Acute trusts have also been told to reduce their usage by at least 25%.
While the general public are concerned with food shortages on the supermarket shelves, they are blissfully unaware of growing concerns amongst the medical profession regarding a shortage of blood specimen tubes.
At the end of July, NHS Supply Chain was notified by the supplier Benton Dickinson Ltd (BDL) of a supply issue regarding gold, light blue, and lavender capped blood collection tubes – claiming that it was a result of significant increases in global demand due to the pandemic.
NHS England is now so concerned about the shortage that it published new guidance calling for delayed student training in the use of the tubes, stopping the practice of double tubing (meaning one sample may have to move to different laboratory areas for testing), using point of care devices for haemoglobin testing, and stopping Vitamin D and infertility testing.
Only clinically urgent tests.
A subsequent letter from NHS England to NHS trusts outlines a severe shortage of 5mls Yellow top – SST 2 – clotted sample (e.g. U&E, LFTs etc), and Purple top – EDTA (e.g. FBC, HbA1c) tubes.
While this letter aims to clarify requests from colleagues on how best to reduce demand in a safe manner, it further restricts blood testing activity by specifying that all primary and community care blood testing must cease until 17th September – except for clinically urgent tests.
Additionally, the letter calls on acute and mental health trusts must reduce their usage by at least 25% up to 17th September.
In response to the NHS England letter, GP and senior clinical advisor at the NHS Confederation Dr Graham Jackson expressed significant concerns; “We have already heard of verbal abuse from patients anxious to have their blood tests… Thousands of appointments will need to be cancelled, adding additional burden to a workforce that is already under significant pressure.”
Absence of a contingency plan.
Additionally, the BMA have expressed their dismay as to how this situation was allowed to become so desperate. BMA deputy council chair Dr David Wrigley acknowledges the need for the further guidance provided but questions the apparent absence of a contingency plan: “It’s not unreasonable to question that there must have been a time when NHS England and the Government knew that blood tube supplies were running low, and therefore, to now ask, ‘Why has nothing been done to mitigate that?’
He goes on to observe that patients will face more cancellations and consequently possible delays in any treatment, which will place medical professionals in a difficult position.
Finally, he asks “what will happen if hospitals or GP surgeries do run out of stock”? Something we would all like to know!