As a GP practice, we are currently trying to manage a huge and unprecedented rise in workload, in part fuelled by a rise in requests from hospitals and other clinics for us to do blood tests/ECGs on their behalf. We have a duty of care to our patients to provide core GP service, which means that we need to be able to offer appointments to our patients for tests that the practice GP or nurse has requested.

The rise in hospital requests is putting a strain on this and meaning our patients are having to wait longer. In addition, patient safety issues can arise when results come back to GPs who are not experienced in managing complex hospital specialist issues.

For these reasons, we have put together a policy to explain which tests we are able to offer in the practice and which we are not. Some tests will require prior approval by a GP before an appointment can be booked, and these requests may be rejected. We will endeavour to respond to you within a week to let you know the outcome of your request.

Blood test requests which we will arrange without need to check with a GP:

• Post hospital discharge bloods – no more frequent than a week (e.g we are not able to do daily bloods at home)
• High risk drug monitoring when we have signed an agreement with your specialist to do this.
• Heart failure nurse requests
• Diabetic specialist nurse requests
• Dementia support worker requests
• Drug and alcohol team requests
• (FCP) Practice based specialist MSK clinician requests

Blood tests which we may do in some circumstances, but will need approval from GP/nurse prior to booking appointment:

• Any requests which ask us to forward the results to hospital/specialist
• Fertility clinic requests
• Requests from outpatient NHS clinics
• Requests from private clinics
• Psychiatry/CMHT requests

Blood tests which we do not do in GP practice:

• High risk drug monitoring during initiation, before shared care in place
• Pre-op checks

ECGs which we will routinely do in practice:

• Annual ECG monitoring for patients established on antipsychotics

ECG requests which require a check with GP prior to booking:

• Requests from elderly mental health team/memory clinic

ECGs we do not do in GP practice:

• Children (age <18)

ECG requested by specialist for check prior to starting medication – e.g psychiatrist/ADHD:

• Pre-op ECG