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Setting up a Nightingale hospital transfusion service

Alison Muir, a Lead Scientist in Blood Transfusion, discusses the issues and challenges in setting up a transfusion service to help cope with the pandemic.

The NHS Nightingale Hospital North East (NHNE) has been designed to care for 460 patients from the North East and Cumbria. The hospital has been created with all processes fully functional and will remain dormant until the call for reactivation is received (if ever). All services will be provided by the Newcastle Freeman Hospital, including sample processing and blood provision. Questions that immediately came to mind were:

  • How will we get group-and-save specimens?
  • How will we manage the blood fridge?
  • What/how much blood to supply?
  • How much blood will be wasted?
  • What about BSQR and MHRA?

Blood transfusion is regulated by the Blood Safety and Quality Regulations (BSQR) 2005. A hospital transfusion lab must comply to ensure the quality and safety of processes. Full traceability of blood and a robust route for notification of adverse reactions and events are essential. The Medicines and Healthcare products Regulatory Agency (MHRA) ensures the laboratory’s compliance with these regulations and must be kept informed of any alterations to the service. Established governance structures exist in a hospital transfusion laboratory but how do you ensure these steps are followed in a temporary hospital?

Getting started

The task was broken down into clinical, including sample process and blood administration, and technical, concerned with logistics, safety and traceability.

From initial discussions with the NHNE command team, it was important to rein in the idea of O-negative stock with no transfusion samples, so a discussion about patient safety needed to be had. A simple transfusion process from beginning to end would need to be designed to fulfil transfusion safety requirements and to ensure compliance in the clinical area.

Time frame and blood stock

First go-live date was 12 days from the initial query. The first task was to source a suitable blood fridge that could be delivered to NHNE and commissioned before official opening. This was achieved in less than two weeks, which gave time for full temperature mapping. 

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