My GP wants me to get some fairly standard blood tests as an overall health check but I'm shielding and so can't get a blood draw. She agreed that I could pay for some private tests where you get a finger-prick kit in the mail but she couldn't recommend a reputable company. She just suggested I google and choose a cheap one. But that seems a poor way to choose! I want tests with results that can be trusted. How can I tell which labs are good? Medichecks are prominent on the web. Any good?
Thriva are decent, although they only do the main 'popular' tests, and they are often grouped into packages that might not suit everyone's needs.
I wouldn't use a private lab and I think finger prick tests are much much more likely to end up producing spurious abnormal results. I would have thought it was up to your GP to find an NHS solution.
In May, we used this Birmingham lab: https://www.vitamindtest.org.uk Clinical Biochemistry Department, Black Country Pathology Services, City Hospital Birmingham, B18 7QH. for a finger-prick Vitamin D test for my adult son. He takes a Vitamin D supplement but we had no idea whether the dose he has been taking for a couple of years is sufficient. His result came back as: Total (Vit D 2 and Vit D 3) 91.3 nmol/L. The following week, his GP ordered a full blood profile + Vitamin D, and also tests that might indicate further investigation for Coeliac disease, Crohn's or IBD. (So had we known that he was going to be NHS tested for Vitamin D, which he wasn't tested for several years ago, when he last had blood tests ordered, we could have saved the expense of a private test). His Total Vitamin D level (via the blood draw) was: 102.4 nmol/L. (The finger-prick test a week or so before was 91.3 nmol/L. So not far out from the blood draw.) He was asked to wear a mask and nitrile gloves to attend a local GP practice, where currently you wait outside and have to ring the bell to register your arrival and then be let in at your pre-booked appointment time. He was in contact with one member of staff only, who was in gloves, mask and face-shield.
The GP told me that the phlebotomists aren't going out to patients who weren't already on their lists, because of Covid. Even if they were, I don't know that I'd want to be anywhere near one. I can't get to the surgery; it's far, far further than I could possibly walk and I daren't get in a car with anyone or go by bus. I don't know what to do, other than try to get a finger-prick test but as far as I'm aware, the NHS don't do them. I feel very stuck!
I can understand that but in my view if the GP recommends these tests it is up to them to provide them. We are being told that the NHS is continuing to provide a service despite Covid. But clearly you need to weigh up the situation for yourself. I cannot urge the detailed situation.
@Jonathan Edwards I know that distrust of private laboratories is widespread in NHS doctors. But let's suppose I was going to see a gastroenterologist privately for some reason, and that private doctor also did NHS work. If the doctor, in his private capacity, wanted me to get some blood tests done I'm assuming that they wouldn't be done by NHS labs and would have to be done by the private labs used by private testing companies. And as @Dx Revision Watch pointed out with her reference to vitamin D testing, some NHS labs do get involved in the private sector, including finger-prick testing, because they need to make ends meet and make a few bob at the same time. The other point I wanted to make is that many of the private testing companies don't do their own testing they are just the middle men connecting the patients to the private and NHS labs. And the laboratories they use are often accredited and regulated by the same organisations as the NHS labs.
I think the situation is actually a bit back to from to that. Since around 1990 a high proportion of NHS services make use of commercial labs. My old hospital UCH uses a private service as far as I know. But these services have a reasonable level of quality control when providing to the NHS. I suspect that in your example of a doctor who does both NHS and private work, if they know what they are doing they will make use of the same lab in the same way through a well organised private hospital like the Wellington in London. Others may be totally unreliable. The problem comes when getting tests through private systems that are not available through the NHS - which is likely to mean they are not subject to he same quality control - otherwise the NHS would provide them. Private labs are not stupid and are likely to try to get away with poor quality control if nobody is keeping an eye - which will be the situation for postal requests from patients.
Is there any data on the reliability of the private tests? I just googled but the first few pages of results seem to be swamped with advertising...
This is what Medichecks, for instance, say about the quality of their tests. I don't know enough to know if that should reassure me: https://medichecks.com/pages/our-laboratories
I've never been in that situation myself. All the blood tests I've ever had done privately have been bog-standard things that a GP would do (and has done in the past) if they had the budget for it.
The Doctors Laboratory is I think what UCH uses. The unknown is to what extent things are quite the same for private routes. I have no idea.
Medichecks operate through NHS hospitals, too, for example, the Haematology Department, Dorset County Hospital, Dorchester does private blood draws for Medichecks: https://medichecks.com/pages/clinic-dorset-county-hospital Medichecks can also apparently offer home nurse visits to collect blood samples (though that service may have been curtailed since Covid-19). Not cheap, though. Their Vitamin D finger-prick home test is listed as £39, whereas we paid £29 for the test from Black Country Pathology Services, City Hospital Birmingham. If your GP recommended a range of tests, it could work out quite expensive. If you were able to arrange for the GP's phlebotomist to do a domiciliary visit, would you not feel safe if they were gloved, masked and wearing a face shield and you also had a mask and face shield? Edited to add: The Medicheck's Iron deficiency finger-prick test: https://medichecks.com/products/iron-deficiency-check-blood-test is £49. To have a blood draw done at a local clinic is an additional £30. To have a nurse take blood at your home is an additional £55.
Thanks very much for all that info. I think it's clear that I can't arrange it - my GP ruled it out - but I wouldn't anyway feel safe.
OK. Has your GP indicated which tests might be the most useful for you to have, if you have to reduce the range of tests if paying for private finger-prick tests? The standard NHS blood profile is a considerable list of results and some of these may not be possible to do via a finger-prick spot test.
She gave me a list of tests and I assume I need all of them. They're all possible by spot-test. Fortunately, I can afford them.
I've used the finger prick Medichecks tests for a number of years and always found them reliable. I've had different tests but the one I have most often is the Thyroid Panel which measures TSH, FT3 and FT4. I do this test about the same time as I have my yearly NHS thyroid review- the NHS test only measures TSH. The Medichecks TSH result always closely matches the NHS test result even when my TSH level has varied over the years.
I have no idea about their results, as is the case for any such company. All I can say is my results have been in line with any contemporaneous NHS-ordered test results. But their service is good, it's a slick operation, and they seem to be a reputable company.