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Blood test shortage and QOF delays cause ‘real distress’ for practice managers

by Jess Hacker
27 August 2021

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Having to reschedule blood tests and associated QOF checks due to a worsening shortage of test tubes sparked by soaring demand will cause ‘real distress’ for practices, the Institute of General Practice Management (IGPM) has said.

Earlier this month, NHS England told GP practices told to suspend non-essential blood tests because of the global supply chain crisis caused in part by ‘UK border challenges’.

But in a new letter sent to practices (26 August), NHSE said that practices must stop all blood tests until mid-September unless ‘clinically urgent’, and that associated QOF indicator checks should be rearranged accordingly.

Responding to the new direction, the IGPM said that having to reschedule blood tests ‘right into the middle of the flu season’ and the Covid vaccination programme is an added stress for practices.

A spokesperson told Management in Practice: ‘We are already struggling to hit targets for QOF, whilst still living through a pandemic, trying to plan flu clinics, and still unsure with regards to the whole Covid booster vaccination programme, with patients contacting us on a daily basis about this.’

They added that headlines alerting patients of the blood test ration will cause ‘real distress to our already struggling practices as the inference is that it is GP surgeries who are making this decision’.

The spokesperson said that such situations increase the risk of verbal and physical abuse staff face from patients: a trend which has increased significantly during the Covid vaccine campaign.

GPs warned last week that the ongoing shortage could lead to further abuse from patients as well as potential financial losses and negative CQC ratings.

Delays and rescheduling

In its letter to practices, NHSE instructed GPs to cancel all tests except those that are ‘clinically urgent’ until 17 September.

Tests that can still go ahead include:

  • those required for two-week wait referrals
  • those that are ‘extremely overdue’ or ‘essential for safe prescribing’ or monitoring
  • bloods which if taken could avoid a hospital admission or onward referral
  • those for patients with suspected sepsis or conditions with a risk of death or disability.

NHSE also added that there are a ‘small number’ of QOF indicators which require a blood test to be taken, and that practices should move blood test activity scheduled prior to 17 September to a later point in the year.

It said: ‘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.’

The letter clarified that there are no current plans to change QOF payment arrangements for these indicators, however this will be kept under review.

Additionally, if a practice has taken these steps but is still likely to run out of products within 48 hours, they should notify their Pathology Incident Director and the NHSE and NHS Improvement regional team.

Commenting on the letter, Dr Graham Jackson, GP and senior clinical advisor at the NHS Confederation, said: ‘We have already heard of verbal abuse from patients anxious to have their blood tests, and clinicians will need to make a judgment based on these guidelines around who should have access to a blood test.

‘Thousands of appointments will need to be cancelled, adding additional burden to a workforce that is already under significant pressure.’