NHS Blood Test Results Explained
What your GP's comment on Patient Access, SystmOnline or the NHS App actually means, in plain English.
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The Quick Answer
When your GP practice reviews an NHS blood test, they usually attach a short comment rather than a full written explanation, things like normal, satisfactory, borderline, or abnormal, please contact the surgery. That comment tells you whether a clinician needs to act, but it is not the same as someone explaining what each individual marker actually measures or how it compares with your own history.
The full report underneath that comment usually contains one or more standard panels, most often a full blood count (FBC), U&Es, LFTs, TFTs, an HbA1c, a lipid profile, or a bone profile. Each of these contains several markers, each with its own reference range printed alongside it.
What Your GP's Comment Actually Means
These are the short comments that appear most often on Patient Access, SystmOnline, myGP and similar systems. Exact wording varies by practice and by the clinician writing it, but the intent behind each phrase tends to be consistent.
Normal, no abnormality detected
Every marker tested fell inside the reference range the laboratory uses for that test.
No action needed on the numbers themselves. If you still feel unwell, book an appointment anyway; a normal blood test does not rule out every possible cause of symptoms.
Satisfactory
The result is acceptable given your particular situation, for example a level being monitored on treatment, rather than a healthy range figure for someone with no conditions.
Continue as advised and keep to your review schedule. If you are unsure what "satisfactory" means for your case, ask at your next appointment.
Borderline, please repeat
A marker sits close to the edge of the reference range. This is common with cholesterol, HbA1c and thyroid results, and is often not urgent.
Book the repeat test on the date given. Some practices suggest diet, activity or weight changes to try before repeating.
Abnormal, please contact the surgery
At least one marker is outside the reference range and a clinician wants to discuss it with you before your next routine visit.
Phone the surgery rather than waiting. Ask whether an appointment has already been booked for you, since some systems send this message before a clinician has set a timeframe.
No action
A quick triage comment, usually written while a GP or practice nurse works through a list of results. It confirms that nothing needs a call back right now.
It is not a line by line explanation of every marker against your personal history. You can still look at the full numbers yourself, and ask for them to be talked through if you want that.
Please discuss at your next appointment
Nothing urgent, but a clinician wants to talk about a finding face to face, often because it relates to a medicine you are taking.
Mention it when you are next seen, or book a routine appointment if none is already scheduled.
The Panels Most GP Practices Order
A single blood draw is often split across several of these panels at once, which is why one visit can produce results for twenty or more separate markers.
Full Blood Count
Includes: Haemoglobin, white cell count, platelets, MCV and related red cell indices
One of the most commonly ordered panels in UK general practice. Checks for anaemia, infection, and general blood health, and is often included alongside almost any other panel.
Urea and Electrolytes
Includes: Sodium, potassium, urea, creatinine, and estimated glomerular filtration rate (eGFR)
Checks kidney function and salt balance. Frequently ordered before starting certain medications, and repeated regularly for anyone on blood pressure tablets or with chronic kidney disease.
Liver Function Tests
Includes: ALT, AST, ALP, bilirubin, albumin, and sometimes GGT
Checks the liver and bile ducts for inflammation or blockage. Also used to monitor medicines that can affect the liver, such as statins, and to investigate fatigue or abdominal symptoms.
Thyroid Function Tests
Includes: Thyroid stimulating hormone (TSH), with free T4 and sometimes free T3 added if TSH is abnormal
Checks whether the thyroid gland is underactive or overactive. Commonly ordered for tiredness, weight change, or a racing or slow heartbeat.
Glycated Haemoglobin
Includes: A single value reported in mmol/mol under the IFCC standard used across the NHS since 2011
Reflects average blood glucose over roughly the last two to three months. Used both to diagnose diabetes and to monitor it once diagnosed.
Lipid Profile
Includes: Total cholesterol, HDL, LDL, non-HDL cholesterol, and triglycerides
Used for cardiovascular risk assessment, often alongside a QRISK score calculated by your GP from your age, blood pressure and other factors.
