To expect the nurse to do blood tests during my appointment?

[hopefulmumofone]

My GP practice has recently amalgamated with several others in the area to create one huge super-surgery. All three practices are still at original sites with satellite surgeries all over the city.

I managed to make an appointment this morning with a Nurse Practioner for a consultation during which she said I needed blood tests and to make an appointment for these at reception. The only appointment in the next few days is later today at another site so I have taken it.

Would it really have been unreasonable for me to expect the NP to do the blood tests there and then? Is this the norm these days? Incidentally there wasn't anyone waiting after me - was totally deserted.

I am unable to drive today but have arranged a lift, if I hadn't had someone to take me these two separate appointments would have required 8 separate buses costing £13.40 and nearly 2 1/2 hours travelling!

Inefficient for the patients, but it is efficient for the practice.

Well obviously.... However, it is certainly not a small inconvenience for patients, many of whom will not be in good health and perhaps potentially hanging on to their jobs by the skin of their teeth.

Employing a phlebotomist at each site with enough appointments free to mop up any on the day blood tests would cost more, and there would be empty appointments if the Nurse Practitioner didn't request many blood tests one day, so paying for a phlebotomist to do nothing.

There wouldn't need to be many empty appointments and considering taking blood takes only a couple of minutes and phlebotomists are paid a low wage, it would hardly cost a practice much.

GP practices are needing to save money, so sadly will have to prioritise their own efficiency over efficiency for the patient.

I think that most will prioritise patients needs over small savings. My practice certainly does.

Around here you gave to go to the hospital (20 minutes drive and £2 to park or three buses each way), take a number and wait (90 minutes for me last time). Our GP surgeries simply don't take bloods at all.

Most of the practices I have a connection with, professionally or personally, have scrapped in house phlebotomy for all but the frailest. I live in a city so it may be different elsewhere.

Staff time, salary, pension, NI and training isn't a small expense, even for lower paid staff. Also the GP practice has to pay for the equipment eg needles. It sounds cheap, but many practices are making savings where they can. Patients going to the hospital phlebotomy is zero cost to the GP practice. So you can see why this is an area to economise on when they need to save money. Also some practices are struggling to find nurses to hire. And a greater priority is to use nurse/ health care assistant staff time for activities that directly improve health and meet targets (thus generating much needed income) like chronic disease checks. So if patients are struggling to get appointments with the nurse for their asthma and bp checks, which can't be done elsewhere, then the blood taking will go.

It's lovely that your surgery still offers blood taking. When I needed blood tests recently it was a complete faff going to the hospital. But I can completely understand why my own practice has stopped offering this to most patients.

Most of the practices I have a connection with, professionally or personally, have scrapped in house phlebotomy for all but the frailest. I live in a city so it may be different elsewhere.

I live in a city but thankfully not where you are, particularly as I have a lot of blood tests (albeit mostly at the hospital). It really isn't a small inconvenience to many patients, many of whom are ill and perhaps struggling to keep their jobs and it is a real shame if practices in some areas are making everyone go to the hospital just to have blood taken. It may save GPs some money but that is at the patient's expense and ultimately it will also probably cost the NHS more. I am a healthcare professional and understand that primary care, NHS etc is under a lot of pressure but I think policies such as this are a big step backwards.

We have to go to the local hospital and you have to make an appointment which can sometimes be the following week. It is only open on weekdays and closes at 4pm, so not convenient for people who work.

Well I've just been for said blood test and maybe I'm nbu after all. The nurse said, 'oh, you were just seen today, was there some reason she couldn't do them?' When I said it wasn't offered she rolled her eyes and said, 'it only takes a minute, it's ridiculous really'.

This wasn't a hospital, it was my GP at another site (so all out of the same budget).

So today I have used two appointments when one would have done. I'm not sure how that is a valuable use of anyone's time to be honest.

My GP doesn't do them anymore. Nor does the midwife. We have to go to the hospital 20 miles away, pay £3 to park then queue up at the clinic and get tested there. Last time I had three kids with me including a newborn and had an hour-long wait. Then I got a call to they couldn't use the sample and could I 'pop back' to give another sample. Erm, no.

In my surgery bloods need an app't with someone who only takes bloods

I'm pregnant and have a chronic condition that requires frequent blood tests during pregnancy. I was very stressed out when I was told about this. The gp suggested that any of the GPs or the practice nurse would be happy to take my blood during a normal appointment if it helped. I couldn't believe it! Then a few weeks later I needed another test, and the gp I was seeing just took my blood! They don't seem to understand how surprising that is when I've been moving heaven and earth at work to try to attend their inconvenient phlebotomy clinics. Our practice nurse definitely does take blood but she usually has at least one other phlebotomist at the dedicated phlebotomy clinic, and sometimes it's two people I don't recognise but not the nurse.

