NHS senior leaders meet to plan how to make blood transfusion even safer

Gail Miflin speaking at the Symposium The Transfusion Transformation Symposium was held by the National Blood Transfusion Committee, NHS Blood and Transplant, and NHS England.

Recommendations discussed included using tranexamic acid to reduce blood loss in surgery, new technology to track all the blood in the system, better data on patient outcomes, and addressing challenges in staffing levels and training.

These align to many recommendations from the Infected Blood Inquiry.

The symposium has now started an engagement process that will develop a new five-year strategy for publication next year.

The new strategic plan will follow on the work of Transfusion 2024, the previous strategy. The achievements of Transfusion 2024 included include integrating data to support better blood matching people with sickle cell and thalassaemia, development of paperless systems for faster access to results and less errors, and the creation of transfusion education initiatives.

The symposium was already planned but closely followed the publication of the Infected Blood Inquiry report. Sir Brian Langstaff’s report recommended a review of progress made into the Transfusion 2024 plan over the past five years, and the creation of a new plan. The new strategy will also reflect on the 2022 Amber Alert on blood stocks in England.

Who took part?

People taking part included:

Professor Cheng Hock Toh, Chair of National Blood Transfusion Committee.
Professor Sir Stephen Powis, National Medical Director of NHS England.
Professor Dame Sue Hill, Chief Scientific Officer for NHS England
Dr Aiden Fowler, National Director of Patient Safety in England.
Dr Gail Miflin, Chief Medical Officer of NHS Blood and Transplant.
Professor Dame Elizabeth Nneka Anionwu, Patron of the Sickle Cell Society.
Doctor Shruthi Narayan, Medical Director of Serious Hazards of Transfusion.
Professor Simon Stanworth, Director of the NIHR Blood Transfusion Research Unit (BTRU) in DataEnabled Transfusion Practice.

What was discussed for the next strategy?

Approaches discussed include:

Rapid adoption of tranexamic acid use in surgery to reduce blood loss, improve safety and reduce costs
Using information technology to support safe and appropriate transfusion and make efficient use of blood
Better sharing of information and recording of consent and outcome
Better patient involvement, including improving patient information and consent for transfusion
Using data to support safe and appropriate transfusion and make efficient use of blood.
Improving workforce resilience Adequate laboratory and transfusion practitioner staffing levels with clear career progression. Ensuring training for all staff involved with transfusion

Sir Stephen Powis speaking at the symposium Around 800,000 people donate blood in England each year. Patients receive around two million blood components saving and improving lives. The Infected Blood Inquiry report said harm to patients is rare but there should be no complacency and there are ongoing challenges in the system which require joint planning.

The symposium discussed challenges such as health inequalities, with patients from ethnic minorities less likely to receive appropriately matched blood. This can result in the development of antibodies which makes future transfusion more difficult.

Other challenges discussed included improving the consent process for transfusion, management of anaemia, and also better blood use - transfusions need to be evidence based yet around a fifth are outside of guidelines. There is also a workforce challenge - the SHOT (Serious Hazards of Transfusion) scheme has found transfusion teams’ staffing and training levels are stretched. There is currently no national system for recording how much blood is held in hospitals. There also needs to be more education and use of alternatives to transfusion such as iron and tranexamic acid. On the donation side, blood stocks have also been under sustained pressure.

Statements

Statement from Professor Cheng Hock Toh

Professor Cheng Hock Toh, Chair of National Blood Transfusion Committee, said:

"Despite challenges we have made considerable progress since the last strategy but we cannot allow complacency to set in. Today is about putting patient safety at the heart of what we do. We need to have patients as equal partners in the transformation of how we use blood and blood products - for example have a patient as co-chair of the NBTC."

Statement from Sir Stephen Powis

Professor Sir Stephen Powis, National Medical Director of NHS England, said:

"Blood underpins many critical areas across the NHS and now is a timely point to review progress of the current transfusion plan, as we continue to learn lessons from the past through the Infected Blood Inquiry. We are investing in projects that drive forward our inequality reduction work, such as a world first blood group genotyping programme for people with sickle cell and thalassaemia. This new joint strategy will enable us to go further for patients in ensuring safe and effective transfusion practice."

Statement from Dr Gail Miflin

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

"We're pleased that the Infected Blood Inquiry report recognised the significance of Transfusion 2024 and the need for a new strategy. We all want to make a positive difference in transfusion care but we must not be complacent. This symposium is a chance to turn lessons learned into action. NHSBT will work to support transfusion care and create a system where every patient receives the donation they need."