A suggestion to NHS Blood and Transplant management from a blood donor of 17 years, a hypothesis on increasing blood stocks, and an approach to start testing it right now.
Who the heck am I?
First off, I’m not a health professional and I have no experience running something as huge as the NHS Blood and Transfusion Service.
However, I have been donating blood for 17 years, recently hitting 50 donations, so I’m probably an “expert” when it comes to donating.
I’m an efficiency and user experience nerd, having worked on digital transformations at NHS Alpha, GOV.UK, Co-op Digital and more.
Blood stocks are low
I was told at my donation that stocks are extremely low. I see from the website that there currently are 4-5 days of stocks for certain blood groups, against a target of 6 days.
I presume there are several levers for increasing stocks, such as:
- recruiting new donors
- encouraging “lapsed” donors to come back
- maximising / optimising the frequency that regular donors attend
This suggestion is concerned with 3.
How booking used to work
I give blood every 12 weeks. I donate at a dedicated donor centre. That’s a building that’s permanently set up for donation, rather than a van that sets up in church halls, schools and so on.
I usually donate at the same time of the week, on the same day. That’s extremely easy to plan around as it’s a habit and there’s nothing to think about each time.
Pre-COVID, I’d attend the session, do my donation, have a cup of tea and a biscuit, then get up to go.
On the way out, I’d ask the front desk to book me in for next time. I’d open my calendar on my phone and we’d negotiate. It was extremely efficient because:
They already have my details: I’m “authenticated” already.
Everyone needs an appointment in either 12 or 16 weeks, so the reception person can keep the diary open on the right day (OK 2 days).
They can suggest the same time of day. They were fast at finding lunchtime appointments across different days, if exactly 12 weeks wasn’t available.
I estimate this occupied the staff for approximately 1 minute, possibly 2 as an absolute maximum.
As a result, I used to donate every 12 weeks like clockwork.
Now I can’t book at the front desk
In recent years, I’ve tried to book as I’ve left and been told (apologetically) that I have to book online or on the phone.
OK, that was slightly irritating because it disrupted something that was working well, but not a huge drama. I left and got on with my life…
And forgot all about it. The habit was broken. Two months later, I was wondering if a donation was coming up, and I realised I never booked one.
By that time, the only slots available at the donor centre were sixteen weeks from my previous donation. That’s four weeks where I was eligible but unable to donate.
Putting the burden onto the user also puts the onus on them
By shifting the burden of remembering to book onto me, it also put the responsibility on me.
I’m an organised person, but life’s full of competing demands. Remembering to book a blood appointment is not at the top of my list.
Booking online had other problems
The next time I donated, I tried to form a new habit.
After donating, I was sitting in the recovery bit, sipping my squash (Aside: tea and coffee went away and still hasn’t come back “because COVID”. Seriously.)
I thought, ah-ha, what a great time to book my next appointment! So I logged into the website on my phone, no bother.
But alas, the website didn’t realise I’d already donated. It wouldn’t let me look for another appointment.
So once again I failed to make an appointment at the desk, walked out, and forgot all about it.
Once again, I couldn’t get an appointment at 12 weeks after my previous donation.
Sometimes appointments aren’t created in time
The next time - yesterday - I actually set myself an alarm for the next day. I logged in, and was told my blood donor centre was “fully booked”.
So I phoned the number, went through the whole security thing, and was told that the diary hadn’t been released yet for July (12 weeks away.)
How this impacts blood stocks
I used to donate every 12 weeks, pretty much on the dot.
Now, it seems if I don’t book a repeat appointment ASAP, I can’t get one at 12 weeks after the last one.
The change in policy where I can’t book at the desk has led to my donation period increasing from 12 to probably 14 weeks.
Let’s extrapolate a bit: let’s assume I’m not the only one.
Let’s assume that this change of policy added 1 week on average to some chunk of regular donors’ period.
If that could be reversed, Every donor that can be “optimised” from 13 weeks to 12 weeks equals 8% more blood donated. That’s a lot!
It’s kind of obvious: donate more often, give more blood.
But perhaps less obvious is the effect of booking user experience on a donor’s average donation frequency.
Hypothesis, and what I propose
Disallowing repeat bookings on the front desk at a donation centre leads to an measurable decrease in donation frequency.
The effect is significant enough to outweigh the additional time taken by front desk staff.
Disagree? Great! Let’s put our opinions aside and run an A/B test!
A simple way to A/B test the hypothesis
OK, “simple” insofar as anything is simple inside the NHS.
Here’s an approach:
- Pick a bunch of donor centres and identify regular donors.
- Take a snapshot of the donation frequency for those donors.
- Tell half of the donor centres to allow / encourage booking a repeat appointment before donors leave.
- After 12 months, compare the donation frequencies in the A and B groups (doing some stats to adjust for any inherent differences visible in step 2.)
User experience matters
The overall experience at my local donor centre is excellent. This is due mostly to the warm, chatty and efficient staff.
The user experience of booking an appointment is inconsistent. Sometimes it’s perfect, sometimes it’s just frustrating.
That has knock-on effects too: I’m less able to recruit new donors as I know they’re going to have an awkward time. (Anecdata: two people I nearly recruited dropped off because they couldn’t find an appointment close to mine.)
User experience matters! Reduce friction, make it simple, make it automatic.
I’ve made a few assumptions and I’m not privy to real data. If you’ve got some more insight, I’d love to hear from you.
Also, I have an idea for a microservice to help recruit new donors. If you’re interested, let’s chat!