Transforming transfusion practice in the NHS
Recently published in the British Journal of Haematology is an article that describes the current state of transfusion practice in the National Health Service (NHS) in England, and the current efforts to address its shortcomings.
Recently published in the British Journal of Haematology is an article that describes the current state of transfusion practice in the National Health Service (NHS) in England, and the current efforts to address its shortcomings. The observations and recommendations developed to improve current transfusion practice in this article have relevance globally to health services confronting similar challenges.
The article highlighted the persistent and preventable errors according to Serious Hazards of Transfusion (SHOT) data and indicators, some of which have worsened in recent years. Over the past decade, transfusion-related deaths in the UK quadrupled, and from 2023 to 2024 increased by 55%, with circulatory overload and delays in transfusion the leading causes. National audits estimated that around 20% or more of transfusions are clinically inappropriate.
The article also sheds light on the underutilisation of alternatives to transfusion, as well as the increasing discard rate of blood products and over-ordering of ‘universal’ blood components, particularly group O Rh(D) negative red cells. Moreover, workforce shortages, transfusion training gaps, inadequate information technology, lack of provision of information to patients about transfusion and their involvement in shared decision-making, blood shortages, rising costs and absence of governance/oversight of transfusion in hospitals were also identified as contributors to the current state of transfusion practice within the NHS.
To modernise transfusion care, the authors propose: 1) immediate investment in workforce capacity and digital infrastructure, 2) the mandatory implementation of electronic transfusion systems, 3) standardised training and competency assessments for all staff involved in the transfusion process, 4) a dedicated national oversight body to co-ordinate hospital transfusion services and blood supplier performance, and 5) rigorous evaluation of new interventions to ensure clinical and cost-effective improvements.
Reference:
Murphy MF, Toh CH. Transforming transfusion practice in the National Health Service to enhance safety, efficiency and clinical outcomes. Br J Haematol. 2026 Jan 29. Epub ahead of print. PMID: 41610882. https://onlinelibrary.wiley.com/doi/10.1111/bjh.70321