GP News Letter November 2019

Home , Burnhope, Neasham

Pathology News to analyse group and screen samples at both the UHND and DMH site. Issue:2 November Turnaround times will be improved 2019 as this technology is quicker than conventional methods and reduces the need for manual methods.

Service users should not notice a difference in The New Pathology News how their patients’ results are reported.

Welcome to the newsletter for GP surgeries of County During the transition period, the new analyser Durham and Darlington. This newsletter aims to provide will not be included in the laboratory’s UKAS communication to all users of our laboratories on a scope of accreditation. This does not affect the number of topics from daily laboratory life, new service quality or standards of the results produced; it developments and changes in practice and staff news is a temporary state while the department and announcement. As the newsletter develops it is awaits re-assessment at the end of June. The hoped that every specialty will contribute with special identification accreditation will be reinstated features on individual laboratories plan. once all UKAS requirements have been demonstrated. Departmental Developments Please contact the laboratory if you require any Blood Transfusion- New Technology further information.

Change in Practice

Biochemistry

Cessation of urine pregnancy testing for general practice.

A few surgeries continue to send urine samples for The Transfusion team is pleased to announce pregnancy testing to the laboratory for confirmatory the introduction of an exciting new analyser to testing. We would like to inform you that this service the laboratory: the IH100, this will now be used will no longer be available from Friday the 1st of November 2019.

The urine pregnancy test offered by the laboratory has no advantage or greater sensitivity than the devices/strips that are available to be used within the home or general practice. If there is any doubt relating to a result from a urine pregnancy test, we advise that you repeat the test after a period of 48 hours. If this is still equivocal or the clinician has concerns we would recommend you send a serum hCG into the Clinical Biochemistry department for analysis (yellow top sample). If you have any questions relating to this please contact Laboratory News Dr Tim Lang ([email protected] ). UKAS Accreditation Sweat testing After discussions over several months between CDDFT Pathology Laboratories are mainly accredited to the laboratory and the department of ISO 15189:2012, however due to the nature of the way paediatrics the laboratory will be removing the in which UKAS grants accreditation, it is the test that is accredited and not the laboratory. sweat testing service as of the 1st December 2019 due to the following reasons. Following UKAS maintains a register of laboratories that are the introduction of newborn bloodspots accredited to ISO 15189:2012, which can be accessed via screening for cystic fibrosis in 2009 the the UKAS website (https://www.ukas.com/search- workload for requests of sweat tests has accredited-organisations/). The UKAS website holds a significantly reduced as evidenced through schedule of accreditation for the laboratory that lists the work load figures, a regional survey and audit individual tests for which the laboratory are currently performed by a foundation year doctor. accredited for. Other tests may be awaiting completion Secondly the laboratory due to the reduction in of Extension to Scope (i.e. new test that is in the process requests are not able to maintain sufficient of being added to the schedule of accreditation) and / or competencies to provide a safe and quality transitioning from CPA accreditation to UKAS. Therefore service that requires a sweat testing collection pathology reports may contain a combination of failure rate of less than 5% . This service will accredited and unaccredited tests. now be provided by the James Cook University Hospital. Please be assured that it is normal practice for laboratories to be accredited for a number of tests; The process for CDDFT requests will be: however there could be a number of tests that are Drop a 1-2 line letter to Dr Jayaraj or his unaccredited. This does not necessarily indicate that colleague respiratory paediatrician Dr Arshid these tests are of inferior quality, the tests have the Murad with request for sweat test. They will same level of internal and external quality assurance book the test and write back to referring associated with them, and they are just yet to be paediatrician with the results. officially accredited by UKAS. Users of the CDDFT pathology service may wish to be For those children who live near Newcastle certain that all tests they are sending for analysis are there is a plan to have a similar arrangement accredited by UKAS. This information can be obtained with the RVI in Newcastle. using the link above to the UKAS website. After viewing the UKAS Schedule of Accreditation, if you would like to discuss the accreditation status of any of our tests please contact the Pathology Quality Manager initially to

discuss, and if further assurance or information is During this period, certain tests will not be required (i.e. how we assure quality results for the test) included in the laboratory's UKAS scope of this information can be provided upon request from the accreditation (8770). This does not affect the departmental lead [email protected] quality or standards of the results produced; it is a temporary state while the department awaits re- assessment in May 2020.

