How the NHS and WCRS got the world talking and giving blood

WCRS, MHP and Engine reveal the strategy behind its "Missing Types" campaign for NHS Blood and Transplants.

Getting people to give blood is a challenge. Asking is hard enough but actually getting people to do it, is no mean feat. 

So when NHS Blood and Transplant’s "Missing Type" campaign saw blood donations rise from an all-time low to recruit 800 donors a week and drive 30,000 new donors to register over the 10-day activity period – we were ecstatic knowing the campaign had potentially improved or saved 100,000 lives, of which 18,114 were aged between 17-24. 

Here is how we tackled what is now a multi-award-winning campaign that has now gone global and been implemented in 21 other countries. "Missing Type" was one of the most awarded campaigns in the UK of 2016. It has won at Cannes Lions International Festival of Creativity, the prestigious Paul Arden Award for Innovation at the Campaign Big Awards and was also recognised at the One Show, Creative Circle and D&AD. 

Giving blood is generally very low down on people’s "to do" list. It’s not because they don’t want to, everyone knows it’s a "good thing", but as with many things, life always gets in the way. However, most assume blood is readily available should they ever need some. 

In 2014, shocking statistics revealed that 40% fewer new volunteers came forward to give blood across England and North Wales compared with a decade ago. So in 2015, NHS Blood and Transplant knew it needed to put blood donation back on the agenda. 

The Challenge 

WCRS, MHP and Engine were tasked with creating a disruptive campaign to spark conversation and initiate behaviour change – creating new donor registrations - rather than simply raising awareness. But one of the issues we faced was, how do you show the problem we’re trying to solve? The fall in blood donation is an invisible issue. You can’t actually see it. 

Using our behaviour change methodology as a starting point, our strategy was developed based around some of the key steps within the model: 

Trigger points: Timing, context and location would be crucial to reach audiences

Facilitation: Make it as easy as possible for audiences to participate (and donate)

Reinforcement: Reset donation as the new normal 

Audience insight confirmed social media channels – Twitter and Instagram – were essential to engage with the primary target audience of young adults aged 17-24 and shareable content would be key. 

Our approach 

The ambition: Create a domino effect based on affirmation and sharing that would enable anyone to join in – individuals from any region, age group or ethnicity through to influential personalities, brands and media. 

"Missing Type" was the creative solution: taking the As, Bs and Os from names, places and brands that we engage with in everyday life. The idea was an inclusive movement where anyone could drop the type from their social media profiles and content. The simplicity of the idea was reflected in the activation: minimal effort was required to create the desired disruption and message delivery. 

The idea was great on paper. There was, however, an element of risk because we were going into uncharted territory by asking brands to do something that is normally anathema to them: asking them to deface their logos for public consumption. Anyone working in marketing knows that this could, in theory, take months of meetings and negotiations to get just one to do it, but we needed a high-volume of household-name brands and we had a matter of weeks. 

Our campaign required a teaser phase in the days building up to National Blood Week, before a big media burst to generate awareness of the issue. We approached partners – such as the Daily Mirror, Campaign magazine, Odeon, O2 and even the Cabinet Office to change the Downing Street sign - that could help seed the idea of "Missing Type" with a series of staged activities to create disruption and provide news and social content. 

Hard-hitting blanket news coverage and social media content would be critical to success as all partnerships with participating brands were earned via goodwill and shared commitment to the cause rather than paid support. 

Method deployed 

1. Teaser (3 to 4 June 2015) 

  • A selection of partner brands and organisations lost their type in the physical and digital world to trigger the campaign: Odeon Leicester Square, Waterstones Trafalgar Square and most importantly, the iconic Downing Street sign. 
  • This imagery was seeded through partners’ social channels and used as collateral for media coverage. 
  • One earned editorial partnership that cannot be overstated was getting Campaign magazine on-board for the teaser phase by agreeing to drop the letter A from its masthead on the Thursday before launch. Campaign may have a negligible reach among NHS Blood and Transplant’s target audience but is read by all the key decision-makers in marketing and digital media of the UK’s biggest brands. In short, we let Campaign break the story and the call to action, without giving the game away to the general public. 

2. Reveal (5 June 2015) 

  • A media relations blitz – using NHS Blood and Transplant spokespeople and patient case studies – ensured coverage appeared across every major national print, broadcast and online source, accompanied by the 40% fall in new donors’ message. 
  • "Missing Type" visuals – such as those of Downing Street and Waterstones - generated features in the likes of Buzzfeed, Sky News, ITV London, Metro, UniLad and Huffington Post with online articles creating huge volumes of social share. 
  • Within hours #MissingType went viral and NHS Blood and Transplant reported a 1000% increase in web traffic over the weekend as people registered to donate online. 

