Workload, organisation, and cost of haematology laboratory out of hours services.

Background: The cost of out of hours services makes up a considerable proportion of the total laboratory budget and this has encouraged haematologists to examine workload patterns and the organisation and cost of out of hours services.
Aim: To review current levels of out of hours workload and examine the organisation and cost of the service in the South Thames region.
Method: Data collection was by questionnaire and data analysis by Microsoft Excel.
Results: A variety of methods of organising and financing out of hours services were identified. There was a large variation in workload between different centres. There has been a rise in total workload and out of hours workload over a three year period. The most common tests to take place outside routine hours are full blood counts and clotting screens. The method of providing out of hours services did not affect total numbers of out of hours tests. There were considerable costs associated with time off in lieu for on call staff.
Conclusions: The variation and increase in out of hours tests is not related to the way that out of hours services are provided, but is more likely to result from changes in medical practice. There are pronounced differences between centres in the numbers of different types of tests performed out of hours, which are not related to the numbers of acute beds. There is no single model of out of hours service provision that suits all situations.