Today (28th December 2011) the BBC has run an article titled “Blood Bank “Perfect Storm” Threat for 2012". It argues that blood stocks in the UK may be hit by the Olympics, Queens Diamond Jubilee and other events this year. This is due to a potential drop in donations. For many years I have had the privilege of working on the blood supply chain supporting NHS Blood Stocks Management Scheme, so it seems appropriate to look at the blood supply chain and understand this threat and what we can do to avoid it.
Most developed countries employ a volunteer only basis for blood donation. Blood is either collected through mobile teams (approximately 90% of collections in the UK), who visit places such as universities and office blocks or at static donor centres. The UK currently has a donor base of 1.4 million donors. A lot of emphasis is placed on making the experience of donation a pleasant one in order to retain donors, a large percentage of blood collected comes from repeat donors (those who have donated blood in the past 2 years), while the rest is through first time donors. Once on the donor register, donors are encouraged to donate 2-3 times a year through blood group specific mail and telephone calls.
The donation process for whole blood lasts around 45 minutes. Donors arrive, are screened, donate their blood (5 minutes) and then are asked to remain, and offered refreshments, in order to ensure that no adverse effects occur. The screening process involves answering a number of questions, which focus on health, lifestyle choices and travel, which over the years these have become increasingly stringent. Holidays to some destinations mean a donor may be unable to give blood for a period of time after returning from that destination, for example.
A potential donor also has a health check by a nurse, in which their haemoglobin level is checked, to see if they have a sufficient amount of iron (which absorbs the oxygen) in the blood to donate. This is done through a prick to the finger, allowing a drop of blood to fall into solution, where is either sinks (has sufficient iron) or remains at the surface, in which case the donor is deferred for pending further investigation.
A single unit of whole blood (470ml, just less than a pint) is taken from a donor during a session, along with 3 sample tubes, which are later used for testing the blood.
The whole blood is then sent for processing where it is split into three main components; Red Blood Cells (which carry oxygen in the body), Platelets (essential for clot formation) and Plasma (also for clotting and to replace large volume loss). These can then be broken down into further specialist products, for example, neo natal products and blood that contains rare antibodies.
The blood shelf life challenge.
The shelf life of a unit of Red blood cells is 35 days, platelets 5 days, and Plasma can last a year. Due to the short shelf life of these products, speed through the supply chain is an essential issue. The processing time for a unit of Red Blood Cells is around 2 days. This varies depending on the location of the hospital and the processing centre. This however, does not include the activation time to mobilise donors, which is harder to map. In times of shortages radio and television ads are used, and the messages given to donors are altered to encourage speedier donation: however due to the unpredictability of people, the unpredictability in supply side is very hard to manage.
This is where the problem lies, the blood supply chain is effectively a chilled food supply chain with a limited shelf life for the majority of components. Think of a product like yogurt! Supply and demand have to be managed carefully but the blood supply chain does not have the luxury of being able to do a two for the price of one offer if stocks get two high! So if everyone goes on holiday for July and August the 35 day shelf life of red blood and more worryingly the 5 day shelf life of platelets is exceeded and we move from feast to famine.
Blood Donors therefore need to be consistent and planning ahead to give blood two to three times a year. If due to the Olympics, a bank holiday or an exotic overseas trip blood is not donated this can put considerable strain on the supply side of the blood supply chain. One tiny bit of good news is that modern surgical procedures mean that for routine surgery less blood is required but if a major incident was to occur when many units of blood are required in a short period of time demand can outstrip supply.
So as the Assistant director, Jon Latham asks in the BBC article “We’re calling on the public to make regular blood donations a New Years resolutions” So on that nice shiny calendar or diary make sure you block out a few days during 2012 to give blood. By doing this the “perfect storm” can be avoided.
Below you will find a YouTube video giving further insights and I have also placed a paper to download in the "Downloads" section of this website that was published in the Chartered Institute of Logistics & Transport's Journal, Logistics & Transport Focus - True Blood - Challenges in the blood supply chain - Logistics & Transport Focus - True Blood.