The accreditation will be reinstated once all UKAS Microbiology in July 2019 voluntarily suspended requirements have been demonstrated following part of the scope of accredited tests while work is introduction of the new analysers. carried out to rebuild the containment level 3 laboratory at UHND. During this time work will be The following tests are now off scope for Blood process at the Darlington Pathology site. Transfusion:

During this period, certain tests will not be  Group and Screens included in the laboratory's UKAS scope of accreditation (9341). This does not affect the For further information please contact the quality or standards of the results produced; it is a Pathology Quality Manager temporary state while the department awaits re- [email protected] assessment at the end of summer. Resignation of Immunology Service The accreditation will be reinstated once all UKAS with UKAS requirements have been demonstrated after the rebuild has been completed. The following tests Pathology services at County Durham and are now off scope for Microbiology: Darlington NHSFT have recently undertaken an exercise to merge our immunology department into our biochemistry department, to implement  Sputum, Broncho-alveolar lavages, service improvements. This has resulted in a Pleural fluids and any other respiratory change to our UKAS accreditation for secretions for C&S. immunology.  RSV testing by lateral flow Immunoassay Our immunology service was registered as a stand-alone service under the UKAS identification 8811. This is now a resigned number, and the tests within that schedule are now undertaken under identification number 8866, our biochemistry schedule. This has no impact on our service provision to The Transfusion Department in October 2019 has you and your patients, but under UKAS voluntarily suspended part of the scope of regulations we are required to make service accredited tests whilst awaiting an Extension to users aware of such changes. If you have any Scope visit from UKAS. This is expected to take questions regarding this change please do not place in May 2020. This is following the hesitate to our quality manager introduction of the new Bio-Rad IH-1000 [email protected] analysers, Blood Transfusion.

Laboratory Tours

The laboratories Members of at both UHND the tour were and DMH during taken around October took all the part in department of laboratory tours Pathology to with Trust understand members and what is Members of the Public as part of behind the scenes involved within tours being carried out throughout CDDFT. each area. They even got a chance to see first-hand the technical skills we apply on a daily basis.

I’m sure you will be pleased to

hear that the tours were a huge success, people really had no idea how much good stuff goes on at CDDFT and quite how much of this is ‘behind the scenes’.

The tours have been used to raise awareness of the work being carried out by our departments behind the scenes, we received some great responses of feedback from the tours to express the amazement at the scale, expertise, speed and effectiveness they witnessed and heard about.

!! It was really interesting to see how everything works on the other side! I have blood tests very We would like to take this opportunity to extend this regularly following my thyroidectomy and it was option to allow users the option of visiting the really amazing to see what happens after my bloods laboratory and talk to our pathology teams. If you would taken! When I walked into the lab my eyes lit up! be interested in arranging this please contact our Given the opportunity, I would be like a child in a Pathology Quality manager [email protected] sweetshop!!!

“Pathology: Disease detectives” at Blood Science Turnaround time data Celebrate Science 2019 held at Durham University SEPTEMBER DATA

GP Darlington University Hospital (<24hrs) Memorial of North Durham Hospital U&E 100 100 (%) TPNI 100 100 (%) CBC 100 100 COAG 100 100

Inpatient Darlington University Hospital Big and small organs and organelles were the themes of (<4hrs) Memorial of North Durham this year’s activities on the Pathology stand at the 10th Hospital annual Durham University’s 3 day Celebrate Science Fair. U&E (%) 88 82 TPNI 86 78 Volunteers from all disciplines and grades at the County (%) Durham and Darlington NHS FT supported the event. CBC 99 99 Visitors were invited to discover how heavy their organs actually weighed and how small intracellular organelles COAG 99 99 were. ED Darlington University Hospital of Over 3 days more than 300 petri-dish/playdough cells (<1hr) Memorial North Durham were made by little hands and some big one too, which Hospital were proudly taken away on completion. U&E 78 70 (%) The organ activity again was a very versatile activity TPNI 67 50 which allows young visitors to explore their organs and (%) different systems in addition to guessing that a can of CBC 99 99 baked beans weighed the same as a lung. COAG 99 99

Immunology September

Liver Ab (%) 94 BioPlex (%) 98 CCP 98 MPO 88 SEP 92 SLC 96

Organiser: Dr Tim Lang, Consultant Clinical Biochemist C3 80

Handbook House Keeping Reminders Stock orders The Pathology Handbook is a great tool for all users to access information regarding all services available When ordering through pathology. The handbook page can be accessed stock for the through the trust internet site and also the link below. surgeries at We would welcome any feedback regarding this function of our service, to help improve the quality if of UHND/DMH the service given to users. All enquiries should be then the forwarded to the Pathology Quality Manager surgeries must [email protected] email cdda- tr.pathlabsuppli Please Click Here to Access [email protected] the Pathology Handbook t and [email protected]

Psychosis Teams

There are four psychosis teams which cover the County Durham and Darlington area:

 Psychosis team Darlington – West Park Hospital, Edward Pease Way, Darlington, DL2 2TS. Tel: 01325 552322

 Psychosis team North Durham – Chester le Street Health Centre, Newcastle Road, Chester le Street, County Durham, DH3 3UR. Tel: 0191 3336000  Psychosis team Easington – Merrick House, Seaside Lane, Easington, County Durham, SR8 3DY. Tel: 0191 527 5050  Psychosis team South Durham – Goodall Centre, Walker Drive, Bishop Auckland, County Durham, DL14 6QN. Tel: 01388 640001

Please ensure you correctly identify the correct source when sending request to Pathology, stating TEWV will delay results being returned for your patient

Immunology Requests Patients requiring requests for Immunology testing must have two separate white topped samples taken for Immunology. This is the white topped tube. Departments are unable to share samples as there may not be enough of the sample available once finished for Immunology to use, processing in one department could Post Vasectomy Semen analysis (PVSA) delay processing in Immunology. Please provide two samples for Immunology. testing

Please note that patients MUST be requested to make their laboratory appointment immediately after their procedure. We currently have a 12-14 week waiting list and we are finding that patients are waiting too long to make their appointment. This adds unnecessary time and stress to the patient experience.

