An audit of the indications for the reporting of blood films: results from the National Pathology Benchmarking Study

Background: The National Pathology Benchmarking Review has completed seven years of analysis of the workload of haematology laboratories in the United Kingdom. Objective: To audit criteria that laboratories use for preparing blood films against guidelines published by the International Consensus Group for Haematology Review. Methods: Each laboratory completed a standard questionnaire about the number of blood counts and blood films done each year. Information was collected on the criteria that were used for preparing a blood film and the manufacturer of the equipment used to carry out the full blood count. Results: 46 NHS trusts (93 laboratory sites) participated in the study. There was wide variation in the criteria used for preparing blood films when compared with the consensus guidelines. The variation in practice appeared to be irrespective of the type of hospital or the manufacturer of the equipment used for the blood count. Conclusions: There is a wide range in laboratory practice in preparing blood films. The publication of the consensus guidelines should help to standardise practice in this area. The next step in the study is to determine what the film review rate should be if these guidelines are implemented. This will then provide a benchmark of good practice which laboratories can use to assess their performance.