“We don’t need to check it, but we do check it”: Views of Primary Care Healthcare professionals on blood test monitoring in three long-term conditions

Problem

Blood testing has increased significantly in primary care, with over half attributed to long-term conditions (LTCs). In the UK, current efforts to optimise have focused on reducing testing. The aim of this study was to understand the views of Health Care Professionals (HCPs) on blood test monitoring for three LTCs (type 2 diabetes, hypertension, and kidney disease) and identify barriers and facilitators to optimising blood testing in LTC monitoring.

Approach

This study was part of the larger Optimal Testing project. 21 HCPs were recruited from 4 primary care practices with varying patient list sizes and diverse patient demographics in the Southwest of England. Qualitative interviews were recorded, transcribed verbatim and analysed in NVivo software using a reflexive thematic approach.

Findings

We identified variation in views of current blood test monitoring across HCPs and practices. HCPs described the workload generated by tests as unnecessary. There was a consensus that current blood test monitoring for LTCs can and should be improved, but no consensus on how this should be approached. Many of the barriers to optimising testing were systemic, including barriers from IT systems, secondary care pressures, and lack of consistent guidelines for practices.

Consequences

Whilst there is a recognition in primary care that blood testing could be optimised, there is a lack of consensus on how to approach this and so practices have moved towards different methods of optimising testing. This has important implications for effective intervention implementation to optimise or update current testing practices and may impact patient care.