Managing Patient Expectations
Setting Expectations
When requesting a test/investigation, explain to patients what they need to do next and what to expect depending on the result.
The process will depend on the type of test and where it is being done.
Blood/Stool/Urine Tests
In general, these types of tests are done entirely within the surgery.
Requesting the Test
- Request the test on ICE (small blue conical flask button in SystmOne)
- Print the form(s) and give to patient before leaving
- Inform patient whether they need to fast (usually for fasting cholesterol, rarely for fasting glucose)
NOTE
You must have a working Smartcard and access to ICE. If unable, write tests carefully in the ‘Plan’ section and reception will request them.
Sample Collection
If you have pots for urine/stool tests:
- Print labels (label printer button on top bar, near patient details)
- Attach labels to pots
- Put request form into pathology bag, seal paperwork edge
- Give pots and bag to patient
- Advise them to hand to reception when samples are ready
Supplies
If you need more pathology bags, urine or stool pots, there is a store cupboard on the ground floor at the end of the corridor underneath the FY rooms.
Blood Test Booking
If a blood test is required, the patient will need to go to reception (or call later) to book.
TIP
Patients may wish to organise blood tests at Thomas Linacre Center or Leigh - they will need to take their ICE request forms with them.
Test Timelines
| Test Type | Timeline |
|---|---|
| Blood test appointment | 2-3 weeks wait |
| Most blood test results | 24-48 hours |
| GP action on results | 24-48 hours after receipt |
| Specialist tests (eg: coeliac) | Up to 2 weeks |
| MSU (negative) | 2-3 days |
| MSU (positive) | 4-5 days |
| Stool cultures | 4-7 days |
| H Pylori tests | Up to 2 weeks |
What Happens Next
Normal results:
- Results sent to supervisor or another GP
- Result noted as normal
- No further action taken
- Patient will NOT be contacted
Risk of Lost Sample
Occasionally a patient will not submit a sample, or the sample will be lost in transit. Make sure you have assessed this risk and made a plan.
Abnormal results:
- GP makes clinical decision on next steps
- Helpful if you document a plan for continued management
- Example: For ESR, if raised will need an urgent ophthalmology referral
Special Considerations
Sometimes you may wish to take action even if a test result is normal (eg: breathless patient with normal BNP).
Options:
- Send yourself a scheduled task to review the result
- Ask patient to contact surgery for results and take action if normal
- Advise patient to book follow-up after test appointment
"Normal" Isn't Always Normal
Some tests may appear within normal range but still need further action. Don’t expect your supervisor to catch these.
Examples:
- A ‘normal’ PSA of 2.3 in someone post-prostatectomy
- A negative MSU in a patient with frank haematuria (may need 2WW referral)
ECGs
- Ask patient to book ECG with reception
- Report will come back to supervisor as a document
Radiology
- Check demographics with patient
- Send referral via lexacomm
- Advise patient report should come back within a few weeks
- Ask patient to call to check result is normal