3. Momentum: National Blood Week (8 to 14 June 2015) 

  • On the Monday, The Daily Mirror issued a full run of 600,000 print copies with an amended masthead – the first time it’s ever been changed - with editorial about the campaign, how to participate and how to register as a donor. 
  • Traditional media now looks to social conversation for what is ‘news’, so as momentum built, the PR team at MHP-Engine managed to secure further #MissingType coverage on This Morning, Sky News and BBC Radio One where DJs gave repeated plugs to guide listeners on how to register to donate. 
  • Meanwhile, the powerful reach and influence of brands helped amplify the call to action and trigger the domino effect. What started with a handful quickly snowballed, creating an unprecedented, organic brand movement and more reactive coverage  and public participation. 
  • "Missing Type" created an unprecedented brand movement. Brands weren’t just dropping letters from logos but producing creative content to stand out. When Spurs joined in, Arsenal raised the bar hours later. McDonald’s UK contacted Engine directly to say it loved the idea and were designing bespoke visuals for priority sign-off at its Chicago HQ. 
  • Over a thousand brands and organisations participated across Twitter, Facebook and Instagram: Coca-Cola, Microsoft, Honda, Nando’s, O2, Spotify, Marmite, Cadbury, Transport for London, Arsenal FC, Wimbledon Tennis, Unison, Heathrow Airport. Even the Church of England and the WI came on board. 
  • The cherry on the cake came on Sunday, World Blood Donor Day, when Google released an image of its logo minus its Os. 
  • Over the course of National Blood Week, tens of thousands of people joined the #MissingType movement, many with their own user-generated content, including hundreds of young people who used social channels to share images of them giving blood at donor centres, demystifying the process and making it a "cool" thing to do. 


"Missing Type" was an ambitious creative that relied entirely on goodwill, asking brands to do something they’ve never done before: rip-up their rulebook and guidelines to change their logos for a common cause. Those participating included global brands and household names but also emergency services, charities, transport hubs, councils, trade unions, colleges, sports clubs and small businesses. 

Proving to be a visceral reminder of how much society needs these letters, the campaign did what it set out to achieve. People weren’t just dropping the letters from their social profiles but registering to give blood in record numbers. On average NHSBT recruits 800 new donors a week. The benchmark set by NHS Blood and Transplant was based on National Blood Week 2014 which achieved 10,000 new donors during the same period. "Missing Type" saw 30,000 new donors registered over the 10 day activity period – we estimate these new registrants could save or improve 100,000 lives. Of those, 18,114 were aged 17-24

The campaign reached over 2 billion people through 664 pieces of earned news coverage and social media activity. More than 27,121 Tweets were sent with the #missingtype and #giveblood, and traffic to from social media sources increased 353 per cent on the previous year. 

NHS Blood and Transplant was also the first UK advertiser to Instagram: featuring a series of carousel ads with "Missing Type" visuals which reached 1.9m people with 2.28m impressions – 81% in the target 17-24 year old age group. 

Creating a legacy 

In 2016, "Missing Type" went global. 25 other blood services from 21 countries joined NHS Blood and Transplant in an international drive, calling for new blood donors to ensure blood donation for future generations. 

In August, As, Bs and Os, once again disappeared from everyday and iconic locations across the UK, Ireland, Canada, USA, Nepal, Belgium, Netherlands, Switzerland, Sweden, Lithuania, Japan, Brazil, South Africa, Hong Kong, South Korea, Singapore, Australia, New Zealand, to visualise the issue of missing blood types. 

There was a domino effect across the world as countries woke up to find the letters of the blood groups missing. From the Sydney Opera House to Giant’s Causeway, Singapore Botanical Gardens to Tokyo Tower and Llanfairpwllgwyngyllgogerychwyrndrobwllllantysiliogogogoch station in Wales to Abbey Road in London. 

Across social media, there were over 54,000 mentions of #MissingType globally in seven days from brands such as Google, Cadbury’s, Paddy Power, Sydney Morning Herald, Qantas, Innocent Smoothies, Tesco and Toronto Police. 

Celebrities and influencers such as Olivia Newton-John, American football quarterback Brady Quinn, Dexter Fowler of the Chicago Cubs joined sports teams such as Glasgow Rangers, Cincinnati Bengals and Great Western Sydney Giants also showed their support through social media. 

Outside of the 21 countries taking part in the campaign, the conversation continued across the world with Poland, Spain, Pakistan and France also joining in on social media, resulting in the hashtag #MissingType being the number one trending topic in over ten countries, above even the Olympics and Justin Bieber. 

In a moving video, patients from around the world have thanked blood donors to highlight that in a world without As, Bs and Os, they would not be here. 

Recipients of blood transfusions from The Netherlands, New Zealand, Japan, Singapore, Hong Kong, Scotland, Korea, Switzerland, South Africa, Republic of Ireland, England, USA and Wales have come together to show how their lives have been saved or improved by blood donors. 

Back here where the campaign begun, with the ambition to extend what had largely been a social and digital campaign in 2015, into the physical world, we collaborated with a number of high profile brands and organisations to make "Missing Type" bigger, better and bolder. 

Microsoft, Guy’s and St Thomas’ NHS Foundation Trust, Boots, Warburtons and Manchester City featured in a new TV ad while other major supporters such as Royal Mail made sure households up and down the country were aware of the campaign by issuing a special postmark that was applied to millions of items of stamped mail during campaign week. 

International Missing Type campaign: Around the world, As, Bs and Os disappeared.  

More than 25,000 people across England registered to become new blood donors during the 2016 campaign, 8,000 of whom registered in the first three days alone. 

This was not just a campaign that can be measured in numbers. Without doubt the most rewarding aspect for all of those involved in "Missing Type" was the personal tweets from people who felt motivated and moved by the work. These included not only first-time donors, but those whose lives have been, or continue to be, saved, thanks to the goodwill of public donation and the inspiring work by the staff at NHS Blood and Transplant and other blood donor services around the world. 

Subscribe today for just $116 a year

Get the very latest news and insight from Campaign with unrestricted access to , plus get exclusive discounts to Campaign events

Become a subscriber


Don’t miss your daily fix of breaking news, latest work, advice and commentary.

register free