UK Diagnostic Order Comms and Results
Checked 25 September 2026. This baseline contains 44 scoped observations covering pathology/radiology requesting and results, LIMS, RIS/PACS and laboratory exchange. It identifies documented organisations and programmes rather than every laboratory, scanner, site or clinical discipline. Use the interactive map to filter the diagnostic layers, or the national diagnostic exchange page for MESH/FHIR and image-sharing services.
Which system does which job?
| Function | Examples in the evidence | Interpretation |
|---|---|---|
| Clinician requests tests and reads reports | Clinisys ICE; EMIS/Optum tQuest and Review; Epic, Oracle/Cerner, TrakCare or Nervecentre interfaces; WCP ETR/GPTR/WRRS | Identify pathology versus radiology, GP versus hospital users, and ordering versus result-only access separately. |
| Laboratory receives and processes work | Clinisys WinPath; Epic Beaker; InterSystems TrakCare Lab | LIMS is the laboratory production layer. It can serve several different ordering front ends. |
| Radiology department manages workflow | CRIS; Soliton Radiology+; locally documented RIS platforms | RIS is distinct from PACS and from external GP order entry. |
| Images stored/viewed and shared | Sectra PACS/NIPACS+; Philips RISP PACS; Carestream historical estate; national image exchange | PACS or image-exchange evidence does not establish the order-comms product. |
| Laboratories exchange requests/results | X-Lab Labgnostic, formerly NPEx | Laboratory-to-laboratory exchange is distinct from the clinician’s order screen. |
Findings that prevent wrong supplier assumptions
- Epic does not imply Beaker or Radiant everywhere. Manchester explicitly identifies Epic orders and Beaker. ESNEFT lists Beaker alongside ICE, DART and Labgnostic. Royal Devon’s evidence retains CRIS and regional radiology constraints; the 2026 PenRAD source describes an ongoing RIS/Radiant decision.
- External and internal routes can differ. NHS Lothian documents ICE for GP requests and TrakCare for hospital ordering/results. Stockport’s new WinPath backend does not establish replacement of GP tQuest. South West London Pathology documents mixed ICE, tQuest and DART routes.
- Nervecentre results access is not a LIMS claim. Leicester’s handbook identifies ICE/Nervecentre results viewing; it does not identify Nervecentre as the laboratory production system. Calderdale/Huddersfield documents Cerner orders and ICE views alongside radiology systems.
- National programmes remain phased and discipline-specific. Welsh WCP ordering/results, TrakCare Lab Enterprise and RISP are separate. Aneurin Bevan’s transfusion WinPath deployment prevents an all-disciplines InterSystems LIMS inference. Scotland’s national Sectra contract does not establish every board’s completed cutover.
- Northern Ireland has several distinct layers. Epic/encompass and EpicCare Link, Clinisys CoreLIMS WinPath, Sectra NIPACS+ and Orion NIECR should not be collapsed into one supplier or one interface.
The tables below carry the source links, evidence dates and narrower scope for these statements. Product documentation establishes function; provider, laboratory or procurement evidence establishes a named deployment or programme.
Pathology and radiology ordering / results
Older guidance and review-overdue pages are retained with explicit limits. live-at-source-date, documented-current-unverified and reported-capability do not mean current service access was tested.