We are working towards reducing our waiting list but new guidelines have required us to provide more Transport of samples complex testing methods, and samples must be produced on site. Your support is appreciated to help us UN3373 regulations for the transport of biological provide a good patient experience. substances are set through the P650 packaging instructions which state: If further advice or information is required, please The packaging shall consist of at least three contact the ACU laboratory at Bishop Auckland Hospital components: 01388 455 849 • (a) A primary receptacle (sample container) • (b) A secondary packaging (sample bag) Or Mrs Jennifer Siddall, cellular pathology department • (c) An outer packaging (transport carrier) manager 019133324

Either the secondary or the outer packaging must be User Survey rigid. All samples should be transported in carrier boxes which all pathology drivers are supplied with. Pathology representatives have been attending the Samples travelling by taxi should be sent using an outer recent practice managers meetings, to discuss future container that is rigid and concealed so that no patient quality improvements within pathology services. identifiable information can be seen to ensure confidentiality and information governance. We would like to thank all practices which have invited us to attend the meetings and present the quality improvement project being undertaken. At present the information gathered is being analysed to determine the first project for improvement to be undertaken.

The Pathology Quality Manager will be in touch shortly to discuss this further with the groups.

If you have an improvement which you would like pathology to look at please contact [email protected]

Zero Tolerance- The First Month Request forms for blood sciences have been amended Compliance from Pathology users to complete the to shade the mandatory fields green to highlight to required fields on a request form to ensure correct users and laboratory staff that these fields must be patient identification has been for many years an issue. completed, mandatory fields include: The service implemented a 3 identifier policy introduce  Patient Forename and Surname some years ago to ensure the correct patient can be  Patient Date of Birth identified with the results being produces. Blood  Hospital or NHS number transfusion has followed a zero tolerance policy for  Time of Sample collection many years which gets good compliance. Zero tolerance  Date of sample Collection pathology wide was also a SHOT recommendation in  Requesting Clinician 2013 and has seen many trusts follow this  Location of Patient recommended guideline. All requests received with any of these essential Over time with the implementation of accreditation criteria not complete are cancelled and not processed standards such as UKAS ISO15189:2012 ensuring We are reporting quality indicators such as pre- The protocol has now been live for one month and we analytical errors. This is highlighted errors like no can report that after the first month the compliance Source being on the request form, no clinician on the increased to 97% for blood requests and compliance request form this meant that in some instances for microbiology from is now at 94.7%. urgent and critical results could not be phoned to wards and departments. Over all the rejection over the first month of implementation has slowly decreased, showing good The nature of the data source meant that we could not compliance to the new protocol. We hope to continue identify who was not completing the required to see a fall in these figures and the process embeds information and so a manual audit was performed over the coming weeks and will continue to monitor during the month of February 2019. All requests the data. forms in Blood Sciences, were assessed against the proposed protocol. The audit showed that at that The great uptake compliance of required information was at 24% of the to the new workload for that time period, the majority of protocol has been these were down to no clinician and no source of presented at a request and we were unable to determine where the recent Quality majority these requests were coming from. and Patient Safety Conference which was attended by The pathology department introduced a zero tolerance the Pathology protocol for specimens and request forms on The 1st Quality Manager, October 2019. This is to ensure that patients can be Patient Safety and correctly identified, the right tests performed in an Noel Scanlon to appropriate timeframe and the results returned to the show the new correct locations and requesting clinicians. This implementation to overcome patient safety issues. protocol change has been approved at all relevant committee meetings within the Trust in response to For a breakdown of departmental rejections for blood numerous patient safety incidents relating to requests please table in see appendix I and for insufficient information on pathology request forms rejection of microbiology sample please see table in and samples. appendix II.

General Enquiries

Working with Us

We are always keen to hear from our user’s especially on aspects of our service that either you appreciate or where you feel we could do better. With this in mind we would like to arrange Innovation and Service User Feedback sessions. If this is something you would be interested in taking part in please contact [email protected]

Pathology Quality Manager

Rebecca Sedman

Tel: 0191 332116

Appendix I- blood form rejections 0 No time of sample recorded 1 Incorrect or no Date of Birth 6 Incorrect patient forename or surname 8 No date of sample recorded 9 Multiple zero tolerance parameters not met P No/incorrect Hospital number or NHS number provided Q No/Illegible Ward or Department

R No/Illegible consultant 0 1 6 8 9 P Q R Sum:

