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There seems to be an trend whereby GPs are becoming increasingly reluctant to bleed their own patients prior to a hospital visit. There seems to be several reasons for this. Firstly, they can be overun by these requests. Secondly, they feel it makes them (or their practice nurse) a lackie for the pompous hospital consultant. Thirdly, providing this phlebotomy is an 'enhanced service' under the new GP contract, so it has certainly been discussed that by withdrawing the service now it means they can introduce it at a later date and get rewarded for it! Eric ----- Original Message ----- From: Mainwaring-Burton Richard (RGZ) <[log in to unmask]> To: <[log in to unmask]> Sent: Wednesday, May 26, 2004 11:52 AM Subject: Re: Assays for patients with diabetes > We also request a pre-visit to either GP or hospital phlebotomy service with > a pro-forma PAS letter which serves as a clinic reminder with a tear-off > "lab request form" for renal, lipid, glycHb and urine alb:creat. > This is not so good for the non-ambulants, so we have a Primus PDQ analyser > in the Diabetes Unit maintained by the lab, but run by the trained DU staff > with results recorded and reported back to our lab LIS. This picks up the > stragglers and is also used for finger/ear-prick samples from kids in the > paediatric clinic. > The lab system is also PDQ but with barcode reading autosampler. > > Feedback from DU is "large majority of patients have results available and > patients mostly satisfied" > > with best wishes > > Richard > > Richard Mainwaring-Burton > Consultant Biochemist > Queen Mary's Hospital > Sidcup, Kent > DA14 6LT > 020-8308-3084 > > > -----Original Message----- > From: Jonathan Kay [mailto:[log in to unmask]] > Sent: 26 May 2004 09:59 > To: [log in to unmask] > Subject: Assays for patients with diabetes > > > Here's the problem: > > 1 We want very high consistency in glycated haemoglobin analysis across > the patch: primary, secondary and tertiary care. > > 2 We are considering assaying glycated haemoglobin, total and HDL > cholesterol, triglycerides and creatinine during the clinic visit for > patients with diabetes. This could be at three sites, > > 3 Capital and revenue costs need to be as low as possible > > 4 Relentless increase in requests for glycated haemoglobin analysis > from primary care > > Because of 1 my first thought was "laboratory-type" analysers for > glycated haemoglobin on trolleys which could be used in the laboratory > and wheeled down and used PoCT in the clinics. This would give high > consistency and low cost but won't give the extended repertoire. > > Air tubes + in-laboratory analysis alone won't solve the problem > because one site doesn't have an on-site laboratory and another doesn't > have enough air tubes. > > Will we inevitably end up with different methods used in the laboratory > and clinic? > > I have a feeling we are not alone in having this problem. Does any one > have good solutions they could share? > > Thanks > > Jonathan > > ------ACB discussion List Information-------- > This is an open discussion list for the academic and clinical > community working in clinical biochemistry. > Please note, archived messages are public and can be viewed > via the internet. Views expressed are those of the individual and > they are responsible for all message content. > > ACB Web Site > http://www.acb.org.uk > List Archives > http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html > List Instructions (How to leave etc.) > http://www.jiscmail.ac.uk/ > > ------ACB discussion List Information-------- > This is an open discussion list for the academic and clinical > community working in clinical biochemistry. > Please note, archived messages are public and can be viewed > via the internet. Views expressed are those of the individual and > they are responsible for all message content. > > ACB Web Site > http://www.acb.org.uk > List Archives > http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html > List Instructions (How to leave etc.) > http://www.jiscmail.ac.uk/ > ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/