Pathology orders and results
| Place / organisation | Supplier · product | Status / evidence date | Documented scope and limits | Evidence |
|---|---|---|---|---|
| England · South East London Synnovis |
EMIS Health / Optum tQuest |
live 2025-02-06 |
GP practices using Synnovis in Bexley, Greenwich, Lewisham, Bromley, Southwark and Lambeth The GP requesting supplier can differ from the EPR at the receiving hospital. | 1 · 2 High: direct provider evidence |
| England · Kent and Medway Dartford and Gravesham NHS Trust |
Clinisys ICE |
live 2025-06 |
Hospital ordering; GP/community routes also documented June 2025 hospital deployment established. Supplier September report described pathology result-return expansion as dependent on later LIMS; do not assume all phases completed. | 1 · 2 High: direct provider evidence |
| England · Greater Manchester Manchester University NHS Foundation Trust |
Epic Epic orders |
live Undated; checked 2026-09-25 |
MFT electronic microbiology/laboratory request workflow Direct laboratory guidance confirms electronic orders and specimen label/collection workflow. | 1 High: direct provider evidence |
| England · Suffolk and North East Essex East Suffolk and North Essex NHS Foundation Trust |
Clinisys; DART supplier not attributed here ICE; DART |
mixed Undated; checked 2026-09-25 |
Pathology requesting/front-end estate Both are explicitly supported alongside Beaker; source does not allocate front ends to every cohort. | 1 High: direct provider evidence |
| England · North Central London Royal Free London NHS Foundation Trust |
EMIS Health / Optum tQuest; Review |
live Undated; checked 2026-09-25 |
GP pathology requests/results at Royal Free/Barnet/related services Trust guidance confirms tQuest support. ICB guidance supplies Review detail but is overdue for review. | 1 · 2 · 3 High: direct provider evidence |
| England · North Central London University College London Hospitals NHS Foundation Trust |
EMIS Health / Optum tQuest; Review |
documented-current-unverified 2026-03-06 review overdue |
NCL GP requests to UCLH Current ICB page explicitly says overdue review; preserve as documented route requiring confirmation. | 1 · 2 Moderate: NHS guidance explicitly overdue review |
| England · Greater Manchester Stockport NHS Foundation Trust |
EMIS Health / Optum tQuest |
documented-current-unverified Undated; checked 2026-09-25 |
Stockport GP electronic ordering FAQ remains online but includes legacy browser guidance. Do not assume unchanged interface after 2026 LIMS migration. | 1 · 2 Moderate: undated provider guidance |
| England · West Yorkshire Leeds Teaching Hospitals NHS Trust |
Clinisys ICE |
live Undated; checked 2026-09-25 |
Immunology ordering Discipline-specific direct operating guidance. | 1 · 2 High: direct provider evidence |
| England · Birmingham and Solihull University Hospitals Birmingham NHS Foundation Trust |
Clinisys ICE |
live 2024-12-04 reviewed |
Primary-care requests and reports across UHB sites Page also describes expansion of imaging; local entitlement and modality availability still apply. | 1 · 2 High: direct provider evidence |
| England · Hampshire and Isle of Wight University Hospital Southampton NHS Foundation Trust |
Clinisys ICE |
live Undated; checked 2026-09-25 |
Published pathology and GP radiology requesting/reporting service Historic client versions on page not asserted current. New Southern Counties LIMS/ICE work remains labelled in progress. | 1 · 2 High: direct provider evidence |
| England · South West London / Surrey South West London Pathology |
Clinisys; EMIS Health / Optum; DART supplier not attributed here ICE; tQuest; DART |
mixed Undated; checked 2026-09-25 |
FIT requests through the referring service’s local platform A network may accept multiple front ends; do not assign one system across all members. | 1 High: direct provider evidence |
| England · Leicester, Leicestershire and Rutland University Hospitals of Leicester NHS Trust |
Clinisys; Nervecentre ICE; Nervecentre |
documented-current-unverified 2024-07 |
Microbiology result viewing Handbook names both for results lookup; no claim that Nervecentre is the LIMS or sole requester. Direct handbook URL returned 404 on 25 September 2026; the indexed provider evidence does not establish unchanged current configuration. | 1 Moderate: provider handbook indexed text; direct URL returned 404 at review |