DERWENTSIDE DERMATOLOGY 1 1

DERWENTSIDE CHD 1 1 2 4

ST CUTHBERT'S HOSPICE 2 1 3

DR. LONG & PARTNERS SPENNYMOOR 1 2 1 4

WILLINGTON MEDICAL GROUP 1 1 1 3

WHINFIELD SURGERY DARLINGTON 10 1 2 2 15

ORCHARD COURT SURGERY 2 7 9

HALLGARTH SURGERY SHILDON 1 1 1 1 1 5

BRIDGE END SURGERY CHESTER LE ST 9 2 2 2 15

MOORLANDS SURGERY DARLINGTON 2 1 1 3 10 17

CLAYPATH & UNIVERSITY MEDICAL GROUP 17 1 3 1 4 26

NEASHAM ROAD SURGERY DARLINGTON 6 1 1 5 9 22

BELMONT SURGERY DURHAM 2 1 1 3 7

SHERBURN SURGERY DURHAM 1 1

STATION VIEW MEDICAL CENTRE B.A. 13 3 2 1 1 20

TANFIELD VIEW SURGERY 11 1 1 2 3 18

CONSETT MEDICAL CENTRE 12 6 5 1 18 42

NORTH HOUSE SURGERY CROOK 1 1 1 1 7 11

AUCKLAND MEDICAL GROUP 9 1 6 2 18

SIR BOBBY ROBSON HOUSE 4 2 1 8 15

MEADOWFIELD SAWMILLS LANE 1 1 2

TOW LAW CHARLTON HSE 1 1

STANLEY MEDICAL GROUP CLIFFORD RD 10 3 2 1 4 20

THE SURGERY WEST RAINTON 1 1 2

BISHOPGATE MEDICAL CENTRE B.A. 11 1 2 16 2 1 2 35

THE SURGERY, SACRISTON 7 1 6 6 20

COXHOE MEDICAL PRACTICE 1 2 1 2 7 13 GROUP PRACTICE SURGERY MIDDLE 20 CHARE 7 1 4 1 1 6

WOODLANDS SURGERY RICKLETON 1 1

THE SURGERY GREAT LUMLEY 3 2 1 1 7

DUNELM MEDICAL PRACTICE 5 1 3 3 1 2 11 26

GILESGATE DURHAM (DUNELM) 2 1 3

MEDICAL CENTRE, FRAM MOOR (DUNELM) 1 1

CARMEL MEDICAL PRACTICE DARLINGTON 4 1 1 1 7

WOODVIEW MEDICAL PRACTICE 1 1 1 2 5 THE SURGERY, PELTON LAVENDER 29 CENTRE 9 1 2 4 1 2 10

PELTON FELL FELLROSE 6 6

BLACKETTS MEDICAL PRACTICE 2 1 2 2 7

STANHOPE MEDICAL CENTRE 1 1 1 10 13

CHASTLETON FRAMWELLGATE MOOR 3 3 3 1 10 20

BEWICK CRESCENT - NEWTON AYCLIFFE 8 3 1 1 13

CEDARS MEDICAL GROUP BURNOPFIELD 3 1 4 8 CLIFTON COURT MED CENTRE 26 DARLINGTON 6 1 1 5 1 12

MIDDLETON-IN-TEESDALE SURGERY 2 1 1 1 5

DR.OAKENFULL & PARTNERS FERRYHILL 5 1 2 1 1 5 15

BARNARD CASTLE SURGERY 2 2

DENMARK STREET SURGERY DARLINGTON 7 1 8 16 ROCKLIFFE COURT SURGERY 1 DARLINGTON 1

QUEENS ROAD SURGERY CONSETT 11 1 2 1 4 19

CESTRIA HEALTH CENTRE CHESTER LE ST 10 1 3 2 14 30

DR.WOOD & PARTNERS SPENNYMOOR 1 1 1 1 4

SKERNE MEDICAL GROUP 6 1 10 17

TRIMDON WYNYARD RD 1 1

CHEVELEY PARK MEDICAL CTR DURHAM 1 3 4

EAST DURHAM MEDICAL GROUP 2 7 12 21

PINFOLD MEDICAL PRACTICE 2 1 1 4

GAINFORD SURGERY 1 1 2

JUBILEE MEDICAL GROUP NTON AYCLIFFE 3 1 1 1 1 7

ST GEORGE'S MED MIDD. ST GEORGE 1 1 2

LANCHESTER MEDICAL CENTRE 5 2 7

DRS LAMBERT& BRUNT 9 WEST RD A.P. 1 1 2

DR.POUNDER & PARTNERS PEASE WAY 1 1

