National Blood Service

NBS mobile blood donation lorry.

The National Blood Service 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 Battenburg markings used on NBS vehicles

The NBS is part of NHS Blood and Transplant, which is a National Health Service Special Health Authority. The authority also includes the Bio Products Laboratory, which supplies blood products to hospitals and UK Transplant, which operates the national organ donor register.

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 fifteen 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 three large 'supercentres' to serve the same geographical area. Staff are opposed to this strategy,^[1] and it is now^[when?] under review. The future organisation of NBS blood processing and testing is still to be agreed.

NBS vehicles are allowed the use of blue lights and sirens (known commonly "blues and twos") for the use of emergency blood transports. In some cases this will also require the use of a police escort for the transporting vehicle in order to safely and quickly navigate major road junctions. Escort is normally provided by several Motorbike units.

Donations

See also: Blood donation

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).

Pre-donation

Prior to each donation, the donor's iron level is checked to make sure they are not anaemic. The donor will be required to fill in a questionnaire to provide consent and declare that the donation will be safe (for example, stating that the donor does not have a heart condition), and it is safe to give the donor's blood to someone else. The client is also given this survey to identify themselves as being homosexual. If they do identify as Homosexual they are considered to be ineligible to donate.

Donating blood

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 10 minutes, during which 470 millilitres (17 imp fl oz) of whole blood is given.

Post-donation

The dressing applied to a donor's arm after giving blood

Following the donation (and subsequent dressing of the wound), donors are invited to refreshments. This period serves two vital purposes: to replace certain lost fluids^{[clarification needed]}, and to allow staff to maintain the donor's wellbeing.

Donations can also be taken by machines called cell separators, usually in larger blood donation centres located in city centres. These machines use a process called apheresis to collect either blood plasma only, or plasma and platelets, the other blood cells being returned to the patient. Platelets are the tiny fragments of cells in the blood which help it to clot and so stop bleeding, and are used in the treatment of cancer and leukaemia. A constant supply is vital because platelets only last five days once collected. People who give plasma and/or platelets can donate every two weeks, and each donation usually gives two or three adult doses. One adult dose of platelets would otherwise require four whole blood donations.

Controversy

The service has come under criticism for a long implemented policy of banning men who have sex with men (MSM) from ever being blood donors. University students in both England and Scotland have protested against the ban,^[2][3] and University of Birmingham's Guild of Students banned the National Blood Service from setting up a recruitment stall during Freshers' Week.

MSMs are banned for life under the policy; heterosexual people who have engaged in risky sexual practices (e.g. sexual activity with a prostitute or intravenous drug user) or who are returning from countries with a high rate of HIV infection are banned for one year. People who have recently had major surgery, acupuncture, tattoos, or body piercing have to wait before they can give blood again.^[4] For tattoos and body piercing the wait is now four months [1]

Officials within the service maintain that despite their screening of blood for infections, no test can be always 100% accurate, and they feel the ban is still valid for safety reasons, as MSMs are at a higher risk of carrying blood transmitted diseases, such as HIV. According to the latest statistics (2005) from the Health Protection Agency a third of newly diagnosed individuals with HIV in the UK were MSM.^[5] However, evidence presented during a court case in Australia has shown that allowing MSMs who practice safe sex to donate blood would result in only one HIV-positive donation slipping through every 5,769 years. The scientists at the trial, brought by a gay man against the Australian Red Cross, contrasted the high risk of patients dying from having been given stale blood—which blood services are giving out due to a lack of donors—with the negligible risk of patients dying from lifting the ban on gay men who use condoms.^[6]

Legal

A vs The National Blood Authority (Queens Bench Division) [2] This trial concerned the claims of 114 Claimants, for recovery of damages arising out of their infection with Hepatitis C, from blood and blood products through blood transfusions from 1 March 1988. All the claimants received blood transfusions or blood products usually in the course of undergoing surgery, whether consequent upon having suffered an accident or otherwise, immediately after childbirth.

See also

• NHS Blood and Transplant England, North Wales
• Irish Blood Transfusion Service Ireland
• Scottish National Blood Transfusion Service Scotland

References

1. ^ "Minutes of Scrutiny Board". Sheffield City Council. 11 June 2007. http://www.sheffield.gov.uk/your-city-council/council-meetings/scrutiny/health-and-community-care/agenda-11th-june-2007/minutes-11-june-2007. Retrieved 2007-10-22. 
2. ^ "Students protest gay donor ban". Pink News. 6 February 2006. http://www.pinknews.co.uk/news/articles/2005-423.html. Retrieved 2007-10-22. 
3. ^ "Students want gay blood rethink". BBC News. 23 February 2006. http://news.bbc.co.uk/2/hi/uk_news/scotland/4743020.stm. Retrieved 2007-10-22. 
4. ^ Who can't give blood - The National Blood Service
5. ^ "Annual Report A Complex Picture HIV and other Sexually Transmitted Infections in the United Kingdom: 2006". Health Protection Agency. November 2006. http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1196942145471?p=1249920575999. Retrieved 2010-01-19. 
6. ^ Hari, Johann (13 October 2008). "People are dying because gay men can't give blood". The Independent. http://www.independent.co.uk/opinion/commentators/johann-hari/johann-hari-people-are-dying-because-gay-men-cant-give-blood-959316.html. Retrieved 2008-10-14. 

External links

• National Blood Service
• Save Our Blood Service - campaign against centralisation
• Amicus (Unite) NBS section - discussion documents and press releases from one of the unions representing NBS technicians, regarding service restructuring and governance