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Pathology services

The main Pathology specialties include Clinical Biochemistry, Haematology, Immunopathology, Microbiology, Histopathology and Virology with several specialties providing a pan-east London service.

The Pathology Directorate achieved full accreditation by Clinical Pathology Accreditation (CPA) in 1999. This accreditation is an external audit of the ability to provide a service of high quality in meeting all the necessary performance standards.

Central pathology

Services provided

  • Phlebotomy services at all hospitals within Barts and The London NHS Trust for inpatients, outpatients and GP patients.
  • Management of specimen transport arrangements.


Clinical biochemistry

Services provided

The Clinical Biochemistry Department offers a 24-hour service at The Royal London and Barts hospitals. It receives in excess of 500,000 requests each year and offers a full advisory and analytical service. The large diagnostic repertoire requires a broad range of techniques and includes:

  • General biochemistry.
  • Endocrinology.
  • Therapeutic drug monitoring.
  • Metabolic disorders.
  • Toxicology.


Services provided

The Haematology service provides a full diagnostic service.

  • General haematology laboratoryG
  • Haemostasis laboratory.
  • Red cell laboratory.
  • Immunophenotyping laboratory.
  • Molecular haematology laboratory.
  • Blood transfusion laboratory.
  • Immunohaematology / transplantation laboratory.


Services provided

  • The Immunopathology service consists of an Immunodiagnostic Laboratory based at St Bartholomew’s Hospital and a Tissue Typing Laboratory based at The Royal London Hospital.
  • The Immunodiagnostic Laboratory provides a full consultant-led diagnostic service for the diagnosis and monitoring of patients with immunodeficiencies, autoimmune disease and allergic conditions.
  • The Tissue Typing Laboratory provides a battery of services in support of kidney, thoracic and bone marrow transplant programmes and for a range of disease conditions with HLA and other immunogenetic associations.

Medical Microbiology

Services provided

  • The Medical Microbiology service provides comprehensive diagnosis, management and control of microbial disease. Clinical advice and laboratory diagnostic facilities are available 24-hours.
  • Communicable disease control - the consultants in Communicable Disease Control (CCDC) are available for enquiries on communicable diseases and for notifications of infectious diseases.


Services provided

The Histopathology service provides a consultant-led diagnostic histopathology, cytopathology and mortuary service for Barts and The London, Newham Healthcare, Homerton Hospital and GPs in the East London and City Area Health Authority.

The diagnostic and research activities are supported by a wide range of routine and specialised technology including:

Immunocytochemistry, using a wide range of cell lineage and tumour markers.

  • Enzyme histochemistry, for fibre typing in muscle disease. 
  • Electron microscopy.
  • Guantitative microscopy, using image analysis.
  • Molecular biology, using labelled probes.
  • Fine needle aspiration cytology.
  • Neuropathological techniques.

The unit encourages formal and informal clinicopathological consultation as an important pathway for the exchange of information between pathologists and clinicians both on individual patients and as a form of audit of the service provided.


Services provided

The Virology service is centralised at St Bartholomew’s Hospital. The fully equipped laboratory currently performs over 150,000 routine investigations each year for the hospital and trusts within East London and the City. These include requests for the diagnosis of acute virus infections and for antibody screening to determine immune status. The routine laboratory, which is amongst the largest in the country, works in close co-operation with the research staff of the combined medical school and provides reference testing for HIV, herpes virus drug resistance and human papilloma virus detection.

Services available

  • Virology clinic.
  • Shingles study.

Infection control and occupational exposure
Virology maintains high profile within infection control. This includes the responsive provision of advice following accidental exposure to blood-borne viruses and advice on post-exposure management including the use of triple antiretroviral therapy for HIV. Other important areas of infection control include the investigation and management of varicella-zoster exposure and the control of influenza and viral diarrhoea outbreaks.