How low are NHS blood supplies and how long will this last?

Blood supplies fell to record lows last week, prompting the NHS in England to issue its first orange warning. With supplies of the “universal” blood type O-, which can be given to anyone, down to just two days’ supply — one-third the level required — health chiefs suggested hospitals do some non-emergency surgeries, such as hip and knee replacements.

Last night MPs, medics and charities demanded urgent action to address the unprecedented blood supply crisis – including the return of walk-in appointments for donors.

They fear the shortages will continue into the new year, meaning thousands of operations will have to be cancelled.

Why are health bosses worried about supplies?

NHS Blood and Transplant (NHSBT) likes to have a six-day supply of blood on hand. But early last week, Britain’s stock of O-negative (O-) blood fell to less than two days. Stocks of O+ blood fell nearly as low.

Because the stocks, which are perishable, have to be distributed across the country, there was a risk that some areas would be left without O-. The stocks of three other blood groups (B-, AB- and A+) are under four days, while the stocks of the other three types (A-, B+ and AB+) are good.

Why are the blood groups O- and O+ so important?

O- is carried by just seven percent of Britons, but its unique properties allow it to be given to anyone, regardless of blood type, without their immune system rejecting it. This is why it is called ‘universal product’.

O+ can also be given to about three quarters of the population.

So when there are no blood types available that are specific to a patient, doctors resort to them, but that puts additional pressure on supplies – especially O-blood.

What action has been taken now?

Under the NHSBT protocols, it should sound an ‘orange alarm’ for blood supplies as a whole when levels of one type – in this case O- – drop below two days. It’s the first time this has happened.

NHSBT describes an orange warning as ‘reduced blood availability for a short or prolonged period with impact on clinical activity’. It is about asking hospitals to take extra care of the blood supply and to limit its use.

What impact does this have on patients?

Some planned operations are likely to be delayed.

In particular, NHSBT has suggested that some non-emergency orthopedic surgeries — such as hip and knee replacements — be delayed.

Emergency surgeries are not affected, as are transfusions for conditions such as sickle cell disease, thalassemia, and blood cancers.

What caused the problem?

NHSBT says the biggest problem is staff shortages, forcing clinics to use fewer donation chairs than usual.

The demand for blood in hospitals has also risen after the pandemic, as scheduled surgeries have resumed. In addition, fewer people have traveled to clinics in the city center to donate.

Unions also argue that cost-cutting measures have undermined staff morale and capacity and made giving blood more difficult for donors.

How long will the shortages last?

NHSBT has said the orange alert will “initially” last for four weeks.

Much depends on the ability to quickly rebuild the stocks of O- and O+. The level of O- has risen in recent days — from 1.92 days last Wednesday to 2.36 on Friday — and thousands of new donors have signed up. But the level is still far too low.

What happens if it gets worse?

If the NHSBT fears a ‘serious, immediate threat to the blood supply’ or a ‘serious shortage’, it could go on a red alert. These are more extreme measures, such as having blood questions checked by advisers. But such a move is considered highly unlikely.

What is the situation in other parts of the UK?

Stocks are lower than they should be in Scotland and Wales, but not critical.

They have their own donation services and their stocks are much smaller than England’s.

Northern Ireland is in a similar position to England.