QS138 Quality Insights Audit Tool

An automated quality improvement national blood transfusion audit tool for hospitals. This tool helps to self-assess compliance to elements of the National Institute for Health and Care Excellence (NICE) QS138 Blood Transfusion Quality Standard developed by the NHS Blood and Transplant (NHSBT) Patient Blood Management (PBM) team.

Its use is a key recommendation in the 2023 National Comparative Audit (NCA) of NICE Blood Transfusion Quality Standard QS138 report which states that hospitals should undertake regular repeat audits of the NICE Quality Standard.

Latest news

HSJ Digital Awards 2024 finalist in the category of Driving Change through Data and Analytics

QS138 Quality Insights has been shortlisted as a finalist in the 2024 HSJ Digital Awards.

Registration is open in England and Wales

Sign up to begin your journey to enhance patient care 

QS138 Quality Insights is a free online platform for data entry. It automatically analyses data and generates instant bespoke trending reports for hospitals, with regional and national benchmarking data, without the need for time-consuming, manual data analysis. 

How do we register?

Agree a Transfusion Practitioner (TP), or equivalent, to manage an account. Access is available to NHS and private hospitals. Accounts are set up per hospital site (not Trust / Health Board) to an assigned individual with a maximum one registration per hospital.

If you work in a team of TPs and / or cover multiple sites you can either set up one dedicated TP contact for all sites, or have a dedicated person per hospital. You cannot use a 
Team email to register.

Email niceqs138@nhsbt.nhs.uk 

Provide the name of the hospital you want to sign up and which Regional Transfusion Committee (RTC) your hospital belongs to.

User agreement

You will be sent a user agreement; accept this to progress.

We give access

Once accepted, we will grant access and send you the information you need to set up your Snap© account and start using QS138 Quality Insights. 

The difference between this audit tool and the NCA audit of NICE QS138 

How QS138 Quality Insights is used will be determined locally by hospital transfusion teams. Less structured than the NCA, QS138 Quality Insights allows the flexibility to audit individual or all the quality statements up to four times per year, providing instant access to results with easily accessible automated benchmarking audit reports. The NCA audit provides a snapshot; results are shared with hospital teams once all the results have been returned and analysed.

Both complement each other; this tool can be used locally between national audits to focus in on improvement areas and monitor the effectiveness of any interventions.

If you already have hospital data from a NCA QS138 audit you can resuse it by submitting it on QS138 Quality Insights, helping inform the next quality improvement project decision.

Background to NICE QS138 

In 2016 NICE published QS138, associated with the NICE guideline for Blood transfusion NG24, which highlights four priority areas for improvement:

  • iron supplementation
  • tranexamic acid for adults
  • reassessment after red blood cell transfusion
  • patient information

NICE guidance (including quality standards) ensures the promotion of good health and good care for people who use services and are in line with the best available evidence of clinical effectiveness and cost effectiveness.

Hospitals are expected to make efforts towards ensuring that clinical practice follows NICE guidance and quality standards, whilst this is not a statutory requirement, compliance may be assessed by the regulator and / or commissioners. 

Background to QS138 Quality Insights 

QS138 Quality Insights has been developed by the NHSBT PBM team with funding from the National Blood Transfusion Committee.

It builds on earlier work by the team and the former South East Coast RTC TP group, who together developed an audit tool (endorsed by NICE) which provided the foundations for the automated version.


QS138 Quality Insights: An automated quality improvement national blood transfusion audit tool

Patient Blood Management NHS Blood and Transplant (2023)

A guide for hospitals

Comprehensive information is available in a user guide 


2023 National Comparative Audit of NICE Blood Transfusion Quality Standard QS138

QS138 Quality Insights: Recommendation that hospitals should undertake regular repeat audits of the NICE Quality Standard published in March 2024.

Read the 2023 National Comparative Audit of NICE Quality Standard QS138 

HSJ Digital Awards 2024

QS138 Quality Insights: Finalist in Driving Change through Data and Analytics category March 2024

Read more on the HSJ Awards website

The National Institute for Health and Care Excellence

Listed QS138 Quality Insights as an Endorsed Resource for Quality Standard QS138 in May 2023.


Referenced in the Key Recommendations section to support Appropriate management of anaemia and making safe transfusion decisions. 

Transfusion 2024
A Five-year Plan for Clinical and Laboratory Transfusion Practice

Listed as a resource to support the implementation of Patient Blood Management Action A1: develop a transfusion practice self-assessment tool to allow benchmarking.

We'd love to hear from you

If your hospital or region have signed up, please share with us how you are using QS138 Quality Insights to evidence your practice and plan your improvement areas to enhance patient care


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