| England · West Yorkshire Calderdale and Huddersfield NHS Foundation Trust |
Oracle Health (Cerner); Clinisys Cerner EPR; ICE |
live 2026-06-29 |
Cerner orders and return results/reports, with ICE alternative result view Radiology also exposes reports through CRIS/PACS. Operational evidence describes real interfaces, not generic supplier compatibility. | 1 High: direct provider evidence |
| Scotland · Lothian NHS Lothian |
Clinisys ICE |
live Undated; checked 2026-09-25 |
GP laboratory ordering available to all Lothian GP practices Distinct from hospital TrakCare and from laboratory production systems. | 1 · 2 High: direct provider evidence |
| Scotland · Lothian NHS Lothian |
InterSystems TrakCare |
live Undated; checked 2026-09-25 |
University Hospitals Division ordering/results Hospital laboratory and radiology communications evidenced; not a claim that InterSystems operates SCI Store nationally. | 1 High: direct provider evidence |
| Scotland · Highland NHS Highland |
InterSystems TrakCare order communications |
planned 2026-05-14 |
Initial laboratory and radiology electronic orders/results May 2026 board recruitment notice calls Phase 2 future implementation. Existing TrakCare EPR deployment alone does not prove order comms live. | 1 Moderate-high: dated board programme description |
| Wales · National Digital Health and Care Wales / NHS Wales |
Digital Health and Care Wales WCP; ETR; GPTR; WRRS |
phased-live 2026 annual report |
National pathology ordering/results services Over 85% of pathology requests electronic in annual-report body; not universal organisation adoption and not the LIMS supplier. | 1 · 2 High: direct provider evidence |
| Wales · Betsi Cadwaladr — East area Betsi Cadwaladr University Health Board |
Clinisys ICE |
live-at-source-date 2025-03-04 award publication |
East-area GP and community electronic requesting/results Contract concluded November 2023 supports an existing service. Procurement explicitly says BCUHB: East area does not mean East Wales. Current national migration status not established. | 1 High for existing-service procurement, current transition unresolved |
| Northern Ireland · Regional HSCNI / GP practices |
Epic EpicCare Link |
reported-capability 2025-07-28 |
GP laboratory order capability described by Department Parliamentary account supports capability; detailed current role, test catalogue and GP workflow need verification. Does not imply primary-care EPR replacement. | 1 Moderate-high: official statement, operational scope not fully specified |
Radiology orders and results
| Place / organisation | Supplier · product | Status / evidence date | Documented scope and limits | Evidence |
|---|---|---|---|---|
| England · South East London Guy’s and St Thomas’ NHS Foundation Trust |
Clinisys ICE |
live 2026-06 |
GP referrals to radiology External referral route; does not identify hospital RIS or imaging archive. | 1 High: direct provider evidence |
| England · Kent and Medway Dartford and Gravesham NHS Trust |
Clinisys ICE |
live 2025-06 |
Hospital ordering; GP/community routes also documented June 2025 hospital deployment established. Supplier September report described pathology result-return expansion as dependent on later LIMS; do not assume all phases completed. | 1 · 2 High: direct provider evidence |
| England · North Central London Royal Free London NHS Foundation Trust |
EMIS Health / Optum tQuest |
live Undated; checked 2026-09-25 |
Radiology GP request pathways at Royal Free/Barnet/Chase Farm and associated hospitals Not proof that all imaging modalities or all recently merged sites use identical workflow. | 1 · 2 High: direct provider evidence |
| England · Birmingham and Solihull University Hospitals Birmingham NHS Foundation Trust |
Clinisys ICE |
live 2024-12-04 reviewed |
Primary-care requests and reports across UHB sites Page also describes expansion of imaging; local entitlement and modality availability still apply. | 1 · 2 High: direct provider evidence |
| England · Hampshire and Isle of Wight University Hospital Southampton NHS Foundation Trust |
Clinisys ICE |
live Undated; checked 2026-09-25 |
Published pathology and GP radiology requesting/reporting service Historic client versions on page not asserted current. New Southern Counties LIMS/ICE work remains labelled in progress. | 1 · 2 High: direct provider evidence |
