Haematology Service

This document is designed to help general practitioners with routine haematological problems. It may also be useful to guide hospital doctors in the further investigation of abnormal haematological parameters.

Guideline Scope 

These guidelines do not apply to children or patients who are pregnant.

It is difficult to give advice for every clinical situation as all patients are different. Further monitoring or investigation may not be appropriate in some patient groups. Likewise patients may present with multiple different abnormalities and therefore further advice may be required.

Where major abnormalities are found on the blood film that require urgent attention
e.g. acute leukaemia, microangiopathic haemolytic anaemia, platelet count less than 10 × 109/L etc. the haematology team will contact a general practitioner directly. When a blood film or coagulation screen is reviewed by a haematologist there may be specific suggestions made to guide referral or further investigations.

As pre-analytical variables can play a part in abnormal results we suggest repeating a sample if an unexpected result is encountered. Frequently our advice is based on the pattern of abnormalities and how these have developed over time and therefore reviewing older blood tests is useful to guide further management.

If we have advised you to perform a blood film please request this with relevant clinical details and request for ‘medical review as per consultant haematologist’.

The laboratory is often able to add on tests to existing samples but this is only usually possible if done within 48 hours. Please see Blood Sciences User Manual.pdf (scot.nhs.uk) for full details on our testing repertoire and how to request add on tests(pages 17&18).

Useful Resources 

• British Society for Haematology Guidelines: Guidelines (b-s-h.org.uk)
• GPNotebook: https://www.gpnotebook.co.uk
• Blood Sciences User Manual.pdf (scot.nhs.uk)
• Applications: Buku Medicine – all you need to know about haematology with GPs in mind – free to download on IOS and Android

Contacting the Haematology Service

If advice is required about a haematological problem this should usually be via the SCI Gateway Clinical Dialogue process in the first instance. If help is required with a patient that is currently under our care or previously known to our service then please write to the appropriate haematologist directly. We aim to reply to all GP Clinical Dialogue requests within two working days but an answer will often come sooner if we are not short-staffed. If you need urgent or emergency advice that cannot wait then please contact the on call haematology consultant via switchboard.

Evaluation and Feedback

Should you wish to provide feedback on this guideline please contact nhsh.haematology@nhs.scot

Document changes

 Any document changes must be updated in:

• iPassport
• Intranet TAM site