Intended for healthcare professionals

Rapid response to:

Practice Change

Reducing routine inpatient blood testing

BMJ 2022; 379 doi: (Published 26 October 2022) Cite this as: BMJ 2022;379:e070698

Rapid Response:

Re: Reducing routine inpatient blood testing

Dear Editor

Reducing routine inpatient blood tests

The Journal has published in the last two months articles on unnecessary preoperative tests, on excessive prescribing of PPIs and, this week, on unnecessary laboratory tests on inpatients, and there have been two shrewd commentaries from Giles Maskell on the inexorable growth of imaging. These are all consistent with the Too Much Medicine campaign that the Journal launched five years ago.

The focus of these articles has been on the financial cost of these tests and it is obviously essential to shift resources from zero or negative value activity to high value activity, either in the NHS or in other essential health services--for example, one fifth of children in Oxfordshire are obese when they leave primary school with more financial cuts to education in the pipeline but finance is not the most critical resource. These tests and their false positives consume the two other resources which are more important, one is the the time of clinicians and patients and the other is carbon. The results should be presented in terms of these two currencies not only because of their inherent importance but also because the opportunity for saving time and carbon would be much more powerful motivators than yet another appeal to clinicians to save money.

Competing interests: No competing interests

24 November 2022
Muir Gray
Anant Jani
The Oxford value and stewardship programme