We stopped FOB testing on 4th May 2009 after consulting the gastroenterologists. A 6 month audit of FOB requests showed that 58% of the requests with legible and relevant clinical details mentioned anaemia, bowel symptoms or previous treatment for bowel cancer and were considered to be symptomatic. Of the 44 patients with positive results only 24 had any  lower GI investigations recorded within the Trust.

Before stopping the service the usual memo was sent to all GPs, consultants and junior medical staff. There have been isolated enquiries from GPs which are satisfied by explaining the poor sensitivity of the test. 

We have had a negative reaction from PCT managers because they were not consulted. This is the first time they have reacted to a change in service and we will be setting up a mechanism to alert them to changes in the future.



Elizabeth Hall

Elizabeth Hall, MSc FRCPath
Principal Biochemist,
Biochemistry Department,
Kent and Canterbury Hospital,
Ethelbert Road,
Canterbury CT1 3SF
Tel 01227 766877 ext 74469
Fax 01227 783077

>>> "Ridgwell Pauline (RC9) Luton & Dunstable Hospital TR"              <[log in to unmask]> 07/08/2009 14:16 >>>
After consultation with our gastroenterologists, we have decided to stop
faecal occult blood testing from 1st September but have no plans (as
yet) to replace it with immunochemical testing.  It was felt that with
the introduction of the bowel cancer screening programme, it was
inappropriate to test asympotomatic patients in the local laboratory.
For symptomatic patients, requesting clinicians are referred to
guidelines from NICE.
 
 NICE guidelines for referral for suspected GI cancer
(http://www.nice.org.uk/nicemedia/pdf/CG027quickrefguide.pdf) 
 
I have only had one response from a GP that is unhappy about this to
date, but we have not stopped doing faecal occult bloods yet!
 
Pauline Ridgwell
 
Consultant Clinical Biochemist
Luton & Dunstable Hospital
 

________________________________

From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Hutton, Hazel
Sent: 06 August 2009 15:40
To: [log in to unmask] 
Subject: Faecal Occult Blood - Advice please



Dear All

 

We are reviewing our faecal occult blood service and I would be
interested to hear if any departments have stopped faecal occult blood
testing without any problems from associated PCT's. We know that the
service is not being used correctly but are unsure how to go about
improving it. Any advice would be welcome.

 

I have been reading Callum Frasers annals article but feel the
implementation of immunochemical testing would not be cost effective for
us with the PCT's unlikely to fund testing, so what do other labs do? 

 

Thanks for your time

Hazel

 

Hazel Hutton

Clinical Scientist

University Hospital of North Staffordshire

 

------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/ 

P Save Paper - Do you really need to print this e-mail?

**********************************************************************
This e-mail is confidential and privileged. If you are not the intended recipient please accept our apologies; please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents: to do so is strictly prohibited and may be unlawful. Please inform us that this message has gone astray before deleting it.

The information contained in this e-mail may be subject to public disclosure under the Freedom of Information Act 2000. Unless the information is legally exempt from disclosure, confidentiality of this e-mail and your reply cannot be guaranteed. Thank you for your co-operation.
**********************************************************************


------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/