Unregulated street health concern c

An investigation by The BMJ reveals that dozens of UK companies are offering private blood tests for a range of conditions and deficiencies, with some making misleading claims, unsupported by evidence, and leaving it to an already overworked NHS to follow up on “abnormal results”. “.

Consumers are promised that such tests will help them monitor their health and detect problems early, but journalist Emma Wilkinson finds that the tests often contradict official medical guidance and do not fully explain the implications of the results for the patient.

In a linked opinion piece, experts highlight several areas of concern and argue that private blood testing companies need clear regulation to prevent further shoddy and overblown testing with potential harm to people and unnecessary costs to the NHS.

Based on the results of this investigation, the BMJ has referred two companies to the UK Advertising Standards Authority for misleading claims about accuracy or detection rates associated with home tests. Another removed the evidence from its website after being contacted by The BMJ.

Examples of private tests include regular blood tests that promise to predict how many healthy years of life a person has left, a fingerstick test to measure tiredness and fatigue that measures iron, thyroid hormones, vitamins and inflammation, and screening with the option of a full refund if users’ results are within the normal range.

But Bernie Croal, president of the Association for Clinical Biochemistry and Laboratory Medicine, points out that 5% of test results will be outside the normal reference range, so very few people will not get “abnormal” results, even if there is nothing wrong with them. .

What’s more, many of these tests are not recommended by the National Screening Committee “because it is not clear that the benefits outweigh the harms”, yet patients often ask their GPs to review the test results deprived of blood, creating more work for an already stretched NHS.

In 2019, the Royal College of General Practitioners published a position statement on private health examinations, warning that “the organization initiating the examination should not assume that GPs will deal with the results”.

However, the companies that sell tests believe that private tests have a role.

Sam Rodgers, a practicing GP in southeast London and chief medical officer at Medichecks, notes that people are directed to their GP after their test in about 7% of cases, while Nightingale said his tests were for “prediction and prevention rather than diagnosis or treatment” and did not provide test results as such, but rather general risk information and lifestyle guidance.

However, it’s clear that there is wide variation in the amount and accuracy of information provided to consumers when they purchase tests online, Wilkinson writes.

For example, prostate cancer risk tests (PSA) are available on the NHS for asymptomatic men over the age of 50, after discussion with a GP about the risks and benefits. However, private tests are readily available without any age recommendation, and some contradict official advice about their accuracy.

Wilkinson reports that private testing is also promoted by the NHS-backed Patient Access app, despite this being something the NHS positively advises against.

Shaun O’Hanlon of EMIS, the healthcare IT company behind the app, says all of the private provider testing services listed on Patient Access have been selected after extensive review by the clinical team. , which includes UK GPs, while NHS Digital says services offered through third-party apps or websites connected to the NHS login service are the responsibility of the companies providing them.

But experts call for better regulation. Dr Margaret McCartney and her colleagues say the NHS “needs to explain in a robust way the criteria for high-quality screening and testing, and explain when consumers should be skeptical and what to question.”

They argue that the Care Quality Commission (CQC) should be empowered to assess apps that promote private screening, as well as the screening companies themselves, and say holding companies accountable for undertaking an investigation of abnormal test break results “could help reduce negative impact on the NHS”.

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