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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)

  • I want a tricorder...

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  • 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)

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  • 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.

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  • 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?

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  • 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.

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  • 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.

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  • @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".

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  • 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.

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