To wonder why I've been refused a blood test?

[NotAHouse]

Impossible to get a speedy doctor's appointment at my surgery, so I filled in the online form asking for my iron levels to be checked. I've been feeling dizzy for months and headachey with low mood, and I've had low iron before.

GP has responded today asking me to schedule a routine appointment instead. None available for a month. Why? I've told them my symptoms, I'll just be repeating the same thing over the phone in a month. I've booked it but not thrilled.

Are they now cheaping out on blood tests or could there be some other reason?

No kidding. I'm waiting for a post saying "Why do you have blood anyway? FFS!"

Thank you for all the helpful suggestions. For those of you who don't know how blood tests or anemia work, y'all have a good one.

I have had low iron before and just go and get the pills from the pharmacy. They aren’t OTC but you can buy them without a prescription. It’s actually cheaper than having them on a nhs prescription.

My doctors know I do this and have no issue, if it didn’t solve my issue then I would make a doctors appointment.

You have flagged up symptoms that your doctor wants to explore before taking the easy option and just requesting a full blood count or iron test. Dizziness is a common symptom with many causes and GP wants to get a history and if required order the appropriate tests.The test is requested by them at the end of the day , if you want to bypass the GP pay for the test.

I've been experiencing the same symptoms, including lethargy.
Did an online consultation, was offered a nurse phone appointment for two days later.
Nurse phoned me, discussed symptoms and said I needed to book appt for blood test.
I had to phone reception to book the blood test (quite quick answer time, fifteen minutes)
Test revealed serious folate deficiency, B12 just on the absolute minimum level acceptable and nurse said I had to buy over the counter B12 but they've prescribed folate for me (free prescription as I've a medical exemption)

I feel fortunate to have been sorted quite quickly, but I do know I'd feel much better if I had a B12 injection regularly. I'm not low enough yet 😞

@NotAHouse

In a nutshell, I have every sympathy with you. I know when my symptoms need treatment..
NHS going to pot unfortunately

indeed. having had symptoms for months it’s a bit stupid to think you can one day think ‘right, time to sort this’ and expect to phone the surgery and request whatever tests you deem necessary and then complain that they don’t instantly comply. on the flip side, you say you know what the issue is: so why haven’t you asked for the required treatment from a pharmacist?

I'm not sure you understand how GP budgets work!

I don't get it… instead of just saying "sure, here's your basic blood test", they've asked her to book one of the limited available appointments with a trained, experienced medical practitioner, to do a proper evaluation of her symptoms and make sure there's nothing else going on. Isn't that better than just relying on the patient guessing right and letting something potentially serious go unnoticed for longer?

You would think so eh?

I recently filled in an econsult for much the same thing, had a few symptoms and knew something was low, just not what do I requested a blood test. Receptionist phoned me the next day to make a bloods appointment and sure enough couple of things were low.

I had something similar recently. I think it's standard protocol with GPs. I was tired all the time. Went to the GP, explained my symptoms and then had the blood test a day later. Turns out it wasn't an iron deficiency, but I had a folate (b9 folic acid) deficiency. Just told to buy some folic acid from the pharmacy.
I may be dumb here, but I honestly didn't realise you could need folic acid when not pregnant. I take other vitamins on a regular basis (vitamin c with Zinc and Elderberry, Vitamin D, Vitamin A, B12 and cod liver oil). Never occurred to me to take Folic Acid. 🤷🏻‍♀️

Did you go to medical school? A GP has spent 5-6 years at medical school and then 5 years training on the job plus however many years they've actually been a qualified GP. Their job is not to just prescribe/order whatever people want/feel they need!

If the GP just ordered a ferritin test and neglected to properly review OP, they would be in hot water if it turned out there was another more sinister cause of her symptoms.

Apologies @mybest, I was trying to respond to @TDoginHats - whoops!

Probably depends on exactly what you said, and the clinical judgement of the doctor reviewing your econsult. I wouldn't blame any doctor for making a judgement that a particular patient needs to have an actual consultation. Their careers are potentially at stake when they make decisions about which patients need to be seen by a doctor and which can just have a test ordered for now.

My GP arranged the FBC and iron studies that I requested via the online consult without needing to speak to me. They also did a script for iron, and were quite amazed that I'd been able to arrange an iron infusion at the hospital - I dont absorb oral iron due to having half my bowel missing (patients are clearly not supposed to be able to do things like that!)

It’s because there are other things that can cause the symptoms you’re experiencing. A blood test might still be appropriate and they might well refer you for one, but they would need to know what other things to request that the sample is checked for. You’ve had low iron before, but that doesn’t mean it couldn’t be something else this time. I think the online form is for people who are on certain medications and need regular checks, rather than for people who just think they might have a deficiency. I can see why it’s annoying for you but ultimately it’s good that the GP is aiming to rule out other concerns.

A blood panel costs the NHS £8000 so no wonder GP wants to see you first.

I've no idea what you're on about but normal routine blood tests cost the NHS a few quid including staff time. Under a tenner for most of the ordinary stuff.

Only a clinician can order a blood test, not a receptionist or secretary etc. Therefore you will need to be assessed by a clinician before the blood tests are ordered. In the grand scheme of things, this is not an emergency and is also something you can have a go at addressing by yourself with over the counter iron supplements.

😂 what the fuck?!

They'll want to see you because it could be anything causing those symptoms. You can buy the same iron tablets that you would be prescribed by going to a chemist and asking for them.

£8000 🤣🤣🤣 8000 rupees maybe, not pounds.

I get why you’re annoyed but it’s hardly cheapskate policy. Depending on the test it can cost hundreds for a blood test, they need to make sure that it’s required.

A diagnosis is not made solely on the basis of a blood test, they are one piece of the puzzle but won’t give the whole
picture. Any results need to be considered in context and to do that they need to take a proper history, possibly an examination, and to consider your past medical history and any social factors that could be relevant. It sounds to me like the want to do a thorough job, rather than just fobbing you off with a blood test which may or may not give you the information you are hoping for.

I think the reason I'm puzzled is because being shoved in the direction of a blood test and then fobbed off has been the standard MO for the last 25 years. Guess I'm not used to them actually wanting to consult with me.

Anyway, I'll speak to a pharmacist for iron supplements while I'm waiting and hope for the best. I have been taking some supplement but I'd been told by a pharmacist that they can take up to 6 months to rebuild iron stores. Hopefully it'll take the edge off.

My dizziness has been getting more and more frequent over the last few months, by the way. Its not like I woke up one morning feeling like a spinning top. I'm sure I'm not alone in trying to ignore a vaguely bothersome symptom hoping it will resolve itself until it's clear it's not buggering off as hoped. Especially given that speaking to the GP since covid is harder than getting into Fort Knox. Plus 6 week hols etc. Stand down, health gatekeepers.