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Ro improvement project

An estimated 14,000 people have sickle cell disease (SCD) in the UK. We need to improve the supply of R0 blood for these people, who need regular blood transfusion, and for their care in emergency and elective situations. This project aims to increase the availability of the blood needed by these people.

Please support us by:

  • Submitting orders 5 working days in advance
  • Ordering R0 units for R0 patients so we have accurate demand data
  • Deleting outstanding orders on OBOS if the order is no longer required, so they can be used for other patients
  • Accepting the substitutions we make in accordance with the substitution matrix
  • Discussing any ordering issues or suggestions with your Customer Services Manager

Demand has doubled to 4,000 units per month and we have increased availability from 975 units to 1970 units, on average per month, since 2014 when the project started. 

We've stepped up our marketing and publicity work, and our drive to meet demand will continue: we need 40,000 black donors, that is to say, 9% of new donors need to be black for three years.

The pressure on blood supply is added to because:

  • The 2014 National Comparative Audit showed that 67% of patients receiving transfusion for SCD are R0 however only 1.2% of the largely Caucasian donor population have the R0 phenotype. There are also increasing difficulties to match the antigen profile of the donor population to the ethnically variable needs of these patients

  • BSH guidance recommends using blood that is 7 days old or less, for red cell exchange and 14 days old or less for top-up transfusions. For automated red cell exchanges, adults may need 8 to 12 units every 6 to 8 weeks

In 2014 the National Comparative Audit noted 50% of R0 HbS negative requests received were substituted for other phenotype compatible units, for example, O rr for O R0

Changes we've introduced:

  • Fast tracking donations
    Labelling units from known R0 donors at donation means they can be fast tracked through manufacturing and ready for issue in 2 days
  • Easy stock location
    A special Rstock location assists monitoring, search, identifying units and distribution
  • Efficient stock holding
    Units are stocked at sites with the largest demand and moved to support individuals when and where needed
  • Updated software
    This allows Hospital Services staff to view R0 orders substantially further in advance than before
  • Raised awareness
    We have raised the profile of sickle cell disease to encourage all those in the supply chain to best understand their role in supporting these individuals
  • Appropriate substitution
    A substitution matrix ensures appropriate use of R0 donations and minimises demand on O D negative red cells


We welcome your ideas or suggestions for improvement, please contact your Customer Service Manager.