NHS Blood and Transplant

NHSBT logo

NHS Blood and Transplant (NHSBT) is a special health authority of the English National Health Service (NHS). It was established on 1 October 2005 to take over the responsibilities of two separate NHS agencies: UK Transplant (now renamed Organ Donation and Transplantation), founded by Dr. Geoffrey Tovey in 1972^[1], and the National Blood Service (now renamed Blood Donation). It's remit is to provide a reliable, efficient supply of blood, organs and associated services to the NHS. Since NHSBT was established, the organisation has maintained or improved the quality of the services delivered to patients, stabilised the rising cost of blood, and centralised a number of corporate services.

Corporate Profile

NHSBT has the responsibility for optimising the supply of blood, organs and tissues and raising the quality, effectiveness and efficiency of blood and transplant services. NHSBT's roles are stated to include:

• encouraging people to donate organs, blood and tissues
• optimising the safety and supply of blood, organs and tissues (within the NHS)
• helping to raise the quality, effectiveness and clinical outcomes of NHS blood and transplant services
• providing expert advice to other NHS organisations, the Department of Health, Ministers and devolved administrations
• providing appropriate advice and support to health services in other countries
• commissioning and conducting research and development
• actively engaging in implementing relevant EU statutory frameworks and guidance
• being involved in broader international developments

Activities

In 2009/10 NHSBT strategic objectives were focused on the efficient provision of a safe and sustainable supply of blood and its components, the identification and referral of more organ donors and the establishment of NHSBT as an effective and responsive organisation, focused on the needs of donors and patients. The year saw a record high in organ donation and transplantation together with an increase in the number of people signing up to donate blood.^[2]

• Blood Donation
  • NHSBT met more than 99.9% of all product requests and stayed above the three-day alert level for total stocks, a key performance indicator.
  • 65% of donors scored the overall service at 9 out of 10 or higher, compared with 63% last year.
  • NHSBT implemented efficiencies which helped to reduce the cost of a unit of red cells from £140 to £130.

• Organ Donation & Transplantation
  • The number of deceased organ donors increased by 7% across the UK, a 19% increase since 2007/08 rising from 809 in 2007/08 to 959 in 2009/10.
  • NHSBT increased the number of people joining the Organ Donor Register by 6%, rising from 16.1 million to 17.1 million by the end of March 2010.
  • 3,706 organ transplants were carried out across the UK, 14% above the 2007/08 baseline and a 5% increase on the previous 12 months.

• Specialist Services
  • NHSBT maintained the British Bone Marrow Registry at above target levels for the number of donors registered (>300,000).
  • The NHS Cord Blood Bank reached 15,000 stored units.
  • 8,500 tissue products were provided for lifesaving and life-enhancing surgery.

Blood Donation

The National Blood Service, now renamed Blood Donation, is the organisation for England and North Wales which collects blood and other tissues, tests, processes, and supplies all the hospitals in England and North Wales. Other official blood services in the United Kingdom include the Northern Ireland Blood Transfusion Service, Scottish National Blood Transfusion Service and Welsh Blood Service.

Service history and organisation

The service was formed in 1946 as the Blood Transfusion Service and is still often referred to as this. The name change came about in 1991 to reflect the move away from a regionally based service to a nationally organised one. The service operates out of 15 centres, and collects around 2.1 million donations per year and supplies 8,000 units of blood every day. Service directors proposed a reconfiguration and centralisation strategy in 2006, based on the closure of most local processing and testing labs, and subsequent operation out of just 3 large 'supercentres' to serve the same geographical area. Staff are opposed to this strategy and it is now under review. The future organisation of NBS blood processing and testing is still to be agreed.

Donating Blood

NHSBT mobile blood donation lorry.

