Elderly FIL and blood test

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My elderly FIL had a blood test booked for yesterday, which was due to take place in the Phlebotomy dept of his local hospital. He turned up and when it was his turn, was told by the phlebotomist that they could not take his bloods because he had not brought his 'blood form' with him. This is a piece of paper which apparently details the type of blood test he needs. So, he had to go home and I've rebooked it for him.

Is this standard procedure or did he encounter a jobs worth? Surely all the info regarding his blood test is held on the NHS computer? It's 2024, not 1994! I'm really
annoyed that an 86 year old man was turned away and that the staff could not have found a solution to this non problem. AIBU?

@QueenCremant None of the posts are blaming the staff. People are aware that NHS staff are as frustrated as the patients.

The critcism is that this state of affairs has been allowed to develop and has become the accepted norm. There are even people on the thread defending it. How can something as simple as a blood test involve so many steps, and why has the responsibility for negotiating an often inpenetrable and illogical system been passed on to the patient, who often has neither the time, resources or knowledge about how to go about it?

When do you think the GP has the time to do [blood tests]? Clearly some GPs still do this. I have regular blood tests - 3 different tests at a time. It takes the GP or nurse no more than 3 minutes to do this. It would save the patient (in this case the OP's FIL) several hours - and relieve much stress.

Imagine if every patient forgot their form and turned up at the GP needing it done? Clearly not every patient is going to forget their form - but what about a system where they didn't need a form at all? One solution is that everything is done electronically (and I appreciate there are major issues with this). Another is that the GP surgery takes the bloods - as they always used to, as some still do, and as is standard in every European country that I've lived in.

There are just not the staff or resources. Agreed. But there are posts on here defending the situation. There are threads on MN about how the NHS is a black hole (despite successive UK governments choosing to invest far less per person in healthcare than other countries invest) and more threads about how taxation that pays for vital public services is too high (despite the UK having one of the lowest rates of personal tax in Europe).

And we wonder why people with learning disabilities and severe mental health conditions have appalling physical health outcomes.

It was even longer ago than that. When the NHS was tendering for the work I worked for a global tech company who thought they'd won the contract. They didn't. I remember thinking it was a lucky escape for anyone who'd be working on it.

Sorry but all those tests wouldn't just take 10 mins in any country 😕

@Lanzarotelady or the GP could get the patient to book in with a practise nurse, which is what happens at our practise. Often the same day but if not, within a week at most.

And if they can't get blood then the patient just makes another appointment, which is exactly what I had to do a couple of months ago when the nurse couldn't find a vein and ran out of time.

I'm really not sure why people are acting as though the only alternative to a clinic is for GP's to spend over an hour doing a blood test!

Completely standard. They won't know what bloods to take without the form. And they can't look at your records to find out.

It's shocking isn't it? And so many people defending it as normal and getting annoyed when patients (rightly) expect better!

NPfIT was a project that started 25 years ago. Many large Consultancies actually declined to bid for the work, despite it being worth billions and at the time, it was the largest IT project in Europe (if not in the world), because it was deemed by the bid teams to be undeliverable. At the time I was working for Big 5 Consultancy that thankfully did not win one of the contracts. People involved in responding to the Tender had stated openly that they would resign rather than work on the project.

Seperate iterations of multi billion spending. There have been several, each wasting vast sums of money for largely the same reasons.

Standard here as well.

FYI.

I get an annual MOT at my GP surgery. Bloods are taken (by the GP) and I receive the test kit for bowel cancer, a meeting which takes about 5 minutes. A week later I go back and get a 2-page A4 printout of my test results, the nurse analyses the bowel cancer test there and then and I spend 10-15 minutes discussing the results with the GP. The test result sheet includes the last 2-years results, and neat little bar charts that show if each measure is within the normal range, and also whether a particular number has increased or decreased since last time. There are about 24 different items on the sheet (liver function, red cells, white cells, vitamin D, HDL, LDL etc)

On to my annual Consultant check. Firstly, I can book this directly - at a time that suits me - rather then being "assigned" a time. The waiting time for an appointment is rarely more than 2 weeks - last time (in November) it was 6 days.

When I arrive at the Consultant's office and after I check in, I either go directly to the nurse for blood tests (which I did the first time I went) or I give her a copy of the test results that I got from the GP (as long as it is less than 30 days old). I then give a urine sample, which the nurse analyses while I'm waiting to see the Consultant. Once in the Consultant's office we spend 5 minutes discussing the results (he can see them on the system) relevent to this condition and then I'm up on the couch for an untrasound scan and internal exam. None of this face-to-face time with the Consultant takes much more than 10 minutes - 15 minutes maximum. From entering the front office to leaving never takes more than 30 minutes.

Compare and contrast with my experience in the UK before I moved abroad.

After the GP sent a referral letter to the Consultant, there was an 8-week waiting list, and I was eventually assigned a date and time that was not particularly convenient, but so be it.

The GP surgery actually offered blood tests (I had these annually) but the Consultant didn't have these results, and nor did I. I had only been told that "everything was OK" but not given any print-out or any details on the phone.

The Consultant spent 5 minutes discussing the condition, was visibly annoyed that no blood test results were available (he couldn't see them on his "system") and suggested an ultrasound scan.... which would have to be booked with a sonographer as he didn't do these scans himself. So another 6-week wait for an sonographer appointment, and then another 8-week wait for the follow-up appointment. The appointments never ran on time - often the wait was as long as an hour.

