This site is intended for health professionals only

At the heart of general practice since 1960

NHS England testing 'Lab in a Bag'

NHS England is testing a mobile ‘lab in a bag’ which would allow GPs to carry out diagnostic tests and get the results quickly themselves without having to wait on hospital labs to do this for them.

The bag - which is currently being tested out by paramedics - contains devices that can measure white blood cell count, haemoglobin, glucose, blood gases, electrolytes, and conduct urinalysis.

This will allow clinicians such as GPs to make sophisticated diagnoses on the move, identify problems and treat patients in community settings, GP practices and even in their own homes, NHS England says.

A trial at two sites began in December, although the results have not been used for the clinical management of patients. Later this year it will be used in clinical settings, and a full rollout is expected early next year.

Health secretary Jeremy Hunt said: ‘This is clearly a fantastic example of the type of innovation which can come about when medical experts and industry professionals collaborate. Improving diagnostics and the transference of crucial data on a patient to hospitals and GPs swiftly and at the point of being attended by a paramedic can only bring about positive shifts which should, in turn, determine more quickly the right care pathway and possibly even save lives.’

The Labkit is the result of collaboration between Surrey Pathology Services – a joint venture that involves Ashford and St Peter’s Hospitals NHS Foundation Trust, Frimley Health NHS Foundation Trust and the Royal Surrey County Hospital NHS Foundation Trust – the South East Coast Ambulance Service, the Ministry of Defence Hospital Unit at Frimley Park and Conworx Technology. NHS England is also providing funding.

This article was amended at 15:00 on 31 March 2015 to reflect that NHS England did not devise the tests, but is testing them, and that they are currently being tested out by paramedics.

Readers' comments (18)

  • As well as the equipment and consumables being refunded to the practices involved, will there be additional funding for the GPs involved in looking after patients more intensively at home? Or is this another way of expecting GPs to do more and more clinical work without the funding stream to ensure there is time and sufficient clinicians and additional nursing and other community support to safely manage patients at home.

    Unsuitable or offensive? Report this comment

  • Odd that we're not obliged to take blood let alone analyse it ourselves.
    Seems even the labs are getting in on the transfer of work to GP.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    (1) So we are expected to become Dr McCoy , Bones , of Star Trek? How long a consultation in general practice should be then with all these included?
    (2) Sensitivity and specificity of these test kits are not the same as lab tests?
    (3) Of course, cost ? Who foot the bill??? It is cut the cost reducing the number of tests in labs? It is cheaper to ask GPs to do everything ?

    Unsuitable or offensive? Report this comment

  • Do GPs need this? How often is lab turnaround time (few hours) too long but patient well enough to stay at home?

    Unsuitable or offensive? Report this comment

  • It sounds like a perk ' will be able to carry out' but we all know where it will end. The longer you deal with NHSE, the more cynical you get:) It would be good to be able to trust someone up there ...sigh!

    Unsuitable or offensive? Report this comment

  • Will we be expected to attach a mobile MRI scanner to our car battery next whilst parked outside their house. 38 days to press the eject button on this idiot.

    Unsuitable or offensive? Report this comment

  • Hey it sounds quite interesting to me. It wasn't long ago oxygen sats monitors where hospital only high tech kit which I regarded as an expensive perk and of little use out in the 'real world' ...now I have one in my bag and I carry it everywhere. Near patient testing is the future and in principle this can't be anything but a good thing.
    Ok it will cost...if it isn't funded and is too expensive it won't work. It's unlikly to be standard kit for every practice but the idea itself is admirable, why knock it?

    Unsuitable or offensive? Report this comment

  • the Tricorder (from Dr McCoy of Star Trek) competition is offering $10 million for a palm sized analytical/diagnostic device ! the NHS one will have to work hard to compete.

    http://tinyurl.com/pj3e42j

    interestingly the device is patient focussed...

    The winners will be the (up to) three solutions achieving the highest diagnostic score regarding a set of 15 distinct diseases in a group of 15-30 people in three days (see Guidelines for full details). This diagnosis must be performed in the hands of a consumer, independently of a healthcare worker or facility.

    Core conditions to be diagnosed
    1. Anemia
    2. Urinary tract infection, lower
    3. Diabetes
    4. Atrial fibrillation
    5. Stroke
    6. Sleep apnea, obstructive
    7. Tuberculosis
    8. Chronic obstructive pulmonary disease (COPD)
    9. Pneumonia
    10. Otitis ("ear infection")
    11. Leukocytosis
    12. Hepatitis A
    13. Absence of Core Conditions

    The Elective Set includes:
    1. Pertussis (Whooping Cough)
    2. Hypertension
    3. Mononucleosis
    4. Allergens (airborne)
    5. Hypothyroidism/hyperthyroidism
    6. Food-borne illness
    7. Shingles
    8. Melanoma
    9. Strep throat
    10. Cholesterol Screen
    11. HIV Screen
    12. Osteoporosis

    Anyone fancy looking for a new job??

