Table 3 Practice characteristics showing suggested solutions and those adopted

1. Delay in access to phlebotomy

1) Reconfigure appointments to meet demand.

2) Increase the hours of phlebotomists.

3) Train existing staff in phlebotomy to provide support for phlebotomists.

Employed additional HCA

Extended clinic to the afternoon

Trained existing staff in phlebotomy.

Kept additional appointments free

2. Receptionists reporting clinical information

1) Support data protection act compliance by receptionists

2) Training for receptionists in how to communicate potentially sensitive information

3) Improving access to teleconsultations with GPs

4) Greater clarity in the script provided by GPs

The importance of the accurate communication of result information was raised with reception staff.

Receptionists instructed to advise patients that there may be results outstanding.

The number of teleconsultations with GPs was increased.

3. Lack of routine communication of results

1) via SMS

2) via letter

3) via email

Selective use of SMS.

Selective use of SMS.

Letters routinely sent to patients with abnormal results advising them to book/keep their appointment.

4. Lack of patient awareness of the communication pathway

1) Poster on wall in waiting room

2) Information leaflet for patients detailing tests ordered and the means of retrieving their results embedded within clinical management system.

Information leaflet for patients printed and distributed by GPs.

Issues with software provider meant it could not be achieved within the timescale of the study.

5. Delays for patients seeking results via telephone

1) Precise time slot for calling for results

2) Separate phone line for results

3) Call waiting

Patient demographic deemed unsuitable.

New telephone system recently procured.

6. Lack of an alert for delayed or missing results

Alerts embedded in the clinical management system issued if:

1) The result has not been returned by the laboratory

2)The result has not been seen by GPs

3) The result has reached patients

The technical development needed could not be achieved within the time scale.

Would not commit to improving existing system with laboratory services out for tender