The Brexit-exacerbated blood bottle shortage: why your doctor may not be able to offer you the blood test you need. UPDATED

About a fortnight ago we saw medics and commentators expressing concerns over shortages of blood bottles. Research indicated that this was a worldwide phenomenon created by the massive hike in demand as a consequence of the pandemic. Now it appears that Brexit is exacerbating an already difficult situation with supply chains interrupted by border issues and transport shortages.

Becton Dickinson, one of the world’s largest manufacturers, said this, two days ago:

“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 challenge”

What does this mean for GP surgeries and hospitals?

We have had sight of the letter sent to clinicians at a major hospital:

NHS England have asked us to take some urgent action because of the shortage of BD  tubes.

Primary Care and community care

All primary care and community testing must be halted until 17 September 2021, except for clinically urgent testing, like:

• Bloods that are required to facilitate a two week wait referral

• Bloods that are extremely overdue and/or essential for safe prescribing of medication or monitoring of condition

• Bloods that if taken could avoid a hospital admission or prevent an onward referral

• Those with suspected sepsis or conditions with a risk of death or disability

Acute trusts, community hospitals and mental health trusts

Acute and mental health trusts must reduce their demand by a minimum of 25% for the three-week period up to 17 September 2021.

These reductions should be made in line with the guidance on recommended actions and can include a combination of reducing non-essential (non-clinically urgent) testing, optimising inpatient and assessment unit sampling, encouraging add-on testing to reduce the need for blood tube usage, increasing use of point of care haemoglobin devices, reducing daily testing where possible and ensuring greater senior clinician input in requesting tests.

All of these measures should be undertaken where safe to do so.

Daily reporting on blood test activity for urea & electrolytes and full blood count, compared with the same activity data from June and July 2021, will be established to monitor the effectiveness of the reductions. Further information on this reporting will be shared shortly.

Full guidance here.

NHS Supply Chain has obtained some BD tubes [that had] previously been part of European stocks, but manufactured in the UK. While these stocks will help, supply of the BD blood tubes will remain constrained. The label is slightly different. The label on the European stock is blank, with no guidance on which Patient Identifiers to add onto label.

This stock is going into the supply chain from next week so your organisation may receive deliveries of these tubes. These should be used in the same way as the UK stock.

GP Online reported deputy chair of the British Medical Association Council (BMA), Dr David Wigley as saying:

“Unless in exceptional circumstances, doctors have been advised to temporarily stop vitamin D testing, as well as screening for pre-diabetes and blood disorders such as dyslipidaemia, along with allergy testing and routine infertility testing,’

This puts doctors in an invidious position and comes on top of the strains caused by the pandemic. It will, of course, be difficult to quantify the impact on patients’ health and outcomes from a missed or delayed test, but the tests are not done for fun, are they? Already there are stories of patients on kidney dialysis forgoing tests and stage 4 cancer sufferers missing out ahead of the prescription of chemotherapy medication.

BREAKING: The UK now cannot do most blood tests. No tubes. GPs are forced to ration. Read this BMA press release from last night. “At a very perilous point”…

From Prof Stephen Powis, NHS England medical director.

Originally tweeted by Anthony Costello (@globalhlthtwit) on 29/08/2021.

This, surely, is a Brexit cost that even the most ardent Brexiter will find intolerable to bear or is the destructive ideology so baked in that our government is willing to stand by and put patients at risk and the medical profession under insupportable stress and strain? Ask your MP what he or she thinks. If you get a response, please let us know.