Coeliac Disease is the most common cause of malabsorption worldwide. It affects ~1% of the UK population and is grossly under-diagnosed. Symptoms are primarily due to malabsorption. The Blood Sciences laboratory recognised it was not following NICE [NG20] guidelines. The laboratory performed a clinical audit to target quality improvements within the testing pathway. Reducing unnecessary tests offers estimated laboratory savings of ~£53,000/annum without compromising patient care.