Patients in north-east London are having to wait up to 21 weeks for a routine blood test on the NHS because a huge backlog built up when the service was suspended during the unfolding of the Covid pandemic.
Margaret Hodge, one of the local MPs, has warned that the hold-ups could lead to patients receiving a late diagnosis of their illness and being forced to wait many months to have surgery.
Tier one – medium
- The “rule of six” applies, meaning socialising in groups larger than six people is prohibited whether indoors or outdoors.
- Tradespeople can continue to go into a household for work and are not counted as being part of the six-person limit.
- Businesses and venues can continue to operate but pubs and restaurants must ensure customers only consume food and drink while seated, and close between 10pm and 5am.
- Takeaway food can continue to be sold after 10pm if ordered by phone or online.
- Schools and universities remain open.
- Places of worship remain open but people must not mingle in a group of more than six.
- Weddings and funerals can go ahead with restrictions on the number of people who can attend (15 and 30 respectively).
- Exercise classes and organised sport can continue to take place outdoors, and – if the rule of six is followed – indoors.
Tier two – high
- People are prohibited from socialising with anybody outside their household or support bubble in any indoor setting.
- Tradespeople can continue to go into a household for work.
- The rule of six continues to apply for socialising outdoors, for instance in a garden or public space like a park or beach.
- Businesses and venues can continue to operate but pubs and restaurants must ensure customers only consume food and drink while seated, and close between 10pm and 5am.
- Takeaway food can continue to be sold after 10pm if ordered online or by phone.
- Schools and universities remain open.
- Places of worship remain open but people must not mingle in a group of more than six.
- Weddings and funerals can go ahead with restrictions on the number of people who can attend (15 and 30 respectively).
- Exercise classes and organised sport can continue to take place outdoors but will only be permitted indoors if it is possible for people to avoid mixing with those they do not live with (or share a support bubble with), or for youth or disability sport.
- Travel is permitted to amenities that are open, for work or to access education, but people are advised to reduce the number of journeys where possible.
Tier three – very high
- People are prohibited from socialising with anybody they do not live with, or have not formed a support bubble with, in any indoor setting, private garden or at most outdoor hospitality venues and ticketed events.
- Tradespeople can continue to go into a household for work.
- The rule of six continues to apply to outdoor public spaces, such as parks, beaches, public gardens or sports venues.
- Pubs and bars are only permitted to remain open to operate as restaurants, in which case alcohol can only be served as part of a substantial meal.
- Schools and universities remain open.
- Places of worship remain open but household mixing is not permitted.
- Weddings and funerals can go ahead with restrictions on the number of people attending (15 and 30 respectively) but wedding receptions are not allowed.
- The rules for exercise classes and organised sport are the same as in tier 2. They can continue to take place outdoors but will only be permitted indoors if it is possible for people to avoid mixing with people they do not live with (or share a support bubble with), or for youth or disability sport. However, in Merseyside, gyms were ordered to close when it entered tier 3.
- Travelling outside a very high alert level area or entering a very high alert level area should be avoided other than for things such as work, education or youth services, to meet caring responsibilities or if travelling through as part of a longer journey.
- Residents of a tier 3 area should avoid staying overnight in another part of the UK, while people who live in a tier 1 or tier 2 area should avoid staying overnight in a very high alert level area.
People with cancer, kidney problems, diabetes and eye problems are among those affected.
The huge delays have prompted the Barking and Dagenham, Havering and Redbridge NHS clinical commissioning group to declare the problem a “system serious incident” and launch an investigation into whether they have led to anyone being harmed. It is looking in particular at the clinical history of those who have had to wait the longest.
Hodge, the Labour MP for Barking and Dagenham, has written to Matt Hancock, the health and social care secretary, describing the delays as “wholly unacceptable” and demanding action.
The delays have been revealed in a letter to Hodge by Ceri Jacob, the managing director of Barking and Dagenham, Havering and Redbridge NHS clinical commissioning group.
In it, Jacob disclosed that waiting times for non-urgent blood tests at the 15 health centres in the three boroughs that offer the service range from four-and-a-half weeks to 21 weeks. The latter is the waiting time at the Elm Park Clinic in Havering.
In her letter, Hodge pinpoints the decision to suspend the blood testing service in March, when the pandemic was unfolding, as the main reason for such unusually long delays.
She outlined “the devastating impact Covid-19 has had upon blood test services in my constituency. For a routine blood test in Barking the current waiting time is anywhere between eight and 13 weeks”.
She added: “It goes without saying that a three-month wait for a routine blood test is wholly unacceptable. If somebody is diagnosed with a serious illness, like cancer, where early treatment is vital, the delay could become a matter of life and death.”
Rachel Power, the chief executive of the Patients Association, said: “It has become clear that the emergency measures taken in the spring to free up NHS capacity for Covid-19 came at a heavy cost to non-Covid patients. Many people have been left feeling increasingly anxious over the suspension of planned treatment or their inability to get diagnostic tests.
“We know the NHS is working to restart these services, and aims not to have to suspend them in the same way during the second wave. It’s important that they succeed.”
This situation appears to be unrelated to the widespread rationing of blood tests the NHS was forced to impose last week after supply problems involving testing kits made by the pharmaceutical company Roche emerged.
Prof Martin Marshall, the chair of the Royal College of GPs, voiced unease at the delays.
“GPs will only request tests or make referrals when they consider it clinically necessary and beneficial in diagnosing a patient or helping to manage an existing health condition. As such, delays in tests being processed are both frustrating and concerning, for GPs and patients alike, particularly in cases where the results will determine or change a patient’s treatment plan, and need to be addressed.”
The Department of Health and Social Care declined to respond directly to the delays. In a statement, a spokesperson said: “We are supporting the NHS as it safely restores services providing £3bn specifically to help the NHS during winter and to update A&E facilities.”
• This article was amended on 15 October 2020 because it was the Barking and Dagenham, Havering and Redbridge NHS clinical commissioning group that declared the system serious incident, not NHS England as an earlier version said.
