Welsh transplant service at risk of non-compliance

Martin Shipton

Shocking deficiencies in hospital transplant facilities have put at risk the continuing accreditation of the service in south Wales.

NHS Wales officials have a tight deadline to introduce improvements to ensure that blood and bone marrow transplant services, including stem cell treatment, can continue to be offered.

Such procedures are necessary for individuals with certain blood-related disorders and specific immune system disorders. They are used to treat a range of conditions, including blood cancers such as leukaemia, lymphoma, and myeloma, where the bone marrow doesn’t work properly and makes abnormal blood cells.

They are also used in the treatment of patients with genetic conditions such as sickle cell disease, which affects blood flow and oxygen transport in the body, as well as those with severe immune deficiencies which can lead to an increased risk of infections and other health issues.

A paper submitted to Cardiff and Vale University Health Board’s Quality Committee this week states: “The South Wales Blood and Marrow Transplant Programme (SWBMT) is delivered between Cardiff and Vale and Swansea Bay health boards and provides Blood and Marrow Transplant (BMT) and chimeric antigen receptor T-Cell (CAR-T) therapy to patients across south and west Wales.

“These services are subject to JACIE (Joint Accreditation Committee of the International Society for Cell & Gene Therapy and the European Society for Blood and Marrow Transplantation) accreditation – an essential requirement both of the Joint Commissioning Committee Service Specification for BMT and CAR-T delivery and the pharmaceutical companies supplying CAR-T products.

“JACIE inspection of the SWBMT Programme took place 18th-19th September 2025 and the health board received the formal written report 12th January 2026.

“Reaccreditation of the SWBMT programme is to be deferred due to critical deficiencies across key areas of the programme, despite strong clinical outcomes and laboratory practice.

“To retain accreditation, the health board must submit a credible, costed and timeline corrective action plan to JACIE by 8th July 2026, detailing how areas of non-compliance are to be rectified.”

Presentation

Health board official Jessica Castle gave a presentation to the Quality Committee, in which she said: “The report findings, just a reminder, had 2300-odd areas of assessment. We were deemed non-compliant with 89 of those. And those are the areas for the main focus, because we know that that’s the area on which we’re going to be judged in terms of our accreditation status.”

The JACIE report highlighted a number of areas in which the health board was not compliant:

* Estates. Adult transplant facilities unfit for purpose. This includes B4/C5, adult Haematology Day Centre, Ambulatory care,and Outpatients + Teenage Cancer Trust areas. Inspection flagged insufficient space and infection control risk.

Processing facility – workforce and safety: inadequate staffing levels and no formal on-call rota pose risks to patient safety.

* Programme-wide quality management: urgent need to recruit to vacant post and maternity cover in the quality management team. Some procedural updates / revisions required to address partial/non-compliance.

* Paediatric programme: current activity levels do not meet the volume thresholds required for accreditation.

* Workforce: in the Swansea Bay service – staffing deficits and over-reliance on a single specialist nurse.

Ms Castle told the Quality Committee: “So where are we currently? … I’ve been in regular contact with the team. They are not concerned around being able to respond to some of those. It’s just the timing and workload. They are reprioritising to make sure that we hit the deadline for the 8th of July with those.

“ … Our covering letter and response is being drafted to accompany the resubmission by the 8th of July. And the team is continuing to work on any areas of non-compliance that are within the gift of the directorate to rectify.”