| England · West Yorkshire Calderdale and Huddersfield NHS Foundation Trust |
Oracle Health (Cerner); Clinisys Cerner EPR; ICE |
live 2026-06-29 |
Cerner orders and return results/reports, with ICE alternative result view Radiology also exposes reports through CRIS/PACS. Operational evidence describes real interfaces, not generic supplier compatibility. | 1 High: direct provider evidence |
| England · Devon / Peninsula Royal Devon University Healthcare NHS Foundation Trust |
Epic; CRIS supplier not identified by local source Epic orders; CRIS radiology workflow |
mixed 2024 survey; 2026-08 network review |
Eastern radiology request workflow and Peninsula shared RIS dependency 2024 service response says Radiant not adopted due to regional CRIS dependency. August 2026 PenRAD still evaluating shared RIS versus Radiant; no current migration-complete claim. | 1 · 2 Moderate: provider/network indexed source text, direct fetch unavailable |
| Scotland · Lothian NHS Lothian |
InterSystems TrakCare |
live Undated; checked 2026-09-25 |
University Hospitals Division ordering/results Hospital laboratory and radiology communications evidenced; not a claim that InterSystems operates SCI Store nationally. | 1 High: direct provider evidence |
| Scotland · Highland NHS Highland |
InterSystems TrakCare order communications |
planned 2026-05-14 |
Initial laboratory and radiology electronic orders/results May 2026 board recruitment notice calls Phase 2 future implementation. Existing TrakCare EPR deployment alone does not prove order comms live. | 1 Moderate-high: dated board programme description |
| Wales · National Digital Health and Care Wales / NHS Wales |
Digital Health and Care Wales WCP; ETR; WRRS |
phased-live 2026 annual report |
National radiology requesting/report access Annual report says almost a quarter of radiology requests electronic; distinguish from RISP image/RIS stack. | 1 · 2 High: direct provider evidence |
| Northern Ireland · Regional HSCNI / referring clinicians |
Epic EpicCare Link |
live 2025-07-30 guidance |
Authorised external clinician imaging requests and access to some results Limited workflow actions accompany primarily read-only record access; not the RIS/PACS archive and not all modalities/roles automatically enabled. | 1 High: direct provider evidence |
LIMS, RIS/PACS and laboratory exchange
Laboratory information systems
| Place / organisation | Supplier · product | Status / evidence date | Documented scope and limits | Evidence |
|---|---|---|---|---|
| England · Kent and Medway Kent and Medway Pathology Network |
Clinisys WinPath |
planned 2025-09-08 |
Seven laboratories at DGT, Medway, Maidstone and Tunbridge Wells, East Kent Network-wide future rollout described in September 2025; no later full-network acceptance found. ICE results training is not LIMS go-live proof. | 1 · 2 Moderate: supplier dated plan |
| England · Greater Manchester Manchester University NHS Foundation Trust |
Epic Beaker |
live Undated; checked 2026-09-25 |
Laboratory module in MFT published microbiology workflow Do not infer every external laboratory shares Beaker. | 1 High: direct provider evidence |
| England · Suffolk and North East Essex East Suffolk and North Essex NHS Foundation Trust |
Epic Beaker |
live Undated; checked 2026-09-25 |
Colchester and Ipswich pathology service Named BAU system; individual discipline and migration-date details not supplied. | 1 High: direct provider evidence |
| England · Greater Manchester Stockport NHS Foundation Trust |
Clinisys WinPath |
live 2026-04-20 |
Microbiology/cellular pathology since September 2025; blood sciences/transfusion final phase April 2026 Supplier reports full deployment; do not carry forward Telepath merely from older job adverts. | 1 Moderate-high: dated supplier report with named customer testimony |
| Wales · National NHS Wales laboratory services |
InterSystems TrakCare Lab 2016 → TrakCare Lab Enterprise |
phased-live 2026-02-05 milestone report |
Staged national laboratory platform upgrade Technical/data-migration and initial clinical milestones do not prove all boards/disciplines migrated. ABUHB transfusion separately evidenced on WinPath. | 1 · 2 · 3 High: direct provider evidence |
| Wales · Aneurin Bevan Aneurin Bevan University Health Board |
