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My Lab: The patient-focused laboratory

Heart of England NHS Foundation Trust provides a wide range of services across East and North Birmingham, South Staffordshire, Sutton Coldfi eld an

Heart of England NHS Foundation Trust provides a wide range of services across East and North Birmingham, South Staffordshire, Sutton Coldfi eld and Solihull, seeing approximately 1.2 million people each year. There are three main hospital sites: Good Hope Hospital, Heartlands Hospital and Solihull Hospital. The andrology laboratory is a small, bespoke, purpose-built suite tucked away near a Good Hope Hospital ward.

The andrology laboratory is UKAS accredited to ISO15189:2012 and provides a comprehensive semen analysis service, covering both diagnostic and post-vasectomy samples. The andrology laboratory began life in 2015 after support from the trust and from Clinical Commissioning Groups in retaining a semen analysis service. The plans were drawn up for a dedicated patient waiting area, a room for the patients to produce their semen sample on-site and a small adjacent laboratory.

This efficient design has allowed staff to communicate privately in clinic with patients who may have delicate concerns or issues to discuss. People often forget that these patients have begun their potentially long and diffi cult journey into the unknown or may be attending after many years of trying to conceive with their partner. We ensure that all of the pre-examination instructions have been read and understood prior to production.

Once the sample for analysis is produced, then testing must begin within timeframes specified by the World Health Organization to avoid deterioration and allow for reliable results. If problems arise, staff are able to discuss with the patients and suggest alternatives to on-site masturbation for semen production. When a sample has been produced, we analyse the sample both macroscopically (volume, pH, viscosity, liquefaction and colour) and microscopically (motility, concentration, round cell concentration and morphology). If there is a requirement to do so, we will also report vitality and comment on whether agglutination or aggregation is present.

Vasectomy operations are still a popular form of permanent contraception and here we ensure there is confidence in the success of the vasectomy to prevent unwanted pregnancies. With these samples, patients are asked to produce semen at intervals advised by their referring clinicians. We assess each sample for numbers of sperm as well as motility if sperm are present and this is in keeping with strict guidelines.

We undertake all activities for andrology within our bespoke suite and liaise with service users, particularly consultants infertility and urology, clinical nurse specialists, GPs and, most importantly, the patients themselves. Our aim is to ensure that they are at the heart of all decisions made. This has allowed us to implement patient-focused quality improvements such as: electronic referrals with simpler online booking, extended clinics (including Saturdays), improved quality assurance procedures and access to trained biomedical scientists during working hours.

We are in the process of increasing our repertoire of tests and hope we can continue to grow the service in light of the increasing need of assisted conception, hopefully helping patients feel more at ease as they begin their journey with their partner.

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