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Nearly half of patients with blood cancer are insufficiently protected against the Omicron variant after three vaccine doses, according to a new study. Experts from the Francis Crick Institute and the Royal Marsden NHS Foundation Trust said their research highlights the need for a fourth jab among these vulnerable people. As part of the ongoing Capture study, scientists have been monitoring the antibody response of hundreds of patients with different types of cancer, after one, two and three vaccine doses. Specifically, the researchers measured levels of neutralising antibodies which identify, attack and block the Omicron variant from infecting the body’s cells. Patients with solid tumours appeared to generate antibody responses similar to people without cancer. But among patients with blood cancer who had three doses of a Covid-19 vaccine, only 56 per cent generated neutralising antibodies, according to the study, which has been published as a research letter in The Lancet. This means that 44% of patients with blood cancer did not generate a sufficient antibody response. The study supports the need for four jabs among these immunocompromised groups of people. “We found that a third vaccine dose boosted the neutralising response against Omicron in patients with cancer, but the effect was blunted in patients with blood cancer compared to those with solid cancer,” the authors wrote. Read full story Source: The Independent, 25 January 2022

A group of survivors and relatives of people who died in the infected blood scandal are suing a school where they contracted hepatitis and HIV after being given experimental treatment without informed consent. A proposed group action lodged by Collins Solicitors in the high court on Friday alleges that Treloar College, a boarding school in Hampshire that specialised in teaching haemophiliacs, failed in its duty of care to these pupils in the 1970s and 80s. The claim could result in a payout running into millions of pounds, and is based on new testimony given by former staff at the school to the ongoing infected blood inquiry. Gary Webster, 56, a former pupil who was infected with hepatitis C and HIV after being treated with contaminated blood at the school in the early 80s and gave evidence to the inquiry last year, is the lead claimant of the 22 survivors in the group. Speaking to the Guardian, he said: “We were lab rats or guinea pigs. We always thought that we may have been experimented on for research purposes, but we had no proof until the evidence given in the inquiry.” Last year in testimony to the inquiry, the former headteacher of Treloars, Alec Macpherson, confirmed that doctors at the school were “experimenting with the use of factor VIII”, an imported pooled plasma that was later discovered to be contaminated with HIV and hepatitis. He said he and other teaching staff did not question doctors about the trials. He told the inquiry: “We didn’t have any authority or reason to interfere. You can’t – doctors are god, aren’t they?” Macpherson said he consented to the treatment because he trusted the doctors, and he could not recall if parents were informed and consulted. Read full story Source: The Guardian, 23 January 2022

NHS stocks of blood may become “critical” this winter, a regulator has warned, as Covid and higher than average winter rates of cold and flu risk donation levels. The NHS Blood and Transplant authority declared a major incident at the end of October after its supply of blood supplies dropped to critical levels, nationally. The regulator’s supply was at risk of dropping to below two days’ supply across the country, when it aims to have at least five days at all times. This is the second time the regulator, which is responsible for blood donation supplies to the NHS, has declared a critical incident in the last 12 months. The last time the regulator declared an incident over low stocks was due to bad weather and snow in 2018 during the “beast from the east” storm and in Cornwall in 2019, which resulted in decreased donation levels. Read full story Source: The Independent, 12 December 2021

Lung transplant patients in Birmingham are facing significantly worse survival rates as a “sobering” report has revealed two-thirds of patients have died within five years, The Independent has learned. Survival rates for lung transplant patients at University Hospitals Birmingham Foundation Trust after five years are now almost 20 percentage points lower than the other main hospitals specialising in lung transplants. The latest figures from NHS Blood and Transplant (NHSBT) have revealed Birmingham’s five-year survival rates decreased from 79% in 2015-16 to 31% in 2020-21, and have consistently been the lowest compared to the other four other transplant hospitals in Newscastle, Cambridgeshire, London and Manchester. The latest NHSBT’s report showed of those patients who had a transplant in Birmingham between 2012 to 2016, 31 per cent survived. During the same period in Newcastle 47 per cent of patients survived, in Papworth and Manchester 51%, while London’s Royal Harefield recorded a 56 per cent survival rate. Birmingham recorded the lowest patient survival rates 90 days after surgery and for one year after surgery between 2016-17 to 2020-21. Although for these measures the hospital was within the national average, unlike its five-year survival rates. One transplant surgeon has raised concerns over the continued poor survival rates at Birmingham, claiming they showed the “staggering” failure for the programme in the city to improve. Read full story Source: The Independent, 23 November 2021

