Actually we agree with the GP's on this one and contact the physician
concerned. As yet we have had no problems which cannot be resolved the
next day (although occasional phone calls to patients have occurred)
However abnormal results to GP's is another story altogether as they
will not take results without contact details but the GP's will not
provide them to the service. We await the first death. One near miss so
far, a K of 7.5 in an known renal failure.
Paul Collinson
Consultant Chemical Pathologist
St George's Hospital, London
0208 725 5934
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Marks Eileen
(RQ6) RLBUHT
Sent: 15 August 2007 09:21
To: [log in to unmask]
Subject: out of hours results
Dear All
The protocol for handling out of hours (OOH) Pathology tests drawn up by
the local provider of OOH GP providers states
"Point 3 Abnormal results generated by samples from hospital
out-patient clinics should be dealt with by the doctors on call for the
relevant specialty, not passed to Primary Care services."
I wrote and pointed out that this is possible for eg the renal team as
there is always someone on call from that team. However, it is not
always possible for the other specialties as no one from those teams may
be available when the abnormal result is generated. Moreover, even if
we did get hold of someone from the relevant team, since the patient is
at home, the doctor would have to contact the patient's GP anyway with
the result - and since the GP is unlikely to be available, the OOH
service will need to be contacted instead.
I just received the following reply from the Medical Director of the OOH
service:
"Point 3 establishes the principle, as recommended by the GMC guidance
to doctors, that the team requesting an investigation remains
responsible for interpreting and acting upon the result. It is
considered unreasonable for an investigation originating in secondary
care to be telephoned to a primary care doctor who has no idea of the
reason the test was requested and has no background on which to base a
decision. If the secondary care team has no member of the team on call,
the result should be managed by the secondary care doctor of appropriate
grade providing cross cover for that specialty."
Has anyone had similar problems with the OOH service and if so, how have
you dealt with them?
Dr Eileen Marks
Clinical Director
Department of Clinical Biochemistry and Metabolic Medicine
Royal Liverpool University Hospital
Prescot St
Liverpool
L7 8XP
Telephone 0151 7064304
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