Phlebotomy & Nursing Services
CQC-compliant nursing care and specialist blood collection — conducted by registered practitioners, in the setting that causes least distress to the patient.
Routine blood draws and specialist nursing care are fundamental to the safe ongoing clinical management of patients with Acquired Brain Injury. Many ABI patients experience significant anxiety, needle phobia, sensory sensitivity or behavioural challenges that make venepuncture in a busy clinical setting deeply problematic — and frequently unsafe for both the patient and clinical staff.
Our phlebotomy and nursing team are experienced in working with neurologically complex patients, applying trauma-informed and person-centred approaches as standard. Every procedure is conducted by a registered practitioner with full NMC accountability, adhering strictly to CQC Fundamental Standards and clinical best practice guidelines.
At Nexus ABI, our endocrinology service provides structured assessment and evidence-based management of post-ABI hormonal conditions, following current NICE guidelines, British Society for Sexual Medicine (BSSM) guidance, Society for Endocrinology recommendations and the British Menopause Society (BMS) position statements.
Phlebotomy — blood tests available
- Routine venepuncture for GP-requested or specialist laboratory analysis
- Pre-treatment and monitoring panels for all Nexus ABI clinical services
- Full hormone panel: testosterone (total + free), LH, FSH, oestradiol, SHBG, prolactin, progesterone, DHEAS
- HPA axis: cortisol (AM fasting), ACTH, IGF-1 (growth hormone surrogate marker)
- Thyroid: TSH, free T4, free T3
- Metabolic: HbA1c, fasting glucose, fasting insulin, HOMA-IR, full lipid profile, uric acid
- Cardiovascular: hsCRP, homocysteine, Lp(a), NT-proBNP
- Haematology: full blood count, clotting screen, haematocrit, vitamin B12, folate, ferritin
- Biochemistry: U&Es, eGFR, LFTs, bone profile, vitamin D (25-OH)
- Medication drug levels: valproate, lithium, phenytoin, carbamazepine, clozapine, methotrexate
- Toxicological and substance screening samples
- Autoimmune and specialist panels as directed by consultant
Nursing services — scope of practice
- Wound care: dressing changes, wound assessment, photography and clinical documentation
- Post-surgical monitoring: suture removal, wound dehiscence assessment, escalation
- Intramuscular injection administration — testosterone (Sustanon/Nebido), B12, antipsychotic depots, anticoagulants
- Subcutaneous injection administration — GLP-1/GIP-GLP-1 weight management agents, insulin, LMWH
- Medication administration and observed therapy — ensures administration and documents compliance
- Catheter care: urethral and suprapubic catheter changes and maintenance
- Stoma care and stoma appliance changes
- Gastrostomy care: PEG and PEG-J tube management, enteral feed monitoring
- Tracheostomy care: stomal care, inner cannula changes (where nursing competency confirmed)
- Continence management and assessment
- Pressure ulcer prevention, grading, treatment and photographic documentation
CQC compliance & governance
- All procedures carried out by NMC-registered nurses with ABI clinical experience
- Strict adherence to CQC Fundamental Standards — Safe, Effective, Caring, Responsive, Well-led
- Infection prevention and control: hand hygiene, PPE, ANTT (Aseptic Non-Touch Technique) for all invasive procedures
- Clinical sharps and waste disposal per HTM 07-01 and COSHH regulations
- Full documentation of every procedure — available to case managers within 24 hours
- Incident reporting and Datix-compatible escalation pathway
- Clinical indemnity and professional insurance maintained by all practitioners
Reasonable adjustments for ABI patients
- Extended appointment times for patients with behavioural or sensory needs
- Familiar support worker or family carer present throughout by default
- Distraction techniques, sensory accommodations and communication adaptations employed as standard
- Butterfly (scalp vein) needle and paediatric techniques for needle phobia or difficult venous access
- Clinical hold and restraint assessment — all physical interventions documented and justified
- Mental Capacity Act 2005 framework applied where the patient lacks capacity to consent
- Best Interests documentation produced where invasive procedures require it
- Pre-visit briefing provided to the care team with clear information about what the visit involves
Frequently Asked Questions
Our FAQ section is here to answer the most common questions about this service and help you feel fully informed before getting started. If you don’t see the answer you’re looking for, please don’t hesitate to get in touch—our team is always happy to help and provide clarity where needed.
Why is in-home phlebotomy preferable to hospital or clinic blood tests for ABI patients?
Many patients with Acquired Brain Injury experience significant anxiety, needle phobia, sensory sensitivity or behavioural dysregulation that makes venepuncture in a busy clinical setting unsafe, traumatic or practically impossible. A hospital phlebotomy department — with its noise, queues, bright lighting, multiple unfamiliar staff and unpredictable waiting times — is one of the most challenging environments for an ABI patient. Our in-home phlebotomy service removes all of these barriers: the patient is in their own familiar environment, the visit is planned in advance so the care team can prepare them, and our practitioners are experienced in working with neurologically complex patients.
