This site is intended for health professionals only


GPs must still ration blood tests despite emergency tube order, says NHS England


blood tests resume


GPs must continue to ration blood tests, NHS England has said, despite its supplier securing an emergency order of nine million test tubes due to arrive this week.

Since last week, GPs have been under instruction to cancel all blood tests except those that are ‘clinically urgent’ until 17 September, due to a shortage of test tubes that NHS England said was still worsening.

It comes as the has BMA warned that if the number of blood tests carried out is not reduced ‘in the coming days’, even the most clinically important tests ‘may be at risk’ due to the ‘severe’ shortage.

Key supplier of blood test tubes to the NHS Becton Dickinson (BD) – which originally warned of serious supply chain issues in July – yesterday said that it will import nine million additional tubes this week for ‘immediate distribution’ under emergency measures.

But an NHS England spokesperson told Pulse that its previous guidance still stands and that GPs should continue not to offer any blood tests that are not ‘clinically urgent’ until at least 17 September.

Tests that can go ahead include those required for two-week wait referrals, those that are ‘extremely overdue and/or essential for safe prescribing’ or condition monitoring, those that could prevent a hospital admission or onward referral, or those for suspected sepsis or ‘conditions with a risk of death or disability’.

The spokesperson reiterated that NHS England has been working to secure additional stock.

They said: ‘While Becton Dickinson has confirmed that it will provide additional blood tube supplies, the stock must first be delivered and then go through the appropriate safety checks before the NHS is able to put them to use in patient care.

‘Therefore, as we continue to face a constrained supply, it is vital that GPs, hospitals and trusts continue to follow the guidance until further advised to reduce the number of tests carried out and prioritise patients with the most urgent need.’

BD announced in a statement yesterday that it has been granted an ‘exceptional use authorisation’ to import additional blood tubes that are approved for use in other regions such as the US into the UK.

It said it will deliver ‘nine million of these additional blood tubes to the NHS this week for immediate distribution’ and that it expects the situation to ‘stabilise and recover through September, based on the volume of tubes we are supplying to the UK’.

It added: ‘BD’s top priority in the UK is to help the NHS in England, Scotland and Wales return to normal blood testing volumes as quickly as possible. 

‘BD is doing everything it can to help the NHS care for patients in the UK by maximising production at all of its global manufacturing facilities that make blood tube products, expediting shipments and importing millions of units from other regions of the world to the UK.’

It said that recently completed improvements to the BD manufacturing facility in the UK have increased production capacity by 20% and will help ‘alleviate the backlog of orders’.

The manufacturer has produced 700 million more blood tubes worldwide this year than in 2020 and nearly 150 million more than before the pandemic in 2019, the statement added.

In a new statement, sent over the weekend, BMA council deputy chair Dr David Wrigley said: ‘This crisis has put doctors and their patients in a terrible, unenviable position. No doctor knowingly undertakes unnecessary blood tests and to now have to ration all those we are doing, as well as cancel hundreds more, goes against everything we stand for as clinicians.

‘However, if we don’t try to follow the NHS guidance, it’s clear we will get to the point where even the most clinically urgent of blood tests may not be able to be done as we simply won’t have the tubes for the blood to go into.’

Dr Wrigley added that it is ‘surprising’ that NHS England has not yet declared a critical incident ‘given the very strong possibility that NHS organisations may temporarily lose the ability to provide life-saving diagnostic testing’.

He said: ‘Many GP practices – like mine – will now have to spend hours assessing which already scheduled tests can or cannot be cancelled and this takes time away from frontline patient care when it is most needed. Cancelling tests makes patients anxious and can mean a missed diagnosis.’

The BMA is calling on NHS England to ‘commit to the changes that are needed for their guidance to be properly followed by doctors’ and to provide patients with ‘detailed, easily accessible information’ about the crisis, he added.

It comes as Pulse revealed last week that the Government is not planning a public information campaign regarding the shortage.

Grassroots GPs, who had called for NHS England to communicate the issue to avoid patient abuse, warned that ‘thousands of GP hours’ will be lost trying to explain the situation.

Previously, GPs had been told to suspend non-essential blood tests amid the worsening shortage, which was sparked by soaring demand and ‘UK border challenges’.

READERS' COMMENTS [8]

Dave Haddock 1 September, 2021 3:33 pm

Aside from the usual NHS expectation of extra work for no extra pay, who is mad enough to take the medicolegal risk of not carrying out usual investigations? Who will be blamed when a patient comes to harm from a delayed diagnosis

Turn out The Lights 1 September, 2021 3:51 pm

DH spot on, carry on we order do the forms we dont suppy the bottle thats someone centrally who didnt plan very well.Come on NHSE own up, take responsibility.

terry sullivan 1 September, 2021 4:04 pm

nhse–abolish it–its obviously useless–what does DfHSO actually do?

David Church 1 September, 2021 6:30 pm

BD produced 700 million more than previous year, Doctors did many many fewer tests, as we had already stretched montoring periods to reduce patient walk-throughs for infection-prevention reasons…..
So where did all the additional tubes go to>

And these tubes coming here instead of America : are they the right kind for use in GB labs analyzers?
Or will they hav eto be sent to private labs for processing?

John Graham Munro 1 September, 2021 11:17 pm

Locums, as we all know can be treated as dog’s bodies—–doing tasks no body else wants to do, under the umbrella of administration—-I’m old enough to remember the days when patients had to go to the local hospital for blood tests, so there were less results to plough through——-these days they are performed for no better reason than ‘routine’—-‘cover one’s back’—–‘just in case’—- these days no one seems to be able to make a diagnosis without them—–so I find myself checking a multitude of blood/X-Ray results hoping that for once something abnormal one would turn up

Patrufini Duffy 2 September, 2021 2:21 pm

The NHS is still ratioining respect and care for its workers.

Marie Williams 2 September, 2021 2:37 pm

Local direction to stop all blood tests forthwith was sent to us this morning
My response to this was- why? As we do not use the bottles in short supply .
The response was that there is a world wide deficit in the manufacture of the plastic which could have a knock on effect on the availability of other bottles.
Anybody in the EU or USA taking the same steps or do they have competent managers and a secure and effective supply chain?
Already had the district nursing team refuse to do bloods on a confused 95 year old bed bound patient recently discharged from the hospital to try and assess whether there is an organic cause for her illness or not. Of course the psychiatrists are unable to assess until the bloods are done.
Welcome to post Brexit Plague island. #yetanothereasonforretirement

John Graham Munro 2 September, 2021 3:12 pm

Marie Williams——–for how much longer are you going to investigate your 95yr old lady?—–it would appear the hospital has already decided enough is enough