The service depends entirely on voluntary donations from the public. Originally, Blood was collected from various donor clinics located over the country. In 1994, the first mobile session was held in Elstree, hosted by The Joely Bear Appeal. Currently, Blood donation sessions are set up throughout the country and take place in many diverse venues. From village halls, to mobile collection units (known as Bloodmobiles), and sessions set up companies and organisations so people can donate at work. Donors are generally required to be fit and healthy, weigh 50 kilograms (110 lb / 7 st 12 lb) and be aged between 17 and 60. However, regular (healthy) donors are permitted to donate past the age of 60 as long as they remain healthy. Donors are encouraged to give blood up to three times a year (once every 16 weeks). Once the preliminary checks are complete, the donor lies on a bed and a sterile hypodermic needle connected to a bag is inserted into a vein in their inner elbow. The donation usually lasts between five and ten minutes, during which 470 millilitres (0.83 imp pt) of whole blood is given.

Platelet Donation

Blood Components

Blood is made in the bone marrow. It is composed of red blood cells, platelets, plasma and white blood cells, collectively referred to as blood components. Donations given at regular blood donation sessions are referred to as "Whole Blood". Platelets are very small cells. They work with the clotting factors in plasma to form a mesh "plug" to stop or prevent bleeding. Plasma is the fluid part of the blood. It contains protein, salts and clotting factors. White cells fight harmful bacteria and help prevent infection. Red cells carry oxygen from the lungs to the tissues.

Platelet Donation

Most platelet donations are given to patients who are unable to make enough platelets in their bone marrow. For example, patients with leukaemia or other cancers may have too few platelets as the result of their disease or treatment. Also after major surgery or extensive injury, patients may need platelet transfusions to replace those lost through bleeding. Platelets given by generous and committed donors are often life-saving and special in that they can help up to 3 adults or even 12 children. As platelets can only be stored for a few days, regular and frequent donors are in great demand and that is why platelet donors are asked to attend at least 8 - 10 times per year.

Organ Donation and Transplantation

As one of the two arms of NHSBT, Organ Donation and Transplantation ensures that organs donated for transplant are matched and allocated to patients in a fair and unbiased way. Matching, particularly in the case of kidneys, is so important that donation and allocation needs to be organised nationally. The larger the pool of organs, the better the likelihood there is of a good match.

Unlike some other NHS organisations, ODT do not have a direct relationship with patients and do not provide "hands on" care. However, in providing support to transplantation services across the UK, everything ODT does has an impact on the quality of service delivered to individual patients.

Service history and organisation

UK Transplant offices in north Bristol

UK Transplant was established in 1991 as the UK Transplant Support Service Authority (UKTSSA). In July 2000, UK Transplant was formed with a new, extended remit to increase organ donation rates. In October 2005 UK Transplant merged with the National Blood Service and Bio Products Laboratory to form NHS Blood and Transplant, an NHS Special Health Authority responsible for optimising the supply of blood, organs, plasma and tissues and raising the quality, effectiveness and efficiency of blood and transplant services.

• 1968 National Tissue Typing and Reference Laboratory (NTTRL) established at Southmead Hospital, Bristol.
• 1972 National Organ Matching and Distribution Service (MOMDS) founded.
• 1979 NTTRL and NOMDS merge to become UK Transplant Service.
• 1991 UK Transplant Service becomes Special Health Authority and is renamed United Kingdom Transplant Support Service Authority (UKTSSA).
• 1993 UKTSSA moves to purpose-built accommodation at Stoke Gifford, in the northern suburbs of Bristol.
• 2000 UK Transplant takes over from UKTSSA with new, extended remit.
• 2005 UK Transplant merges with the National Blood Service and Bio Products Laboratory to form NHS Blood and Transplant.
• 2008 UK Transplant renamed Directorate of Organ Donation & Transplantation.

NHS Organ Donor Register

The NHS Organ Donor Register is a national, confidential list of people who are willing to become donors after their death. It can be quickly accessed to see whether an individual has registered a willingness to be an organ donor.

External links

• Official website
• Blood Donation Official website
• ODT Official website
• Regulations governing NHS Blood and Transplant, (statutory instrument).

Notes

1. ^ http://www.telegraph.co.uk/news/obituaries/1365785/Geoffrey-Tovey.html
2. ^ http://www.nhsbt.nhs.uk/annualreview/pdf/22187_Annual_Review.pdf