IBMS issues blood tube shortages joint recommendations

18 October 2021

In reference to the global shortages of blood tube products, the IBMS informs members of the NHS guidance intended to apply to every site in order to balance demand, regardless of system being used.

18 October 2021 - NHS England

A letter has been sent to the NHS system providing an update on the supply disruption related to BD blood collection products. Best practice guidance for primary and secondary care has been issued encouraging clinicians to think twice, check twice and order once. The letter advises that NHS testing activities in line with the best practice guidance can, local stocks permitting, resume. The SitRep established for acute trusts, community hospitals and mental health trusts will now move to a weekly collection, taking place on Tuesdays.

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:

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

Please note:

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

Resources

DHSC & NHS England and Improvement: Supply disruption alert

NHS England Blood Tube Supply Disruption Alert 26 August 2021

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.