BROWNEY HOUSE SURGERY 1 1 1 3

OAKFIELDS HEALTH CENTRE 3 1 1 5

BURNHOPE HAVEN 1 1 2 4

EVENWOOD SURGERY 1 3 4

DENHOLM HOUSE BRANDON 3 2 1 6

CRAGHEAD MEDICAL CENTRE 1 1

WEST CORNFORTH SURGERY 1 1 2 3 4 2 2 15

BOWBURN MEDICAL CENTRE 3 1 1 1 6

LEADGATE SURGERY 1 6 7

21 GARDINER CRESCENT PELTON FELL 3 2 1 10 16

PARKGATE SURGERY DARLINGTON 3 3

ANNFIELD PLAIN SURGERY DURHAM RD 2 2

AFFINITY HEALTHCARE 1 1

APPLETREE - CAMBIAN GROUP 1 1

BAGH WARD 4 STROKE REHAB UNIT 1 1

BAGH WARD 6 MEDICAL 1 1 2

BAGH WARD 16 ELDERLY 3 3

BAGH WARD 18 ORTHOPAEDIC/SURGICAL 1 1

BAGH WARD 19 ORTHOPAEDIC 1 1 BAGH WOMENS CENTRE ANTE-NATAL 1ST 2 F 1 1

BAGH DERMATOLOGY BIOP 1 1

BAGH FERTILITY OUTPATIENT (ACU) 5 1 1 2 9

BAGH MAIN OUTPATIENT DEPARTMENT 17 7 6 3 9 42

BAGH GUM CLINIC 2 2

BAGH MARA UNIT 3 1 4 8

BAGH WARD 20 OUTPATIENTS 2 2

BOWES LYON DAY UNIT EH 1 1

CLS WARD 1 5 1 2 8

CEDARS MEDICAL GROUP HOSP 1 1 1 3

CLS GENERAL OUTPATIENTS 4 4

CLS CHILDRENS DEPT 1 1 2

DMH WARD 21 PAEDIATRICS 5 2 3 10

DMH WARD 23 EYES 1 5 6

DMH WARD 24 PAEDIATRIC 1 1 1 1 4

DMH WARD 31 9 1 1 2 13

DMH WARD 32 GENERAL SURGERY 4 1 2 1 1 9

DMH WARD 33 GENERAL SURGERY 4 1 5

DMH ACUTE MEDICAL UNIT 7 1 1 4 13

DMH WARD 41 GEN MEDICINE RHEUM 4 2 4 10

DMH WARD 42 HAEMATOLOGY 10 1 9 20

DMH WARD 43 GENERAL MEDICINE 13 1 2 4 20

DMH WARD 44 GENERAL MEDICINE 6 3 9

DMH WARD 51 CARDIOLOGY 10 1 1 2 14

DMH WARD 52 6 4 10

DMH WARD 61 OBSTETRICS 1 1 7 9

DMH WARD 62 GYNAECOLOGY 5 1 1 1 1 6 15

DMH ACCIDENT & EMERGENCY 32 3 1 1 3 4 1 46 91 DMH ANTE-NATAL OUTPATIENTS WOMENS 3 C 1 2

DMH CORONARY CARE UNIT 3 3

DMH CLINICAL DECISIONS UNIT 1 2 3

DMH DERMATOLOGY BIOP 2 1 1 4

DMH ENDOSCOPY UNIT 2 2

DMH MAIN OUTPATIENT DEPARTMENT B 33 1 5 5 3 27 74

DMH GUM CLINIC 1 1 2

DMH INTENSIVE THERAPY UNIT 1 2 7 9

DMH INTENSIVE THERAPY UNIT 2 1 1

DMH LABOUR WARD 5 5

DMH MEDICAL DAY UNIT 5TH FLR 6 1 8 15 DMH OPHTHALMOLOGY OUTPATIENTS 2 WARD 2

DMH PAEDIATRIC OUTPATIENTS, WARD24 3 4 7

DMH HAEMATOLOGY OUTPATIENT 4 1 5

DMH PREGNANCY ASSESSMENT UNIT 3 5 8

DMH RAMAC WARD 2 1 6 9

DMH SPECIAL CARE BABY UNIT 3 3

FARNHAM WARD - LANCHESTER ROAD 2 HOS 1 1

SEDG FRANZISKA WILLER WARD 1 1 3 5

MEADOWFIELD SURGERY HOSP 1 1

FRIARAGE HOSPITAL 1 1 2

JAMES COOK UNIVERSITY HOSPITAL 6 1 1 5 13

NEWCASTLE GENERAL HOSPITAL 2 2 4

ROYAL VICTORIA INFIRMARY 2 1 1 4

SUNDERLAND ROYAL HOSPITAL 1 1 1 3 RICH STARLING WARD RICHARDSON 2 COMM 2