    Unsuitable or offensive? Report this comment

  • And now GPs should also work as Phlebotomists, Lab Technicians, Microbiologists, Pathologists and Haematologists - another example of co-ordinated care

    Unsuitable or offensive? Report this comment

  • I see the Luddites are out today
    This is just ammo for the DM "GPs resisting change"

    Unsuitable or offensive? Report this comment

  • I want a tricorder...

    Unsuitable or offensive? Report this comment

  • When I started as a GP registrar and my trainer was discussing possible contents of a GP bag, he was very surprised when I mentioned
    pulse-oximeter. I suspect umpteen moons ago an an apprentice mentioned the same about thermometer or BP machine and had a similar response.
    Now I think its considered standard although not compulsory.
    I also use a hand-held ECG machine in my doctors bag , our prevalence of AF increased dramatically after we were able to pick up many more AF`s esp in home visits.
    CRP, Hb and electrolytes would be helpful in a Urgent care Setting/centre but blood gases maybe specialist at present.

    So the idea of making better informed decisions with an acutely ill patient is useful but knowing which to use and when is wisdom!
    Also we need to think that cost is an issue- bean counters will argue its cheaper to check these at home visit than to send to hospital but once its available we will check more as its easy to do and then we have many people being sent to A&E as Potassium was high or low etc and cost more.
    So if its cost saving the answer is no, if its to improve quality and diagnostics -Maybe.
    Trials with non -enthusiastic GP`s are useful ( the enthusiasts will always say it was useful)

    Unsuitable or offensive? Report this comment

  • For once , a balanced response from most people. Look, noone saying this will be needed or indeed used all the time but in the same way some people have said here if like ox sat monitors , it helps to give better and safer care for patients, then lets look at it sensibly. Yes the economics are important and it would be useful to see how this impinges on other budgets via less antibiotics prescribing and admissions.
    Certainly, for OOHs it will be a great step forward.

    Unsuitable or offensive? Report this comment

  • You don't need to calibrate a stethoscope or an ECG you need confidence and experience. Glucose measurement is more reliable these days provided that you use it with care and primarily for screening but as you move further into NPT you need to ensure that your results are accurate and consistent. The laboratory service provides reassurance that their results can be trusted because they have rigorous quality assurance both internally and externally to support them. The tests are performed under laboratory conditions which ensures reagents and equipment are kept in ideal condition and to ensure that one set of results on a patient can be compared with the last set or the next. With the best will in the world how reliable and consistent will your NPT results be and will you be certain of the results?

    Unsuitable or offensive? Report this comment

  • Is portable chest ultrasound feasible or useful? If we had a solid diagnostic tool, rather than the subjective stethoscope (the results of which patients cannot see) antibiotic requests would be a lot easier to resist.

    Unsuitable or offensive? Report this comment

  • Interesting discussion re contents of a Doctor's bag- reminds me of my work in Oz.
    The government there gives the Dr an allocation of emergency drugs every month and you go to the local pharmacy and pick up all the painkillers, antibiotics and sutures etc that you have run out of or may require. There is a pad you have to tick the things you want and the pharmacy takes of page 1 with your signature.
    Getting a free 'lab in a bag' is unrealistic if you can't get the basics free of cost in UK. We stopped buying B12, Depos, Pneumonia vacs, Hep A vacs etc as we realized that although we paid for these from our pockets, the reimbursements did not cover half of our costs. There is no system to check what payments you are entitled to and who is responsible for payment.
    Our patients now buy these on prescriptions and it's mutual bliss. Let's just take this bonus lab in bag with a pinch of salt.

    Unsuitable or offensive? Report this comment

  • @Gp reg at 2.26 pm
    USS does not detect chest infections. I am given to believe fairly useless for air filled cavities as a general rule that`s why we can`t look inside lungs or bowel with USS! XR and CT are better but the NNH is small (radiation wise) and is like using a sledgehammer to swat a fly. Interestingly the WHO definition of Pneumonia (in adults) is based on findings on X -ray.
    But I agree with your sentiment - Objective way to show patients they don`t need Abx would be useful and also medico legally safer as one can "prove" that they didn`t need Abx at that point in time.
    I agree with Sanjeev about the cost and issue of who pays for this and the consumables -eventually it will become "expected of GP".

    Unsuitable or offensive? Report this comment

  • Will Acute hospital CEOs see this technology as a good way to open a virtual hospital and take on a primary care role and up their turn over at the expense of others in the NHS?

    GPs should grab this technology with both hands and get payments for keeping people out of hospital.

    National GP negotiators need to cotton onto this potential source of revenue redistribution from acute to primary care.

    Unsuitable or offensive? Report this comment

Have your say