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GPs can refuse to offer patients Covid-19 antibody test, says BMA

Exclusive GPs are not obliged to offer patients Covid-19 antibody testing, the BMA GP Committee has told Pulse.

NHS England had told GPs they could offer the test to any patient who 'wishes' to know if they have had the virus, if they are having bloods taken anyway.

NHS England's letter to GP practices, sent at the end of May, said this had been decided by health secretary Matt Hancock.

But BMA GP Committee chair Dr Richard Vautrey said GPs could use their clinical judgement when deciding whether to offer the test, and there was no obligation to do so.

Some LMCs had already told GPs they could refuse to administer the tests on the basis that the work is currently unfunded.

Asked if GPs could refuse a patient the test, Dr Vautrey said: 'Yes, it's not obligatory. You just have to use your clinical judgement as to whether it's appropriate or not.'

He added: ‘Whenever you're doing any test, you need to explain what the test is and follow up on the results. So it's understandable why some practices would want to be cautious about offering the option for such antibody tests.'

And he said practices should not be asked to offer the Covid-19 antibody test to a patient who was not having a blood test for another clinical reason.

He said: 'There is no clinical benefit of just having an antibody test and we wouldn't want to see that driving up inappropriate attendance in GP surgeries.'

At the moment, Dr Vautrey said, the only benefit of the antibody test is as 'a surveillance tool' which tells you whether the illness you had a few months back was or was not Covid-19.

‘We need to really understand much more about the long-term benefits of having antibody tests other than it being a surveillance tool for public health purposes,' he said.

Meanwhile, Kent LMC has told local GPs they would support anyone who refused to offer antibody testing.

Its newsletter said: ‘To offer the Covid-19 antibody test to patients already having blood tests for another reason requires counselling, recorded consent and explanation of the result.

'This constitutes a screening or epidemiological research programme. Other screening programmes are funded by national enhanced services or target payments and research supported by grants and led by relevant organisations and educational institutions.

‘This issue has been raised with the GPC nationally. The potential additional workload this represents is substantial and currently unresourced. Kent LMC will support all GPs who decline to offer Covid-19 antibody testing.’

Dr Yvette Rean, who is a GP in Kent, told Pulse: ‘I'm delighted that the LMC have taken this stance on supporting their local GPs if we decide to refuse widespread/general antibody testing to any patient who requests it.

'I can see no clincally significant indication where management would be altered from a primary care viewpoint to know what a patient's Covid-19 antibody status is.

‘I believe it to be academic and useful for data collection and research which although is important, is not in our remit.’

The news comes GPs could be asked to take on live coronavirus testing as NHS England said that swab testing in primary care is the 'next step' in the programme.

Readers' comments (22)

  • Rattled GPs might refuse a lot more than that.

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  • Typical NHS response to refuse something that might help patients be better informed. No testing when people were sick, no testing to see if they had the antibodies - remind me again what the role of GP’s are now- to follow guidelines rather than exercise professional judgement.

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  • @Dr J J

    Are you saying GPs should for work for free?

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  • We are struggling to provide adequate phlebotomy services with the restrictions imposed by infection control measures. We are looking at reducing demand not increasing it so we can provide enough testing for our patients for chronic disease management and medication monitoring. An open ended unfunded service to test for Covid when there is no subsequent change in management, just fulfilling a whim to satisfy curiosity and collect data for public health? I don't think so!

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  • The reluctance to take on extra work is legitimate.

    But the argument that testing is not useful to patients is nonsense.

    If an antibody test is positive then all restrictions of lockdown are irrelevant to that individual - with huge implications for work and social life.

    There is no evidence of second or recurrent infection in those testing positive.

    Hiding workload constraints behind fictional clinical concerns is dishonest, and probably breaches GMC guidance for clinicians.

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  • @Anon GP
    Perhaps Locum Dr JJ is offering his services for free?

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  • There is just zero facility to offer it. Not even a choice locally.

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  • OK Stelvio where is your evidence that a positive result confers any immunity to future infection and that it allows any relaxing of SDG? You are disagreeing with the WHO there.

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  • It is quite useful if staff are tested to see how effective their infection control procedures have been

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  • just say no

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