Blood donation: the lifeblood of the NHS
As the NHS turns 70, Petra Kiviniemi delves into the MRC archive to reveal a history of blood donation closely intertwined with the birth of the NHS.
Every two seconds, someone needs blood. Blood donations help millions of people, and many would not be alive today if it wasn’t for the generosity of donors and care by our NHS.
The experience of being a volunteer blood donor was a very different picture back in the 1920s. Back then, nearly a century ago, and more than 20 years before the birth of the NHS, donations needed to be directly transferred from one person to another.
Donor and recipient lay side-by-side in hospital beds, with needles in their arms connected by tubes. The procedure took hours. Doctors were reluctant to use blood thinners, so sometimes the blood would need to be passed via a cup, manually stirred to prevent clotting. And as a volunteer donor you could be called upon at any hour, summoned by police officers knocking on your door.
Since then, the process of blood transfusion and donation has advanced significantly with new techniques, technologies and processes – driven by discoveries in medical research and new innovations in deliveries of service.
The first volunteer
The world’s first voluntary blood donation service was set up in London in 1921, by Percy Lane Oliver. The Honorary Secretary and a founding member of the Camberwell Division of the British Red Cross, Percy, with his wife, had set up and run four local refugee hostels to help those fleeing persecution during World War One.
After the War, he received a call at the Red Cross from King’s College Hospital, who were in urgent need of a volunteer to give blood. He went to the hospital, where nurse and Red Cross worker
Sister Linstead became the first voluntary blood donor. Percy was so inspired by this experience that he established a panel of local blood donors. The deal: they could be called upon to give fresh blood whenever it was needed, without receiving payment for their donation.
A free blood transfusion service
The British Red Cross Blood Transfusion Service solved the problem of sourcing blood and provided a transfusion service available around the clock. It was called upon 13 times in its first year. However, word soon spread and by 1925 they were receiving over 400 annual calls for assistance.
In 1938, just before World War Two, Britain faced the threat of war and imminent air raids. In response, the MRC prepared to establish four blood depots in London. Soon after, the War Office created the Army Blood Supply Depot in Bristol. Instead of having to rely on bleeding military personnel on the frontline, they could supply wounded soldiers at the battlefront with blood from central blood bank stores.
Filling the blood banks
The plan was a tremendous success. Blood could be collected and stored in large quantities and refrigerated in bottles ready to deliver wherever it was needed.
But vast numbers of donors were required to supply the demand for the blood they were now capable of stockpiling. So the MRC launched a nationwide campaign for new donors to come forward. The appeal – via newspaper, pamphlets, medical journal adverts, radio and cinema – was an unprecedented success. 100,000 donors registered within the first month.
A national health service
By this time, blood transfusions were no longer reserved for emergencies and were incorporated into routine surgery in hospitals. Both donors and recipients had their blood types tested to search for matching pairs.
Previously, Type O had been thought to be universally safe for all transfusions. But the discovery of more blood groups proved this wasn’t the case. After the discovery of the Rhesus factor in 1941 in New York, the Medical Research Council Blood Group Unit (BGU) in London carried out extensive research, identifying the antigens that make up the Rhesus system of blood groups. Some of these groups were much rarer than others, and matches were more difficult to find, but for most people finding a match was relatively simple.
After the War the Ministry of Health took control of the regional blood banks and created the National Blood Transfusion Service of England and Wales (NBTS) – in September 1946 just before the birth of the NHS in 1948.
Blood donation today
From a fledgling arm-to-arm ordeal, the service has evolved into NHS Blood and Transplant – with 1.3 million registered blood donors today.
And 70 years on, it’s still crucial that the NHS has a consistent, regular supply of fresh blood. In the UK, there’s usually less than a week’s supply of fresh blood in our blood banks at any one time. So as part of the celebrations for the NHS’s 70th birthday, people are being encouraged to give the NHS a present by signing up to be a blood donor.
Many people still don’t know their own blood type, but you can find out by registering. And unlike in 1925, you can book a donation slot that’s convenient for you.
Blood donation of the future
Today medical research by the MRC, the NIHR and other organisations is investigating further ways to improve blood donation and transfusion.
For example, the NIHR has invested £15.1 million in NIHR Blood and Transplant Research Units (BTRUs), research partnerships between universities and NHSBT. Earlier this year the NIHR BTRU in Red Blood Cell Products at University of Bristol discovered a way of generating red blood cells with rare blood group types in the lab using genetic engineering. This process could one day be used to help patients who cannot be matched with donor blood.
Meanwhile the INTERVAL, study jointly funded by NIHR and NHS Blood and Transplant (NHSBT) and supported by the MRC, found that giving blood more frequently – up to every 8 weeks for men and every 12 weeks for women – has no major side effects and could help to increase blood stocks.
And at the MRC Molecular Haematology Unit (MRC MHU), over 100 scientists are working to understand how mature blood cells are normally made from stem cells, and how their production is disrupted in blood diseases such as leukaemia and Von Willebrand disease (the most common bleeding disorder). The clinical and academic researchers work closely with local NHS services, so that their discoveries can be rapidly translated into improved care for patients.
And the NIHR is preparing for the future of blood donation by asking patients, donors, relatives and clinicians to identify and prioritise the most pressing unanswered questions about the therapeutic use of red blood cells, platelets and plasma. The questions identified by this James Lind Alliance (JLA) Priority Setting Partnership will guide funding decisions on blood donation and transfusion research.
When Percy Lane Oliver had his spark of inspiration almost a century ago, he surely couldn’t have imagined what an incredible service we’d have today.
The NIHR’s I Am Research campaign gives patients, the public and health and social care research professionals a chance to shout about how fantastic research is. They aim to raise awareness of the benefits of research and the positive impact it has on people’s lives. More information on this year’s campaign, which also celebrates the NHS’s 70th birthday, is available on the I Am Research campaign page.
*Stills from the wartime public information film Blood Transfusion Service, directed and edited by H. M. Nieter, a Paul Rotha production (Ministry of Health in cooperation with the MRC and the Blood Transfusion Units of the Fighting Services, 1941). The film was part of the drive to recruit donors, and it covered the history and development of blood transfusion. Printed with permission of Wellcome Film (Wellcome Library, London).
This post was originally published on the NIHR blog.