All this was happening at a clinic 45 mins drive from home, so entailed taking an afternoon off work and a 3-4 hour round trip.

What takes minutes here in Europe (I've lived in 3 different countries) takes weeks or months in the UK, yet this is accepted as being "normal" and for whatever reason, there are people on here defending the situation and seemingly refusing to see that there might be other ways of addressing the situation.

Yes that sounds extremely efficient! I'm not going to try and defend the UK health system but your experience of NHS is quite different to mine. I can get a GP appointment fairly quickly and blood test results are on my app within 24 hours at most. My nearest GP is 2 mins away and hospital is 35 mins away and usually pretty efficiently run, I've never had to wait an hour. So much in the UK probably depends on where you live too unfortunately .

Honestly this is not unusual - its quite normal in modern healthcare systems elsewhere.

I've had similar experiences elsewhere in Europe - 15 minutes to cover appointment, samples, tests and scan (localised, not full monty). All samples processed in the same site, even if the nurse takes some of them (such as blood), all results digitised - no paper in sight. This is normal patient centric healthcare in most developed countries - and its a lot cheaper to operate than fragmented and disjointed care.

That latter is the big frustration - the entire bureaucratic mess doesn't even save money!

Just because it happens at your practice, doesn't mean it happens at every practice, why is this concept so hard to grasp for some people.

Except our clinics are already full to bursting from open to close. If we did bloods on the spot for the GP for every patient that needed then they'd have to free us up from doing something else such as vaccinating babies or taking smears or I'd be there until midnight.

I work for a large NHS trust in the North West, 4 hospitals, One all computerised, very little paper, one of the other trusts in the same alliance, all paper!
We are the same trust!

@Evencloserties My nearest GP is 2 mins away and hospital is 35 mins away and usually pretty efficiently run, I've never had to wait an hour. So much in the UK probably depends on where you live too unfortunately

Indeed. There are some really efficient and effective NHS services, even down to individual GP surgeries, and yet others are seemingly still stuck in the 1970s. My biggest frustration when I worked in the NHS - which I did for 4 years - is that those areas which are struggling are seemingly unable or unwilling to learn from the better organised and better managed services. (My second biggest frustration was that quite often, the better run services were unwilling to share their knowledge and experience about how to improve with anyone else).

@C8H10N4O2 "the entire bureaucratic mess [in the UK] doesn't even save money!"

Not only do the inefficiencies cost money, but more importantly, they erode trust in the NHS (making it more difficult to attract and retain staff, and easier for certain politicians to attack and starve of funds), they frustrate patients, patients' families, friends, neighbours and employers - and ultimately they end up "costing" people their physical health as their treatment is delayed or their mental wellbeing if they are unable to navigate the labyrinth of often illogical processes and the special NHS language.

I know this - but surely sending patients miles away to a clinic that then relies on a piece of paper and has no fallback option is not really a sensible option in the 21st century.

One alternative, suggested by several posters, is that on-the-spot bloods are made available for certain patients only in exceptional circumstances - in the OP's case, the patient was an elderly man with cancer and reliant on others for transport to a clinic many miles away.

[There's a completely different discussion to be had about why clinics (and hospitals, and GP surgeries etc) are full to bursting and therefore unable to offer truely patient-centric services]

Well for one thing - decades of propaganda about "the" NHS.

However I read that post differently. If one trust or practice can do something well why cannot others learn from it? And its a damned good question because IME of working with parts of the NHS the utter intransigence and resistance to learning even from each other let alone other countries or sectors is mind numbing. @Havanananana is spot on.

Just because it happens at your practice, doesn't mean it happens at every practice, why is this concept so hard to grasp for some people.

But that's my point It's clearly not impossible so why can some practises manage it with no issue and others can't?

Thanks @C8H10N4O2 that's exactly what I was trying to say. It can quite clearly be done, and done well, so we should be looking at why that's not the case across the board.

Thats like asking why M&S have different policies to Primark, but they both sell knickers.
Each GP practice is a business, they run their business in the best way they see fit, they employ staff etc, although they are part of the NHS, they are completely separate entities.

And different businesses contracted to provide the same services to the "same" entity can't learn from each other?

Bloody hell, that will be a shock to just about every other sector, private or public, on the planet.

Oh and incidentally - M&S and Primark so spend a lot of time and effort analysing each others' supply chains, products, processes precisely because they do want to learn from each other - that is where improvements come from. It is normal practice in every other industry and public sector.

In my experience the usual reasons are trotted out:

Well, we're different here in "Thistown" - what works in "Othertown" and "Anytown" won't work here.

Well, that's all very well but "Process X" wasn't invented here, so we don't have the time to analyse what they did in "Othertown" and we're not willing to give people time to go and look at what they're doing differently over there.

Well, we tried something like that once before - about 20 years ago - and it didn't work then. No - nobody knows why and there's nobody around from then to explain what worked and what didn't.

Who are you to tell us that things need to change. We've got a well-oiled system and it doesn't need changing - despite our waiting lists being years long and staff leaving in droves.

(and one from the business world) We're very good at managing complaints - we handle thousands a year, all within our target times. [Erm ... how about striving to avoid getting complaints in the first place ..?]

I agree its bloody laughable, I can go to the other side of the world and take £10 out of my account and my bank account is updated instantly
I can go to Bolton A&E, Salford A&E, Wigan and Manchester and not one of those systems talk to each other! Its a bloody joke.