Bring back walk-in clinics to fix blood crisis: As shortage threatens vital knee and hip operations, the Mail on Sunday calls for urgent action
- NHS England issued its first amber alert for record low blood supply levels
- MPs, medics and charities are demanding urgent action to deal with the crisis
- The Mail on Sunday calls on walk-in services to be reinstated across England
- They were ditched in 2016 as a cost cutting drive to become more efficient
MPs, medics and charity bosses last night demanded urgent action to tackle the unprecedented crisis in blood supplies – including the return of walk-in appointments for donors.
They fear shortages are set to last into the New Year, meaning thousands of operations may have to be cancelled.
Blood supplies dropped to record lows last week, prompting the NHS in England to issue its first amber alert. With stocks of the ‘universal’ blood type O-, which can be given to everyone, down to just two days’ supply – a third of the required level – health bosses suggested that hospitals postpone some non-urgent operations, such as hip and knee replacements.
But Shadow Health Secretary Wes Streeting said last night: ‘The Government must get a grip, secure blood supplies and ensure patients don’t see further delays for operations.’
MPs, medics and charity bosses last night demanded urgent action to tackle the unprecedented crisis in blood supplies – including the return of walk-in appointments for donors
Now The Mail on Sunday launches a campaign to tackle the crisis. Health professionals, experts and politicians backed our calls for:
- Walk-in services to be reinstated and the process of giving blood made easier for donors
- A renewed focus on getting black people to donate, as they are far more likely to have a type of blood that is in particularly high demand
- The main NHS app – downloaded by 30 million people – to be used to drive donations
Walk-ins were scrapped in 2016 as part of a cost-cutting drive. NHS Blood and Transplant (NHSBT) claimed they were inefficient and expensive, and replaced them with appointments booked via the internet, phone or the NHS Give Blood app.
But last night Caroline Abrahams, the charity director of Age UK who has previously described the walk-in ban as ‘crazy’, called for a rethink.
She said: ‘Processing blood donors online is no doubt cheaper and administratively easier than doing it in the traditional way, but the end result may be that some people who are keen to give blood will no longer be able to do so. At a time when we know the NHS would like more blood to be donated, making the process online-only will hardly help.’
The Mail on Sunday has launched a campaign to end the blood donor crisis and reopen walk-in clinics
Rachael Maskell, a Labour member of the House of Commons health committee, said: ‘NHSBT should be doing everything possible to make it easy for people to donate. Walk-in appointments seem to be a very good idea.’
Peter Bowell, a former manager of Oxford Blood Centre, which used to process donations from across southern England, said scrapping walk-ins was ‘a mistake’ and that ‘they should be brought back’. He added: ‘The donor is king and we should be doing everything to get as many people as we can through the door.’
NHSBT stressed that walk-ins only ever accounted for one in 12 donors, and that having people book appointments in advance allows the NHS to target those with blood groups most in need at the time.
Targeting has become increasingly important as demand for O- blood has crept up even as overall demand has fallen. One reason for this is the growing prevalence of the blood disorders sickle cell disease and thalassaemia, which are more common in black and South Asian people. Patients with these disorders can require frequent transfusions to keep healthy.
Walk-ins were scrapped in 2016 as part of a cost-cutting drive. NHS Blood and Transplant (NHSBT) claimed they were inefficient and expensive, and replaced them with appointments booked via the internet, phone or the NHS Give Blood app
If stocks of a blood group match are not available, the patient is given O- instead. For those with sickle cell, an ideal match is often a sub-type called Ro, carried by about half of black Britons.
Tracy Williams, manager of the Sickle Cell Society’s Give Blood, Spread Love campaign, said recruiting more black donors was vital, both so there was more Ro blood available and to take the pressure off O- supplies.
The campaign is supported by NHSBT but she said more could always be done. ‘We’d call on as many black heritage donors who are able to give blood, to consider giving blood,’ she added.
An NHSBT spokesman said it is bringing in extra staff to man clinics, speeding up recruitment and encouraging the use of town centre donation sites which have more availability.
Wendy Clark, the interim chief executive of NHS Blood and Transplant, said last night: ‘Patients are our focus. I sincerely apologise to those patients who may see their surgery postponed because of this.
‘With the support of hospitals and the measures we are taking to scale up collection capacity, we hope to be able to build stocks back to a more sustainable footing.’
Experts also believe that the main NHS app could help boost blood donation. It is already used to raise awareness of organ donation, with almost half a million people making their wishes clear through it.
Arjun Panesar of DDM Health, who helped develop the Gro Health app which provides NHS-certified health programmes for people with chronic conditions, said the NHS app could ‘absolutely’ be used to boost blood donation if done carefully.
Tory MP Marco Longhi, a member of the Health Select Committee, said of NHSBT: ‘The inability and unwillingness of holding to account failed NHS management is especially visible in this once-respected public service organisation.’
Just how low are NHS blood supplies and how long will this last?
Why are health bosses worried about supplies?
NHS Blood and Transplant (NHSBT) likes to have six days of blood supplies on hand. But early last week, England’s stock of O negative (O-) blood fell to less than two days’ worth. Stocks of O+ blood fell almost as low.
As the supplies, which are perishable, must be split across the country, that raised the risk of some areas running out of O-. Stocks of three other blood types (B-, AB- and A+) are below four days, while stocks of the other three types (A-, B+ and AB+) are good.
Why are the blood types O- and O+ so important?
O- is carried by just seven per cent of Britons, but thanks to unique properties it can be given to anyone, regardless of their blood type, without their immune system rejecting it. As a result it is called ‘universal product’.
O+ can also be given to about three-quarters of the population.
So when blood groups that specifically match a patient are not available, doctors resort to these, but that puts extra pressure on supplies – particularly of O- blood.
Blood supplies dropped to record lows last week, prompting the NHS in England to issue its first amber alert
What action has now been taken?
Under NHSBT protocols it must declare an ‘amber alert’ over blood stocks as a whole when levels of one type – in this case O- – fall below two days’ worth. It is the first time this has happened.
NHSBT describes an amber alert as ‘reduced availability of blood for a short or prolonged period with impact on clinical activity’. It involves asking hospitals to take extra care of blood supplies and to limit use.
What impact does this have on patients?
Some planned operations are likely to be delayed.
In particular, NHSBT has suggested that some non-urgent orthopaedic surgeries – such as hip and knee replacements – be postponed.
Emergency operations are not affected and neither are transfusions for conditions including sickle cell disease, thalassemia and blood cancers.
What has caused the problem?
NHSBT says the main problem is staffing shortages, which are forcing clinics to operate fewer donation chairs than normal.
Hospital demand for blood has also risen post-pandemic, because planned operations have resumed. Coupled with that, fewer people have been travelling to town centre clinics to donate.
Unions also claim cost-cutting measures have undermined staff morale and capacity, and made giving blood more inconvenient for donors.
How long will the shortages last?
NHSBT has said that the amber alert will ‘initially’ last four weeks.
A lot depends on the ability to rebuild supplies of O- and O+ quickly. Levels of O- have risen in recent days – from 1.92 days’ worth last Wednesday to 2.36 on Friday – and thousands of new donors have signed up. But levels are still far too low.
What happens if things get worse?
If NHSBT fears a ‘severe, imminent threat to the blood supply’ or a ‘severe shortage’ it could move to a red alert. This involves more extreme measures, such as requests for blood being reviewed by consultants. But such a move is considered very unlikely.
What’s the situation in other parts of the UK?
Supplies are lower than they should be in Scotland and Wales, but not critically so.
They have their own donation services, and their stocks are much smaller than England’s.
Northern Ireland is in a similar position to England.
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