One Care has been involved in supporting general practice and system partners to develop a new process for taking bloods in community settings.
Prior to the Covid pandemic, there were 18,000 bloods taken across general practice and acute outpatient departments every week via the North Bristol Trust (NBT) and University Hospital Bristol (UHB) labs, with additional bloods being done at Weston General Hospital.
For many years, general practice has taken outpatient bloods on behalf of secondary care (hospitals), taking responsibility for both the phlebotomy but also the interpretation, communication and risk holding associated with these blood results.
This has been a significant workload for practices, but they have not been contracted to do the work. It is beneficial for patients to have their bloods taken in general practice as it means they can access care closer to home.
The community phlebotomy programme – otherwise referred to as secondary care bloods – has sought to address the governance of this work, ensuring blood results are returned to the requester in secondary care and to properly resource general practice to deliver this service. Over the last year primary and secondary care have been working together, supported by the CCG, to establish a standard process for this, putting patient experience and safety at the heart of the programme. This collaborative approach saw general practice and the trusts working as equal partners in the design of this new way of working.
The community phlebotomy service was fully launched on 31 October after a soft launch on 1 July, which saw primary and secondary care all working to the same standard operating procedure. Primary and secondary care will continue to work together with the CCG in this new phase of the programme to ensure a smooth transition into this new way of system working and to scope out further potential for development.
One Care have been well placed to support practices in the programme’s development due to the trusted relationships already established with practices.
As an integral part of the working group, One Care was involved in the first aspects of building up the business case for the programme, including initial data collection to confirm phlebotomy volumes and negotiating an item of service fee so practices were sufficiently remunerated for the work.
Throughout the programme, which has supported the outpatient transformation in a clinically safe, understood, and funded way, One Care has provided support for practices, in the form of regular communications, training for practice staff, trouble-shooting issues practices are having and developing EMIS resources to support the programme.
The next steps will see One Care analyse the data being collected to monitor the numbers of secondary care bloods being done in primary care and develop a dashboard to present this information back to practices. This data will also be used to monitor the success of the programme and will highlight any areas for improvement.
GP Collaborative Board Coordinator Rosie Southwell said: “A huge thanks goes to Nicola McGuinness (GP Collaborative Board lead) and Geeta Iyer (CCG Primary Care Development Clinical lead) for their leadership in the programme.
“It’s been really inspiring to see how general practice can influence positive change in the system when we come together with one voice. This has been one of the first programmes of work driven forward by our newly formed GP Collaborative Board.
“Practices have been really supportive and engaged throughout the programme – the feedback we’ve received has been extremely encouraging.
“We have lots of learning to take forward into the future as partners across our system begin to work even more closely together in an Integrated Care system. This is a great example of what can be achieved when we work collaboratively to find a solution that works for our population.”