Advice for GPs and pathologists to improve the reporting of abnormal test results out-of-hours has been developed by The Royal College of Pathologists (RCPath) and The Royal College of General Practitioners (RCGP).
The document has been produced in response to instances where laboratory staff have been unable to find an appropriate primary care physician to act urgently on a markedly abnormal test result.
Containing advice for GPs, primary care trusts, out-of-hours providers and laboratory staff, the document highlights three key problem areas in reporting and acting on abnormal results:
- Lack of information over whom to contact outside GP surgery opening hours.
- Staff at the out-of-hours provider failing to appreciate the importance of the abnormal result, and not taking appropriate responsibility.
- Staff at the out-of-hours provider being unable to contact the patient and/or unable to access patient records.
The document recommends that stakeholders work together at a local level to develop an appropriate system to ensure good communication out-of-hours.
Specifically, the document suggests PCTs should inform the laboratory of arrangements for making contact with a GP out of hours; GPs who request tests must provide sufficient patient details and clinical information to allow effective communication between the lab and the out-of-hours provider; and, crucially, engagement and dialogue must be promoted across the whole local urgent care network.
The document also identifies a need for a protocol for the laboratory to report lack of response from out-of-hours providers and a system to be put in place to quality assure abnormal results.
Professor Adrian Newland, RCPath President, says: “Our intention is that this document will be used as a basis on which pathologists can construct local guidelines to address current problems with the reporting of results and to ensure a good working relationship with out-of-hours providers.”
Professor Steve Field, RCGP Chairman, says: “This document is essential for primary care teams and pathologists. Whether we are dealing with results which show that an individual requires immediate medical attention, or those that may have implications for public health, an effective system for reporting and acting on abnormal test results will ultimately lead to better patient care.”
Your comments: (Terms and conditions)
“I am a Practice Manager at Probert Road Surgery Oxley, Wolverhampton. I also work at Doctors on Call in Wolverhampton. One problem we find is when the hospital ring with abnormal results they don’t give us enough information about the patient. We do not have access to patient records and the hospital does not always have telephone numbers for patients. This makes it difficult for us to contact them so it usually results in the doctor having to visit the patient” – Name and address supplied