GPs have warned that an ongoing shortage of blood test tubes could lead to further abuse from patients as well as potential financial losses and negative CQC ratings.
Last week, GPs were told to suspend non-essential blood tests amid a worsening shortage of test tubes sparked by soaring demand and ‘UK border challenges’.
The NHS guidance followed an earlier call for GPs to take steps to minimise blood tube wastage after medical technology company Becton Dickinson (BD) warned of serious supply chain issues.
NHS Supply Chain had initially said it expected to see improvement from next month, however NHS England later said that the supply shortages are set to last for ‘a significant period of time’.
Now GPs have warned of the potential consequences of the crisis, including managing ‘patient expectations’.
North Staffs LMC secretary and BMA GP Committee policy lead on NHS England Dr Chandra Kanneganti told Pulse that central communications must go out to patients to prevent them from blaming GPs for their cancelled appointments.
He said that while it is ‘too early to say’ whether there have already been incidents in his area, practices cancelling routine blood tests are facing questions from patients wanting an explanation.
Dr Kanneganti said: ‘[A] communication should go to the patients as well – “there is a national shortage of this thing, please understand” – because what will happen is that when we cancel [bloods] which are routinely booked because of this new advice, they will blame GPs.
‘We get abuse for everything. [But] this is not our fault or anybody’s fault, it’s a national shortage.’
It comes amid rising abuse levied against GP practices, which last week saw practices targeted with bomb threats.
Nottinghamshire GP Dr Prakash Kachhala also told Pulse there will be ‘a lot of annoyed patients who can’t understand why this is happening’ and added that there could be repercussions on practices’ QOF scores if the shortage continues.
He said: ‘A lot of our chronic disease reviews include bloods, so if this becomes a longer issue, no doubt we’ll be cancelling these reviews – [this] would certainly impact on QOF [and] patient safety, including drug monitoring.’
And Londonwide LMCs medical director Dr Elliott Singer added: ‘Practices are already struggling to deliver on QOF targets and that is before we start on phase three of the Covid vaccination programme and flu vaccines.
‘If practices have to delay routine testing due to the shortage, there will be insufficient time and capacity to make this up, which will potentially have a significant financial impact on practices, many of whom are already struggling financially.’
Dr Kanneganti also said his ‘main worry’ is that practices may be ‘penalised’ by the CQC for not completing blood tests and called on NHS England to halt the monitoring of services that are affected.
He told Pulse: ‘Most of the CQC visits that have started recently are looking at monitoring of disease-modifying antirheumatic drugs (DMARDs). All these things need blood tests every three months.
‘The CQC is checking whether practices are doing [regular monitoring for certain drugs], but now that this guidance came out NHS England should tell CQC to stop assessing practices based on that.’
He added: ‘[Practices should] not feel that they’re penalised and rated badly because they were given this guidance.’
And Dr Peter Holden, chair of the BMA’s professional fees committee and a GP in Derbyshire, told Pulse his practice is already facing ‘stroppy’ patients and that he is concerned about potential clinical liability.
He said: ‘We are annotating our notes to say blood tests would be desirable but [we have] no blood bottles. We can’t be liable for something that is beyond our control.’
He added: ‘We do phlebotomy sampling on behalf of the hospital to save people a 40-mile round trip and we’ve had to stop that as well. It’s going to impact patients who are going to have to travel unless we get the bottles. The patients are getting very stroppy about it.’
Meanwhile, GPs have taken to social media to express their concerns.
Dr Kachhala tweeted that he feared for patient safety with only 25 test tubes for his 16,000-patient practice this week.
And a Bexley-based member of a Facebook group for EMIS users said the shortage was ‘being investigated as a significant event’.
Additional reporting by Caitlin Tilley and Nicola Merrifield
This story first appeared on our sister title, Pulse.