NHS England has issued guidance urging doctors to stagger blood tests if clinically safe due to global supply chain issues at BD, which supplies collection vials to the NHS.
BD says it has faced unprecedented demand for the products due to the need for tubes to test for Covid-19. Demand has also increased now that routine blood testing procedures that were delayed at the height of the pandemic have resumed.
BD has also said it is facing “transportation challenges that have affected all industries, including port and transport capacity, air freight capacity and UK border challenges”.
NHS England has now temporarily suspended fertility testing for patients under 35, screening for pre-diabetes, allergies and some non-urgent blood disorders. Routine wellness screening has also been deprioritised, as has Vitamin D testing except in exceptional circumstances. GPs have been urged to stagger regular blood tests if clinically appropriate.
The guidance states that there are global shortages of blood tube products beyond those produced by BD. Clinicians have been urged not to stockpile the products they do have access to and continue to maintain normal order levels.
Medical student training that involves the use of blood tubes has also been delayed until the supply disruption has been resolved, with catch-up training to be required instead. Double tube practices are also to be halted, with the exception of blood transfusions.
Point-of-care devices should also be used for haemoglobin measurement in settings such as critical care and operating theatres, rather than using blood vials, NHS guidance stated.
The NHS says that work is ongoing between the Department of Health and Social Care (DHSC), NHS Supply Chain and BD to resolve the disruption.
Similar guidelines have also been issued by NHS Wales, where tests for patients at immediate high risk will be prioritised for the next three months. Doctors in Wales have also been advised not to collect blood if patients are referred straight to secondary care.
Supply issues could worsen NHS backlog
Patients across the country have tweeted about the difficulties the NHS blood vial shortage is already causing, with their practices cancelling their blood test appointments.
So both my partner and myself have received this text from our respective GPs. WTAF?! Anyone else had this? Anyone know why? Is this another consequence of B**x*t? pic.twitter.com/IqhnXeaS2V
— leftieOAP 🌼🍰🐬🐙🐞🐷🐈🐕Julie (Jools) Holland (@leftiebitch) August 25, 2021
Had to take my daughter for a blood test this morning. The clinic told us they’re being asked to only book urgent tests now due to a shortage of vials. More #Brexit issues??
— JoJeffers 💙 (@just_j0) August 24, 2021
The British Medical Association (BMA) has warned that a lack of tubes could worsen the backlog already faced by the NHS due to the Covid-19 pandemic.
BMA council deputy chair Dr David Wrigley said: “While NHS England has provided some guidance for clinicians to follow, no doctor wants the consequence of delayed diagnosis for patients due to these shortages, and they also need to know they are protected from any possible negligence claims.
“We need to have adequate supplies of these tubes resumed, without further delay, and it is vital, going forward, that processes are put in place to ensure that supply chains of medical equipment are maintained at all times.”
BMA Cymru chair Dr David Bailey said: “We have raised our concerns about the impact this could have on regular tests for NHS Health checks, the monitoring of quality of care, and medication reviews particularly as some patients will have gone without their routine chronic disease monitoring reviews during the Covid-19 pandemic.”
An NHS Supply Chain document states that in response to the shortage it has obtained some BD tubes that were previously part of European blood vial stocks but were manufactured in the UK to help keep up with demand.
While the labelling on the European stock is different to the UK stock, the products are functionally identical and can be used in the same way.