To think someone at the GP surgery should do my blood test

[JacobReesMogadishu]

I've got an rare chronic condition which I've had for years. It puts me at risk of kidney and liver failure. I live up north but due to it's scarcity I'm under a consultant in London. This consultant sorts my medication and treatment plan out and I travel to London a couple of times a year.

I haven't seen anyone face to face since Dec as my last appt in March was cancelled.

The hospital emailed me yesterday to say they've realised I'm overdue a kidney and liver function test and can I contact my GP asap to sort this. My GP surgery has done this before, in fact they've rung me before to say I need one.

I rang and spoke to a receptionist today who said now due to covid they're no longer doing hospital bloods. That I have to go to the hospital. I pointed out that firstly it's 4 hours to the hospital and that my clinic isn't seeing people face to face due to covid either.

So she told me to go to the local hospital and to get a blood form from the london hospital. London hospital have said they'll send me a blood form but said they doubt my local hospital will accept it as the forms are different and the lab won't be able to bill the London hospital so won't want to do it.

What the heck has happened to joined up treatment and thinking about the patient holistically? A friend works at a GP surgery 5 miles up the road and they're still doing hospital bloods so it's obviously not a county wide decision to stop doing them.

@Oldbagface

And if you are asked what it is about tell her you'd rather not say and will discuss with gp. If she presses and you're not feeling assertive tell her it's personal and delicate or just say it's to discuss problems you are having with your long-term condition.

When I get asked this I just reply 'me' and they always leave it at that.

Seems a lot of GPs are doing this at the moment. Mine texted me last month asking me to arrange an appointment with the nurse for annual blood tests, I rang the next day to be told "Oh no we're not doing blood tests at the moment, we don't know when they'll be available again"...

Nothing wrong with doing peak flow readings and blood pressures at home. Usually the BP will be lower! They certainly don't warrant a visit to the surgery in most cases. Peak flow itself is a risky procedure for Covid and spirometry currently banned. Just ring the readings through and follow up with a telephone consultation.
I've been doing most things at our surgery throughout all this, and since tested positive for antibodies.

Can you do an e-consult for your GP? Ours are very good at responding to those and the bonus is you don’t have to have a chat with the receptionist. Alternatively our GP is also doing phone triage so if you ask for an urgent appointment you should get a same day callback.

I’m not sure if bloods are being done at our surgery but I did see the practice nurse a while ago for help with a wound that was being difficult. Full PPE was involved for her and I was the only patient in the building.

For bloods in recent non covid times we are now encouraged to go to the hospital drop in sessions. But I have no idea if that’s happening now.

If you can’t get anywhere with GP then it’s probably time to email the practice manager

YABU because your local hospital may well accept the form given the circumstances. Call them.

Also you’ve had this GP for 30 years who is very good and takes a genuine interest and didn’t think to call to speak to her/him about this?!

I know exactly what you are going through.

Numerous relatives with cancer, liver problems, those on Warfarin, are all having problems with getting blood tests.

What ARE GPs doing right now? Can someone answer?

I work in Admin in a GPs Surgery. Recently due to shortages I've been helping out reception. I can tell you it's a thankless task and they are only doing what is asked of them by a GP. I for one don't care what's wrong with you and only ask for info as otherwise I would be asked to call you back and as. The reason for the refusal is more than likely financial but I can assure you the receptionist is not trying to make your like (or hers) difficult.
I suggest asking your consultant's secretary for labels/blood forms to be posted to your Practice and then trying again.
I'm going through them massive backlog of
our own bloods due ATM and calling patients in.
Good luck

My husband had a similar issue, he also has a rare chronic liver condition and has blood tests periodically, he rang the surgery to get them sorted and they told him no, emergencies only! Fortunately he was going for a scan at the local hospital so had them done at the walk in clinic there(no problems) about a week later the gp rang to book him in for a blood test as they had had a request from his consultant! Very hit and miss ☹️

This seems silly. Just ask the London hospital for the list of bloods you want done and then get the GP to request them.

I've actually told my GP what bloods I wanted done myself!!

OP similar situation. I take medication which can damage my kidneys and liver. Meant to have blood tests every 6 months. Pre Covid I couldn’t have a repeat script without having the blood test. My GP and hospital aren’t doing routine blood tests at the moment. They’ve told me it’s fine to just have the mediation.

I’ve paid for a private blood test next week.

To get past the receptionist, say it's a gynae issue.

I have a child who has regular liver and kidney function bloods, also managed in London. During COVID the London hospital wrote to my GP, who completed the local blood form and off we went to local hosp.

One other thing you could try is to ring the phlebotomy department at the local hospital and explain the situation and see how they respond ? I am not sure if they have the authority or access to raise a blood form though ?
But at least you can go back to the Surgery and say the Phleb's have said I need x form printing out , please can you ask the duty Doctor to do this.

I have found that different gp receptionists offer different things. Iwould ring again and if you get the same one, ask for a doctor to ring you.

