Imagine you’re a chemotherapy patient who needs a blood transfusion in addition to your treatment, but the nearest hospital isn’t in your home town. Wouldn’t it be better if instead you could go to somewhere locally and receive your blood transfusion?

Some cancer patients prefer to receive treatment closer to home. And with some of them becoming anaemic due to chemotherapy treatments, these patients need blood transfusions.

The solution: Blood on the Bus.

 

How it started

 

Hospital staff observed that often cancer patients due to anaemia require blood transfusions, but in some cases treatment close to home would be so much better. This sparked the idea of taking the blood transfusions to the patient via a mobile Chemotherapy unit. This new project, introduced by the East Kent Hospitals University NHS Foundation Trust, is called Blood on the Bus (BoB).

Affectionately called BoB by the programme’s professionals, this initiative was begun by Lead Chemotherapy Nurse Tracey Rigden and Angela Green, Blood Transfusion Co-Ordinator for East Kent Hospital University Foundation Trust.

Tracey said, “Every month, up to 150 patients living in some of the coastal towns use the unit for essential cancer treatment and avoid having to come to Canterbury. But some patients, depending on their condition, may require blood transfusions as part of their treatment. This is something we haven’t been able to provide until now, because the process is complex and patient safety is paramount.”

Using the East Kent Hospitals’ Mobile Chemotherapy Unit (MCU), patients living in Deal, Folkestone and Herne Bay will now be able to receive the blood transfusions they need at convenient locations near them.

 

How it works

 

A patient who is already receiving treatment at Kent and Canterbury Hospital and has been transfused before could be suitable for this project. There is a very narrow criteria for patients, and those with haematological disorders are prioritised. The only change is where they receive the treatment, and by working with patients who have already begun treatments, it’s a huge improvement.

The bus is owned and maintained for by the charity ‘Hope for Tomorrow’. The East Kent Mobile Chemotherapy Unit (MCU) was the fifth MCU to be launched by Hope for Tomorrow who now have 11 MCU’s on the road across the country, with two reserve MCUs in place to ensure continuity of service during the maintenance schedule. The bus ‘Caron’ was named in memory of Gloria Hunniford's daughter Caron Keating, who sadly passed away from cancer, and was launched at Canterbury Hospital by Caron's brother, Michael Keating, on the 14th October 2014.

Hope for Tomorrow also provides a Nurses Support Vehicle with each MCU, which allows the nursing team to travel to and from the daily treatment locations. This bus can visit up to five locations a week to provide treatments which are carefully chosen by East Kent Hospitals University NHS Foundation Trust, to maximize the number of patients they can treat at any given location.  The MCU and BoB will visit Herne Bay, Dover and Cheriton.

The bus itself is equipped with four treatment chairs, a kitchenette, a toilet, and is manned by a team of chemotherapy nurses and a driver. This mobile chemotherapy unit is trying to get as many patients through as safely possible. A blood transfusion usually takes anywhere from 2.5 to 4 hours, so patient safety and a full audit trail of the blood is essential, especially when transporting blood outside of the hospital.

 

How is the blood stored? Is it safe?

 

The blood is supplied by the Blood Transfusion Laboratory from Kent and Canterbury Hospital. It is kept in the lab and signed out to a nurse. The blood is packed in carefully labelled and validated transport blood boxes . The blood must be stored at a specific temperature in the box. If it goes outside of the specified temperature it will not be suitable for use and will have to be wasted.

As soon as it is removed from the storage box the transfusion must begin quickly and the patient needs to be monitored throughout the transfusion.

 

Success

 

Catherine Lorenzen, Chief Biomedical Scientist & Phlebotomy Service Manager for Kent and Canterbury Hospitals said, “There was quite a lot of work-up to do for something we do every day for the hospital wards. All nurses receive extra training to give blood transfusions and we must adhere to very strict national guidelines and are very keen to make it work safely and efficiently for everyone involved.

To actually do this out of the hospital setting with no immediate back up, the safety of the patient is absolutely paramount; there cannot be any uncertainty. We’ve been working with the chemotherapy team to ensure that all blood transfusions taking place in the MCU operate to the highest national standards.

It’s been really fantastic working with the nurses; it was wonderful to experience it for ourselves and to know we’re helping patients. This is a big step forward for patient experience.”

This healthcare initiative went live 1 June.