1. ARTICLE TRANSFUSION SCIENCE
218 THE BIOMEDICAL SCIENTIST MARCH 2009
Housed in what looks like a huge gleaming
box, it’s still hard to guess from its futuristic
exterior that the new NHS Blood and
Transplant (NHSBT) blood centre is home
to one of the most advanced blood processing
hubs in the world. But walk through the doors
and the endless white spaces, electronic
security and the calm hum of efficiency leave
no doubt that you’ve entered a 21st-century
state-of-the-art facility.
Hidden away in a nondescript business
park in Filton, north Bristol, this is the
world’s largest blood processing centre,
handling a third of the NHSBT’s blood
supplies. Taking up 14,000 square metres,
it already deals with 600,000 units of blood
a year – a figure set to rise yet further to
a staggering one million by the end of 2009.
And alongside its massive throughput, the site
also houses the World Health Organization
(WHO) International Blood Group Reference
Laboratory, the British Bone Marrow Registry,
the NHS Cord Blood Bank, and training
facilities for an external MSc in transfusion
and transplantation science.
The new centre is the culmination of
The future of blood
Since the middle of last year, the focus of blood services for the south-west
of England has been on Filton, a suburb of Bristol. Susan Pearson explains
the workings of this advanced blood processing hub.
several years’ work and planning to consolidate
blood services for the entire south-west of
England. While there has been a blood centre
on the Southmead Hospital site in Bristol
for decades, this had been so extended and
adapted over the years that, despite providing
an excellent service, it was obviously bursting
at the seams.
According to Stuart Penny, regional
operations manager for NHSBT’s patient
services in the south-west: “It got to the
point that if we wanted to introduce new
technologies, such as variant CJD testing when
it comes along, we just couldn’t fit anything
more into the old building. We soon realised
that we could improve efficiency and quality
enormously by consolidating all the south-
west’s processing and testing under one
roof, and this would allow us to operate
in a completely different way.”
MULTI-MILLION DOLLAR BABY
The project needed £59.8 million in funding,
which it received directly from the Department
of Health. Building started in October 2006
and the first services moved to the new site
in July 2008. Since then, the centre has pulled
together all routine donor testing from Bristol,
Birmingham, Oxford, Southampton and
Devon and Cornwall to serve 14 million
people and 90 hospitals.
The new centre now handles everything
that was handled previously at Southmead:
blood grouping and microbial screening,
quality control, the ‘manufacture’ of red cells,
fresh frozen plasma, buffy coats, leucocyte
concentrates and platelets, histocompatability,
immunogenetics (previously tissue typing), red
cell immunohaematology (including additional
phenotyping) and research running alongside
these departments. Only Southmead’s blood
donation clinic has stayed behind to serve
the therapeutic apheresis clinic for hospital
in-patients and to provide continuity for blood
donors. The rest of the building has been
transferred to the North Bristol NHS Trust.
While all these services from the region’s
other centres have also been absorbed into
the new site, stockholding units have been left
at Birmingham, Oxford, Southampton and
Plymouth to distribute blood screened and
grouped at Filton to local hospitals in these
areas. Blood donations are still collected locally
and the UK’s blood stocks are still managed
on a national basis to ensure that blood groups,
for example, are equalised across the country.
LEAN CULTURE
What has been most significant about working
on a much larger scale is that it has enabled
a complete change of culture. “We now talk
about ‘manufacturing’ rather than processing,”
says Stuart Penny, “because some of the
systems we’re now using are more akin to
manufacturing set-ups you might see in the
world outside blood. What we’ve created is
more like a pharmaceutical manufacturing
environment, operating on Lean principles.”
In this Lean culture, equipment is laid
out to create a very specific flow of processes
through the laboratories, and staff ‘gown up’
more than previously and wear more personalThe futuristic exterior of the new NHS Blood and Transplant blood centre at Filton, near Bristol.
‘Hidden away in a nondescript
business park in Filton,
north Bristol, the new centre
handles a third of the
NHSBT’s blood supplies’
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2. ARTICLE
THE BIOMEDICAL SCIENTIST 219MARCH 2009
protection equipment. Each laboratory
has only one entrance, which can only be
accessed via a clean ‘gowning up’ area.
The manufacturing area is maintained to
a specific grade – not only is it a white coat
area, but temperature, humidity and
particulates are also managed to create
a high-tech pharmaceutical environment.
The centre is already attracting
international attention for its achievements.
The laboratories have passed two Medicines
and Healthcare products Regulatory Agency
(MHRA) inspections with higher than
average results, and, when nucleic acid
testing for hepatitis C is brought across from
Birmingham, Filton looks set to become
Europe’s most efficient blood testing centre.
