He also hinted at that time that NHSBT, the public sector body responsible for the collection, storage and distribution of life-saving blood, tissues and organs across the UK, was looking to the cloud for ways to streamline that supply chain.
Intrigued to find out more, I spoke to Gerry Gogarty, NHSBT’s assistant director of business development and strategy. The food-company analogy is a strong one, he agreed, but with one particular caveat:
If there’s no yoghurt on the supermarket shelf - well, that’s unfortunate. The customer will have to pick something else. If there’s no blood on the hospital shelf, the consequences are very, very different. The level of risk we’re dealing with here is the big difference. We simply can’t afford for blood not to be available for patients, when they need it and where they need it. Whichever way you look at it, blood is a life-saving product.
But there’s no doubting the complexity that NHSBT faces in blood supply, where it’s responsible for all deliveries to hospitals in England (as opposed to tissues and organs, where it serves the whole UK.) The perishability of blood components is just one issue: red cells have a shelf-life of 35 days, while the shelf-life of platelets is only seven days. Then there are a stack of rules and best practices around storage and transportation to contend with, which naturally mandate the use of temperature-controlled and sterile environments. And, of course, supply and demand for each blood group can vary significantly.
With that in mind, Gogarty explains, NHSBT has recently implemented software from supply chain management specialist ToolsGroup, with the aim of achieving an integrated ‘vein-to-vein’ view that stretches from donors to patients and back again - and includes everything in between.
This ‘everything’, incidentally, includes 80 blood collection teams, active every day. Around 20 of these are based in static locations - the rest are mobile, setting up shop each day in a different location, such as public libraries and community centres. Then there’s five manufacturing laboratories, a couple of testing centres and 15 stock holding units, or SHUs, which act as distribution hubs for the hospitals in their areas, collectively delivering around 5,000 units of red blood cells to them each day.
ToolsGroup’s SO99+ software, Gogarty explains, is helping NHSBT to forecast blood demand, optimize blood stocks nationally and replenish hospital blood banks automatically, improving availability while minimizing costs due to overstocking, expiry dates and excessive transport costs. It runs on NHSBT’s Microsoft Azure-based cloud, an implementation that Ian Trenholm previously discussed with Diginomica, and was one of the first applications to run on that platform.
Stock management is an extremely important part of this picture, because it puts the patient at the heart of this vision, says Gogarty. Already, hospitals can order blood online from NHSBT and have it delivered to them through those 15 SHUs, but there are improvements to be made here, he explains:
Online ordering enables us to see hospital demand, but that’s as far as our sight will take us. We can see the time a hospital ordered blood from us and the volume and blood types ordered, but we want to do better than that. With ToolsGroup integrated with hospital fridges and laboratories, we get better visibility, because we see exactly what is coming out of a hospital’s fridge. That’s much better intelligence, because it focuses specifically on current patient requirements.
At present, around eight hospitals are now using NHSBT’s VMI [Vendor Managed Inventory] system from ToolsGroup, with a further 12 due to come online in the near future. Those 20 hospitals will send automated order feeds back to NHSBT and benefit from automated replenishment.
Meanwhile, NHSBT is using ToolsGroup’s wider suite to finesse its demand planning and inventory optimization operations. Says Gogarty:
The big point here is that we’re basically changing from a ‘push’ model to a ‘pull’ model of supply, transforming our supply chain so that all our work is aligned with meeting specific patient requirements, in specific areas.
Take, for example, sickle cell disease, a range of genetically inherited blood disorders, affecting around 12,000 people in the UK, mostly of an African or Caribbean family background. As many as three-quarters of them are thought to be based in London and some require regular blood transfusions to manage their condition. That means that hospitals in the London boroughs of Lewisham or Brent, for example, will have very different blood requirements than those in Exeter or Norwich, if they’re to effectively serve the needs of their local patient communities. Says Gogarty:
If we can understand patient requirements on a local level, rather than simply hospital order histories, we can then jump right back to the start of our supply chain - the donor base. We’ll know what is the donor base we require, what donors we need to recruit and how frequently we need those donors to be donating.
And in a really optimized supply chain, which we’re on our way to achieving, we’ll be able to source the blood as close to the hospital as possible, hold it in an SHU nearby and deliver it from there. We don't want to be moving blood around the country - transportation is a cost to us, it's a cost to the NHS and it's not a green solution. So that’s where the ToolsGroup system is taking us - to the position of always holding the right amount of stock in exactly the right location.