What blood tests can be collected in the home?
We can collect samples for virtually any blood test that would be requested in a hospital or GP setting. This includes the full range of tests relevant to ABI patients: hormonal panels (testosterone, oestradiol, SHBG, LH, FSH, prolactin, cortisol, ACTH, IGF-1), thyroid function, HbA1c, lipid profile, full blood count, liver and renal function, vitamin D, B12, folate, ferritin, clotting screen, inflammatory markers, medication drug levels (valproate, lithium, clozapine, phenytoin), and toxicological screening samples. Samples are sent to a UKAS-accredited laboratory with results typically returned within 24–48 hours.
What if the patient has difficult venous access or is very anxious about needles?
Our phlebotomists are trained in techniques specifically suited to patients with difficult venous access and needle phobia. We use butterfly (scalp vein) needles where appropriate, apply topical anaesthetic cream where indicated, and allow extended time for the visit so there is no pressure on the patient. Patients are encouraged to have a familiar carer or support worker present throughout. Where a patient’s anxiety or behavioural presentation is significant, we request a pre-visit briefing from the care team so we can plan the approach appropriately before we arrive.
What nursing procedures can be carried out in the home?
Our NMC-registered nursing team can carry out a broad range of clinical nursing procedures in-home, including: wound care and dressing changes, post-surgical suture removal, intramuscular and subcutaneous injection administration (including testosterone injections, antipsychotic depots, weight management agents and vitamin B12), medication administration and observed therapy, catheter care (urethral and suprapubic), stoma and gastrostomy care, tracheostomy stomal care, continence assessment, and pressure ulcer prevention, grading and treatment. Procedures are documented and a clinical record sent to the case manager within 24 hours.
What qualifications do the clinical staff have?
All nursing staff providing services under our CQC registration are NMC-registered nurses with current practising registration. Phlebotomists hold a recognised phlebotomy qualification from an accredited training body. All clinical staff undertake mandatory training in ABI-relevant competencies including the Mental Capacity Act 2005, safeguarding adults, moving and handling, infection prevention and control, and medicines management. Professional indemnity insurance is maintained for all practitioners.
How is infection prevention managed during in-home procedures?
We follow the same infection prevention and control standards in the home as we would in a CQC-registered clinical setting. This includes strict hand hygiene (WHO 5 moments), appropriate PPE for each procedure, Aseptic Non-Touch Technique (ANTT) for all invasive procedures, sharps disposal via our own clinical waste containers (never left with the household), and decontamination of reusable equipment between patients. All practitioners complete annual infection prevention and control training as a mandatory CQC governance requirement.
What happens to the blood samples after collection?
Samples are labelled with the patient’s details at point of collection, placed in appropriate transport bags with biohazard packaging, and transported to our partner UKAS-accredited laboratory via secure medical courier. The laboratory produces results in the agreed turnaround time — typically 24–48 hours for standard panels, with urgent same-day processing available where clinically indicated. Results are reviewed by a Nexus ABI clinician before being communicated to the referring case manager and placed in the patient’s clinical record.
Can the nursing team administer testosterone or HRT injections in the home?
Yes. Administration of intramuscular testosterone injections (Sustanon 250 or Nebido) is one of our most commonly requested nursing procedures, delivered within the wider TRT programme managed by our endocrinology service. We also administer subcutaneous injections for weight management, anticoagulants and vitamin B12. All injections are administered by an NMC-registered nurse, documented on the patient’s MAR chart, and reported to the supervising clinician. Injection administration is only carried out where a valid prescription and appropriate clinical oversight are in place.
Do you carry out phlebotomy for Court of Protection or legal purposes?
Yes. Where blood tests are required for legal proceedings, deputyship review or Court of Protection applications — for example, therapeutic drug monitoring, endocrine panels supporting treatment decisions, or baseline metabolic testing for legal documentation purposes — we can produce a detailed clinical report alongside the laboratory results, with chain-of-custody documentation where required. Results are formatted for use by solicitors, financial deputies and the Court.
How are phlebotomy and nursing visits funded?
In-home phlebotomy and nursing visits are funded through personal injury settlement budgets, deputyship funds and NHS Continuing Healthcare where appropriate. Laboratory analysis costs are billed at cost price with no mark-up. We provide itemised invoices specifying the procedure carried out, the clinical indication, the practitioner’s registration details and laboratory costs separately — suitable for deputyship audit. Bundled visit pricing is available when phlebotomy is combined with diagnostic monitoring or injection administration.