TEES ESK WEAR VALLEY 8 1 1 2 5 17

SBH WARD TWO 1 1 1 3

SBH WOODLANDS MIU AND CHEMO 5 1 6

SBH GENERAL OUTPATIENT DEPT 5 4 9

TALBOT WARD - LANCHESTER ROAD HOSP 1 3 4 TUNSTALL WARD - LANCHESTER ROAD 9 HOS 2 1 1 5

UHND WARD 1 G.MEDICINE 13 3 1 2 2 3 24

UHND WARD 2 G.MEDICINE (STROKE) 9 1 1 4 1 1 4 21

UHND ACUTE MEDICAL UNIT 31 1 2 2 12 48

UHND WARD 5 G.MEDICINE 11 2 1 2 16 UHND WARD 6 CARD/ENDOCRINE 38 MEDICINE 24 1 3 1 1 8

UHND WARD 7 (TREETOPS) PAEDS 5 1 2 1 1 2 12

UHND WARD 9 WOMENS HEALTH UNIT 4 1 2 1 3 11

UHND WARD 10 GYNAE 6 1 1 5 13

UHND WARD 11 CARDIOLOGY 16 2 2 1 6 27 UHND WARD 12 TRAUMA/ORTHOPAEDIC 19 UNI 11 2 1 3 2

UHND WARD 14 GASTROENTEROLOGY 24 1 1 2 4 32

UHND WARD 15 PLASTIC + ORTHO SURG 9 9

UHND WARD 16 GENERAL SURGERY 10 1 1 1 13

UHND WARD 8 & 10 OBSTETRICS 8 1 2 11

UHND WARD 8 & 10 (WELL BABIES) 1 1

UHND WARD 8 & 9 OBSTETRICS 1 1 UHND ACCIDENT & EMERGENCY SHORT 95 STA 55 7 7 1 4 21

UHND CARDIAC DAY UNIT DAY CASE 3 1 2 6

UHND CLINICAL DECISIONS UNIT 2 1 3

UHND DERMATOLOGY BIOP 3 3

UHND DERMATOLOGY 17 4 1 1 1 3 27

UHND DAY SURGERY UNIT IP 2 1 3

UHND MEDICAL INVESTIGATIONS UNIT 4 2 6

UHND ENDOSCOPY UNIT 1 3 4

UHND GENERAL OUTPATIENTS 72 21 13 5 5 12 128

UHND GUM CLINIC 2 1 1 2 6

UHND GYNAECOLOGY DEPT 2 1 1 1 5

UHND INTENSIVE THERAPY UNIT 9 2 11

CHEMO DAY UNIT UHND MIU 13 3 3 2 21

UNKNOWN LOCATION 118 1 24 110 12 662 176 1103

UHND NURSE PRACTITIONER UNIT 5 4 9

UHND PREGNANCY ASSESSMENT UNIT 5 1 3 9

UHND PAEDIATRIC OUTPATIENT DEPT-TRE 1 2 1 1 5

UHND MEDICAL ASSESSMENT WARD 2 2

UHND SURGICAL ADMISSIONS UNIT 9 1 4 14

UHND NEONATAL UNIT (SCN) 2 1 1 1 5

UHND DAY SURGERY UNIT SHORT STAY 1 1

VICTORIA HOUSE - CAMBIAN GROUP 1 1

ELM WARD WEST PARK 1 1

MAPLE WARD WEST PARK 1 1 2

OAK WARD WEST PARK 1 2 3

SRI DERMATOLOGY O.P. (CDDFT CLINIC) 10 3 1 3 3 6 26

SBH OUT OF HOURS CENTRE 2 2

UHND OUT OF HOURS CENTRE 1 2 3

URGENT CARE CENTRE BAGH 1 1

URGENT CARE CENTRE (DMH) 1 1 4 6

HMYOI DEERBOLT 0

HMP DURHAM 2 2 6 2 12

HMP FRANKLAND 5 1 5 3 14

Appendix II- Microbiology sample rejection data for October

H No/Unknown/Illegible consultant on request form

M Multiple omissions - request form

R Less than 3 patient identifiers on request form

S Less than 3 patient identifiers on specimen

V No specimen date/time given

W No/Unknown location on request form

H M R S V W Sum:

