Minimum standards should be set for near patient testing

EDITOR,—Richard Hobbs's editorial on near patient testing in primary care is welcome,1 as a large expansion in the use of such testing can be predicted. However, the importance of collaboration and discussion with hospital laboratories, and of adequate quality control, needs to be highlighted. The following recommendations should be useful.

Firstly, there should be a formal training programme for staff performing the tests. This could include training in the collection of specimens, the principles of the analysis, use of the machines, how to document results correctly, calibration and quality assessment, expected values of the analyte in health and disease, and the safe disposal of samples.

Secondly, the users of near patient testing apparatus should have to show their competence at regular intervals.

Thirdly, patients should be tested only by certified users.

Fourthly, a quality assurance programme, including both internal and external quality control, should be in operation and preferably should involve the local pathology laboratory.

Fifthly, well defined user manuals, which should include standard operating procedures, should be instigated.

Sixthly, apparatus and associated equipment should be adequately maintained and cleaned regularly.

Seventhly, results should be documented adequately and an equipment logbook kept.

Finally, the laboratory may be able to advise about what equipment to purchase.

This list is not exhaustive but could form a minimum standard of expectation and is compiled from several sources.2 3 In this way near patient testing would provide the best possible results for the patient.