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The National Blood Service

Effective measures are now in place to ensure that blood is safe for transfusions. That is one of the main findings in a National Audit Office report into the National Blood Service. The report also concludes that, despite the long time taken by the Service since its creation in 1993 to make the transition from a regional to a single national service, there are clear signs that it is now doing so.

The report, presented to Parliament today by NAO head Sir John Bourn, does, however, identify a number of areas where the Service could make further changes.

Key findings in the report are as follows:

  • there are effective measures in place to ensure that blood is safe for transfusion. The Steering Group of the Serious Hazards of Transfusion Scheme (a confidential voluntary reporting system for major transfusion events) concluded in their 1998-99 report that blood transfusion is now extremely safe. The National Blood Service has taken additional measures to reduce the theoretical risks associated with variant Creutzfeldt-Jakob disease;
  • the Service’s performance at collecting blood from donors and delivering to hospitals is as good as, and in many areas better than, it was before its establishment as a national service. Hospitals were broadly satisfied with the service provided and the responsiveness of the organisation;
  • the Service has taken action to secure a sufficient supply of blood. There were restrictions in the supply of blood during 1998, and the Service acted promptly to avoid any repetition in the foreseeable future. In 1999-2000 the Service fully met hospital demand; and
  • between 1995-96 and 1998-99, the National Blood Service cut its costs by some 5.4 per cent. The Service’s performance indicators have, however, a number of weaknesses. These prevent the indicators from forming a complete and appropriate basis for accountability to the NHS Executive, or for the direction and management of the Service’s business.

The report identifies a number of areas where the National Blood Service could build on the improvements brought about since its creation and makes recommendations:

  • communications with hospitals: the Service should increase the number of hospitals it involves in clinical audits to widen awareness of good practice; use more active ways of disseminating research findings; and improve responsiveness to complaints from hospitals;
  • encouraging people to give blood: the Service should address factors that put people off giving blood, for example by reducing the time it takes to give blood; and set more demanding internal targets for the time people have to spend waiting during donor sessions; and
  • managing efficiency and effectiveness: the Service should identify and adopt good practice throughout the country, making fuller use of unit cost information and benchmarking and developing a hierarchy of performance indicators tailored for the needs of accountability, direction and management.

The National Blood Service welcomes the broad thrust of these recommendations and plans to encompass them in the design and implementation of its new management structures and systems.

"The availability of blood is essential to the NHS and many people owe their lives to transfusions that were made possible by voluntary donations of blood. The National Blood Service has had to change the blood service from a regional to a national one, cope with the emergence of variant Creutzfeldt-Jakob disease and, at the same time, maintain supplies to hospitals of sufficient safe blood.

This process of change has been accompanied by some controversy and appeared to lose momentum at one stage. But the indications are that the Service has made good progress towards providing an effective national service."

Sir John

Notes for Editors


The National Blood Service was set up in 1993 and in 1994 took over the services previously run by individual regional health authorities. The Service is responsible for collecting, processing and testing blood components and distributing them to hospitals. Employing some 5,300 people, in 1998-99 the Service:

  • collected 2.4 million voluntary blood donations from 1.9 million people;
  • supplied blood for around 800,000 transfusions;
  • spent £241 million.

Press notices and reports are available from the date of publication on the NAO website at Hard copies can be obtained from The Stationery Office on 0845 702 3474.

The Comptroller and Auditor General, Sir John Bourn, is the head of the National Audit Office employing some 750 staff. He and the NAO are totally independent of Government. He certifies the accounts of all Government departments and a wide range of other public sector bodies; and he has statutory authority to report to Parliament on the economy, efficiency and effectiveness with which departments and other bodies have used their resources.

PN: 72/00