Agenda item

Mr Richard Ellis, Joint Borough Lead Director Hillingdon at North West London Clinical Commissioning Group (NWL CCG), advised that phlebotomy was the taking of blood samples for testing and was a basic part of healthcare.  Each week, approximately 3,000-4,000 blood samples were drawn in Hillingdon.  Traditionally, this service had been based at Hillingdon Hospital and Mount Vernon Hospital but the pandemic had highlighted issues with the service in relation to cramped conditions, long waits and PPE, and the safety of the service had come under scrutiny. 

Covid had highlighted opportunities to change the service delivery to better suit patients.  As such, NWL CCG had looked to move to a practice based service which would be in line with how most of the rest of NWL offered the service.  This had been rolled out across Hillingdon between August 2020 and January 2021 and every practice in the Borough was now offering a phlebotomy service.  Mount Vernon Hospital was still providing specialist appointments. 

Now that the changes to service delivery had been implemented, the impact and effectiveness needed to be monitored (for example, waiting times for an appointment, volume of patients being seen at each practice, sufficient capacity for the age and condition of patients, etc).  It was agreed that the Committee receive an update on these issues at its meeting on 7 October 2021 with a pre and post Covid comparison of figures. 

Patients had immediately welcomed the changes that had been made.  However, it was recognised that there were some challenges with regard to some patients preferring a walk in service and high levels of demand for appointments in some areas.  Concern was expressed that some surgeries were only offering phlebotomy appointments before midday to enable to samples to be collected for testing and results made available the same day.  Mr Ellis advised that some practices were doing morning only appointments but that others were offering appointments in the afternoon and early evening.  This was all part of the current learning and conversations would need to be had with the practices so that the right level of resources could be put in place.  It was suggested that patients should be able to get a phlebotomy appointment in another surgery in the Borough if there was no capacity in their local practice. 

NWL CCG was looking at the best way to resource the new service delivery.  This was likely to mean the transfer some of the phlebotomy funding from The Hillingdon Hospitals NHS Foundation Trust (THH) to primary care.  This would also mean that costings would need to be established for the collection of samples from 45 GP practices rather than a single point of contact.  Consideration would also need to be given to the need for urgency on some tests. 

Members were assured that the staff that drew blood at the GP surgeries were trained phlebotomists.  Some had previously worked at Hillingdon Hospital. 

It was suggested that consideration be given to including phlebotomy as a community service.  For example, the service would be combined with things like vitamin B12 injections, blood pressure checks and routine observations to provide a more joined up service to patients.  This would have the added benefit of treating the patients in a more familiar, comfortable and relaxing environment and therefore provide a better result (possibly making it easier to find a vein and leave less bruising on the entry site).  Mr Ellis noted that there was already a service like this provided for housebound patients and those in care homes and consideration would need to be given to extending it further. 

RESOLVED:  That:

1.    Mr Ellis provide an update on the impact and effectiveness of the phlebotomy service changes to the meeting on 7 October 2021; and

2.    the discussion be noted.