Located in an uninspiring industrial estate in the outskirts of Bristol, Filton is the location of the largest blood processing in the world. The scientists here deal with 3000 of the UK’s 7000 blood donations each day. Opened in 2008, the building itself is white, gleaming, and perfectly rectangular, and contrasts starkly with the waste disposal plant adjacent to it.
The inside of the blood centre consists of a vast labyrinthine set of corridors and laboratories. First stop on the tour was the manufacturing hall. ‘Manufacturing’ really is the word to use – the blood is ‘manufactured’ in the bone marrow of the donors who give it.
A blood transfusion is not simply about taking blood from one person and infusing it into another person. Blood must first be separated into three parts – red cells, plasma, and platelets – by spinning it rapidly in a centrifuge machine. The red cells are used for patients who have lost large amounts of blood. Platelets, which are tiny blood cells involved in blood clotting, are given to patients who fail to make their own (as a result of chemotherapy, for example). The proteins within plasma are also very useful, and when purified, can be used for treating diseases such as haemophilia. White blood cells must also be removed to stop the blood reacting against the recipient.
The manufacturing hall is an intimidating place, with a strongly dystopian feel to it. Thousands of blood pouches hang from strange machines, which beep and whir in a seemingly random fashion. The process itself is wonderfully efficient, with blood travelling from one end of the room to the other in an ordered production line. Every worker has a specific job, which they carry out repeatedly and methodically. Numerous warning signs – biohazards, radioactivity – are visible, adding further to the rather sinister atmosphere of the place.
It is therefore rather hard to imagine the hall under a foot of water. In 2012, severe rain combined with a blocked drain caused the entire facility to flood. NHS Blood and Transplant moved blood stocks to other centres in response, and ran other centres through the night while Filton was out of action. Remarkably, no blood stocks were lost, and normal processing was resumed within days. Clean up was rapid, and the centre received an award for the way in which they dealt with the crisis.
Next stop was the laboratories used for testing before any blood is available for use in a hospital. The most obvious test is for blood group, which is carried out using antibodies that form a precipitate in the presence of a particular blood type. If the wrong blood group is transfused into a patient, potentially fatal widespread blood clotting will occur.In addition, blood borne diseases must be screened for, such as HIV and Hepatitis. This is done using a chemical test, in which a colour change occurs if the disease is present.
The logistical challenges are clearly huge given the disastrous consequences of making a mistake. Tens of thousands of tests are done every day, and it must be possible to know which blood pouch corresponds to which blood test. A further complicating factor is that some of these tests take up to a week to detect a bacterial disease (if the infection is low level), by which time the blood may have left Filton. The whereabouts of every blood unit must therefore be known at all times, so it can be recalled before it is too late.
The next stop was the cryogenic vat room. Rather than being used to store the bodies of 1940s billionaires, the purpose of this room is to store stem cells from patient’s bone marrow. This is Filton’s second purpose: as well as being a blood processing centre, they also process many organs in readiness for transplant. The cryo room contained around 20 or so large steel vats, which let off wonderfully atmospheric mists when they were opened, as the -150 ° C air was released.
Filton bloodbank is a key part of the global bone marrow network. A bone marrow transplant is potentially life-saving for a patient with leukaemia or an autoimmune disease; however, only 30 per cent of people can find a donor within their close family. The remaining 70 per cent must turn to bone marrow registries; for 90-95 per cent of these people, a match is found. The database is truly global, and it is not unheard of for bone marrow to travel across the entire world.
Tim Knapp, Corporate Scientific and Technical Training Consultant, is certainly proud of Filton. “It’s the future of blood processing. Every procedure we do here has been looked at to make sure it’s as efficient as possible. We’ve managed to bring the price of a blood unit down from £140 in 2009 to £122 today,” he said.
It is estimated that the price drop has saved around £25 million each year – considering the centre cost only £60 million to build, the centre has already paid for itself. “There’s been a lot of visitors from other countries to see how Filton works. We’re leading the world,” he added proudly.
Julie English, another member in the training team at the centre, explains why Filton does not suffer from the so-called ‘culture of secrecy’ that can often persist in other parts of the NHS: “There is a culture here of ‘if you make a mistake, you own up to it’ – you won’t necessarily get penalised, but we’ll make sure you get retrained so you don’t make the same mistake again. Could the rest of the NHS learn from this attitude? Yes, I think they could.”
For all its glistening efficiency and gleaming modernity, at times on the tour, Filton appeared to be suffering from low moral amongst its workforce – the employees of the blood bank were seen working in silence, looking rather tired of their work. In one corridor, there was a series of photographs of Filton’s employees showcasing their hobbies – seemingly an attempt for the workforce to remind each other that life can be interesting. Tim, however, assures us that “everyone knows they’re doing a job that saves lives. I suppose some people do find the work tedious, but who doesn’t sometimes? Everyone is proud of what they’re doing, and find satisfaction from it.”
The government took a substantial risk when setting up Filton Blood Centre. Nothing on the scale of Filton had been attempted before, and significant logistical challenges had to be overcome; other centres would be closed, which would increase transport costs. However, it seems that in many ways, the risk has paid off. Inspections have praised Filton consistently, and – from a visitor’s point of view, at least – appears to be a well-run and efficient centre. Challenges, of course, remain – the centre must attempt to bring down the price of blood further, as the budget for the NHS becomes increasingly stretched.
For more information on blood donation, visit the NHSBT website http://www.nhsbt.nhs.uk/ or the NHSBT Give Blood website http://www.blood.co.uk/. You can also locate Blood Donation Sessions for you anywhere in England or North Wales using the app NHSGiveBlood developed by the NHSBT.