About

The Red Cell Dosage Calculator is a web-based application (registered medical device) for use within the UK National Health Service. Its purpose is to calculate the volume of red blood cells to transfuse to a patient with anaemia, to reach a target haemoglobin level.

It is an innovation conceived and designed by Dr Sharran Grey, Honorary Consultant Clinical Scientist at Bolton NHS Foundation Trust. It was inspired by her doctoral research on 'accelerated red cell transfusion' which highlighted the importance of the volume of red cell transfusion in the context of a patient's body weight.

A baseline audit showed that only 35% of patients met their target haemoglobin level when an empirical policy of 1 or 2 units of red cells was in place, with 26% being under-transfused and 39% being over transfused.

A team of colleagues at Bolton NHS Foundation Trust (collectively known as the Transfusing Wisely Team) were involved in development of a prototype application, testing, validation, assessment of clinical effectiveness, MHRA Medical Device registration, UKCA marking and clinical implementation. This successful collaboration has delivered a number of benefits:

  • Around 90% of patients who have red cells prescribed as per number of units recommended by the application now meet their target haemoglobin, reducing cases of over and under-transfusion.
  • Red cell usage was reduced by around 18% in the first year of implementation, ensuring appropriate use of donor blood and delivering cost savings.
  • Compliance with national guidance on weight-adjusted red cell dosing:
  • A personalised approach to aiming for 'right first time' patient blood management.

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The Importance of Using UKCA Marked Clinical Applications

It is crucial to prioritize the use of clinical applications that bear the UKCA (UK Conformity Assessed) mark, which has replaced the CE mark after Brexit. The presence of this mark, regulated by the MHRA (Medicines and Healthcare products Regulatory Agency), ensures that the application meets necessary criteria and is both operationally functional and clinically secure. It is advisable to avoid using medical applications that lack a UKCA mark.

Please note that the medical device registration with the MHRA (UKCA mark) is applicable to users in England, Scotland, and Wales ONLY. Therefore, this class 1 medical device is not registered for use in Northern Ireland or outside the UK and cannot be marketed in these regions. Additionally, the application is based on the specifications of UK red cell units and is not suitable for use outside the UK.

Application Developers

Technical Solutions Worldwide Ltd is a software and cybersecurity company that has collaborated with Bolton NHS Foundation Trust and many other NHS Trusts across the UK for over 20 years. The company boasts a diverse portfolio of solution-based healthcare projects.

This long-standing partnership leverages medical, scientific, and software programming expertise to develop a validated and clinically effective application.

Sharing Good Practice

The Red Cell Dosage Calculator significantly reduces healthcare costs while enhancing patient care.

While the cost savings are noteworthy, the Bolton NHS Foundation Trust prioritizes the tool's impact on improving patient outcomes.

Collaborating with Technical Solutions Worldwide Ltd for software development, the trust is eager to extend this innovation to other NHS healthcare organisations, aiming to broaden its benefits and help more patients receive optimal care.

Meet the Team

Image of Dr Sharran Grey DClinSci FRCPath, Honorary Consultant Clinical Scientist at Bolton NHS Foundation Trust.
Sharran Grey

Dr Sharran Grey OBE, DClinSci FRCPath, Honorary Consultant Clinical Scientist at Bolton NHS Foundation Trust.

Image of Managing Director, Principal Software Engineer and Cyber Security Specialist at Technical Solutions Worldwide Ltd
William Humphreys

Managing Director, Principal Software Engineer and Cyber Security Specialist at Technical Solutions Worldwide Ltd.

Image of Karen Farrar BSc (Hons), MSc, Transfusion Laboratory Manager at Bolton NHS Foundation Trust.
Karen Farrar

Karen Farrar BSc (Hons), MSc, Transfusion Laboratory Manager at Bolton NHS Foundation Trust.

The project team is indebted to Peter Kinsella for his work on the Beta version of this application.