Why does it matter?
Every day, NHS laboratories process millions of patient specimens, including blood samples, tissue biopsies, urine, and other samples. Accurate specimen labelling and tracking is essential for reliable diagnostic results and safe patient care. Errors at any stage of the process, from sample collection to laboratory analysis and results reporting, can lead to delayed or incorrect diagnoses, unnecessary repeat procedures, and direct patient harm.
“Wrong Blood in Tube” (WBIT) errors are one of the most significant risks in specimen management. A WBIT error occurs when a blood sample is collected from one patient but labelled with another patient’s details. In 2023, 986 WBIT near-miss events were reported across the NHS. The primary causes were incorrect patient identification at the bedside (44%) and labelling samples away from the patient (31%). If a WBIT error is not detected before a blood transfusion, it can result in a patient receiving incompatible blood, which can be fatal.
Beyond WBIT, mislabelled or misidentified specimens of all types can result in incorrect treatment decisions. Tissue biopsies sent to histopathology, urine samples, and other diagnostic specimens are all subject to the same risks when manual labelling processes are used.
Most specimen collection currently relies on manual labelling, creating opportunities for human error at multiple points: when the label is generated, when it is applied to the sample, during transport, and at laboratory receipt. In primary care settings, where patients attend GP practices or community clinics for blood tests without wearing a wristband, the risks of identification errors are particularly relevant, as patient identity relies entirely on the details written or printed on the request form and verbal verification by the clinician.
How does barcode scanning help?
Barcode scanning at the point of collection creates a verified, digital link between the patient and their specimen from the moment the sample is taken. Print-on-demand labelling systems generate a patient-specific barcode label at the bedside, immediately before collection, significantly reducing the risk of pre-labelling errors or labels being applied to the wrong sample.
Key benefits include:
- Reduced specimen mislabelling errors
- Lower sample rejection rates: electronic labelling has been shown to reduce rejection rates by 46.9%
- Real-time tracking of specimens through the laboratory workflow
- Comprehensive audit trails from collection to results reporting
- Faster turnaround times through automated tracking and workflow management
- Reduced need for repeat sampling, minimising patient inconvenience and clinical risk
Tissue and histopathology tracking
For tissue samples and surgical specimens sent to histopathology, tracking presents additional challenges. Samples may pass through multiple departments and processing stages before analysis, and delays in locating samples can affect diagnostic turnaround times and patient pathways.
Barcode and RFID scanning technologies can provide real-time visibility of sample location throughout the laboratory workflow. Systems that track specimens from receipt through processing, embedding, sectioning, and reporting can significantly reduce the time spent locating samples and improve turnaround times. This technology is still emerging in NHS settings, but early implementations have demonstrated significant workflow improvements.
Extending beyond the hospital
Most current guidance focuses on specimen tracking within hospital settings. However, a significant proportion of blood tests and diagnostic samples originate in primary care, with samples travelling from GP practices to NHS laboratories. There is an opportunity to extend digital tracking across this wider pathway, from sample collection in the community through to laboratory receipt and results delivery back to the requesting clinician and patient.
Implementation
Implementing barcode scanning for pathology and specimen tracking typically involves:
- Deploying print-on-demand label printers at point-of-care collection areas
- Integrating labelling systems with electronic patient records and laboratory information management systems
- Ensuring reliable WiFi coverage in all collection areas
- Training clinical staff on electronic labelling workflows and patient identification processes
- Establishing governance processes for managing labelling exceptions and near-miss reporting
- Working with laboratory teams to integrate tracking into existing laboratory workflows
For guidance on blood transfusion safety, including vein-to-vein tracking and bedside electronic verification, visit our Blood tracking page.
GS1 standards for pathology and specimen tracking
Pathology and specimen tracking uses three GS1 identifiers to create a reliable, traceable digital record at each stage of the specimen journey.
Consumables such as specimen tubes and collection containers already carry GTINs (Global Trade Item Numbers) assigned by their manufacturers. Trusts should assign Global Individual Asset Identifiers (GIAIs) to individual specimens, enabling each sample to be uniquely identified and tracked through laboratory workflows. Global Location Numbers (GLNs) identify the specific locations — such as laboratories and collection points — where samples are received and processed, creating an accurate record of where a specimen has been at each stage.
Together, these identifiers provide the foundation for end-to-end specimen traceability, from point-of-care collection through to results reporting.
GS1 UK provides further guidance on implementing these standards in healthcare settings at healthcare.gs1uk.org.