ST CUTHBERT'S HOSPICE 1 1

QUEENS PARK MEDICAL CENTRE 1 1

WOODBRIDGE PRACTICE 1 1

THE LINTHORPE SURGERY 1 1

PARK LANE SURGERY 1 1

DR. LONG & PARTNERS SPENNYMOOR 7 1 3 5 4 20

WILLINGTON MEDICAL GROUP 3 1 6 10

WHINFIELD SURGERY DARLINGTON 22 7 4 33

ORCHARD COURT SURGERY 7 1 4 12

HALLGARTH SURGERY SHILDON 4 4

BRIDGE END SURGERY CHESTER LE ST 1 1 2

MOORLANDS SURGERY DARLINGTON 13 2 2 14 31

CLAYPATH & UNIVERSITY MEDICAL GROUP 11 1 6 1 19

NEASHAM ROAD SURGERY DARLINGTON 16 1 3 7 2 29

BELMONT SURGERY DURHAM 5 1 9 3 18

STATION VIEW MEDICAL CENTRE B.A. 24 1 1 3 3 32

TANFIELD VIEW SURGERY 3 4 5 12

CONSETT MEDICAL CENTRE 17 1 2 20

NORTH HOUSE SURGERY CROOK 21 3 5 3 4 36

AUCKLAND MEDICAL GROUP 21 1 13 35

SIR BOBBY ROBSON HOUSE 2 1 1 1 5

STANLEY MEDICAL GROUP CLIFFORD RD 4 2 1 7

THE SURGERY WEST RAINTON 1 1 1 2 5

BISHOPGATE MEDICAL CENTRE B.A. 15 3 4 1 23

THE SURGERY, SACRISTON 3 3 6

COXHOE MEDICAL PRACTICE 1 1 2

GROUP PRACTICE SURGERY MIDDLE CHARE 1 1 2

THE SURGERY GREAT LUMLEY 1 1

DUNELM MEDICAL PRACTICE 6 3 1 3 2 15

CARMEL MEDICAL PRACTICE DARLINGTON 14 2 3 19

WOODVIEW MEDICAL PRACTICE 2 2

THE SURGERY, PELTON LAVENDER CENTRE 1 1 1 3

PELTON FELL FELLROSE 1 1 2

BLACKETTS MEDICAL PRACTICE 18 2 12 2 34

STANHOPE MEDICAL CENTRE 6 1 7

CHASTLETON FRAMWELLGATE MOOR 12 2 3 17

BEWICK CRESCENT - NEWTON AYCLIFFE 7 3 15 25

CEDARS MEDICAL GROUP BURNOPFIELD 1 2 3 6

CLIFTON COURT MED CENTRE DARLINGTON 25 1 1 7 3 37

MIDDLETON-IN-TEESDALE SURGERY 3 3

DR.OAKENFULL & PARTNERS FERRYHILL 3 1 1 5

CHILTON HEALTH CENTRE 1 1

BARNARD CASTLE SURGERY 2 3 5

DENMARK STREET SURGERY DARLINGTON 23 1 1 2 2 29

ROCKLIFFE COURT SURGERY DARLINGTON 1 1 1 3

QUEENS ROAD SURGERY CONSETT 9 1 1 11

CESTRIA HEALTH CENTRE CHESTER LE ST 19 2 4 2 27

DR.WOOD & PARTNERS SPENNYMOOR 6 1 1 1 9

SKERNE MEDICAL GROUP 5 1 2 2 10

CHEVELEY PARK MEDICAL CTR DURHAM 2 2

EAST DURHAM MEDICAL GROUP 3 1 4

PINFOLD MEDICAL PRACTICE 1 1 2

GAINFORD SURGERY 1 1 1 3 6

JUBILEE MEDICAL GROUP NTON AYCLIFFE 22 1 2 3 28

ST GEORGE'S MED MIDD. ST GEORGE 2 1 5 8

DRS LAMBERT& BRUNT 9 WEST RD A.P. 1 1 2

LAMBERT - LOUISA SURGERY, STANLEY 1 1

DR.POUNDER & PARTNERS PEASE WAY 6 1 2 2 11

DR.ROY SPENNYMOOR 1 2 3

BROWNEY HOUSE SURGERY 1 1 2

OAKFIELDS HEALTH CENTRE 2 1 3

BURNHOPE HAVEN 1 1

EVENWOOD SURGERY 6 1 1 8

CRAGHEAD MEDICAL CENTRE 2 2

WEST CORNFORTH SURGERY 1 1

BOWBURN MEDICAL CENTRE 2 2 4

LEADGATE SURGERY 4 1 5

21 GARDINER CRESCENT PELTON FELL 1 1

PARKGATE SURGERY DARLINGTON 5 1 1 7

ANNFIELD PLAIN SURGERY DURHAM RD 1 1 2

BAGH WARD 3 MEDICAL 1 1

BAGH WARD 4 STROKE REHAB UNIT 7 1 1 9

BAGH WARD 6 MEDICAL 4 1 5

BAGH WARD 9 OPTHALMOLOGY 1 1

BAGH WARD 16 ELDERLY 9 2 11

BAGH WARD 18 ORTHOPAEDIC/SURGICAL 1 1

BAGH WARD 19 ORTHOPAEDIC 1 7 8

SCORTON SURGERY 1 1

MOWBRAY HOUSE SURGERY 1 1

THE FRIARY SURGERY RICHMOND 1 1

BEWICK CRES SURGERY HOSP 1 1

BAGH MAIN OUTPATIENT DEPARTMENT 2 10 6 18

BAGH GUM CLINIC 1 1

BAGH MARA UNIT 1 1

BAGH MARA UNIT, 1ST FLOOR OP 1 1

CLS WARD 1 10 1 11

CASH CLINIC PETERLEE H C 1 1

CASH CLINIC UHND 1 1

