Haematology Health

Haematological issues often present subtly through abnormal blood test results, fatigue, bruising, or infection. From common conditions such as iron deficiency anaemia and vitamin B12 deficiency to more complex presentations like clotting disorders, haemoglobinopathies, or suspected haematological malignancies, GPs play a key role in early recognition, initial investigation, and appropriate referral.  

• HH1. Diagnose and manage common and important haematological disorders through history, examination, investigation, and follow-up.
• HH2. Interpret full blood counts and related investigations, recognising normal variants and serious pathology.
• HH3. Identify red flag features and refer urgently via local rapid access pathways.
• HH4. Manage haematological emergencies in General Practice, including stabilisation and emergency care coordination.
• HH5. Assess and manage common bleeding disorders, including investigations, risk stratification, and referral.
• HH6. Provide ongoing care for chronic haematological conditions, collaborating with secondary care.
• HH7. Manage anticoagulation therapy, including initiation and monitoring.
• HH8. Provide counselling on anticoagulation and coordinate care with specialists.
• HH9. Recognise haematological effects of medications and substances.
• HH10. Communicate sensitively with patients and families about diagnoses and implications.
• HH11. Offer lifestyle and preventive advice relevant to haematological health.
• HH12. Implement recall systems and safety netting for monitoring and follow-up.

For each problem or disease, consider the following areas within the general context of primary care:  

• Natural history of the condition
• Incidence and prevalence
• Typical and atypical presentations
• Recognition of normal variations
• Risk factors
• Diagnostic features and differential diagnosis
• Red flag features
• Relevant investigations
• Interpretation of test results
• Management and continuing care
• Patient and carer education
• Prognosis

Signs, Symptoms & Presentations

• “B” Symptoms of Lymphoma
• Anaemia
• Bleeding
• Bone Pain
• Bruising
• Dyspnoea
• Fatigue
• Hepatomegaly
• Jaundice secondary to haemolysis
• Lymphadenopathy
• Pallor
• Pathological Fractures
• Petechiae
• Purpura
• Recurrent Infection
• Recurrent Miscarriage
• Splenomegaly
• Unilateral Calf Swelling
• Weight Loss

Common and Important Conditions

• Acute Leukaemia
• Anaemia
• Anaemia of Chronic Disease
• Antiphospholipid Syndrome
• Aplastic Anaemia
• B12 Deficiency
• Chronic Lymphoid Leukaemia
• Chronic Myeloid Leukaemia
• Common Abnormalities of the blood film
• Deep Venous Thrombosis
• Disseminated Intravascular Coagulation
• Folate Deficiency
• Functional Asplenia
• Haemoglobinopathies
• Haemolytic diseases
• Haemophilia
• Hemochromatosis
• Immune Thrombocytopaenic Purpura
• Iron Deficiency
• Lymphoma
• Monogammopathy of undetermined significance (MGUS)
• Multiple Myeloma
• Myelodysplastic Syndromes
• Myeloproliferative Neoplasms
• Pancytopenia
• Polycythaemia Rubra Vera and Secondary Polycytaemia
• Pulmonary Embolism
• Splenectomy
• Thrombocytopaenia
• Thrombocytosis
• Use of Anticoagulants
• Von Willebrand’s Disease

Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

Self-Directed 

Blended Learning Resources (Education Platform)

Haematology in GP (Currently being produced)

Blood Test Management in GP

Useful Websites

NCL Haematology Pathway

UHL MGUS Management Guidance

KCH Haematology Referral Guide

Myeloma and MGUS Guide for GPs

LearnHaem RBC Overview

Workplace Based Learning

Workplace-based learning provides valuable opportunities to develop clinical skills in recognising and managing haematological conditions across both general practice and hospital settings. In hospital rotations, trainees may encounter acute presentations such as severe anaemia, thrombocytopenia, bleeding disorders, venous thromboembolism, and haematological malignancies, often requiring urgent investigation and multidisciplinary care. These experiences enhance understanding of diagnostic tools such as peripheral blood films, coagulation studies, and bone marrow biopsy interpretation. In general practice, trainees routinely interpret full blood counts, iron studies, and vitamin levels, and manage common conditions like iron deficiency anaemia, B12 or folate deficiency, and anticoagulation monitoring. Primary care also plays a key role in identifying early warning signs of more serious conditions (such as persistent lymphadenopathy or abnormal white cell counts) and initiating appropriate referral pathways. Through direct patient care, reflection, and guided supervision, trainees develop confidence in safe investigation, clear communication of results, and appropriate long-term follow-up.

Day Release

Day release sessions offer an ideal setting to explore haematology in a structured and supportive environment. Through case-based discussions, trainees can deepen their understanding of common presentations such as microcytic anaemia, raised platelets, or abnormal white cell counts. Sessions may include interpreting full blood counts, understanding patterns of anaemia, and discussing the management of anticoagulation, including DOACs and warfarin. Case reviews also provide an opportunity to consider red flag features suggestive of haematological malignancy and when to initiate appropriate investigations or referrals. Peer discussions around uncertainty, incidental findings, or complex results can help build confidence in clinical reasoning and improve decision-making in the context of primary care.

Registrar Tutorials

Registrar tutorials provide a focused opportunity to explore haematological issues in the context of real patient care. These sessions can be used to review recent cases, such as a newly diagnosed anaemia, concerns about thrombocytopenia, or management of a patient on long-term anticoagulation. With trainer guidance, trainees can discuss investigation pathways, shared care responsibilities with haematology teams, and how to communicate results sensitively to patients. Tutorials also provide space to consider risk-based decision-making; such as when to initiate treatment, when to repeat tests, and when to refer. Reflecting on clinical experience helps consolidate knowledge and reinforces a safe, systematic approach to haematological care in general practice.

Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

 EPA 17: Manage the integration of evidence-based therapeutics into patient care and prescribe and manage medications

For EPA 17, initiating anticoagulation therapy for atrial fibrillation demonstrates competence in evidence-based prescribing, patient counselling about bleeding risks, and planning monitoring. A CBD can be used to review the rationale for treatment, risk-benefit discussion, and safety netting strategies.

Core Knowledge Test (CKT)

• Interpretation of a Full Blood Count

• Assessment of unexplained thrombocytopenia

• Management of sickle cell disease 

Clinical Competency Test (CCT)

• A patient presenting with fatigue and easy bruising.
• A patient with history of splenectomy.
• A patient with low platelets on blood test.

Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.