Description of specialty
Haematology is a varied specialty involving both clinical and laboratory practice, and the interface to diverse aspects of medical care. After core training in medicine, haematologists undergo professional training in all aspects of the specialty. An increasing number of haematologists work exclusively in either malignant or non-malignant haematology, although the majority currently work across both areas.
Malignant haematology relates to the diagnosis and management of patients with blood cancers, such as leukaemia, lymphoma and myeloma. The incidence and prevalence of blood cancers continue to increase due to an ageing population and improved survival. There are around 130 different blood cancers, with many different sub-types of leukaemia and lymphoma.
Non-malignant haematology relates both to the general non-cancer aspects of haematology (including general/consultative haematology) and to specialised areas such as haemostasis and thrombosis (bleeding and clotting disorders), haemoglobin disorders (including sickle cell disease and thalassaemia) and transfusion medicine.
The specialty includes several key areas of work:
- Haematologists are responsible for the direct care of patients with a wide range of malignant and non-malignant haematological disorders – from diagnosis to management. The supportive management of complications of haematological disease or treatment form a key part of a haematologist's work, particularly in malignant haematology.
- Haematologists provide the haematology laboratory service (including transfusion) with professional direction, and are clinically responsible for the laboratory. Haematologists also undertake key laboratory functions including reporting of blood films and bone marrow biopsies, provision of interpretative results for flow cytometry, thrombophilia screening and other tests. The provision of a specialised integrated haematology malignancy service is recommended by NICE to provide an optimal multidisciplinary approach and minimise errors.
- The dual laboratory/clinical role puts haematologists in a position to be able to offer laboratory interpretation and clinical advice to laboratory users and other professionals ranging from primary care professionals to colleagues within hospitals.
- Haematologists perform a wider patient safety role, including in transfusion medicine and venous thrombosis prevention.
- Haematologists undertake or direct a number of practical procedures, including bone marrow biopsies (a common procedure, which is usually undertaken electively on a day care unit) and administration of intrathecal chemotherapy.