Blood testing capacity issues could be preventing GPs from referring patients with symptoms of leukaemia as quickly as they wish, a survey has shown.
A poll of 1,000 GPs done for Leukaemia UK and Leukaemia Care found that the vast majority of GPs would be likely to refer for a test when a patient presented with unusual or unexplained bruising or bleeding, fatigue and repeated infections.
But of the 30% who said this might not always be possible, more than half said the main factor that would stop them requesting a full blood count would be lack of capacity in blood or phlebotomy services.
There was some variation in responses around the country with GPs in the North East least likely to cite this as an issue compared with the North West.
Lower rates of GPs raising issues with access to blood tests were also seen in Scotland and Northern Ireland, the survey showed.
The charities said the results suggested a need to focus on improving existing services as well as innovation in diagnosis.
More than a quarter of those who listed barriers to sending everyone with non-specific symptoms for a full blood count said there was a lack of clarity in the guidelines about whether this was the best step.
In response to the findings, the charities have written to the health secretary Wes Streeting as well to ask for investment to help speed up leukaemia diagnosis.
Figures from NHS England suggest that 55% of people with acute myeloid leukaemia (AML) are diagnosed at A&E, often when symptoms have progressed, and survival rates may therefore be lower, the charities noted.
Leukaemia UK and Leukaemia Care have also highlighted figures suggesting that with 30% of people visit their GP more than twice with their symptoms before being diagnosed with AML.
It suggests there is a ‘clear window’ to make sure more people are diagnosed following a GP referral for a full blood count test as per NICE guidelines when patients present with symptoms, they said.
Colin Dyer, CEO of Leukaemia Care, said: ‘We welcome the focus on cancer diagnosis from the new Secretary of State for Health and Social Care.
‘However, the UK Government needs to look at the NHS capacity to undertake business as usual activities, such as phlebotomy, in addition to more scanners and expensive projects. Leukaemia is easy to rule out with a full blood count. People should not die early due to an inability to do a simple test.”
Fiona Hazell, CEO of Leukaemia UK, added: ‘It is no exaggeration to say that timely diagnosis of leukaemia through a simple, effective and inexpensive blood test can save lives, yet we know that for many people showing symptoms the NICE guidelines aren’t being followed correctly.
‘That’s why we’re calling on the Government to make sure that the NHS has sufficient capacity to deliver on these important guidelines, offering a full blood count test to those that need it before it’s too late.’
Professor Azeem Majeed, a GP in Tooting and professor of public health and primary care at Imperial College London said in his practice they do their own phlebotomy testing so capacity has never been an issue.
‘We have had difficulty accessing lab tests since June but that it is a local due to IT failures at our provider Synnovis. Once this is resolved, and it is taking a long time, I would expect our lab testing to revert to normal.’
