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Non-clinical use

Why hasn’t my blood been used for transfusion?

This happens for a variety of reasons, for example if a donation is not the correct weight or volume, if there have been problems maintaining your donation at a safe temperature or if your donation has expired before it can be used by a hospital and is therefore potentially unsafe to transfuse. Additionally, during the donation process, some blood remains in the tubing and filters that would need to be discarded.

For these reasons, NHSBT sometimes holds back donations that cannot be used for transfusion and which would otherwise be incinerated at a cost to the NHS.

What happens to blood not used for transfusion?

NHSBT is committed to 'saving and improving patients’ lives' and understands donors of blood and blood components give their donations so that they can be used for the benefit of patients. Where they cannot be used for clinical use, donations can still benefit patients in areas like the development of future treatments and therapies.

Blood (and its four main components) are important in research and development and in supporting work related to health and health improvement. For example, helping to train healthcare professionals and developing tests that guarantee the precision and reliability of vital laboratory equipment.

As a responsible NHS organisation, NHSBT helps to support such work and where we are unable to use your donation for clinical transfusion, we may (after thorough scrutiny) release it to approved organisations for agreed research and development and other projects.

NHSBT carefully manages this through a service we call 'Non Clinical Issue'. Providing blood to approved organisations for approved non-clinical uses is an additional activity and we will only use blood that cannot be used for transfusion.

Do you sell my blood?

No.

When we supply blood and blood components to hospitals for transfusion, NHSBT is required to recover the costs we incur in making those components available. Similarly, NHSBT uses the same approach when we recover the costs we incur when we make donations available for non-clinical use.

In allowing NHSBT to recover our costs in making donations available for non-clinical use, The Department of Health requires NHSBT to retain those monies for the benefit of the wider health service.

Just as with the supply of blood to hospitals for clinical use, we do not put any financial value on (or sell) your donation itself (and are prevented by law from doing so). The costs we recover are related to things such as blood equipment, collection bags, staff, processing costs and our other associated overheads.

Also, when we supply blood to approved organisations for approved non-clinical uses we specifically prohibit them, too, from placing a monetary value on (or selling) your blood.

How can approved organisations use my blood?

NHSBT has developed a strict list of approved uses that we consider when supplying blood for non-clinical purposes. These are:

  • Education and training
    Under the endorsement of a bona fide institution and usually within a recognised course or training programme
  • Laboratory diagnostics/Quality Assurance/Quality Control
    Including national Quality Assurance schemes and laboratory control schemes for example to ensure reliability and consistency of testing protocols and in validating diagnostic tests, equipment and processes
  • Transfusion and transplantation service development
    For example in blood pack or test kit validation or in the development and introduction of a new process or diagnostic tests
  • Development of, or use in, the manufacture of medicinal products and medical devices
    For instance in the development of assays, diagnostic test kits or reagents used in laboratory equipment
  • Research and development for the purpose of improving health and patient outcome
    Either in a laboratory/research environment or in examining clinical use of the blood, cells or tissues. Blood and cells provided non-clinically are never used for direct transfusion or transplantation into patients.

Do you use my blood for testing involving animals or for genetic analysis?

NHSBT takes your donation with the intention of using it for transfusion.

As an apheresis donor or as a donor of whole blood (which we use to provide a range of blood components) you give 'generic' consent for us to take and use your donation.
When giving generic consent you agree that - where it is not possible to use your blood for clinical uses - your donation can be used for approved non-clinical uses. Generic consent does not cover the use of your blood in research that (directly or indirectly) involves animals or genetic testing.

Occasionally, NHSBT is approached by organisations who wish to use blood in ways that are not covered under generic donor consent. This type of work is often at the cutting edge of research and - because of this - can be controversial and may include animal work or work to examine blood at a genetic level.

In the case of genetic testing you are required by law (and in the case of research using animals, you are required by NHSBT’s policies) to give 'specific consent' to approve the use of your blood in this way.

If NHSBT feels it would like to support such work we will make it a condition for the organisation to arrange for donors to give 'specific' consent for their blood to be used in the work they are undertaking.

Obtaining specific consent for these projects uses a different process to the normal 'generic' consent and requires that - prior to your donation - you are given detailed information about the exact work and how (if you consent) your blood will be used.

Representatives of the organisations may also spend time with you individually so that you are clear on the work they are doing.

It is important to stress that NHSBT is under no obligation to make your donation available for non-clinical uses. We can (and do) reject applications from organisations where we do not believe the request to be an appropriate use of a donor’s gift.

Requests are reviewed at a senior level in NHSBT with a wide variety of stakeholders, including clinicians.

General and specific consent is always given voluntarily. Donors who are approached to give specific consent can decline without any effect on their donation or future donations.

How do you decide who can receive my blood?

NHSBT strictly defines the types of uses we will consider for blood we cannot use clinically. We also consider the nature of the organisation that is asking for access to your blood and how and why they will be using it.

This review is undertaken at senior medic or clinician level within NHSBT by staff who are trained and experienced in assessing requests for access to blood for non-clinical uses. Consideration is also given to whether the work being undertaken requires (and has been granted) ethical approval from a body recognised by the NHS Health Research Authority (HRA).

NHSBT is under no obligation to make your donation available for non-clinical uses and we can (and do) reject applications from organisations where we do not consider the intended use to be an appropriate use of a donor’s gift.

Can I see a list of organisations to whom you supply my blood?

The supply of blood to organisations (including individual researchers, university organisations, companies, laboratory control organisations) for non-clinical uses is covered by confidential contracts that set out what can, and cannot, be done with your donation.

It is important to stress that our contract specifically prohibits approved recipients of your blood from 'selling' it on to other people or from using it in ways other than those we have specifically agreed.

Because of the often novel and ground-breaking nature of the work they carry out it is reasonable for researchers and other recipients to expect their work to remain confidential.

As part of the formal application process, NHSBT asks for full and transparent disclosure of relevant information that will be used when assessing whether we will, or will not, approve a request for access to blood and blood components for non-clinical uses.

Research involving the use of blood and blood components is often subject to a range of external certification and licensing which also provide strict limitations on the use of your donation.

Will I be contacted by a researcher about anything they may find out about my donation?

No.

Organisations who receive blood and blood components from NHSBT that are obtained under 'generic' donor consent are barred from making any attempt (either intentionally or accidentally) to identify donors or to contact NHSBT with any information related to the donations that have been supplied to them.

Blood and blood components are provided to those recipients anonymised. This means that your donation does not contain any personally-identifiable information or data that would enable a donation to be traced back to you.

NHSBT’s IT systems are configured to anonymise your donation as it passes through our various stages of 'manufacture' and supply. This means that our staff do not have access to information that could be cross-referenced with other information to re-identify you.

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