Agenda item

Mr Richard Ellis, Joint Lead Borough Director at North West London Integrated Care System (NWL ICS), advised that the move of phlebotomy to GP practices had taken place almost two years previously and it had been anticipated that it would have capacity for around 185,000 blood tests per year.  This year, the service was on track to do approximately 165,000 tests so there was still some capacity in the system.  It was noted that the actual number might have been lower than anticipated as the new system prevented some patients from having unnecessary repeat tests or the original data might have been incorrect. 

Members were advised that there had been a small logistical issue at one point in relation to a nation shortage of the bottles used to store the blood samples but that this had been resolved within 6-8 weeks.  Although the majority of blood tests were routine for the ongoing monitoring of a patient's health and could wait for three days for the results, a new urgent blood test provision had been introduced that could get results by the end of the day.  If the sample was taken in the morning, the results could be relayed by the GP to the patient in the afternoon.  If the sample was taken in the afternoon, the results could be relayed to the patient by NHS 111 if the GP practice was closed. 

Mr Ellis noted that staff that had previously been employed at Hillingdon Hospital in the phlebotomy service had been given the opportunity to work in the GP practices when the service had transitioned (although there was still a phlebotomy service available at the hospital).  Health Care Assistants (HCAs) had been given the opportunity to retrain as phlebotomists but there had been some delays.  Some practices had felt that they were not able to provide the phlebotomy service and had made arrangements with another practice to do their phlebotomy for them.  High demand had caused some bottlenecks in the service which had since been resolved. 

The concept of one GP practice providing services for another was being investigated further.  Consideration was being given to the provision of tests such as ECGs across practices.  The use of north, central and south hubs was also being looked at for the provision of diagnostic services so that local services could be arranged locally.  Members were assured that these hubs would be based in an NHS GP practice.  Dr Ritu Prasad, Co-Chair of the Hillingdon GP Confederation advised that the hubs would be GP-led, similar to the extended access hubs that were currently available in the Borough that were accessible to patients. 

There had been a significant increase in the number of request for GPs to carry out bloods on behalf of hospital departments and community services when the service had been modelled on GPs only managing this work up to the time when a patient attended hospital.  As well as impacting capacity, this raised clinical governance issues as responsibility to manage the results fell to the clinician that requested the test when the GP might not know why the test had been requested.  This was being addressed by the NWL ICB Primary Care Team. 

Members had received next to no recent complaints from residents about the new delivery of the service and were reassured that the challenges faced had been addressed. 

RESOLVED:  That the discussion be noted.