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                                                       Held on
            Monday 13th October 2008 at Haydock Park Racecourse, Merseyside

              Lesley Adams                                     MCHFT Leighton Hospital
              Elaine Addison                                   Blackpool Victoria Hospital
              David Alderson Chair (DA)                        Trafford General Hospital
              Sanchia Baines                                   Royal Preston Hospital
              Pete Baker                                       Royal Liverpool University Hospital
              Stuart Blackwell                                 NW RTC Lay Representative
              Gill Cassie                                      Royal Preston Hospital
              Tony Davies                                      NHSBT
              Mike Desmond (MD)                                Liverpool Heart & Chest Hospital
              Clare Dundas                                     Salford Royal Hospital
              Sumaya Elhanash                                  Royal Oldham Hospital
              Jack Flevill                                     Macclesfield Hospital
              Rebecca Gerrard (RG)                             NHSBT
              Mike Goldberg                                    Arrowe Park Hospital
              Jan Gorry                                        Aintree Hospitals NHS Foundation Trust
              Marie Green                                      Trafford General Hospital
              Steve Griffiths                                  MCHFT Leighton Hospital
              Claire Grinnell                                  Spire Manchester Hospital
              Tracey Hall                                      Alder Hey Children s Hospital
              Sophia Holden                                    Royal Preston Hospital
              Andy Houghton                                    Royal Liverpool University Hospital
              Peter Hudson                                     Blackpool Victoria Hospital
              Eithne Hughes                                    Glan Clwyd Hospital
              Brian Jackson                                    Manchester Royal Infirmary
              Laura Johnstone                                  Stepping Hill Hospital
              Mark Lyon                                        NHSBT
              Louise McCreery                                  Wrighton, Wigan & Leigh NHS Trust
              Christine McQuillan                              Aintree Hospitals NHS Foundation Trust
              Mary Metcalfe                                    Manchester Royal Infirmary
              Jane Murphy (JM)                                 NHSBT
              Moira Norton                                     Countess of Chester Hospital
              Julie Oakes                                      Royal Preston Hospital
              Sharran Payne                                    Royal Bolton Hospital
              Jenny Rodger                                     Wrexham Maelor Hospital
              Deepak Sadani                                    NHSBT
              Vikki Sandland                                   NHSBT
              Mark Storah                                      Tameside Hospital NHS Foundation Trust
              Lesley Sutton (LS)                               Wythenshawe Hospital
              Elaine Thompson                                  West Pennine
              Tom Trimble                                      Trafford General Hospital
              Ruth Turner                                      Macclesfield Hospital
              Jane Uttley                                      Manchester Children s Hospital
              Julie Yates                                      Warrington Hospital
1.    Apologies

      Therese Callaghan
      Hillary Leggat
      Vanessa Martlew
      Emma Milser
      Catherine Quine
      Paul Sharples
      Dr Wardle

2.    Minutes of RTC Meeting 17.04.08

      The minutes of the last meeting were agreed.
      Action: To be changed to confirmed on website. (JM)

2.1   Action List: All completed
      6.6 Contingency planning group not formed, template to be produced from earlier
      work done by Dr Love. (MD)
      Wigan to be asked to share lessons from contingency planning exercise at next
      7.2 NBTC Chairman not written to Chief Executives as all correspondence has to go
      through NHS Gateway.

3.    Feedback from HTC s

3.1   NPSA SPN Transfusion Competencies
      Discussed along with the issue of keeping staff up to date and competent. Training
      is ongoing and competency assessments cannot be done by e-learning.

      Glan Clwyd Hospital shared an experience of assessing an FY1 doing pre-sampling
      assessment who passed, but then 5 days later took a sample for FBC from the
      wrong patient and labelled it incorrectly.

      NPSA SPN No.14 Writing Group are to have an extraordinary meeting in January 09
      to address outstanding issues e.g. should hospitals say that no staff should
      undertake blood transfusion practice unless they have passed the relevant
      assessments, and what to do re the issue of competency assessment where
      electronic tracking is in place as the current frameworks are not applicable.
      Action: Await outcome of January 2009 meeting.

3.2   Medics as sole prescribers
      It was stated that it does not legally have to be a medic who prescribes blood. A
      workshop is being held in Birmingham, 17th October 2008 on Nurse Prescribing.
      However, it is expected that prescribing by nurses will be defined to specific nurses
      in specific situations. Comment made that perfusionists also need guidance.

3.3   Guidelines re Use of FFP and Platelets in Cell Salvage
      Request made for any hospital that has guidance on this. At Wythenshawe, cell
      salvage is done in relation with TEG. Suggested that it would be advantageous for
      Dr Shwe to speak to Sarah Haynes, Autologous Transfusion Co-ordinator, at
      Wythenshawe Hospital regarding this.
      Action: Arrange for Dr Shwe to speak with Sarah Haynes. (LS)

3.4   Fibrin Sealants and Traceability
      Is it a blood product or not? A number of fibrin sealants are used in cardiac surgery
      and the same process is used as with heart valves the label off the bag is stuck in
      the patient notes. It might be a good idea to survey hospitals about the procedures

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      currently being used?
3.5    Shock Packs/ Formula Replacement
      Some hospitals discussing this. Not currently recommended by BBTS, awaiting
      national guidelines.