Bone Profile
Includes: Adjusted (corrected) calcium, phosphate, alkaline phosphatase, and albumin
Checks calcium and bone metabolism. Often ordered alongside vitamin D, or when investigating bone pain, kidney disease, or unexplained fatigue.
Reading the Report Itself
NHS laboratory reports carry some wording that looks unusual if you have never seen it before. None of it changes what is actually being measured.
Haemoglobin estimation
An older laboratory heading for the haemoglobin line in a full blood count. "Estimation" refers to the original colorimetric method used to measure it, not to the number being a rough guess. It is the same haemoglobin figure used everywhere else on your report.
Serum sodium, serum ALT, serum cholesterol
Most chemistry tests, including LFTs, U&Es, and lipids, are measured on serum, the liquid left once blood has clotted. "Serum sodium" and "sodium" are the same measurement, described with and without the tube type.
Plasma glucose
Some tests, particularly glucose, are drawn into a tube containing an anticoagulant and measured on plasma rather than serum. The prefix tells you which tube was used, not a different test from the one your GP asked for.
eGFR (CKD-EPI) or eGFR (MDRD)
Estimated glomerular filtration rate, a calculated figure derived from your creatinine, age and sex rather than measured directly. Laboratories are gradually moving from the older MDRD formula to CKD-EPI, and the two can give slightly different numbers for the same blood sample.
Corrected calcium or adjusted calcium
Around half of the calcium in your blood is bound to albumin and is not biologically active. Laboratories adjust the raw calcium result using your albumin level, and this corrected figure, not the raw one, is the one your GP will act on.
The reference range printed next to your result
This is the laboratory’s own interval for that test, not a single fixed NHS wide standard. Ranges vary slightly between hospital trusts and the exact analyser used, so a result described as normal at one hospital laboratory can sit just outside the printed range at another, without either being wrong.
Saving Your NHS Results as a PDF
NHS GP systems do not always have a single obvious download button, but every one of them can be turned into a PDF using your browser.
Open your GP practice’s online system
Most GP practices in England, Wales and Northern Ireland use Patient Access, SystmOnline, or myGP. Scotland and some GP practices elsewhere use their own local online services. Sign in with the same login you use to book appointments or order repeat prescriptions.
Find the full test results, not just the summary
Look for a section usually called Test Results, Documents, or Health Record. Some apps only show a tick or a one line comment on the home screen; open the actual result to see every marker and its reference range.
Save the page as a PDF
On a laptop or desktop, use the browser’s print option and choose "Save as PDF" instead of a physical printer. On a phone, use the share or print button in the browser and choose PDF or save to Files.
Create a free SmarterBlood account and upload
Upload the PDF, or a clear photo if a PDF is not available, on the Upload page. SmarterBlood reads every marker automatically and adds it to your own timeline.
No app access at all
Ask your GP surgery reception for a printed copy of your results, which you are entitled to as part of your own health record. A clear photo of the printed page, or emailing it to mail@smarterblood.org once you have an account, works just as well as a PDF.
When to Contact Your GP Promptly
Most NHS blood test results can wait for your next routine contact with the practice, but a few situations are worth acting on sooner:
"Abnormal, please contact the surgery" with no appointment offered
Phone the surgery rather than waiting for a letter or a further message. Some systems send this comment automatically as soon as a result is flagged, before a clinician has set a timeframe for you to be seen.
Chest pain, breathlessness or severe symptoms alongside an abnormal result
Do not wait for a routine callback. Use NHS 111 for urgent advice, or 999 if symptoms are severe or getting rapidly worse.
A result marked critically high or low
These are usually phoned through by the laboratory directly to the surgery on the day they are processed. If you notice one online yourself, contact your GP practice promptly rather than waiting for further contact.
A value drifting the wrong way over several tests, even while each one is individually normal
Mention the trend to your GP. A single result inside the reference range can still represent a meaningful change from your own previous results.
A result you do not understand and cannot get explained quickly
Book a routine appointment to have it talked through, and use plain English explanations such as SmarterBlood’s while you wait to be seen.
