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11
WQ.402/2019
WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY C.S. ALVES OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 8th OCTOBER 2019
Question
Will the Minister advise –
- under what circumstances, if any, requests for investigations submitted by primary health care providers are rejected or not processed by the Hospital and the reasons why this may occur; and
- under what circumstances specimens taken by primary health care providers would be rejected or not processed by the Hospital and the reasons why this may happen?
Answer
- Some investigations (for example, x-rays) can have a negative impact on people's long-term health as well as a short-term diagnostic benefit. Choosing to conduct these investigations involves weighing up the clinical benefits against the risks. The hospital follows national and local evidence-based best practice to decide whether a requested investigation is clinically effective and in a patient's best interests. Occasionally, a request from a GP may not be accepted if another clinician who is expert in that field feels the risks to the patient outweigh the benefits. Some investigations are only available to specialist clinicians because interpretation of the results is required.
- Requests for analysis of specimens are assessed in the same way as other investigations. In general, requests are reviewed in the light of national evidence-based best practice. If occasionally a request is not fulfilled, it will be because such best practice shows it to be clinically ineffective or not in a patient's best interests.
Apart from occasional inappropriate requests, a reasonable number of specimens are rejected because:
- the wrong type of specimen has been sent;
- the specimen has been inappropriately stored or transported and is now unsuitable for analysis;
- the specimen is not labelled sufficiently well to precisely identify which patient it is from;
- the requested investigation is not in the laboratory's repertoire; or
- the request is a repeat of investigations already performed.
The hospital continues to work with GP surgeries to reduce the number of instances of these issues. Most recently, the hospital has started a GP newsletter promoting good practice in laboratory requesting. A project is underway to introduce electronic test requesting. It is hoped that this will reduce sample mislabelling, create an opportunity to provide guidance to GPs at the point of requesting and give better visibility to GPs of what has been requested previously.