Six point-of-care tests experts call essential in out-of-hours primary care

Design

Modified three-round Delphi consensus

Population

Expert panel from 20 European countries in out-of-hours primary care

Primary outcome

Consensus (66.6% or more) on essential, optional or unnecessary tests

Effect

6 essential, 12 optional, 10 unnecessary of 28 tests

A modified Delphi study in the British Journal of General Practice (September 2026) asked an expert panel from 20 European countries which of 28 point-of-care tests out-of-hours primary care services should have. Consensus was set at two-thirds agreement over three rounds, including an in-person workshop.

Six tests were rated essential: blood glucose, urine dipstick, C-reactive protein, pregnancy test, ECG and haemoglobin. Twelve were optional and ten unnecessary. Panellists' concerns were inappropriate use, variable clinician confidence and patient-driven demand.

This is expert consensus from European services, not evidence that the tests improve outcomes. But the list is short, inexpensive and familiar.

The value is as a checklist: can the clinic that sees patients out of hours do all six?

• Check that your out-of-hours or single-handed clinic can do glucose, urine dipstick, CRP, pregnancy test, ECG and haemoglobin
• Use CRP to support decisions about antibiotics in respiratory infection, not to replace examination
• Do a pregnancy test before prescribing or imaging in any woman who could be pregnant
• Keep an ECG available for chest pain, palpitations and syncope out of hours
• Agree locally who is trained to interpret each test

Why it matters

It gives a short, defensible minimum for the equipment a clinician working alone after hours should have.

Don't overread it

This is expert consensus from Europe; it does not show that these tests change outcomes.

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