COVID-19 – service arrangements

Overview

This page details a few changes that have been made to local service delivery in Renal & Transplant Medicine in light of the COVID-19 pandemic.

 

How to arrange outpatient blood tests

What are the options for an outpatient blood test?

An outpatient blood test can be arranged through one of four routes:

  • in an outpatient clinic (OPD) during a routine or “bloods-only” appointment
  • in the Clinical Research Facility (CRF)
  • through the GP (although note strain on GP services at present) *
  • through the Renal & Transplant Mobile Phlebotomy Service (MPS) **

* GP bloods may be possible if this is through a prior arrangement (e.g. epo monitoring) or if specific agreement has been sought.  We should be mindful of the immense pressure currently faced by primary care and avoid requesting blood tests through the GP if possible.

** The mobile phlebotomy service has limited capacity (around 20 patients per day on the days that it is running). Ideally it should be reserved for patients fulfilling the criteria below. The bus will park in an accessible location, typically a supermarket carpark. Patients will be given a timed appointment (15 min intervals) and asked to stick rigidly to this so that we can maintain good social distancing.

 

Which option should I use?

The first three options (OPD, CRF and GP) are able to accommodate urgent blood tests but will expose the patient to a healthcare environment (with associated risks of contracting the COVID-19 virus).

The mobile phlebotomy service (MPS) is suitable for patients who fulfil the following criteria.  If in doubt, please discuss with the MPS team:

  • blood test required within a relaxed and non-urgent time-window (e.g. any time in the next 4 – 6 weeks)
  • patient mobile enough to climb into the van (up one step) and able to get to wherever the van is parked (typically a supermarket car park)
  • patient has medical condition that means they should be following shielding / enhanced social distancing measures
  • no cognitive / communication issues that would prevent the MPS team arranging the appointment (typically with 24 – 48 hrs notice)
  • patient lives in Edinburgh / Midlothian / West Lothian / East Lothian
  • not possible or desirable to use any of the other three above options for outpatient blood tests

 

How do I arrange the blood test through the Clinical Research Facility?

Arrange via the Renal admin team (Jack / Allan).  Appointments in the CRF can also be used for clinical review, giving treatments (e.g. rituximab, iron infusions), dispensing medicines etc.

 

How do I arrange the blood test through the Mobile Phlebotomy Service?

The MPS can only be used for blood tests (and for patients to return urine samples if they already have a sample container).  It cannot be used for any form of clinical assessment or to dispense medicines.  Arrange blood tests as below via the MPS team (currently Rob Hunter / Sarah Lundie / Mel Philips / Carol-Ann Veitch).  

 

Dates and deadlines for early Summer 2020:
Cycle # Deadline for referring patients First day of bus cycle Last day of bus cycle
3 Monday, 11 May 2020 Monday, 18 May 2020 Friday, 5 June 2020
4 Monday, 1 June 2020 Monday, 8 June 2020 Friday, 26 June 2020
5 Monday, 22 June 2020 Monday, 29 June 2020 Friday, 17 July 2020
6 Monday, 13 July 2020 Monday, 20 July 2020 Friday, 7 August 2020
7 Monday, 3 August 2020 Monday, 10 August 2020 Friday, 28 August 2020

 

To request blood tests via the MPS:
  • MPS team will invite requests for patients in a 3-week window (the next “bus cycle”)
  • at this point, referring clinician needs to refer patients as follows:
    • for RENAL & TRANSPLANT patients, enter patient details in excel spreadsheet on the shared drive (S:/Renal/COVID mobile phlebotomy service/Referrals.xlsx); the mandatory information is:
      • CHI number
      • Referring clinician (initials)
      • Blood tests requested
      • …and please ensure that contact phone number on VitalData is up to date
    • for patients in OTHER SPECIALTIES, e-mail details to RWH (preferably in an excel spreadsheet); the mandatory information is:
      • CHI number
      • Surname
      • Forename
      • Postcode
      • Contact telephone number for patient
      • Referring clinician (name & contact details)
      • Blood tests requested
  • thereafter, the referring clinician need not do anything other than assume responsibility for chasing results (and ideally forewarn the patient that they will get a call from the MPS team at some point)
  • the MPS team will allocate patients to their nearest “bus clinic”, request blood tests on Trak and phone patients (usually with 48 – 72 hrs notice) to let them when and where to go and confirm that they are free from Covid-related symptoms

See here for a flow diagram of how the MPS service operates.

 

“Blood bus” FAQs:
  • How do I know when my patient will be having their blood test on the MPS?  The bus team will send an e-mail at the start of each cycle, to let referring clinicians know which clinics their patients have been allocated to.  In between times, you can see the clinic lists as excel sheets on the shared drive.  These are used to manage clinic lists in real time and there are often last-minute changes.  Therefore please DO NOT attempt to manipulate these; if you would like any further information or to make any changes then please e-mail Carol-Ann.
  • How do I know when my patient has had their blood test on the MPS? The bus team will send an e-mail at the end of each week that the bus is running to let referring clinicians know when their patients have had blood tests.
  • Can I request MPS blood tests at short notice?  Yes – although the system can only accommodate a small number of last-minute add-ons so please use this option sparingly.  E-mail Carol-Ann with any such requests and we will let you know if we can accommodate them.

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