CLAYPATH SURGERY HOSP 2 2

CLS GENERAL OUTPATIENTS 1 1

DMH WARD 21 PAEDIATRICS 5 2 1 8

DMH WARD 23 EYES 3 3

DMH WARD 31 56 5 3 64

DMH WARD 32 GENERAL SURGERY 15 3 1 2 21

DMH WARD 33 GENERAL SURGERY 24 1 1 26

DMH ACUTE MEDICAL UNIT 134 1 1 5 15 156

DMH WARD 41 GEN MEDICINE RHEUM 21 1 1 1 24

DMH WARD 42 HAEMATOLOGY 11 2 1 3 17

DMH WARD 43 GENERAL MEDICINE 8 1 1 10

DMH WARD 44 GENERAL MEDICINE 20 1 1 1 23

DMH WARD 51 CARDIOLOGY 15 1 16

DMH WARD 52 14 1 1 16

DMH WARD 61 OBSTETRICS 11 1 1 13

DMH WARD 62 GYNAECOLOGY 17 2 1 20

DMH ACCIDENT & EMERGENCY 42 3 1 46

DMH ANTE-NATAL OUTPATIENTS WOMENS C 3 3

DMH CARDIO ANGIOGRAPHY 1 1

DMH CORONARY CARE UNIT 9 2 11

DMH OUTPATIENT DEPARTMENT, FLOOR C 3 1 4

DMH CARDIO RESPIRATORY OUTPATIENT D 1 1

DMH OUTPATIENT DEPARTMENT, FLOOR D 1 1

DMH ENDOSCOPY UNIT 1 1

DMH MAIN OUTPATIENT DEPARTMENT B 5 1 18 38 62

DMH GUM CLINIC 2 1 3 DMH GYNAECOLOGY OUTPATS WOMENS 2 CENT 1 1

DMH HIGH DEPENDANCY UNIT 3RD FLR 2 2

DMH INTENSIVE THERAPY UNIT 1 22 4 26

DMH INTENSIVE THERAPY UNIT 2 8 2 10

DMH LABOUR WARD 2 1 3 DMH OPHTHALMOLOGY OUTPATIENTS 2 WARD 1 1

DMH PREGNANCY ASSESSMENT UNIT 8 1 2 11

DMH RAMAC WARD 6 1 1 8

DMH WELL BABIES WARD 1 1

ROSEBERRY BOWES LYON UNIT 1 1

FARNHAM WARD - LANCHESTER ROAD HOS 1 1

SEDG FRANZISKA WILLER WARD 9 1 2 12

HAMSTERLEY WARD AUCKLAND PARK 1 1

RICH STARLING WARD RICHARDSON COMM 6 1 7

TEES ESK WEAR VALLEY 2 2

SBH WARD TWO 3 3

SBH WOODLANDS MIU AND CHEMO 1 1

SBH OBSTETRIC/GYNAECOLOGY DPT 1 1 2

TUNSTALL WARD - LANCHESTER ROAD HOS 1 1

UHND WARD 1 G.MEDICINE 5 1 6

UHND WARD 2 G.MEDICINE (STROKE) 41 1 3 1 46

UHND ACUTE MEDICAL UNIT 261 4 4 1 7 10 287

UHND WARD 5 G.MEDICINE 4 1 5

UHND WARD 6 CARD/ENDOCRINE MEDICINE 21 1 1 1 24

UHND WARD 7 (TREETOPS) PAEDS 2 1 1 4

UHND WARD 9 WOMENS HEALTH UNIT 12 2 1 15

UHND WARD 10 GYNAE 9 3 1 13

UHND WARD 11 CARDIOLOGY 20 20

UHND WARD 12 TRAUMA/ORTHOPAEDIC UNI 19 8 3 30

UHND WARD 14 GASTROENTEROLOGY 21 1 1 1 24

UHND WARD 15 PLASTIC + ORTHO SURG 3 3

UHND WARD 16 GENERAL SURGERY 13 2 2 17

UHND WARD 8 & 10 OBSTETRICS 8 1 9

UHND WARD 8 & 10 (WELL BABIES) 1 1

UHND ACCIDENT & EMERGENCY SHORT STA 24 1 4 8 37

UHND CARDIAC DAY UNIT DAY CASE 3 1 4

UHND DERMATOLOGY BIOP 1 1 1 3

UHND DAY SURGERY UNIT IP 2 2

UHND ENDOSCOPY UNIT 1 1

UHND GENERAL OUTPATIENTS 6 2 1 1 15 49 74

UHND GUM CLINIC 2 2

UHND GYNAECOLOGY DEPT 1 4 5

UHND INTENSIVE THERAPY UNIT 23 1 7 31

CHEMO DAY UNIT UHND MIU 4 1 1 6

UNKNOWN LOCATION 15 1 2 24 42

UHND NURSE PRACTITIONER UNIT 2 2

UHND ANTE-NATAL OUTPATIENTS 2 2 6 10

UHND PREGNANCY ASSESSMENT UNIT 10 2 12

UHND DRESSING CLINIC 9 1 2 12

UHND MEDICAL ASSESSMENT WARD 1 1

UHND SURGICAL ADMISSIONS UNIT 8 3 1 12

UHND NEONATAL UNIT (SCN) 3 3

UHND DAY SURGERY UNIT SHORT STAY 1 1

UHND TRAUMA/ORTHOPAEDIC DEPT' 1 1

WEAR WARD 1 1 1

WHINFIELD SURGERY HOSP 3 3

WEARDALE COMMUNITY HOSPITAL PHYSIO 1 1

OAK WARD WEST PARK 1 1

SRI DERMATOLOGY O.P. (CDDFT CLINIC) 1 1 2

SBH OUT OF HOURS CENTRE 1 1

UHND OUT OF HOURS CENTRE 1 1 2

URGENT CARE CENTRE (DMH) 2 2

HMYOI DEERBOLT 1 1

HMP DURHAM 1 1