4.    Working Group Reports

4.1   Audit
      No further regional audits are being undertaken at present due to the number of
      national audits/surveys underway.

4.2   Education and Training
      Next meeting being held on 26th November 2008.

4.3   Paediatric
      Meeting held at Alder Hey on 28th August 2008 which was very positive. Discussed
      the comparisons between transfusion triggers/policies/practices at both Alder Hey
      and RMCH. Issued raised with regards to the transfer of patients between trusts and
      the standardisation of documentation. Next meeting being held on 15th January 2009
      at RMCH.

5.    Role of RTC Education Group/ Education for Junior Doctors

      RG reported they had tried to obtain medical input to RTC Education Group but had
      no volunteers. Ideas sought for future projects/education days/work from the group
      but none were suggested.

6.    NHSLA Presentation

      Presentation given by Gill Feerick which is available on the RTC website.
      NW RTC website link:

6.1   Q & A following presentation:-
      Q Does report go to the HealthCare Commission?
      A The report gets posted on the NHSLA website and can be used by them.

      Q    What if there is a conflict between the Trust s Training Needs Analysis and
      A     Need standardisation of policies and TNA in transfusion, action plans and

7.    Suggested New Working Group on Policies/ Guidelines

      Mike Desmond volunteered and recommended that the group would benefit from
      input from a Consultant Haematologist. David Alderson to mention this at the next
      NW Consultant Haematology group meeting.
      Action: Any volunteers for a working group to look at policies/guidelines to contact
      Rebecca Gerrard or Jane Murphy.
      Agenda item at next sub group meeting. (DA)

8.    Key Elements from NBTC Report

              The NBTC acknowledged comments about audit fatigue. However, it was
              emphasised audits are not an exercise but a continuing process to improve
              standards in all clinical aspects of blood transfusion and that message should
              be reinforced within the regions.

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              Regarding NHSBT service delivery, transport of blood is a major item. There
              is a requirement to work together to reduce the number of deliveries and
              wastage of blood products.
              There are specific issues regarding improving blood transfusion training for
              medical staff, the transfer of competencies between Trust employers and
              what happens if staff fail competency assessments. A RTC Chairs meeting is
              being held in June 2009 to focus on this.
              Transfusion Practitioners have heavy workloads and the NPSA SPN
              transfusion competencies assessments are contributing to this. A letter is
              being written re lack of junior doctors transfusion training from NBTC to DH.
              Transfusion Laboratory Managers group looking at a national policy for
              transferring blood with patients and to include when it is appropriate to do so.
              The Transfusion Awareness Day on 7 November 2008 is being advertised,
              important particularly in relation to keeping patients informed about
              An online survey to assess the implementation of the recommendations in the
              HSC 2007/001 Better Blood Transfusion: Safe and Appropriate Use of Blood
              will be sent to Hospital Transfusion Teams early in November. The results will
              presented at a Better Blood Transfusion Seminar in London on 3 March
              The next SHOT annual meeting will be held on 30 June 2009.

9.    NHSBT Hospital Liaison

      Suggested that members review the Key Performance Indicators document and if
      have any issues to contact a member of the Hospital Liaison Team.
      Stock levels are at a good level of 48,400 but O Neg at 3 days and B Neg at only 2.7

10.   Feedback from TLM s & TP s

      No issues raised by either group.

11.   UK Transfusion Laboratory Collaborative

      Discussed point regarding staffing levels and qualification and how this can be
      achieved in small hospitals.
      Action: Comments needed for taking forward. (DA)

12.   BSMS Data

      BSMS seeking feedback from RTC s and hospitals on usefulness of data. It was
      agreed data on O neg can be misleading when put as a %. Moving towards
      deanonimisation. A letter will be sent to Medical Directors shortly regarding this.

13.   RTC Budget

      Spent approximately £1,500, funding:-
         BSMS road show delegate expenses
         places on national conferences
      The RTC will continue to try and fund places for hospital representatives to attend
      education conferences. Please let the RTC know of any such events with a view to
      funding being provided. Delegates will be expected to feedback learning at next RTC

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14.   Papers for Information

      2 papers circulated with the agenda for information:-
             Coagulation & Trauma Masterclass Flyer
             Audit of Red Cell Use in hospitals in the South West and West Midlands

15.   A.O.B.

      Non raised

16.   Date of Next Meeting

      Provisionally planned for April 2009 at Haydock Park.
      Date to be confirmed.

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