NHS and military join forces to develop battlefield transfusion in era of drone warfare

Defence Medical Command and NHS Blood and Transplant have signed a strategic partnership which will help innovate battlefield transfusion in an era of drone warfare.

The agreement was signed by the most senior Defence Medical Command leaders at NHSBT's largest blood centre.

The joint research will drive research, improve urgent transfusion care in complex environments, and have dual use capability, supporting civilian emergency care by air ambulances, trauma units, and more.

The partnership delivers on key goals in the 2025 Strategic Defence Review, which calls for Defence Medical Command and the NHS to work more closely together, increasing shared capacity and capability for the benefit of both. (1)

The agreement affirms a wider strategic bond that began when the national blood service was created from the pioneering work by the army's transfusion service during the second world war.

Today, the close relationship remains, but warfighting has changed.

Innovation in battlefield trauma care is even more important in a new era of drone warfare. Drones kill people more in Ukraine than artillery. They keep the battlefield under constant surveillance, inhibiting movement. More care - including transfusions - needs to be delivered closer to the frontline or at the point of injury. Developing transfusion products which are both portable and easy to transfuse is critical.

What the partnership means

The partnership was signed at NHSBT's largest blood testing and processing facility in Filton in Bristol, by Air Marshal Clare Walton, who is Chief Defence Medical at Defence Medical Command, and by NHSBT's Chief Executive, Frances O'Callaghan.

The joint work includes:

The Spray Dried plasma project for battlefield trauma, for use in battlefield trauma care, under the Blood Far Forward programme. Plasma is needed for massive blood loss; dried plasma can be stored and carried more easily, making it more suitable for battlefield use.
NHSBT is the leader of the SWiFT trial, working with Air Ambulance services and the Ministry of Defence to assess the safety and feasibility of whole blood for prehospital transfusion. Whole blood is easier to store and transfuse than multiple blood products, so it can be used in difficult situations.
Collaboration on research and development covering both blood and blood components, and supporting capability such as blood group testing.
NHSBT will provide further expert haematology and product safety advice to the Ministry of Defence and their NATO partners, supporting trauma product development and transfusion governance.
NHSBT is also trialling using drones to deliver blood, separate to the partnership, which could have military use on the future.

Research forms one part of the partnership.

There are 3 other pillars set out a vision to collaborate on NHSBT's clinical support to the armed forces such as providing blood for deployments, specialist education and training, and engagement with the North Atlantic Treaty Organization (NATO) Blood Panel. (2)

It will also help both organisations scale-up services in the event of major conflict.

After signing the agreement, Air Marshal Claire Walton and Surgeon General Major General Phil Carter toured the blood manufacturing hall and scientific laboratories.

Statements

Statement from Air Marshal Clare Walton

Air Marshal Clare Walton, Chief Defence Medical, said:

"It has been an honour to visit the NHS Blood and Transplant centre at Filton and see the amazing work that is being done to deliver this critical service to the nation. I can think of no better place to sign this strategic agreement which represents a significant step forward in strengthening the partnership between Defence and NHS Blood and Transplant.

"By bringing together operational expertise and clinical excellence, we are enhancing our collective ability to deliver life-saving care in the most demanding environments and ensuring that the Armed Forces can rely on resilient, world-class blood support. This agreement will improve end-to-end blood management, drive research and innovation and improve the quality of training to our people. It will also enhance our ability to promote interoperability with allies.

"Ultimately, this partnership underpins our commitment to providing the very best medical support to our people, wherever they serve."

Statement from General Phil Carter

Surgeon General Major General Phil Carter said:

"Our shared aim is to deliver lifesaving blood and plasma to injured service personnel in conflict zones as swiftly as possible. The partnership with NHS Blood and Transplant is a vital component of that mission.

"As a blood donor myself, I know that the armed forces are strong supporters of blood donation. It is perhaps the easiest way to save a life. We were, therefore, extremely proud to sign this agreement during National Blood Week."

Statement from Dr Gail Miflin

Dr Gail Miflin, NHS Blood and Transplant Chief Medical Officer, said:

"NHSBT is not just critical national infrastructure for health but also for defence. The Strategic Defence Review recognised that strengthening the partnerships between the Ministry of Defence and the NHS is in the national interest.

"The new products we create together will be dual-use innovations, which improve both military and civilian healthcare, and will position the UK as a global leader in health security. Together, we can develop new transfusion products and prepare to scale-up wider capacity during any future conflict."

Statement from Professor Renata Gomes

Prof Renata Gomes, NHS Blood and Transplant Chief Scientific Officer, also a professor of veteran's health, said:

"New research is often the result of long-standing collaborations between partners, such as NHSBT and Defence Medical Command, who share a common understanding.

"Innovation is needed. The nature of warfare is changing. In Ukraine, where drones now dominate the skies, making casualty evacuation even more difficult. Care is needed closer to the injury. Blood services need to create new products to support frontline transfusion needs.

"We already play a critical role in supporting the UK’s armed forces. Our unique national infrastructure and world-class research capability allows us, through this new agreement, to do far more."

Press release notes

1. Referenced on Page 130 of the Strategic Defence Review 2025

2. The partnership consolidates and coordinate activity across 4 priority areas of mutual interest and existing cooperation:

Clinical delivery, including (a) Clinical use of blood and blood components for resuscitation in the deployed setting (b) Blood management, assurance and enabling capability, including governance, data transfer, equipment for storage, testing, and collection, and diagnostic elements necessary to maximise blood availability and trauma support.
Research and development covering both blood and blood components and supporting capability (e.g. point-of-care screening / grouping devices). This includes collaborative funding activity, partnering on research proposals, and continuing to promote the importance of R&D in blood products across HMG and external funders.
Training and education.
North Atlantic Treaty Organization (NATO) engagement via the NATO Blood Panel to promote