This article was last reviewed on
This article waslast modified on 8 February 2019.

Specimen collectors (phlebotomists) are expert in all types of collection but especially blood collection (phlebotomy). Some may have a nursing background but most have been trained by one of the pathology organisations or by external training providers. They need to be technically highly-skilled, but also be able to put patients, who may be feeling nervous, at their ease. For more see Coping with discomfort and anxiety.

Samples have to be stored carefully, sometimes in special transportation liquids or at specific temperatures. They must also be transferred to the lab as quickly as possible. Although this might be just a matter of walking up the corridor in a hospital, it could mean being transported from a GP surgery to a hospital for analysis. Some samples may then need to be sent onto a specialist laboratory for testing.

Once the samples reach the laboratory they are booked into the laboratory computer system, using the patient’s unique identification (name, date of birth, NHS number etc), alongside any clinical information provided by the healthcare professional who requested the test(s). For more, see Why identification is important. This is the job of the specimen processing staff who also carry out first-stage steps such as centrifugation and aliquotting (dividing the specimen up into smaller portions for specific tests) and forwarding test samples to the correct part of the laboratory.

Behind the medical and scientific teams are often many support staff. Many of the jobs in the pathology lab are similar to those in other large organisations -- administration staff, data entry teams, IT support, and healthcare scientists. The whole team are essential for providing a pathology service to the hospital and GPs, 24 hours a day, 7 days a week. The laboratory never closes its doors!

Many samples have to be processed before they can be tested. For instance, tissue samples must be dissected, embedded in wax, sliced into thin wafers of tissue –about a cell thick - and stained before being placed on a slide to be viewed under the microscope. Blood and bodily fluids are smeared onto a slide to be examined under a microscope. For more, see: Cellular Pathology, Tissue Preparation.These jobs are usually handled by highly skilled and qualified healthcare scientistswho must be technically highly-skilled and have the ability to work accurately and dexterously, often at speed if the test is urgent.

Some tests are very labour intensive. Many are dependent on observations made through the microscope and the pathologists and scientists are required to make professional judgements based on what they see. They may be looking for a just few abnormal cells among hundreds of thousands on a Pap smear, or identifying unusual patterns of cells in a blood sample that indicate leukaemia.

Some scientists work with advanced assays and technology, setting parameters and interpreting results. Many tests are at least partly automated. Many chemical and immunoassay tests measuring simple chemicals or proteins and haematology tests analysing the cells in blood are performed on large and sophisticated automated analysers. The scientific and technical staff operating these analysers must have a very wide knowledge of biological science, the principles of the assays being performed, the mechanics and software of the analyser and the sometimes, subtle signs that may indicate potential problems. They must also have a sound knowledge of quality control procedures and the interpretation of QC results since maintenance of analytical quality is central to all laboratory operations.