Blood bottle shortage in the NHS

There is a shortage of blood bottles in the NHS. Here is why.

There is a shortage of blood bottles in the NHS. Here is why.

There is a shortage of blood bottles across the entire of the UK.

The company Becton Dickinson supply the blood bottles that we used to test patients’ blood across the entire of the UK and in most places across the world.  Unfortunately, due to increased testing because of Covid and because of the backlog of patient activity now there’s a shortage of his blood bottles which is causing a strain on the NHS.

Why has this happened?

This is in part due to changes with resources, increasing demand, and problems with international distribution like the Suez canal incident and in the UK. It is made worse due to port changes, lorry driver shortages, and other aspects caused in part by Brexit.

As a result, NHS England has announced that there should be a reduction and rationing of the types of blood tests that are done across the entirety of the UK.

There was previous guidance issued on 10th August about checking stock, maximising the use of existing supplies, and looking at alternative supplies and options. Alternative supplies has been hampered by the worldwide use and distribution issues.

On 26th August NHS England has recommended a rationing of blood tests to survive this crisis. This relates to:
1. 5mls Yellow top – SST 2 – clotted sample (e.g. U&E, LFTs etc)
2. Purple top – EDTA (e.g. FBC, HbA1c)

This shortage is an immediate issue likely to continue till mid-September but may continue to occur in the next few months.

Changes include (taken from the document)

All primary care and community testing must be halted until 17 September 2021, except for clinically urgent testing.
Examples of clinically urgent testing include:
• Bloods that are required to facilitate a two-week wait cancer referral
• Bloods that are extremely overdue and/or essential for safe prescribing of medication or monitoring of conditions
• Bloods that if taken could avoid a hospital admission or prevent an onward referral
• Those with suspected sepsis or conditions with a risk of death or disability

In hospitals, each area is asked to make a 25% reduction in blood testing using add-on policies and local laboratory guidance. There will be monitoring on activity in the hospital especially UE and FBC testing.

Testing for routine things like wellness checks, vitamin D*, fertility testing* allergy testing* with some minor exceptions for these recommendations.

The guidance accepts this may cause harm.

There is an ask to support other local areas, and routes to do this if shortages are expected within 48 hours.

The guidance also states that regulators have been informed including CQC and NHS resolutions and that any complaints as a result of the shortages will be captured in the Clinical negligence scheme for GPs and trusts, respectively. This unfortunately is not the directive many practices would hope for as it doesn’t help manage the complaints directly sent to the practice.

Possible implications

Risk to patient health of delay in diagnosis and possible inability to test for vital issues if the shortages are worse.

Risk of increased complaints to practices and NHS services due to delays in blood testing

Further compounding the backlog of work that is building due to COVID and now a blood bottle shortage

Further delay in referrals where they are required ‘mandatory blood tests’. Noting these have been recommended to stop due to the shortage but communication on this may take time to filter.

Hospitals transferring work to the community and GP to have bloods done due to shortages where these shortages may be even more dire causing confusion and delay and further harm.

Impact on practice workload with a reduction in QOF income as the inability to do the work General Practice is meant to do.

Possible actions

Stock check your existing supplies and review your policies

Inform your patients via practice website, social media and possible sms campaigns feel free to site to this video

Consider bulk adding to all records, or shortcuts when issuing blood tests about the ‘instruction to ration blood test as per guidance B0933 from NHS England on the Becton Dickinson blood specimen collection – supply disruption(26.8.21)’ to manage any future complaints.

Work with ICP and local hospital trusts to prevent the inappropriate transfer of work due to shortages. We are all in this together. Consider changes to referral pathways.

Becton Dickinson blood specimen collection – supply disruption…

Becton Dickinson Blood Specimen Collection Portfolio supply disruption 10.8.21:…

Minimum testing guidance by RPATH:…

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