I take a drug which can damage my kidneys and liver, and thyroid, and I also have to have a test for something called a BNP level to track the progress of my heart’s deterioration.

The heart failure nurse at the hospital just wrote to my GP saying this was the blood test I needed to have, they called me and I went up there yesterday. But our local hospital are doing tests by appointment only.

If the GP aren’t doing any blood tests at all then that is one thing, but if they’re still doing some blood tests then I would speak to your consultant and get them to write to the GP with the relevant forms.

Can you do an email consult directly with the G.P? You can at my surgery it's been a godsend, being able to bypass arsey receptionists is something we can thank Covid for. I have had hospital requests done at my GPs

@RobinlovesCormoran I can’t speak for all surgeries but we’re pretty much back to normal now, with some restrictions and limitations.

We have been doing bloods all the way through but only urgent and pre-chemo bloods (partly because our hospital labs wouldn’t process anything else), we’re now playing catch up for routine and monitoring bloods and we’ve got a huge amount to do. Given that we’re also playing catch up with everything else such as smears, some baby imms and chronic disease monitoring, appointments for bloods are precious.

Our GPs are working flat out doing a combination of telephone and F2F appointments, as well as chasing referrals, expediting appointments and doing their usual paperwork and management.

We’ve now also got to start doing flu clinics which is even more challenging given the need for social distancing, extended eligibility groups and demand.

Apart from a strangely “quiet” few weeks in April we have been increasingly busy.

Unfortunately, reduced hospital services due to Covid have sent a tidal wave of hospital work into already over-stretched GP practices. So practices are trying to cope with more work than usual, without any extra funding or staff.

As a GP, I employ enough staff to take the blood tests the practice needs. I don't have spare staff to do extra work. If we have to do blood tests for the hospital, we will not be able to do all the blood tests the practice needs done - we would require thousands of extra appointments. Look at all the threads on here, complaining about GP waiting times as it is. There is no way GPs can take on this extra work, because we don't have the staff or the physical space.

Just ring and ask for a GP call back who I’m sure will sort it for you.

You need a ‘shared care agreement’ the hospital consultant needs to write to your GP to request this. Write to your consultant and copy in your GP, write to your GP and copy in your consultant, email would be easier but paper if you don’t have the email addresses (they could be in previous letters). Don’t be put off by the receptionist, they are just gatekeepers. I actually rung yesterday about my blood test and was very clear when she said, “oh do you have the forms?” Me: “No I have a shared care agreement, the GP will issue the forms.” Her: “oh does x date suit you?” You have to manage your own care I’m afraid, you can’t rely on the NHS to do it for you. Good luck.

Does shared care exist in England? I'm in Wales and have shared care between my hospital and GP. Either of which can request bloods when necessary. If my hospital needs bloods and I can't get there, I make an appt for bloods and nurse copies over from one form to the other.

Surely your hospital can email gp and they can do a blood form?

@MissLucyEyelesbarrow

Unfortunately, reduced hospital services due to Covid have sent a tidal wave of hospital work into already over-stretched GP practices. So practices are trying to cope with more work than usual, without any extra funding or staff.

As a GP, I employ enough staff to take the blood tests the practice needs. I don't have spare staff to do extra work. If we have to do blood tests for the hospital, we will not be able to do all the blood tests the practice needs done - we would require thousands of extra appointments. Look at all the threads on here, complaining about GP waiting times as it is. There is no way GPs can take on this extra work, because we don't have the staff or the physical space.

Well that makes sense I guess. See in my mind I couldn't understand why it was ok for a hospital phlebotomist to be at risk but not the GP one.

I do still think it's arguable whether it's a hospital test or a GP one. The receptionist decided it was a hospital one because the hospital has reminded me/them that it's overdue. But surely as someone with a long term chronic condition my GP needs to take some ownership of me as a patient? It's not like it was a pre hospital operation blood test. Guess it's a bit of a grey area.

Anyway the form arrived from London hospital this morning (great service) and I rang the local hospital phleb clinic who after a bit of discussion have agreed to translate the form onto one of theirs and do it.

That's good. Def look into shared care though if possible, its made a world of difference to me in being able to manage my condition, and has meant less face to face appts etc as I can keep track of things.

My GP practice has an in house pharmacist, and he manages my shared care...much better than a GP in many respects, as he obviously is more acquainted with my various meds ptecribed by specialist eg. He prescribes steroids when needed at appropriate doses which is way higher than most GPs would want to.

It would be a waste of a GPs time for me to see them when I can contact the pharmacist and they can sort everything. I only need to see a GP for unrelated stuff, thus freeing up time for everyone.

Well that makes sense I guess. See in my mind I couldn't understand why it was ok for a hospital phlebotomist to be at risk but not the GP one.

It's not satisfactory for patients. I think we need additional community clinics running while hospitals are (understandably) seeing fewer patients because of Covid. It's nuts for you to have a 4 hour round trip for a blood test. But, if your practice is anything like mine, it's already bursting at the seems and short on staff, even without any extra work.