Blood tubes shortage sees GPs across Yorkshire start cancelling 'non-urgent' tests

All primary care and community testing has been halted until September 17 except in clinically urgent cases as a result of the shortfall, while hospital and mental health trusts have been ordered by NHS England to reduce their usage levels by at least 25 per cent.

While supply is expected to improve from the middle of September, NHS England has said overall supply “is likely to remain challenging for a significant period”.

Practices across Yorkshire have started contacting patients to advise them appointments may be cancelled or rearranged after being reviewed to assess whether they fall into the urgent category.

Health centres in Sheffield have been texting patients about the issue and posting the following message on their Facebook pages: "Due to a global shortage of blood testing tubes, NHS England have instructed all GP practices to cancel all routine and non urgent blood tests immediately.

"We are awaiting further guidance from NHS England who are monitoring the situation. We are expecting this to be in place up to and including September 17, however we will update you should this change."

Examples of clinically urgent tests that should still go ahead are those for people with suspected sepsis, ones that could avoid a hospital admission, those that are required to facilitate a two-week referral to hospital and those that are essential for the safe prescribing of medication or monitoring of a condition.

Tests that are deemed non-urgent are being rearranged for later in the year.

The UK has secured millions of additional blood tubes to help deal with the shortage, with nine million being diverted from the US to the UK this week and more planned in the coming month. Shortage problems have been blamed on extra demand for testing on Covid patients and routine testing for procedures delayed by the pandemic, as well as "UK border challenges" among other issues.

On Tuesday, it was announced that medical technology company Becton Dickinson (BD) had received “exceptional use authorisation” to import blood tubes into the UK.

A Department of Health and Social Care spokesperson said: “We have secured tens of millions of additional blood tubes, including importing additional supplies from the EU and the US, which will be available to the NHS soon and there continues to be stock in place to ensure clinically urgent testing continues.

“Patient safety is always the top priority and we continue to work closely with NHS England, the devolved administrations, and the NHS to minimise any impact on patient care.”

BD also said it has completed recent improvements to its manufacturing facility in the UK that has “increased production capacity by 20 per cent” to help alleviate the backlog of orders.

Earlier this month, NHS England issued guidance amid a global shortage of blood tube products.

Dr David Wrigley, BMA council deputy chair, had labelled the situation a “crisis” which put doctors in a “terrible, unenviable position”.

A BD spokesman said last week there had been “unprecedented” demand for its vacutainer blood collection tubes in recent months.

This was driven by the need for tubes for testing for Covid-19 patients, as well as routine testing for procedures delayed due to the pandemic.

He added: “In addition to increased demand, we are seeing continued transportation challenges that have affected all industries, including port and transport capacity, air freight capacity and UK border challenges.

“Suppliers are also challenged to meet increased demand for raw materials and components.”

On Saturday, Dr Wrigley said: “This crisis has put doctors and their patients in a terrible, unenviable position. No doctor knowingly undertakes unnecessary blood tests and to now have to ration all those we are doing, as well as cancel hundreds more, goes against everything we stand for as clinicians.

"However, if we don’t try to follow the NHS guidance, it’s clear we will get to the point where even the most clinically urgent of blood tests may not be able to be done as we simply won’t have the tubes for the blood to go into. We are at a very perilous point and it’s surprising that NHS England hasn’t declared a critical incident given the very strong possibility that NHS organisations may temporarily lose the ability to provide lifesaving diagnostic testing.”

He added: “Many GP practices – like mine – will now have to spend hours assessing which already scheduled tests can or cannot be cancelled and this takes time away from frontline patient care when it is most needed. Cancelling tests makes patients anxious and can mean a missed diagnosis.”

Dr Vishal Sharma, BMA consultants committee chair, said: “The very suggestion that an acute hospital trust needs to reduce testing by 25 per cent is highly alarming. However, to try and avoid a situation where there are simply no more blood tubes, we have no choice but to now make very careful decisions about which tests to carry out. It is shocking that this situation has been allowed to develop - in particular, the apparent over-reliance on one manufacturer and the woeful lack of any kind of reserve supply.

“The manufacturers should also have to explain how they allowed stocks to run so low that patients will now suffer as a result. If we don’t get on top of this shortage – and quickly – then we could very easily end up in a catastrophic position, particularly in hospitals where patients come to serious harm.”

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