Blood recycling first in South West

Published: 13 March 2018

Torbay Hospital have been leading the way when it comes in intra operative cell salvage and there is remarkable benefits for patients as a result, including reduced risk of infections and complications, shorter hospitals stays and preservation of vital blood supply.

Torbay and South Devon NHS Foundation Trust (TSDFT) has routinely used intra operative cell salvage, a process that uses specialist technology to recycle a patient’s blood for reinfusion back into his or her own body during a procedure, for a number of years. The process is also well used across in hospitals across the country but the appointment of a blood conservation coordinator at the hospital three years ago has enabled the Trust to focus on making positive changes to the way that the cell salvage service operates. This culture change has been done by standardising training and ensuring the involvement of all staff in the process. As a result, it now means that Torbay Hospital is the first hospital in the South West to provide cell salvage for all necessary procedures, 24 hours a day, seven days a week.

This means that many patients who may have previously needed a transfusion would no longer need one at all or receive less blood via a transfusion, which is much better for their overall outcomes and means the hospital always has a vital stock of blood for those who absolutely need it.

As part of the patient blood management program, the Trust has also taken a new approach to pre assessment and all patients who are having elective surgery are now tested for anaemia. Patients with low results are more likely to need a transfusion and by identifying them before an operation patients can take reasonable steps in the diet or medication to improve their iron levels and ensure they are as fit and ready for surgery and the best recovery possible. Patients are also given medication during surgery as a precaution to reduce the chance of bleeding and the Trust has run an internal staff campaign called ‘Don’t give two without review’ to reduce the amount of blood transfusions people need. So, where patients do need to have a transfusion they only receive what is absolutely necessary and one unit of blood at a time, which is much better for them.

The drive to implement cell salvage and change how patient blood is managed has been to improve patients overall outcomes following surgery, but as a result the Trust has also been able to significantly reduce the amount of blood stock it holds. Around 360,000ml of blood has been recycled and returned to over 1000 patients in the last three years. The reduction in the amount of donor blood needed has also generated major cost savings for the organisation, saving over £300,000 since 2013.

Dr David Portch, Anaesthetist and cell salvage lead at Torbay Hospital said: “Having a blood transfusion is something that we want to avoid where possible, but it is also vital the blood stocks we do have are given to patients who absolutely need them. Using cell salvage, reviewing patients anaemic levels before surgery and ensuring more stringent review when blood is needed allows us to achieve both of these things and ensure the very best outcomes for our patients. We know that by avoiding transfusion or reducing the amount a patient needs, will result fewer complications, faster recoveries and shorter stays in hospital.

“If someone is about the have surgery there are lots of things that they can also do to ensure they have the best outcomes during and post-surgery. Eating lots of iron rich foods such as breakfast cereals, eggs, lean red meat, green leafy vegetables can really help people to have a high iron level which is optimum for reducing the risk of transfusion and enhancing recovery; plus taking regular exercise and stopping smoking can really help people recover more quickly and get home sooner after an operation.”

Liz Davenport, Interim Chief Executive at Torbay and South Devon NHS Foundation Trust said: “Pockets of innovation to improve patient outcomes are happening all over our organisation and the progress that has been made via our patient blood management programme over the last three years is excellent.

“It really does show what phenomenal impact can be made to the people we care for by bringing about small but significant changes to how we approach care and treatment. Medical technology and advances will always assist with this but the change here has very much been about best practice, working together and changing up the way we do things for the better. It is a brilliant example of how we are all working together to deliver our care model for the people of Torbay and South Devon.

“I want to thank all of the staff involved for the hard work that has gone into improving our patient blood management.”

The Trust plans to continue the work around patient blood management by raising awareness of alternative treatments and further implementing safe ways to reduce the amount of transfusions for people who need it, to help improve their recovery and health.