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Martin,
regarding your "complaining GPs" - if you you receive a request and a blood sample for BNP from one of them what do you do with it? Do you say it is unavailable and bin it? Or are you "creative" and analyse it?
Ian Barlow
Scunthorpe
-----Original Message-----
From: Myers Martin [SMTP:[log in to unmask]]
Sent: 18 June 2003 09:21
To: [log in to unmask]
Subject: Re: BNP
Paul,
At the risk of being accused of taking the bait, here goes.....
Paul, I fundamentally disagree with your basic premise. If you ask the
Clinical Biochemistry Community whether they think BNP should be introduced,
then I would bet that 100% would agree. Paul, I will buy you a pint for
every one that disagrees!
The Clinical Biochemist Community have the advantage of being highly
educated, highly trained and are key decision makers in Pathology. We are
however not ivory tower boffins. We have a complex duty of care. A key
duty of care is to provide an appropriate Pathology service, but another
duty of care is to provide a service within the financial constraints of the
organisation (the NHS). The simple truth is that whilst the NHS pretends to
be a National Health Service, it is in reality a Local Health Service.
Primary Care Trusts, run by family doctors, have the budget to purchase
Pathology and if they decide that something else has a priority over BNP
then the Clinical Biochemist would be irresponsible to introduce it (unless
creativity was involved- we've all been there!). When NICE or the NSF says
do something for other areas of medicine, then money gets found. This is
not the same for pathology. If NICE or the NSF think that BNP should be
introduced- just like all Clinical Biochemists- then the organisation in
which we work should fund it. If the organisation does not fund it, then
don't shoot the Clinical Biochemist. Criticising ourselves is futile when
we should be unified and ensure that pathology gets the support provided.
I have GPs who complain to me about not having BNP yet do not appear to
complain to their line managers who have the money! We are an easy target
but we are the wrong target. I, like many Clinical Biochemists have been
trying to get BNP for almost two years. I have another list of tests that I
know should be introduced but am having to fight. I will continue to fight
but I am not the decision makers.
The same argument can be applied to many tests in pathology. We want to do
them but the organisation will not pay.
Lets get into Real Politick rather than self abuse!
Regards
Blood pressure normal, but frustrated with the system not the Clinical
Biochemists
Martin Myers
-----Original Message-----
From: Paul Collinson [mailto:[log in to unmask]]
Sent: 17 June 2003 22:01
To: [log in to unmask]
Subject: BNP
Yet again we see the response of the Clinical Biochemistry community to
a new test
NO, NO, NO, NO, ARGGH, over my dead body, think of my budget, I am here
to deny tests NOT provide a service. What, talk to clinical colleagues,
the temerity of these patients wanting A GOOD MODERN SERVICE, We know
what's good for you, sit down and shut up. AND DO NOT ASK!!!!!
No wonder FOCUS had to run a theme on the value of diagnostic tests.
The data for BNP is beginning to accumulate and is very compelling. Take
your heads out of the sand and start talking to patients, clinicians and
PCT's NOW. Must we again show that UK Clinical Biochemistry is always
the last to innovate?
Personally I am delighted that patients groups are taking an interest.
About time. Look at the troponin fiasco - now the Gold standard.
I begin to wonder if Mr Blair isn't right after all (and many know my
views) - patients seem to be the last that lab folk focus on.
On call U and E only indeed.
PS if your blood pressure is not yet up I have failed!!!
We have been running BNP for 2 years.
--
Paul Collinson
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