From the end of 2021, a question on sexual activity of partners in areas where HIV is widespread will be removed from the donor safety check form, in an effort to increase inclusivity among donors. The changes will particularly improve the ease to donate blood for Black African donors. Currently, prospective donors are asked if they have recently had sex with a partner who may ever have been sexually active in an area where HIV is endemic, which includes most of sub-Saharan Africa. If they have, the donor will then be deferred for three months after the last sexual contact with that partner. This can often mean Black African and other potential donors in long-term relationships have been unable to donate blood. Now, the UK Government has outlined plans to remove the question from those asked in the donor safety check, opening the door to a greater number of donations. Increasing blood donor inclusivity for those who are Black African, Black Caribbean, and of Black mixed ethnicity is particularly important because they are more likely to have the rare blood sub-group, such as Ro, that many Black sickle cell patients need. The change, making it easier for people from these groups to donate, will create greater opportunities to meet the ongoing need for rarer blood types and help improve and save lives in the UK. Read full story Source: National Health Executive, 11 October 2021

It was "regrettable" that the government said there was "no conclusive proof" AIDS could be transmitted by blood products in 1983, a public inquiry has heard. Giving evidence, former secretary of state Lord Fowler said it would have been better to add that it was likely NHS treatment could be contaminated. But he said he didn't think the change would have made a crucial difference. Survivors have accused ministers of playing down the risks at the time. It's thought around 3,000 haemophiliacs died of AIDS and hepatitis C after being treated with a blood-clotting product called Factor VIII in the 1970s and 1980s. Groups representing families of those affected by the scandal claim the use of the phase "no conclusive proof" minimised the danger from blood products at the time. Read full story Source: BBC News, 22 September 2021

GP surgery staff are facing abuse from patients who are “angry and upset” that their blood test has been cancelled because of the NHS-wide chronic shortage of sample bottles. “Patients are angry when we ring them up and say, ‘Sorry we can’t do your blood test after all’. A lot of people are quite angry and concerned about their own health,” Dr David Wrigley, the deputy chair of council at the British Medical Association, said. “Patients are quite rightly upset and some get quite aggressive as well. They are worried because they don’t know what the implications of their cancelled test are for their health.” GP practices in England had begun cancelling appointments because the NHS’s main supplier could not deliver stocks as planned for one to two weeks because of “unforeseen road freight challenges”. NHS England has responded to the shortage of blood sample bottles by telling GPs to cancel all but clinically urgent blood tests and hospitals to cut back the tests they do by at least 25%. Read full story Source: The Guardian, 6 September 2021

Becton Dickinson (BD), which manufactures most of the blood tubes used by the NHS, has alerted NHS England and NHS Improvement (NHSE/I) to a global shortage of some of its products, including two types of blood tubes: those with a yellow or purple top. BD says that the COVID-19 pandemic created the most unpredictable demand it has seen in the past 70 years. The company says that it has also been difficult for customers to predict the types and quantities of blood tubes they will be using from month to month, which affects manufacturers’ abilities to meet demand. “Adding to the issue are global transportation delays that have resulted in more products being tied up in transportation than is normal, creating additional delays in deliveries,” BD said in a statement. “Raw material suppliers are also challenged to keep up with demand for materials and components.” In the UK, BD has been authorised to import blood tubes that are approved for use in other regions of the world, including the United States. It plans to deliver nine million of these additional blood tubes to the NHS for immediate distribution. Read full story (paywalled) Source: BMJ, 3 September 2021

Doctors have warned GPs are having to make difficult choices about which patients get blood tests because of the ongoing shortage of test tubes, describing it as a "perilous" situation. Due to the shortages, the NHS in England and Wales have told surgeries and hospitals to temporarily stop some blood testing, which includes tests for fertility, allergies and pre-diabetes. One woman, Alison Webb, has said she cannot have her yearly thyroid and cholesterol checked due to the shortages - and her tests are already overdue by four months. A Department of Health and Social Care spokesperson said, "The health and care system continues to work flat out with the supplier and stakeholders to put mitigations in place, and restore normal supply, and there continues to be stock in place." Read full story. Source: BBC News, 30 August 2021