PROCESS FLEXIBILITY
As well as scale, the key to Filton’s efficiency
is flexibility. The huge spaces of the blood
screening and manufacturing laboratories
are set up so that all workstations can be
reconfigured at any time. This is achieved by
keeping all equipment on wheels, with power
points supplied via overhead arms that can
be turned in any direction. While diagnostics,
blood typing and manufacturing follow a series
of cells in a logical flow around their respective
laboratories, the laboratories’ flexible
design means that new diagnostics and
manufacturing processes can be introduced
easily at any time without disrupting this flow.
In the ‘manufacturing hall’, which looks
similar to a high-tech factory floor, units of
blood are identified electronically before being
passed to an overhead leucocyte filtration unit.
This is a massive piece of equipment based
on a machine in Munich and is designed
specifically to fit into Filton’s huge space.
This impressive mechanism allows hundreds
of blood packs to be filtered each day before
passing through the lines of manufacturing
cells arranged along wide aisles.
At the first cell, blood is centrifuged to
separate red cells and plasma, then it moves
on to a sophisticated bag press which pushes
the plasma out into separate bags. Those
destined for platelet manufacture bypass the
initial leucocyte filtration and are spun at
different speeds to separate the buffy coat
from the red cells and plasma. All the
separated components are then logged
and stored temporarily.
At secondary posts, separated buffy coats
are pooled and platelets separated via a
connecting device that utilises a hot blade
to weld together the tubing between the bags.
The platelets then move on to a station where
they are washed through with plasma, before
progressing for labelling.
The red cells, platelets and plasma are
quarantined in a series of cold stores, incubators
and freezers, respectively, while waiting for
microbiology and grouping results. Once the
results are available, the components move on
to a validation station where they are labelled
with a barcode. They then return to storage.
All the blood components are moved around
the laboratory via a system of conveyor belts,
their final destination being the hospital
services department at the end of the
manufacturing hall furthest from the
laboratory entrance. Here, separate exit doors
mean that the blood can be loaded straight
from the building onto NHSBT temperature-
controlled delivery vans waiting outside
the door.
IRRADIATION DEBATE
Another innovation at Filton is the use of
X-ray rather than gamma ray irradiators to
eliminate transfusion-associated host-versus-
graft disease. There has been considerable
debate in the blood transfusion world about the
replacement of gamma irradiators with X-ray
units. Gamma rays require a sealed room as
well as efficient control of access to prevent
unauthorised use, including any individuals
who might want to misuse radioactive sources.
After Oxford, Filton is only the second centre
in the country to introduce X-ray irradiators.
STAFFING ISSUES
The blood manufacturing hall is a 24/7
operation with a team of around 85 staff
working rotating shifts, while diagnostics,
grouping and quality control has a bank of
60 staff working in shifts from 7.00 am to
11.00 pm, six days a week. In total, Filton
employs 500 staff, which includes 100 new
jobs in Bristol. Inevitably, there have been
some job losses elsewhere in the south-west,
but every effort has been made to keep
redundancies to the absolute minimum.
Wherever possible, staff members have been
redeployed, while those who cannot be
accommodated have been offered retraining
and advice.
The staff have been key to adoption of
the change of culture at Filton and to getting
the centre up and running so quickly and
smoothly. “They have been fantastic,” says
Stuart Penny. Good communication at all
levels has been crucial, he says, to ensure that
people are comfortable in the new working
environment. There are monthly group
meetings and ongoing in-house training,
and staff can relax outside their laboratories
in informal seating areas and in an attractive,
airy restaurant.
CARBON CONSIDERATIONS
As a 21st-century facility, the Filton operation
has been planned carefully to minimise its
carbon footprint. The building has been built
to meet high NEAT (New and Emerging
Technology) standards, which, through
applied research, aim to enhance the quality,
efficiency and effectiveness of health and
social care. The building has also been
designed so that it can be extended easily,
while security – another 21st-century
consideration – is an integral part of the
operation, with controlled areas that can
only be accessed by electronic passes.
PARK AND RIDE
Much thought has also gone into minimising
the movement of huge quantities of blood
around the country, and the Filton NHSBT
centre has won a five star ‘Motorvate’ award,
the government scheme for scoring public
services on good transport management.
Filton is easily accessible by bus and a green
staff transport plan, which includes shuttle
buses to the Southmead site, encourages
cycling and car sharing. ᔢ
To find out how you can donate blood,
visit www.blood.co.uk or telephone
0845 7 711 711.
In the ‘manufacturing hall’, which looks similar to a high-tech factory floor, units of blood are
identified electronically before being passed to an overhead leucocyte filtration unit.
BLOOD FACTS
•Platelets have a shelf-life of five days
•Whole blood has a shelf-life of 35 days
•1.3 million individuals make 2 million donations
every year, which means that some people
donate their blood three times a year
•15% of National Blood Service donors drop out
each year
•It takes 40 minutes to donate whole blood and
90 minutes for platelets
•Blood donors must be aged 17–59, weigh over
7 st 12 lbs and be in general good health
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