Andrew McGregor
Consultant, Newcastle Upon Tyne Hospitals NHS Foundation Trust
Tom Butler
Consultant, Barts Health NHS Trust
Perhaps one of the most exciting jobs in medicine is liaison haematology. What is it, and why do practitioners regard it as interesting?
Liaison haematology is the bridge between the laboratory and the clinician. As well as identifying and treating blood disorders, we’re responsible for interpreting blood test results and communicating them effectively to GPs. In hospitals, we work with multiple healthcare professionals, advising on everything from blood clotting and transfusions to immune system disorders — from pregnancy and newborns to end-of-life care.
Liaison haematology must access all areas
The job has an appealing aspect of having to ‘access all areas.’ Liaison haematologists are busy bodies. On any day, we can get a phone call from maternity one minute and then, the next, have to ensure the right blood goes to a patient who needs a liver transplant. We’ve got an important part to play right across the board in the functioning of a good hospital.
Flexible roles from lab to bedside
Haematologists are both laboratory specialists and clinicians — we have to pass the exams of both the Royal College of Pathologists and the Royal College of Physicians. We fill a gap between specialists and generalists.
These days, there’s a tendency to become more and more specialist, but you also need people who can use their specialist training to help diagnose and treat people — whatever the problem is. That’s what liaison haematologists do. We work across boundaries with GPs, nurses, healthcare scientists and other specialists — and there’s a real joy to walking in other people’s shoes. There’s an educational element to it, too.
Interpreting blood films and why it’s important
When patients have a blood test, computers quickly generate blood counts. If there’s something unusual, the liaison haematologist steps in, often looking at blood films under a microscope and detecting unexpected diseases such as leukaemia.
Part of our role is understanding how those laboratory tests are performed; the possible pitfalls; how errors can occur and then interpreting those results in a meaningful way — considering a patient’s medical history and examination.
These days, GPs can usually communicate with liaison haematologists using web-based systems. Nine times out of ten, we can reassure them about the results. If not, we advise on what other tests might be useful or whether the patient should come and see us. Liaison haematology has often been overlooked by NHS job planners, but it is finally coming to be recognised as a role that lies at the heart of good medical care.
