King’s College Hospital and Guy’s and St Thomas’ have collaborated to prevent an estimated 3.3 million duplicate and repeat tests for patients since October 2023, thanks to the shared use of the Epic electronic patient record (EPR) system. This initiative has also freed up approximately 275,000 hours of nursing and phlebotomy time across both trusts and spared patients from unnecessary blood draws.
The integrated system automatically cancels duplicate blood test orders placed within an hour of each other. It also allows clinicians to add a test to an already obtained sample, eliminating the need for additional blood draws. These features have prevented around 2.9 million unnecessary blood tests across the two trusts, which collectively serve over three million patients annually.
Furthermore, the trusts have incorporated national and Royal College guidelines into their test and blood product ordering processes. Alerts are triggered when a clinician orders a repeat test sooner than recommended, displaying the patient’s recent results and requiring confirmation for the new order. These alerts have prevented over 384,000 tests, saving approximately £3.6 million. Similar alerts for blood transfusion orders have averted more than 6,000 unnecessary transfusions, conserving the blood supply and saving about £489,000.
“"Every test we can safely avoid matters. A repeat test ordered too soon is unlikely to change how we manage a patient, but skipping it spares them a blood draw, frees up more time for our nurses and the lab, and saves money."
“"Our staff response to this campaign, which we have called ‘Choose Wisely, Test Smartly’, has been fantastic, saving time, money, and discomfort for patients."
Guy’s and St Thomas’ will now extend this approach to imaging, implementing interval checks for imaging orders to reduce repeat scans. Lewisham and Greenwich NHS Trust is set to join the shared Epic system in April 2027.
