Histology Result Failsafe SOP

What's inside

This standard operating procedure is fully drafted and structured, ready to brand and complete for your service. It covers:

• 1. Purpose
• 2. Scope
• 3. Definitions and abbreviations
• 4. Who does this, and when
• 5. Responsibilities
• 6. The weekly reconciliation
• 7. When a result arrives
• 8. Acting on the result
• 9. If you cannot reach the patient
• 10. Escalation
• 11. If a result is missed or delayed
• 12. Monthly assurance
• 13. Training and competence
• 14. Monitoring and audit
• 15. Version control and review
• 16. Common failure modes
• 17. Escalation contacts
• 18. Appendix A - Weekly reconciliation record
• 19. Appendix B - Patient contact attempt record
• 20. Related documents
• 21. Disclaimer

CQC fundamental standard

Legislation & standards it maps to

• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - in particular Regulation 12 (Safe care and treatment), Regulation 17 (Good governance) and Regulation 20 (Duty of candour)
• National Institute for Health and Care Excellence guidance on suspected cancer recognition and referral
• General Medical Council good medical practice
• Data Protection Act 2018 and the UK General Data Protection Regulation

Who it applies to

The named person responsible for reconciliation and their deputy, all clinicians reading results, and the clinical lead of [Organisation Name]

Glossary

Plain-English explanations of the technical terms and legislation used in this document.

Clinical review

A clinician actually reading a result, deciding what it means and what to do, and writing that down.

Discordant

When the laboratory result does not match what the clinician expected to find.

Duty of candour

The legal duty to tell a patient promptly when something has gone wrong, apologise, and explain what will be done.

Failsafe

A check designed so that a step cannot be quietly skipped without it being noticed.

Histology

Examination of removed tissue under a microscope to say what it is.

Incomplete excision

The microscope shows the lesion reaching the edge of what was removed, so some may still be in the skin.

Melanoma

A serious skin cancer that can spread if not caught early.

Non-diagnostic

A sample that did not contain enough usable tissue to give an answer.

Reconciliation

Checking a list against reality, here to confirm every specimen sent has a result.

Statutory notification

A report a registered provider is legally required to make to the Care Quality Commission about certain events.

Turnaround time

How long the laboratory normally takes to report a specimen.

How it works

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2. Download your editable Word file from the link we email you straight away.
3. Complete the placeholders for your service, then have it approved before use.
4. Add the optional updates subscription and we keep it current as guidance changes.