Blood tests: They’re not only extremely common and, let’s face it, not particularly popular with patients, they are also a huge drain on health service resources.
Blood samples make up a significant proportion of the 2million pathology tests conducted daily in the NHS, tests which cost up to £3bn a year by some estimates.
And, inevitably, there’s controversy around the costs. A full decade ago, Labour peer Lord Carter highlighted ‘wide variations’ in the costs of pathology tests at laboratories throughout England, and he estimated £500million could be saved if such services were rationalised.
But many of the labs themselves are under intense pressure. Last year, The Guardian published an inside account of working life at an inner-city pathology lab, with claims of ‘crumbling floors’, staff and equipment shortages, and under-funding.
The system, then, like so many parts of the NHS, is under extreme pressure. It’s not surprising but what can be done about it?
At least part of the answer lies with technology, and this summer Health and Social Care Secretary Matt Hancock announced a cash injection of almost £500million to help transform the use of technology in the NHS… the same amount Lord Carter estimated could be saved by transforming pathology services.
When it comes to services as simple as blood tests, we have recently seen some great examples of the ways that technology can take the strain off both patients and the NHS.
Diabetics can now have under-skin implants that analyse their blood without any need for fingerprick tests, with results sent to their mobile phone. Parents can monitor a diabetic child’s glucose levels remotely – in fact, in the US, there have been almost 900 patent applications this year alone relating to glucose monitoring.
In the UK, scientists at Aston University’s School of Engineering and Applied Science, in Birmingham, have a remarkable machine which can carry out a battery of health checks with beams of light.
The Aston system uses lasers to perform painless, non-invasive checks on medical indicators such as cardiovascular performance and other key metabolic information, which can be useful when looking at energy levels or diet balance.
The tests take just minutes, and they can help assess variables such as regulatory rhythms, the metabolic activity of tissue (eg how effectively tissues are consuming oxygen) and a range of tissue biomarkers (providing evidence of a particular disease or physiological state).
No needles are necessary, which is good news for patients.
But, perhaps more significantly, the tests and delivery of results take just a few minutes and no blood has to be sent to a pathology lab for analysis. You can almost hear the NHS cash registers ringing at that news.
Professor Edik Rafailov, of Aston Institute of Photonic Technologies (AIPT), said: ‘This machine makes great use of our growing understanding of the technology around lasers to carry out straightforward tests without having to involve a laboratory.
‘The whole process is completely painless – there is absolutely no reason for patients to feel nervous. And the results are available there and then, which is better for patients and more efficient for healthcare providers.’
The device uses three separate lasers and several techniques to carry out its analysis:
- Laser doppler flowmetry to look at variables such as how effectively a subject’s blood is being delivered to their tissue
- Tissue oxymetry to measure levels of oxygen in blood vessels and tissue
- Tissue fluorescence to assess cell metabolism, a technique useful in areas such as obesity prognosis and cancer diagnosis
The tests involve nothing more stressful than laser beams being shone on a patient’s skin – the patient feels nothing. The results are processed by a computer there and then, and displayed as easy-to-interpret graphs.
Dr Sergei Sokolovsky, Senior Research Fellow at AIPT, said: ‘The machine does away with the need for needles, blood samples, laboratory analysis – the potential cost savings are obvious. A machine such as this could be used to perform initial tests on a patient and, where further investigation was deemed necessary, more traditional tests could be carried out.
‘Even taking a little pressure off pathology labs would help the hard-pressed teams who work there. And, of course, patients don’t have to endure a nervous wait for results to be known.’
The Aston machine has already proved its worth in trials at Dundee’s Ninewells Hospital.
As well as helping analyse blood content, it has been used as part of the diagnostic procedure for strokes and skin cancers. For example, it can constantly monitor blood delivery above the eyebrows, helping doctors mitigate the risk of stroke in patients with hypertension.
The laser device is also a high-precision way of identifying the boundaries of head and neck skin cancers, helping surgeons avoid tumour reoccurrence and reducing the need for additional cosmetic surgery.
This technology also has the potential to cross over into non-medical applications. For example, the data it provides can help athletes determine their optimal levels of physical exercise, helping to prevent stress and exhaustion and fine-tuning exercise regimes in real time.
A prototype of a wearable monitor has been developed that athletes can simply wear on their wrists, like other fitness monitoring devices.
Such a device could also be extremely useful for diagnostic work away from surgeries and hospitals, taking us closer to the ‘medical tricorder’ device made famous by the Star Trek series.
Much of the technology is ready to go into production now, and Aston recently launched Aston Medical Technology to commercialise inventions such as this.
With the cost of common blood tests still ranging from a few pennies to more than £13, it’s highly likely that health authorities could benefit from the additional cost control that in-house laser testing could bring.
And the rest of us can thank science for helping to reduce the number of needles we must endure.