LESSONS FOR THE LABORATORY FROM A GENERAL-PRACTITIONER SURVEY

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.