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NHS England orders GPs to stop all blood tests not ‘clinically urgent’ until 17 September


blood tests resume


NHS England has instructed GPs to cancel all tests except those that are ‘clinically urgent’ until mid-September, while warning the shortage of blood test tubes is due to worsen over the coming weeks.

Earlier this month, GPs were told to suspend non-essential blood tests amid a worsening shortage of test tubes sparked by soaring demand and ‘UK border challenges’.

But in a letter sent to GPs today, NHS England clarified its guidance on reducing test tube demand, saying that practices must stop all blood tests until 17 September unless ‘clinically urgent’.

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’, it added.

According to NHS England, supply is ‘forecasted to become even more constrained over the coming weeks’ and while the shortage is ‘anticipated’ to improve ‘from the middle of September’, ‘overall supply is likely to remain challenging for a significant period’. 

It followed warnings from GPs that the ongoing shortage could lead to further abuse from patients as well as potential financial losses and negative CQC ratings.

In today’s letter, NHS England said it has made regulators including the CQC ‘aware’ of the guidance.

It also said it had ‘confirmed’ with NHS Resolution that any clinical negligence claims arising from it ‘will be captured in the usual way by the respective state indemnity schemes’.

Meanwhile, it added that it is seeking ‘alternative products’ to ‘alleviate the constraints’ but that there is ‘also significant pressure on a number of similar products’ and that it will ‘take time’ to import and deliver them in bulk.

It added: ‘Organisations are asked not to switch to alternative products unless doing so in coordination with the Pathology Incident Director and NHS Supply Chain.’

Practices should prepare to provide ‘mutual aid’, while those that have followed the guidance but are still likely to run out of blood test tubes within 48 hours should notify their NHS England regional team and their Pathology Incident Director, it said.

The BMA said doctors have been left in an ‘incredibly difficult position’ and called on NHS England to communicate with patients about the scale of the shortage.

NHS England also told GPs that there are ‘no current plans’ to income-protect affected QOF indicators and that practices should reschedule QOF checks.

This comes as Pulse revealed this week that the BMA is lobbying NHS England for QOF income protection to ensure GP practices are not financially impacted by the shortage.

The letter said: ‘There are a small number of QOF indicators that require a blood test to be undertaken. We appreciate that this temporary position is frustrating for patients and services alike. 

‘It may mean practices rescheduling certain QOF indicator checks for later in the year when supply has improved. Given QOF is an annualised process, there are no current plans to change QOF payment arrangements for these indicators though we will keep this under review.’

Deputy BMA council chair Dr David Wrigley said: ‘Doctors have been left in an incredibly difficult situation, with no choice but to inform their patients that they cannot carry out certain blood tests for the time being and that appointments they may have for a test could be cancelled. 

‘Patients need to have clear information about the scale of the problem, the impact it may have on them and what’s being done to keep them safe. That needs to come from NHS England and very soon.’

He added that NHS England must also clarify ‘as a matter of urgency’ what will happen if GP practices or hospitals run out of stock.

Dr Wrigley said: ‘It’s not unreasonable to question that there must have been a time when NHS England and the Government knew that blood tube supplies were running low, and therefore, to now ask, “Why has nothing been done to mitigate that?”

‘Fundamentally, if shortages are due to a manufacturer not fulfilling its obligations, then it’s clear that much better resilience in the supply chain is needed.’

Previously, GPs were asked to temporarily stop vitamin D testing, as well as screening for pre-diabetes and blood disorders such as dyslipidaemia (raised cholesterol levels), along with allergy testing and routine infertility testing.

READERS' COMMENTS [13]

Turn out The Lights 26 August, 2021 9:03 pm

No give from the fat controllers side no give from the front line.Carry on if they run out they go to where the bottles are.NHSE are not very good at winning friends and influencing people.

Bonglim Bong 26 August, 2021 9:18 pm

As per turn out the lights. I’m not sure why GP practices should be paying for difficulties in getting blood bottles through their profits, particularly if is so simple to offer a solution.

Can apply to just blood tests and ‘reviews’ which probably involve blood tests – but they can just lower the thresholds by 2% for every week the shortage continues for.

Vinci Ho 27 August, 2021 7:01 am

Well , calamity after calamity got NHS E/I
The temptation is to label all blood test requests as ‘urgent’ to get things done😈

Nicholas Sharvill 27 August, 2021 10:03 am

PLEASE CAN WE BE ADVISED WHAT THE HOSPITAL SECTOR HAS BEEN TOLD ABOUT REDUCING BLOOD TESTS AND THE PROPORTION OF THE NATIONS SUPPLY/STOICK THAT GOIES TO PRIMARY VS SECONDARY CARE

Deborah White 27 August, 2021 10:25 am

Does NHS England have a clue? A blood test isn’t the appropriate management of suspected sepsis by a GP.

Nick Mann 27 August, 2021 12:38 pm

WHy were NHSE unaware of this impending national problem in time to mitigate it?
Why did NHSE blame “an international shortage” when it appears to be a problem only in UK (according to a French national journalist)?
Is NHSE covering (lying) for DHSC and Govt Brexit planning failures?
What is the “soaring demand” for blood tests due to and where is the evidence that this statement is even true?
Blood tests are fundamental to the function of the health service and safety of patients. HSIB should now investigate NHSE. Why is this not a matter of critical national importance and action?
Where has the truth gone? Please can somebody find out?

Craig Hughes 27 August, 2021 1:42 pm

Test

Turn out The Lights 27 August, 2021 1:57 pm

Boris the government,Tories NHSE and the word truth are not good bed fellows.

Mr Marvellous 27 August, 2021 2:13 pm

Rumour has it that the shortage is due to Department of Health relabelling each bottle as a new hospital.

Patrufini Duffy 27 August, 2021 2:13 pm

There’s a lot of “non-essential” things that should stop. Not seen any “leader” on TV or a podium about this. Use the GP for the battering yet again.

Patrufini Duffy 27 August, 2021 3:37 pm

Not sure what you’ll do with all those bloated, feverish and tired patients after Festival Weekend?

terry sullivan 1 September, 2021 4:51 am

gps are self employed–just carry on as normal

nhse costs 4.5 billions a year yet cannot source bottles???? heads must roll

David Turner 2 September, 2021 2:16 pm

‘orders’ , ‘instructs’ !?!!!!
I am self employed, nobody orders me to do anything, especially not a group of pen pushers hiding behind the lines at NHSE!
I will do what I need to do in the best interests of the patient in front of me thank you very much.