Local NHS organisations are increasing their efforts to conserve ubiquitous blood collection products amid concerns current measures are not working and stocks may run even lower. There is also a concern in east London that the message to reduce routine tests is not being heeded, with GPs not cutting back enough. However, this week the British Medical Association raised concerns over suspending routine tests, including “NHS Health Checks, monitoring of quality of care, and medication reviews”. The union said: “It would also be unreasonable to ask healthcare staff to simply delay these tests until a later date — not only for the sake of our patients, but also the entire system, which is already tackling an enormous backlog of care.” Read full story. Source: HSJ, 25 August 2021

On 10 August NHS England issued guidance for healthcare workers, including medical directors and GPs, in the light of global shortages of blood tube products, now, doctors have raised concerns about the effects that a shortage of blood tubes in England will have on patient care and the NHS, which already faces backlogs. Read full story (paywalled). Source: BMJ, 24 August 2021

Plasma from blood donations in England will be used to make a life-saving drug whilst also helping to secure NHS plasma stocks to make the antibody-based medicines, called immunoglobulins. The service will begin roll-out in the coming months, with other parts of the UK potentially following suit. Gerry Gogarty, from NHS Blood and Transplant, welcomed the decision, calling it a huge step forward. "By recovering plasma from blood donations, we can improve long-term supplies of immunoglobulin medicine, and each generous blood donation will go even further in helping to save the lives." Read full story. Source: BBC News, 17 August 2021

According to reports, Barts Health Trust and most other providers in the north east London health system may run out of blood tube collection products by the end of August. Though, according to notes seen by HSJ, a “mitigation plan with demand management in place this may extend into September”. After warning colleagues in north east London that the shortage of blood collection tubes made by Becton Dickinson affects “all NEL areas” except acute trust Barking, Havering and Redbridge University Hospitals Trust, Diane Jones, chief nurse of the NEL integrated care system has said “NHSE are looking at mitigations, but nothing confirmed as yet, and [they] may take a few weeks to come on stream. The mitigation may get us up to 50 per cent of usual supply in the short term.” Read full story (paywalled). Source: HSJ, 13 August 2021

According to NHSE guidance today, non-essential blood tests should be stopped and GPs should prioritise genomic tests over others. Vitamin D testing should also be stopped in all, but "exceptional circumstances" amid shortages in the blood collection tube stocks. The guidance, issued by the NHSE has advised genomics for testing of unwell neonates, prenatal screening and cancer diagnoses are “a high priority". NHSE have also said changes to testing “should be made in consultation with individual patients” and that “it is important to make clear that routine tests will be deferred only where it is clinically safe to do so”. Read full story (paywalled). Source: HSJ, 10 August 2021

A national shortage in blood collection tubes has meant trusts are having to limit blood tests, with some trusts advising doctors to only order blood tests if they deem it absolutely necessary or using the same tubes for different tests rather than using a different tube of blood for each test. It has also been reported that the global disruption to the supply chain may mean shortages could continue before the supply lines recover. The NHS Supply Chain, has said there was “some improvement in the supply position in September” but that controls on the products "are likely to continue to be applied beyond this until supply stabilises”. Read full story (paywalled). Source: HSJ, 9 August 2021

A public inquiry into the infected blood scandal has heard that the government was right to say there was "no conclusive proof" that Aids could be transmitted by blood products in 1983. According to Lord Clarke, the phrase was entirely accurate at the time it was said. However, evidence in documents reveal senior health officials believed HIV could be carried through blood. "Somebody, somewhere, decided that that was the best most accurate line to take. It was repeatedly used by every minister. We kept repeating that because that was the scientific advice we had until it was perfectly clear to the medics that there was in fact sufficient proof... we weren't playing down that possibility. It seems to me... it's a perfectly accurate description of where medical opinion was at that time." Lord Clarke told the inquiry. Read full story. Source: BBC, 28 July 2021

From 1974 to 1987, children from Treloar's College, a boarding school for children with physical disabilities, were offered treatment for haemophilia. However, more than 120 children were given contaminated drug which infected many with HIV and viral hepatitis, with at least 72 having died as a result. Treloar's College had a specialist NHS haemophilia centre on site, however, the blood plasma used to make the drug had been imported from overseas. Only 32 out of the 122 children with haemophilia are still alive today. It is hoped that the public inquiry may shed some light on what happened. Read full story. Source: BBC News, 21 June 2021

Oxford writer Wayne Brown describes how he tried donating blood in the middle of the pandemic last year but was turned away due to his same-sex marriage of 14 years. However, since the ban has been lifted, he has already booked his appointment to donate. Wayne Brown discusses how since the ban has been lifted, it may now mean more progress and positive changes are happening for gay men. Read full story. Source: BBC News, 13 June 2021