Clinisys WinPath 2023.3 |
live Autumn 2025; reported 2026-01-12 |
Grange transfusion testing/issuing supports four hospitals Replaced LabCentre for this service; specific discipline exception to any blanket all-Wales InterSystems assumption. | 1 Moderate-high: dated supplier report with named customer testimony |
| Northern Ireland · All five HSC trusts and NIBTS HSC Business Services Organisation / regional laboratories |
Clinisys WinPath Enterprise |
live 2025-04-28 final go-live week |
Belfast, South Eastern, Northern, Western, Southern and Northern Ireland Blood Transfusion Service Separate system from Epic/encompass; final phases reported complete, not an Epic Beaker deployment. | 1 High: direct provider evidence |
Radiology information systems and image archives
| Place / organisation | Supplier · product | Status / evidence date | Documented scope and limits | Evidence |
|---|---|---|---|---|
| England · Kent and Medway Medway NHS Foundation Trust |
Sectra; Soliton IDS7 PACS; Radiology+ RIS |
live-at-source-date 2024-02 |
Medway radiology Installed August 2023 and February 2021 respectively; source contracts run to 2033, not proof of unchanged configuration today. | 1 High for dated NHS FOI inventory |
| Scotland · Shetland / hosted by Grampian NHS Shetland |
GE Healthcare / Carestream (source naming) Carestream RIS; Carestream PACS |
replacement-unverified 2025-03 request |
Shetland RIS and PACS supported through Grampian FOI records legacy estate and intended 2025/26–2026 replacement. No cutover confirmation; do not colour as current Sectra solely on national award. | 1 High for historical/transition inventory, current cutover unresolved |
| Scotland · National NHS Scotland / NHS National Services Scotland |
Sectra PACS reprovisioning programme |
contracted-rollout-unverified 2023-12-08 contract start |
National PACS replacement Award establishes supplier and programme only; board-specific deployment and RIS supplier need separate confirmation. | 1 High for procurement; insufficient for completed rollout |
| Wales · National phased rollout Digital Health and Care Wales / Welsh health boards and trusts |
Philips (prime/PACS); RIS and dose suppliers not named in award RISP PACS / RIS / dose management |
phased-live 2026-02-05 milestone report |
Reported live PHW, Powys, Betsi Cadwaladr and Hywel Dda; national procurement scope Hywel Dda go-live 1 December 2025. Remaining organisations and completed 2026 rollout not established. Prime contractor attribution does not identify each subcontracted module. | 1 · 2 High: direct provider evidence |
| Northern Ireland · All five HSC trusts HSC Business Services Organisation / HSC trusts |
Sectra NIPACS+ regional imaging |
live 2025-05 final Phase 2; closure event 2026-06-25 |
Radiology plus additional imaging specialties BCH/RVH integrated; old guidance excluding those hospitals is superseded. July 2026 operations handover announced but not retrospectively verified here. | 1 · 2 High: direct provider evidence |
Laboratory exchange
| Place / organisation | Supplier · product | Status / evidence date | Documented scope and limits | Evidence |
|---|---|---|---|---|
| England · Suffolk and North East Essex East Suffolk and North Essex NHS Foundation Trust |
X-Lab Labgnostic (formerly NPEx) |
live Undated; checked 2026-09-25 |
Pathology IT supported lab-to-lab exchange Separate from clinician-facing ICE/DART and Beaker. | 1 · 2 High: direct provider evidence |
| UK-wide · NHSBT laboratory partners NHS Blood and Transplant |
X-Lab Labgnostic |
live-at-source-date 2025-07-31 award |
Laboratory-to-laboratory requests/results for donor characterisation Public procurement found through X-Lab sibling wiki; no private supplier documents copied. Not equivalent to GP order entry, LIMS or a shared-care-record viewer. | 1 High for official existing-service award |
Validation priorities
The immediate gaps are site/discipline acceptance for Welsh LIMS/RISP, Scottish PACS cutovers and Highland order comms; current supplier/configuration evidence where old FOIs or overdue guidance remain; and separate departmental coverage for hospitals already in the EPR table. These are recorded in the existing validation queue. No live endpoint, integration contract or permission to place an order is established by this inventory.