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P023 ‘It’s all about the money money money’? Optimising blood investigation requests for HIV patients
  1. Daisy Ogbonmwan,
  2. Nathan Sankar,
  3. Mayur Chauhan
  1. New Croft Centre, Newcastle, UK

Abstract

Background/introduction In 2010 Quality Innovation Productivity and Prevention (QIPP) was introduced to enable the NHS to provide cost efficient services. The 2013 BHIVA Standards of Care include the need to provide quality cost effective care.

Aim(s)/objectives Our aims were to assess whether unnecessary blood tests were undertaken during routine HIV assessments; to ensure minimal patient disruption and cost stewardship.

Methods Standards were established using current BHIVA and HIV CRG CD4 blood monitoring guidelines. A retrospective audit was carried out on patients attending for a routine review between the 1st of December 2014 and the 31st of January 2015 who had been on treatment for at least three months. Laboratory medicine cost data was ascertained.

Results 41 patient’s notes and HARS entries were reviewed, 71%, 90%, and 83% had their CD4 count, full blood count and lipids, respectively, unnecessarily requested. 44%, 39%, 56% of the Syphilis, Hepatitis B and Hepatitis C blood tests respectively, were either not done as per the standards or inappropriately requested. There was a potential cost saving of over £1300 on blood tests where over 30% were unnecessarily requested.

Discussion/conclusion Blood monitoring should not be a tick box exercise. Requesting unnecessary blood tests is not only costly but minor changes in the results may lead to unnecessary patient intervention. Clinic proformas can be used as an aid to whether investigations are required. Testing for Syphilis, Hepatitis B and C outside of the recommended standards should be guided by sexual histories taken during consultation.

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