Observations

Should we abandon routine blood tests?

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2091 (Published 03 May 2017) Cite this as: BMJ 2017;357:j2091
  1. Alastair Faulkner, orthopaedic trainee1,
  2. Mike Reidy, ST8 in trauma and orthopaedics and Scottish clinical leadership fellow2,
  3. James McGowan, public health specialty registrar3
  1. 1Ninewells Hospital, Dundee
  2. 2NHS Tayside
  3. 3East of England deanery
  1. a.faulkner1{at}nhs.net

The practice of ordering routine blood tests for patients attending hospital regardless of clinical need is wasteful and potentially damaging

Historically, blood tests in secondary care were requested for defined indications and only after a detailed clinical history and examination of the patient. Like modern day imaging requests, every investigation required justification. In the 21st century, the technological evolution of healthcare has changed this dynamic. Blood analysers are now capable of processing thousands of samples every day at a fraction of their former cost, rendering careful consideration of indications a thing of the past. The potential workload of laboratories has become the expected workload, and “routine bloods” has entered the lexicon of modern day clinical practice.

Studies have shown that the NHS is a comparatively efficient healthcare system by international standards.12 The UK spends less per capita on laboratory tests than other economically developed nations, with fewer errors in laboratory reporting. Growing evidence, however, shows the extent of unwarranted variation in …

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