IBMS issues blood tube shortages joint recommendations
Please note for Northern Ireland
The ongoing issue with blood tube supply does not affect Northern Ireland who use a different supplier.
13 September 2021
The UK transfusion guidance for safe transfusions during blood sample tube shortages has been finalised and is available from either website:
- Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC)
- Serious Hazards of Transfusion (SHOT)
This document has been developed collaboratively by National Blood Transfusion Committee Emergency Planning Working Group, SHOT and RCPath Transfusion SAC, with input from British Society for Haematology Transfusion Task Force. This guidance document should be used in line with local arrangements for risk assessment and concessionary release. While the ongoing shortage is expected to be resolved soon, this guidance document is meant to be a blueprint for Trusts/Health Boards to use to manage from a transfusion point of view. Severity of shortages is variable across the UK and measures implemented are likely to vary, these will need to be used in conjunction with current national guidelines, be risk assessed and implemented collaboratively with frontline clinical and laboratory teams. The provision of safe and timely blood components remains a priority.
26 August 2021 - update to include NHS England guidance
The supply position remains constrained and is forecasted to become even more constrained over the coming weeks. While it is anticipated that the position will improve from the middle of September, overall supply is likely to remain challenging for a significant period.
The tubes impacted by this shortage are:
- 5mls Yellow top – SST 2 – clotted sample (e.g. U&E, LFTs etc)
- Purple top – EDTA (e.g. FBC, HbA1c)
Alternative products are being sought to alleviate these constraints; and all labs that will be switching to these supplies have received samples for testing and validation.
However, it will take time for these products to be imported and delivered in volume to services. It is important and urgent that demand is reduced as much as possible and that this letter is acted upon immediately.
There is also significant pressure on a number of similar products. Organisations are asked not to switch to alternative products unless doing so in coordination with the Pathology Incident Director and NHS Supply Chain.
The following measures should be applied across the NHS in England:
All primary care and community testing must be halted until 17 September 2021, except for clinically urgent testing.
Examples of clinically urgent testing include:
- Bloods that are required to facilitate a two week wait referral
- Bloods that are extremely overdue and/or essential for safe prescribing of medication or monitoring of condition
- Bloods that if taken could avoid a hospital admission or prevent an onward referral
- Those with suspected sepsis or conditions with a risk of death or disability
20 August 2021 - updated to include NHS Scotland guidance documents
With the news of the global supply disruption to Becton Dickinson Blood Specimen Collection Portfolio, NHS England has issued recommended actions for medical directors, nursing directors, GPs and pathology laboratories to optimise resources for pathology laboratory work.
The recommendations have been developed by clinical experts from pathology teams, primary care and acute care, including input from the IBMS, Royal College of Pathologists (RCPath), the Association for Clinical Biochemistry and Laboratory Medicine (ACB), Genomics Implementation Unit (NHSE) and the Academy of Medical Royal Colleges (AoMRC).
David Wells, IBMS chief executive said:
"Our members are involved in performing over 1bn tests a year in the UK and hundreds of million blood tubes are used for several thousand different blood tests. Whilst this could have serious ramifications, we urge our members to follow the guidance set out in this document should issues arise from any supply disruptions."
Information for the devolved nations will be published when received and this news story will be updated.
NHSE steps up action on blood test tube shortage - HSJ (subscription required), 10 August 2021
Blood Bottles Action Log Aug 2021 - Jill Beech (Pathology Services Manager) and Milton Keynes University Hospital NHS Foundation Trust