Blood Tests and Injections

1. Introduction

1.1 Purpose

This policy sets out Bredbury Medical Centre’s position regarding requests from patients, including those who are healthcare professionals working elsewhere, to have blood tests and/or injections (e.g. vitamin B12) undertaken at their own workplace rather than at the practice. The aim is to ensure patient safety, clinical governance, clear accountability, and compliance with NHS, GMC, NMC, and CQC requirements.

1.2 Scope

This policy applies to:

• All registered patients of Bredbury Medical Centre.
• All clinical and administrative staff at Bredbury Medical Centre.
• Requests for blood tests, injectable treatments (including but not limited to vitamin B12), and similar clinical procedures that have been requested, initiated, or authorised by the practice.

1.3 Policy Statement

Bredbury Medical Centre requires that blood tests and injections requested or authorised by the practice are carried out at the surgery (or another formally commissioned NHS service arranged by the practice), rather than at a patient’s external workplace. This applies equally to patients who are healthcare professionals and who may have access to clinical facilities elsewhere.

2. Rationale                                                     

The practice’s position is based on the following considerations:

2.1 Clinical Governance and Accountability

• The practice retains clinical responsibility for investigations and treatments it requests.
• Procedures carried out off-site create ambiguity regarding accountability, documentation, and follow-up.
• Results management, adverse event reporting, and incident handling are more robust when procedures are undertaken within the practice’s established governance framework.

2.2 Patient Safety

• The practice cannot assure the clinical environment, infection control standards, equipment, storage of medicines, or emergency preparedness at a patient’s external workplace.
• Management of immediate adverse reactions (e.g. anaphylaxis, vasovagal episodes) must occur in a setting with appropriate protocols, equipment, and trained staff.

2.3 Medicines Management

• Injectable medications prescribed by the practice must be administered in line with the practice’s medicines management policies.
• The practice cannot oversee cold-chain compliance, storage conditions, or administration practices at external workplaces.

2.4 Documentation and Continuity of Care

• Procedures undertaken at the practice are recorded contemporaneously in the patient’s clinical record.
• External administration increases the risk of incomplete or delayed documentation, which may affect ongoing care and medico-legal safety.

2.5 Professional and Ethical Considerations

• Healthcare professionals are advised by their regulators (e.g. GMC, NMC) to avoid treating themselves or receiving informal care outside proper clinical arrangements.
• A clear boundary protects both the patient and the professionals involved.

3. Exceptions                    

Exceptions will be considered only in rare and exceptional circumstances, for example:

• Where a service is formally commissioned elsewhere by the NHS and arranged by the practice.
• Where there is a written shared-care or service-level agreement explicitly defining responsibility, governance, documentation, and indemnity.

Any exception must be:

• Approved by a GP Partner or the Practice Manager.
• Clearly documented in the patient record, including rationale and agreed responsibilities.

4. Patient Requests                                                         

When a patient requests to have blood tests or injections carried out at their workplace:

• Staff should explain that this is against practice policy.
• The rationale should be communicated clearly and respectfully, emphasising safety and governance rather than trust or competence.
• Patients should be offered timely appointments at the surgery to minimise inconvenience.

A standard explanation may be used, for example: > “As the practice requesting and overseeing your care, we need blood tests and injections to be carried out at the surgery so we can ensure patient safety, proper documentation, and clear clinical responsibility.”

5. Responsibilities                        

• Clinical staff are responsible for adhering to this policy and not authorising offsite procedures without approval.
• Administrative staff are responsible for booking appropriate appointments and communicating the policy consistently.
• Practice Manager and GP Partners are responsible for approving any exceptions and reviewing the policy.

6. Equality and Fairness

This policy applies equally to all patients, including healthcare professionals. No preferential arrangements will be made based on a patient’s occupation.

7. Review                                                     

This policy will be reviewed every 2 years, or sooner if there are changes to national guidance, commissioning arrangements, or regulatory requirements.