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Updated actions required for national supply issue with blood tube products

August 27, 2021

There are now additional actions required in order to balance the demand of blood tubes and ensure there is no disruption to urgent clinical care for patients.

It is important to note:

  • Primary care have been asked to cancel all routine blood testing until September 17th. Please consider any impact on requests where follow-up testing is requested after discharge from hospital services – both timing and necessity for testing.
  • To illustrate the scale of the request that is asked of us all, a 25% reduction in blood tube usage is asked for over the next 3 weeks. Please consider the approaches below again and how you can help minimise the risk of severe restrictions, the consequences of which will be great. Please discuss options daily with your teams.
  • We are awaiting an update SOP for add-on testing to facilitate that process for additional tests where a sample already exists and will get that out as soon as it is available.
  • The tubes affected are:
    1. 5mls Yellow top – SST 2 – clotted sample (e.g. U&E, LFTs etc)
    2. Purple top – EDTA (e.g. FBC, HbA1c)
  • A summary of the new guidance is below:

Acute trusts, community hospitals and mental health trusts

Acute and mental health trusts must reduce their demand by a minimum of 25% for the three-week period up to 17 September 2021. We are asking laboratories to help you in documenting this change

These reductions should be made in line with the guidance on recommended actions and can include a combination of reducing non-essential (non-clinically urgent) testing, optimising inpatient and assessment unit sampling, encouraging add-on testing to reduce the need for blood tube usage, increasing use of point of care haemoglobin devices, reducing daily testing where possible and ensuring greater senior clinician input in requesting tests. All of these measures should be undertaken where safe to do so.

Primary Care and community care

All primary care and community testing must be halted until 17 September 2021, except for clinically urgent testing.

Examples of clinically urgent testing include:

  • Bloods that are required to facilitate a two week wait referral
  • Bloods that are extremely overdue and/or essential for safe prescribing of medication or monitoring of condition
  • Bloods that if taken could avoid a hospital admission or prevent an onward referral
  • Those with suspected sepsis or conditions with a risk of death or disability

There are a small number of QOF indicators which require a blood test to be undertaken. Unless clinically urgent, practices should move blood test activity scheduled prior to 17 September to a later point in the year when supply improves. 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.

Please review the guidance and actions required in previous messages but also think about other ways your service can safely reduce test requesting.

Talk to your clinical lead if any concerns or queries.