Tracking Your Results Over Time
A single NHS result only tells you where a marker sits against a general reference range on one day. It does not show you whether that marker has been slowly rising or falling across your last five tests, and GP systems are built for individual results, not for showing you a graph of your own trend.
SmarterBlood is a free, independent tool that is not affiliated with the NHS or any GP practice. Upload a PDF or a clear photo of your NHS pathology report, or email it to mail@smarterblood.org, and it automatically extracts every marker, graphs it over time even when your results come from different labs, flags anything outside its reference range, and explains what each marker measures in plain English. You can also generate a printable summary to take to your GP. SmarterBlood is not a clinic or a laboratory and does not order tests.
Sources and reference ranges
Adult reference ranges on this page follow the AACB and RCPA harmonised reference intervals unless stated otherwise; the range printed on your own report always takes precedence because laboratories differ.
NHS Blood Test Results, Frequently Asked Questions
What does "no action" mean on my NHS blood test result?
"No action" is a triage comment written by a GP or practice nurse quickly working through a list of results, not a full interpretation of every marker. It means nothing on your test needs a call back or a change to your medicine right now. It does not mean every number has been individually explained to you, and you can still ask to have your results talked through if you want that.
Why does my NHS letter say "satisfactory" instead of "normal"?
"Satisfactory" is often used when a result is acceptable for your particular situation rather than a strictly healthy range figure for someone with no conditions. For example, a cholesterol level while you are taking a statin, or an HbA1c while you are managing diabetes, can be marked satisfactory even though the raw number would look different on a healthy person’s report.
What is the difference between U&Es, LFTs and TFTs?
These are three separate chemistry panels that are often ordered together. U&Es (urea and electrolytes) check kidney function and salt balance through sodium, potassium, urea and creatinine. LFTs (liver function tests) check the liver and bile ducts through markers such as ALT, ALP and bilirubin. TFTs (thyroid function tests) check the thyroid gland, usually starting with TSH and adding free T4 if that is abnormal.
Why is my HbA1c reported in mmol/mol instead of a percentage?
The NHS moved HbA1c reporting to the IFCC standard, measured in mmol/mol, in 2011, replacing the older DCCT percentage that some other countries still use. As a rough guide, most UK labs treat below 42 mmol/mol as normal, 42 to 47 mmol/mol as pre diabetes range, and 48 mmol/mol or above as diabetes range, though the exact cut offs and your own baseline are for your GP to confirm.
What does "haemoglobin estimation" mean on my report?
Haemoglobin estimation is simply an older laboratory name for the haemoglobin measurement inside your full blood count. Some NHS laboratory systems still print this heading because it comes from the original colorimetric method used to measure haemoglobin. It refers to the same haemoglobin figure used everywhere else, not a rough guess.
I cannot download a PDF from Patient Access or the NHS App, what can I do?
Most browsers let you print any web page and choose "Save as PDF" instead of sending it to a physical printer, which works even if the app itself has no dedicated download button. If that still is not possible, you can take a clear photo of the results on screen, or of a printed copy from the surgery, and either option can be uploaded to SmarterBlood or emailed to mail@smarterblood.org once you have a free account.
Can I see my results if my GP practice does not use an app?
Yes. You can ask reception for a printed copy of your results, which you are entitled to under your right to access your own health record. A clear photo of a paper printout works just as well as a PDF once uploaded, so a lack of app access does not stop you from tracking your own results.
Does SmarterBlood replace my GP or the NHS?
No. SmarterBlood is an independent tool that is not affiliated with the NHS or any GP practice. It reads the numbers already sitting in your NHS results and explains them in plain English and graphs them over time, but only your GP has your full history and can tell you what a result means for your own care.
Related Reading
Got Your NHS Results in Front of You?
Upload your PDF or a photo and SmarterBlood will explain every marker in plain English, flag anything outside range, and build a timeline you can bring to your next appointment.
This page provides general educational information about NHS blood test comments and panels. It is not a substitute for professional medical advice, diagnosis, or treatment, and SmarterBlood is not affiliated with the NHS. Always contact your GP practice about your own results; they have your full medical history and can interpret your results in context. SmarterBlood does not provide medical care.