000 and 8,000 blood transfusions are carried out at the hospital each year and it's our job to make sure that we are giving people the correct blood for them.

“Most people know about the common blood groups like A and B, but there are many more than people realise and if blood is not matched properly it will be rejected by the patient.”

The scientists use an electronic cross-matching system to ensure that people get the blood that is right for them.

One of the main aims of the team is also to ensure that they are using blood wisely and look at ways of reducing the amount used.

Sharon Kaznica, blood transfusion nurse specialist, said: “We want to reduce the use of blood as much as possible and introduce alternatives to transfusion. For example, blood can be filtered and given back to a patient.

“Blood is a very precious resource and I think the general public are aware of that. Often they don't want to have blood or blood products unless it's absolutely necessary.”

The hospital gets all of its blood from the National Blood Service who screen it carefully for things like HIV and CJD, but this comes at a price - each unit of blood costs the hospital £132.52.

When patients receive blood, it is actually only the red blood cells they are given. Other blood products like white blood cells and plasma are taken out and given to patients separately if needed.

Mrs Kaznica said: “Blood has never been safer. White blood cells are taken out and if you are going to catch a virus that's where it would be.”

The haematology department also investigates disorders of the blood such as anaemia or leukaemia.

Sometimes it is the smallest things that can make the biggest difference and nowhere is that more true than in the hospital's cytology department.

Scientists there have recently been awarded government funding which has helped them to revolutionise the way cervical smear tests are analysed - leading to fewer women needing to be recalled for tests.

The idea is simple - cells are held in liquid rather than smeared on to a slide - but it could prevent hundreds of women from the worry caused by an insufficient sample.

Sue Pinkney, head biomedical scientist in cytology and histology, said: “We analyse around 30,000 smears a year and we are among the first in the country to be using the new technology.

“Normally what happens is that a nurse or doctor at a GP's practice will take a swab from a lady's cervix and smear that on to a slide. With the new technology the cells are suspended in liquid instead and we get a much better view of them - it's like looking at a poached egg rather than a fried egg.

“This means that the number of women who are recalled for tests because of an insufficient sample should be greatly reduced.

“It means less work for us and less worry for patients.”

With an increased awareness of sexually transmitted infections and a national chlamydia screening programme being rolled out across the country, the hospital's microbiologists have never been busier.

Incidences of the sexually transmitted infection are on the rise and an increased awareness of the importance of getting tested means the team's workload is already on the up.

Steven Dorkings, head biomedical scientist in microbiology, said: “The government's national screening programme for 16-24-year- olds is being gradually rolled out and that will certainly result in an increase.

“At the moment we probably screen more than 12,000 samples a year but I would expect that to double within about three years.”

The majority of the samples screened by the team come from the hospital's sexual health clinic but there are also a number of outreach clinics springing up across the county - including one at the 4YP centre in Lower Brook Street.

Sexual health teams also work closely with young offenders at places like Warren Hill in Hollesley.

The biochemistry laboratory is one of the busiest in the hospital and carries out the widest range of tests of any department.

Scientists here can be involved in diagnosing anything from liver disease to fertility problems.

Bob Keeble, principal biomedical scientist, said: “What we deal with in this laboratory is the diagnosis, treatment and monitoring of conditions which are biochemical in nature, so that's things like diabetes and liver or kidney disease.

“It also involves things like fertility problems where you would be measuring the level of hormones in people's blood.”

The bulk of the tests that the biochemistry department carries out are done from blood or urine samples and the lab is home to a vast array of highly-specialised equipment.

With so many samples being analysed at any one time, by complicated pieces of technology, safety is paramount in the lab, and control tests are constantly run on the machines to ensure that the results they produce are accurate.

Samples which the scientists know exactly what to expect from them are placed in the machines and any flaws are immediately picked up.

Mr Keeble said: “With so many tests going through the labs we have to ensure that we have very stringent controls in place to prevent any errors.

“The machines are tested on a regular basis to ensure that the results they are producing are accurate.”

N Did a hospital test help you? Who's your behind-the-scenes hero of the hospital? Write to Your Letters, The Evening Star, 30 Lower Brook Street, Ipswich, Ip4 1AN or email eveningstarletters@eveningstar.co.uk.

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