Q&A: How is the blood we donate transported? NHSBT’s transport manager explains

Every day thousands of units of blood is transported across the country. We spoke to Jed Caswell, the man behind the operation, to find out more about what goes on.

Hello Jed. What is your role at NHS Blood and Transport and what does it involve?

My job title is National Transport and Logistics Resource Planning Manager at NHS Blood and Transplant. There is a phrase in logistics about ‘getting the right product, to the right place, in the right condition, in the right quantity, at the right time’. Basically my job revolves around that.

I tend to look at how we do things, either; how we currently do things, how we can improve or how we can adapt.

Why does blood need to be transported and where does it go?

Blood of course comes from donors at donation sessions throughout the country. You then need to get it somewhere to go through the manufacturing and testing process.

If you have a session held at a church hall we will collect the blood and take it back to the nearest NHSBT location that has temperature controlled holding areas. That will either be a stockholding unit (which is an interim point) or a manufacturing unit (which is a final point).

If it goes to a stockholding unit we then move it overnight to a manufacturing unit. Once at the manufacturing unit we then reload it with the opposite side of the operation – the finished product – and take it back to the stockholding unit. Eventually it finds its way out to the hospitals and into the patient.

How much blood is transported every day?

On a day-to-day basis if you just look at the outwards side of things it is about 12,000 units being transported per day. Now that can vary by day, but it tends to be quite a lot heavier mid-week and quieter at weekends.

Do you use specialist vehicles to transport blood?

There’s a variety of vehicles we use depending on how long it takes.

The blood has what is called a validation period in packaging; we can only keep it at an ambient temperature for so long. Normally it is six and a half hours from when it is taken from the donor to when it has to go into a maximum temperature controlled area.

We then move it between centres and to hospitals in a variety of different ways. They are all temperature controlled but they can vary from refrigerated vehicles to boxes which are temperature controlled – if you can think of a very sophisticated picnic box, we use that!

What are the busiest times for transporting blood?

There are two busy times; the first one is about nine o’clock in the morning when we do the routine rounds to the hospital. We call these ‘milk rounds’ and deliver at the same time every day, between one and five times a day.

At nine o’clock in the morning a lot of them to do the first hits. They mostly carry red cells, which is most people’s perception of what blood is; the ordinary blood that we put into people. That is in quite heavy volumes because red cells have up to a 30-day shelf life so the hospitals order lots as it is the stock product.

You then have a lot of activity mid afternoon, either taking second and third deliveries to hospitals or doing a lot of ad hoc deliveries, where the hospital wants something that it needs before its next routine. It may not be an emergency but in their eyes it’s urgent.

At the same time we also have our busiest activity with all the session collections – there are about 100 of them a day and we go to them at mid-point to pick up the blood. This is because the time a session takes plus the travel time back to a stockholding unit is usually greater than the six and a half hour validation period, so the mid session collections never exceed that.

We may have 200 or 300 movements on the road at any given time.

What infrastructure does NHS Blood and Transplant have in place to transport blood across the country?

We have what is a network that runs 24/7, 365 days a year. It’s timed runs between sessions and can be the output from sessions going to manufacturing sites, the finished products from manufacturing sites going to stockholding units, specialists platelet movements or specialist testing movements – but there are about 450 routine inter-centre runs per week.

We also do around 120 ad hoc deliveries a week. On top of that we also run the warehousing deliveries where we deliver consumables to the locations throughout the country, plus the work bringing back and supporting the sessions, taking back the teams, helping them set up and bringing them back.

Who transports blood and how are they trained?

The first port of call is we have 300 of our own drivers and our own vehicles. They are trained as part of our good manufacturing practice and they go to retraining depending on which core work it is.

We also operate a national carrier contract. Again that is used on a more specialised basis; we tend to use that for more of the reactive work. We plan our own people and say ‘how many people do we need to keep them going 24/7?’ There is no spare capacity in our system.

Above that we use our external providers, who are trained on a yearly basis and have to carry ID and certification that they are trained.

What plans are in place for instances such as bad weather and a vehicle breaking down?

If one of our own vehicles breaks down we have a national contract with a leasing company. They know that if we put a call in we get priority above all their other customers. An empty vehicle doesn’t have a priority, but if it’s one of our major vehicles and it’s full of a lot of blood they have to be there within half an hour. They either repair it or arrange for it to be transported to the closest NHSBT location.

As with bad weather, it varies. The first thing we have is some of our own 4x4s that we can use. We can also call on hire companies to supply us. We have a whole series of contingency plans depending on the weather and the activity – that may be rather than run it in larger vehicles, run it more frequently in smaller vehicles.

How do charities such as Blood Bikes assist the NHS?

Charities such as Blood Bikes actually work directly for hospitals. They normally work night times and some work weekends. On behalf of the hospitals they will run what they class as urgent, so they may come to us to collect blood, they may run samples or x-rays between sites. They work for the hospitals, they don’t work for NHSBT.

Thanks Jed for taking the time to talk to us, it’s been really interesting to find out more about a process that can easily go unnoticed!

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