Article Text

Download PDFPDF

Managing demand for laboratory tests: a laboratory toolkit
  1. Anthony A Fryer1,
  2. W Stuart A Smellie2
  1. 1Department of Clinical Biochemistry, Keele University School of Medicine, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, Staffordshire, UK
  2. 2Department of Biochemistry, Bishop Aukland General Hospital, Bishop Aukland, UK
  1. Correspondence to Dr Tony Fryer, Department of Clinical Biochemistry, Keele University Institute of Science and Technology in Medicine, University Hospital of North Staffordshire NHS Trust, Hartshill, Stoke-on-Trent, ST4 7PX, UK; anthony.fryer{at}


Healthcare budgets worldwide are facing increasing pressure to reduce costs and improve efficiency, while maintaining quality. Laboratory testing has not escaped this pressure, particularly since pathology investigations cost the National Health Service £2.5 billion per year. Indeed, the Carter Review, a UK Department of Health-commissioned review of pathology services in England, estimated that 20% of this could be saved by improving pathology services, despite an average annual increase of 8%–10% in workload. One area of increasing importance is managing the demands for pathology tests and reducing inappropriate requesting. The Carter Review estimated that 25% of pathology tests were unnecessary, representing a huge potential waste. Certainly, the large variability in levels of requesting between general practitioners suggests that inappropriate requesting is widespread. Unlocking the key to this variation and implementing measures to reduce inappropriate requesting would have major implications for patients and healthcare resources alike. This article reviews the approaches to demand management. Specifically, it aims to (a) define demand management and inappropriate requesting, (b) assess the drivers for demand management, (c) examine the various approaches used, illustrating the potential of electronic requesting and (d) provide a wider context. It will cover issues, such as educational approaches, information technology opportunities and challenges, vetting, duplicate request identification and management, the role of key performance indicators, profile composition and assessment of downstream impact of inappropriate requesting. Currently, many laboratories are exploring demand management using a plethora of disparate approaches. Hence, this review seeks to provide a ‘toolkit’ with the view to allowing laboratories to develop a standardised demand management strategy.

  • Education
  • Evidence Based Pathology
  • Health Services Res
  • Information Technology
  • Laboratory Tests
View Full Text

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.