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From: SHOT

To: All HV reporters

When: 13/10/2022

Title: Amber level alert for red cell stocks in England

Attached (below): Letter from NHSBT & NBTC to hospitals

In England, NHS Blood and Transplant have issued an amber level alert for red cells. NHSBT will remove the alert once they are confident that stocks have reached a sustainable level but expect the alert will continue for at least four weeks.

The alert and associated restrictions are currently only affecting England. No restrictions to clinical care are currently in place in the devolved nations. The stock situation is being monitored closely so that appropriate timely actions can be taken. 

To allow a swift recovery in England, prevent a similar shortage in the other UK nations and sustain the supply chain nationally in the longer term, we must focus on the appropriate use of blood (patient blood management – PBM).

NHSBT and NBTC have sent a letter to all the hospitals, attached below for information.

SHOT would like to highlight the following messages:

Give blood only when needed and prevent wastage:

    • Guidance on implementing Patient Blood Management strategies in clinical practice can be found in the PBM toolkit. There are 6 core strategies that underpin appropriate use, patient safety and blood conservation and a suite of useful resources
    • Use the NBTC Blood Component App and document the rationale for all transfusions given above guidance threshold – (available IOS & Android free of charge)
    • Refer to and use the relevant British Society of Haematology (BSH) guidance –


  • During implementation of your hospital emergency blood management arrangements for an amber shortage status it is essential to liaise with transfusion teams and haematologists around decision making and advice




  • If you are a blood donor, we encourage you to book an appointment, especially if you are O negative or O positive. In England, you can do this by calling 0300 123 23 23 or by searching for an appointment on


  • Hospitals should report adverse incidents in patients or with the operation of the NBTC Red Cell Shortage Plan through local governance systems, SHOT, SABRE and also with NHSBT as needed. A copy of the SHOT reporting definitions document can be found here: Definitions of current ( and contains guidance, for example, reporting situations where transfusion would have been clinically appropriate but could not be given due to lack of availability of a suitable component during recognised blood shortages. A screenshot of the relevant page is shown below:

  • Here is the snip from the Dendrite questionnaire for ADU categories showing the question that needs to be answered in relation to the stock situation. There are 2 possible answers that cover the situation, and the closest fit to the situation should be selected by ticking one answer only




Please contact SHOT if you would like to discuss any points from this communication.


Kind regards,


The SHOT Team