Private blood tests pushing up patient attendance rates and 'mobilising the worried well', warn GPs
Half of GPs have seen a jump in the number of patients attending practices following private screening of their glucose or cholesterol levels - even though many of the patients do not actually require treatment - a Pulse survey reveals.
Of 363 GPs surveyed, 49% said that they had noticed an increased attendance rate as a result of private screening, with respondents estimating that, on average, just 10% of these patients were need of treatment. 43% of GPs said they had not seen a rise while 8% were unsure.
It is becoming commonplace for pharmacies to offer glucose and blood pressure tests, with the GPC warning that some patients are paying up to £500 for private screening.
GPC prescribing lead Dr Bill Beeby said practices were having to ‘pick up the pieces’ from patients receiving results from these screenings.
He said: ‘GPs sometimes have to pick up the pieces by interpreting things that should have been interpreted by the people who did the screening. If someone is doing a test they should be able to explain the results to the patient.’
Patients who obtain isolated readings for cholesterol or glucose levels could become either unnecessarily worried or falsely assured, he added. ‘I don’t mind if people want to get screened privately, although it can cost them £300-£350 to find out something that we can do for free. Sometimes with private screenings all they get is a printout that just tells them to stop smoking, lose a bit of weight and do some exercise.’
Dr Stewart Findlay, chief clinical officer of Durham Dales, Easington and Sedgefield CCG and a GP in Bishop Auckland with an interest in primary prevention, said the pressure on workload could increase when local authorities take responsibility for public health checks.
He said: ‘Local authorities will outsource it, and it will become normal for patients to have the screening and then see the GPs after. This is inefficient and means duplication of work. If you are over 40 then you should be having your health check every five years. You don’t need to go anywhere else if you are not receiving treatment.’
Screening on pharmacists’ premises has very limited use, because tests are often done in isolation, Dr Findlay added. ‘They might only do checks for cholesterol, and not thyroid or blood sugar.’
Professor Ahmet Fuat, a GP in Darlington and a professor of primary care cardiology at the University of Durham, said he had noticed an increase in patients at his own surgery following private screenings.
But he added: ‘I don’t think there is anything wrong in people getting private screening. Many of the patients have been screened at a chemist’s, and they are entitled to that. It does create a bit more work for GPs – but screenings pick up treatable conditions.’
However, Professor Fuat said that he did not believe private screening should include ultrasound tests and ECGs.
Dr Andrew Mimnagh, a GP in Sefton, Merseyside said: ‘The high street ambulatory services have mobilised the worried well. The majority of folk who come to my surgery thinking they have high cholesterol find out they don’t actually have any problems once they have had a proper intervention using something like the QRISK prediction algorithm for cardiovascular disease. All they need is lifestyle advice. In the high street there is no access to literature or personal support so they come to the GP practice. There is a big disconnect there.’
‘In terms of hard-pressed GP practices, these patients are a long way down the pecking order. We don’t have a huge number of patients turning up after private screenings, but a key problem among them is that they are experiencing disproportionately high anxiety levels.’