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.