Aims-To assess the current performance of the clinical biochemistry se
rvice provided to general practitioners, with particular attention to
result turnround times, and to identify any improvements required. Met
hods-Postal questionnaire survey of general practitioners in the Londo
n Borough of Tower Hamlets who used the clinical biochemistry laborato
ry of the Royal London Hospital. A flow analysis study of turnround ti
mes for general practitioner samples was also performed. Results-Respo
nses to the questionnaire showed that although 82% of general practiti
oners thought the current quality of service provided was better than
fair, the actual turnround times achieved were longer than the accepta
ble times required. There was also a strong demand (> 66% of responder
s) for additional information-such as highlighting of abnormal results
-to be provided with results. There was wide variability between pract
itioners in their use of the laboratory (from none to > 800 requests p
er year), with no apparent correlation to practice size. Of the repert
oire of tests requested, a surprisingly high percentage (14.3%) were f
or thyroid function. Flow analysis of turnround times for thyroid func
tion tests showed that problems lay not with the time taken for analys
is (only 7.8% of the total turnround time) but with the pre- and posta
nalytical phases, that is, the sample collection and results delivery
service. Conclusions-Increasing the proportion of health care delivere
d in the primary care sector will inevitably increase the requirement
for pathology services. Improvements in the specimen collection and re
sults delivery service to general practitioners are needed to meet the
ir expectations. It remains to be determined whether increased investm
ent in these aspects of laboratory service would result in improved pa
tient care in the primary sector.