GPs have been asked to limit the samples they send to the one of the largest pathology providers in the NHS due to ‘significant’ Covid-related staff absences.
Staff shortages at NHS East & South East London Pathology Partnership have meant the lab is struggling to meet ‘turn-around times for clinically imperative samples’ which is in turn delaying the delivery of clinical care.
It warned that if the turn-around times continue to grow, it will have to ‘introduce further measures to manage demand’.
And as of yesterday, the lab has stopped processing ‘any skin, hair or nail samples submitted for mycology’.
The London NHS Trusts lab, run by Barts Health, sent a letter to GPs which said: ‘The current wave of Covid-19 is causing a significant shortage of laboratory staff within the NHS East & South London Pathology Partnership microbiology and virology laboratory services, with staff isolating at home with Covid-19, or caring for family members with the virus.
‘These staffing shortages are having an impact on the microbiology and virology laboratory’s capacity to maintain our turn-around times for clinically imperative samples, which is having a knock-on effect in causing delays in delivery of clinical care.’
Primary care asked not to send unless ‘clinically imperative’:
- Skin, hair and nail samples for investigation of dermatophyte infection
- Urine samples from asymptomatic patients (except prior to urological procedures involving stone fragmentation). This includes “routine” catheter urine specimens and screening for asymptomatic bacteriuria in pregnancy
- Gential swabs (except for Group B strep screening and STI testing)
- Wound swabs from ulcers
- Non-purulent sputum samples from immunocompetent patients
- Non-bloody faecal samples from primary care
- H. pylori antigen testing
- Surveillance mycobacterial cultures from patients with cystic fibrosis
- Multi-drug resistant screes from multiple body sites (send rectal swab only)
Source: NHS East and South East London Pathology Partnership
The letter said the pathology partnership will ‘continue to monitor the turn-around times of critical samples, and if these continue to increase then we will have to introduce further measures to manage demand’.
Meanwhile, one in seven doctors (13.9%) are off work in London, and one in 13 (7.4%) due to Covid, according to a survey by the Royal College of Physicians (RCP).
The RCP said the figures in London are comparable to the start of the pandemic, but ‘further exacerbated by exhausted and demoralised staff working under the extreme pressure of rising Covid-19 cases coupled with usual winter illnesses’.
Across the UK, more than one in 10 doctors (10.5%) are off work and one in 24 (4.2%) due to Covid.
From those off work, 18% had suspected or confirmed Covid cases and 19% were isolating due to having contact with cases.
RCP president Andrew Goddard said staff absence is ‘the worst we have seen during the pandemic other than at the end of March 2020’.
He said: ‘But at that point we didn’t have access to the PPE we needed, we had cancelled almost all other activity, it was spring and we were dealing with a less transmissible strain of Covid-19.
‘Today, we have a tired and demoralised workforce that has been managing the impact of the pandemic for almost two years, we are trying to deliver as much non-Covid care as possible and we have the usual winter rise in other respiratory conditions. At the same time, many colleagues are taking well-earned holiday to spend some time with their families and friends over Christmas.’
The survey also found:
- 14.5% of UK respondents felt they had insufficient PPE
- 6.5% said they had not been able to get UKHSA advised PPE in the last two weeks
- 99% of UK doctors had been double jabbed, with 96% having also received a booster and 2% have booked in to have it
The guidance for health and social care workers – including GPs and practice teams – is the same with some additional mitigations, including continuing to test negative with daily LFTs until day 10.