Gps don't do ENA blood test ?

[Sc12Coco]

This blood test was requested February 2023 from a London Hospital. GPS phoned just now and said they don't do this ?

[PMRpro]

Do they say "who" doesn't do it? I've been looking at various Trusts for info but can't see if it something GPs can request. It isn't uncommon for GPs to get very iffy about requesting expensive tests as it comes out of their budget and they think the hospital should pay!

Do you mean Feb 2023? Taken them long enough to decide ...

[Sc12Coco in reply to PMRpro]

Yes 2023. Useless.Surely the hospital I'm under know what GPS can do. It's a large hospital I'm under and very good.

Thanks for your reply.

[PMRpro in reply to Sc12Coco]

Individual doctors don't always realise. It is an ongoing money fight and it is perfectly possible the GP CAN order the tests but their practice has restricted it to save their budget. And it has pushed the question a year down the road in your case - so it works doesn't it?

[KayHimm]

I am in a totally different health care system but wondering if what might be going on is that doctors don’t order tests they cannot interpret properly. As an example, a GP in the US could order a rheumatology panel but wouldn’t know what to make of them.

I am wondering why the doctor didn’t order the tests. This is hard to understand.

That is a long time to go without the tests being done. You need to know why.

[Sc12Coco in reply to KayHimm]

Thanks for your replyI have been on to the gps for ages saying they want blood tests.

I'm really thinking of changing GPS.

I have got a lot of health problems.

I hope you are getting on not too bad.

[stiff19 in reply to Sc12Coco]

I was asked by neurologist not local hospital to do a 24 hour urine sample and to get the container from my gp and he sent the paperwork to me to put with it when done. my gp flat refused and said no if he wants the test he can provide the container, hence I never did get a 24 hour test. its about money

[KnitSewPurl]

As far as I am aware if the test is requested by your consultant to do stated in your letter to your GPs during a clinic appointment they have to do It whether or not they like it or not whilst it may come out of their budget it is not the issue . It is still a test that a patient requires for her health. It is their responsibility to find someone who can interpret those result appropriately.

[AgedCrone in reply to KnitSewPurl]

A Consultant can only request of a GP…he can’t order or demand anything….see - nhs.com - it says………

“Whether you see a private specialist, with or without a GP referral, or are referred to an NHS specialist, your GP is not obliged to accept the specialist's recommendations.”

I think the answer could be to get the test done privately….but from a Quick Look that could cost around £300! Then you would need somebody to interpret the result.

[KnitSewPurl in reply to AgedCrone]

Or get it done by your consultant at the hospital you are with is what I normally do. I don't get any of my bald test done by my GP unless they specifically want my bld as they feel they need to check as it has not been done for X number of year.

[OldTed60]

I have only ever had ENA tests done by my hospital at consultant’s request and been under rheumatology for 13 years with changing diagnoses, different hospitals and GP practices so I’ve had many ENA screens done over this time. The GPs have run Rheumatoid Factor and ANA tests in past but otherwise just do the routine DMARD monitoring as specified by my consultant in their letters because my GPs prescribe my Mycophenolate under a shared cared system. Also they do my thyroid bloods yearly and I can request tests for inflammation or folate if I speak to GP and they agree.

My present GP will tell me which blood tests they can or can’t run and I accept this as the latest protocol. They can’t do some of the tests that I have needed including micronutrients, DNA and ENA. And anyway these should be reported back to the consultant not to the GP. So I would think it’s the hospital’s job if it’s a large NHS hospital. They usually have their own phlebotomists and should have given you labels to take to the hospital phlebotomists or asked the nurses to take these straight after your consultation last year.

I would phone the hospital department who requested them and explain. It is likely different if you saw the consultant privately but it may be too difficult for GP practice to get the local trust to agree to pay so you might need to get this done privately as well I’m guessing - if your initial consultation was private. Blue Horizon or Monitor My Health are pretty reliable - especially the latter which I believe is owned by the NHS?

[StriatedCaracara]

When I had my 'strange long covid' in 2021 I phoned the Immunology blood testing unit of our local hospital trust, where GP blood tests get sent. I knew nothing of systemic autoimmune disease.

I was put through to the lead clinician who told me to ask my GP for the ANA test.

They said I had the right to have an ANA test done and GP should agree. If not, they suggested that I should change my GP - they realised I was concerned about symptoms.

My GP requested the ANA blood test, no issue at all.

My understanding is, only if the ANA result is then positive, do they precede with ENA screen and anti-ds DNA testing relevant to symptoms GP thinks should be investigated. They use the same blood sample.

Repeats of this test I presume become the responsibility of rheumatology. I don't think GPs can do them a second time.

(I had anti-ds DNA done privately a second time because GP said they were unable to repeat. Unfortunately I did not understand the results. The method and cut-off were in a completely different realm to my first test - as local private hospital had outsourced testing there was nobody I could talk to and I was not under a rheumatologist there).

If you Google the telephone number on the Immunology blood testing department of your local hospital trust you could phone them and ask about bloods GPs can order from them. It was a wonderful conversation that I had here. Learnt so much about the way testing is done.

[Sc12Coco in reply to StriatedCaracara]

Hi I'm going to call my GPS again The hospital that requested the test is up London. They diagnosed BMS

They only phone me (it will be over a year now). I have only been there once Guys Hospital.

I'm not going all the way there to have a blood test. I am thinking of changing GPS.

Another time I see an advanced nurse who knew nothing about a stool test for fat. She said it doesn't exist.

My dietitian got onto them.

They said if it's available on the NHS they will do it.

I thought I'm not asking for a

Face lift....

Thanks so much for your reply and everyone else . Linda

[Potatoheat]

My original GP who diagnosed me in 1991 did it, but it was sent to London, since then its always been ordered by my consultant and only once a year.