I realise I'm lucky, but I'm just adding this to say you are not being completely unreasonable. I think the most unreasonable part of your story is having to go to a different site to have the blood drawn. I bet they're going to get lots of confusion and people showing up to the wrong place.

I'm in a city, too. Our local hospital has a sign on the door of the blood room saying they will not draw blood if it's a request by a gp from certain CCGs, including mine, so the hospital trust is obviously forcing the GPS to pay for it themselves.

Not uncommon but totally unreasonable and stupid.

I take blood from people all the time in routine appointments. It takes a couple of minutes tops. And that includes labelling samples (because if you concentrate and aren't being a div you don't mislabel them...). It is easy.

GPs I understand why they don't take them, because of a 10 min appointment taking 2 or 3 mins to do bloods might well make you run even later than you inevitably are, but given that not everyone from a clinic will need bloods doing, if you are there already the nurse might as well do them than waste everyone's time sending you elsewhere!!

Unless she's not phleb trained. Which I would be a bit hmmm about if she's got to practice nurse level and can't take blood as it's a piss easy skill to learn.

It right winds me up when I have to get bloods done because I do not appreciate having even more time out of my day taken up with stuff like this. I'm self employed and time is money for me. I'd take it myself if I could!!

It will be because your CCG has paid the GP practices extra to run their own phlebotomy clinics, socially, presumably with a condition that they do all their own bloods.

Yes hopelessly. What I was trying to say is that a gp practice can't just decide on its own to stop offering phlebotomy services if the hospital isn't commissioned to provide them.

Same here, took ds in as he was having an allergic reaction to something. He had big red painful spots from head to toe and they were getting progressively getting worse so they ordered a blood test. Next appointment for getting blood taken (which took less than 5 minutes) was 4 days later.

I'm in a city, too. Our local hospital has a sign on the door of the blood room saying they will not draw blood if it's a request by a gp from certain CCGs, including mine, so the hospital trust is obviously forcing the GPS to pay for it themselves.

I don't blame the hospital and I think this highlights the fact that the policy is nothing to do with saving NHS resources and is likely to increase costs (as well as being very inconvenient for patients).

I'm in a city, too. Our local hospital has a sign on the door of the blood room saying they will not draw blood if it's a request by a gp from certain CCGs, including mine, so the hospital trust is obviously forcing the GPS to pay for it themselves.

I don't blame the hospital and I think this highlights the fact that the policy is nothing to do with saving NHS resources and is likely to increase costs (as well as being very inconvenient for patients).

The issue is whether the GP practice is commissioned to perform blood tests. Some are as part of their basic contract, some are for an extra payment, some aren't at all. If the GP practice isn't commissioned for blood tests, then either the GP practice provides them out of goodwill, or the hospital phlebotomy dept do them.

My hospital is obviously not commissioned to provide phlebotomy to my gp, and they've decided not to. So even if my gp decides that needles and phlebotomists' pensions are too expensive, I don't see how they can decide to stop providing the service.

The issue is whether the GP practice is commissioned to perform blood tests.

Presumably, the hospital is refusing to do the tests because the GP practices have been commissioned to perform blood tests or the patients have been directed to the wrong clinic...

I'm a Practice Nurse, I'll often take the bloods myself on the spot if I have time.
The reasons why I might not include; if it's fasting bloods, I'm running late, I need to discuss the request with a colleague, the courier who collects the samples has gone.
If it was a straightforward test and you explained that you had to take time off work I'd do my best. Most of us would.

I remember years ago being told I could go to the hospital to get blood drawn. So either commissioning has changed or the hospital was never commissioned to do it and they decided to stop doing it for free. Having worked for the hospital trust, I would bet on the latter.

I'm a practice nurse too like kidisagoat - and in the same way I'll take bloods if it's something I can do in the short time I have available.

Often I can't take the bloods as they need to be fasting, or if the courier has gone (we don't have a collection after 1100 whereas our sister site has a collection at 1500), or if I'm running horrendously late. It's rare that I won't do them, I'd need a really good reason and of course will always try and accommodate patients especially if they need to take time off work, or need to move heaven and earth to get elsewhere.

Regarding the NP not being busy because there was no-one else in the waiting room - often with split sites or dual site practices the staff may do a clinic in the morning at one site then need to get away promptly to do an afternoon clinic at the other site.

socially presumably your GP practices are commissioned to provide blood tests. In that case the GP practice has agreed to take on that role and a payment agreed.

I would guess that the porter had already picked up the bloods for that day to take to the local path lab, so your sample would have been hanging around until the next day. Porters pick up from us at around 2pm if any bloods are taken after this time it would mean driving up to the local DGH with them. HCPs don't do things to be deliberately awkward

In my surgery, we have a practise nurse who takes blood but you can be sent to the treatment room nurse in a different site of the practise