The archive · Public & Social · Marketing decision · 2015–2016
NHS makes A, O, B vanish from British signs — 30,000 new donors in a week
When new-donor numbers fell 40%, NHSBT pulled the blood-group letters A, O and B out of Britain's signs and brands — 30,000 people signed up in one week.
NHS Blood and Transplant
What it had to solve
NHS Blood and Transplant needed to recruit new donors, especially 17–24-year-olds, to replace an ageing donor base, but past National Blood Week awareness campaigns were not converting attention into registrations.
How it works
In June 2015, NHS Blood and Transplant revealed that 40% fewer new volunteers had come forward to give blood in 2014/15 than a decade earlier — 120,000 fewer people than in 2004/5. With the donor base ageing and the service needing around 204,000 new donors a year to keep stocks safe, National Blood Week (8–14 June) had to do more than raise awareness: it had to convert attention into registrations.
Agency Engine's idea was to make the shortage visible. It removed the letters A, O and B — the three main blood groups — from names, signage and social media, and invited Britain to notice. The Daily Mirror ran a print run of 600,000 copies with A and O missing from its masthead; the Downing Street sign lost its O; more than 1,000 organisations from Google and Coca-Cola to the Church of England joined in, and the public posted their own missing-letter versions under #MissingType.
The campaign reached about two billion people through news coverage and social activity, and more than 30,000 people registered as new donors during the launch week — around eight times the normal weekly number, with over 18,000 aged 17–24. A year later, 25 blood services across 21 countries ran Missing Type together and 46,000 new donors registered across nine reporting countries; PR Week later voted it Campaign of the Decade.
Why it lands
- The idea acted out the problem instead of describing it — absence made a hidden risk tangible.
- Participation cost almost nothing, so 1,000+ brands and organisations joined as volunteers, not sponsors.
- It reached 17–24-year-olds in the spaces they already lived in: social feeds and everyday signs.
- The two-stage reveal — letters vanish first, reason revealed days later — turned the campaign itself into news.
What it did
Two billion reach through news coverage and social activity; 30,000+ new donor registrations in the launch week (about eight times a normal week and 20,000 more than the previous year), over 18,000 of them aged 17–24. A year later 25 blood services across 21 countries ran it together, adding 46,000 new donors in nine reporting countries.
What you can take
Make the message the medium: instead of telling people blood types matter, remove the letters and let every participating brand physically act out the shortage.
Since then
The campaign won a Cannes Health & Wellness Lion in 2016 and PR Week named it Campaign of the Decade in 2019 after a public vote. NHSBT repeated Missing Type in 2016 with 25 blood services across 21 countries: letters disappeared at landmarks including the Sydney Opera House and Abbey Road, #MissingType drew over 50,000 mentions, and 24,000 people in England registered as new donors. It remains a standard reference for behaviour-change PR and for how a public service can borrow brand visibility without buying media.
Sources
- Donors in decline: 40% fewer new blood donors in 2014/5 than 2004/5
- PR Case Study: Missing Type
- Missing Type campaign inspires 24,000 new blood donors
- ‘Missing Type’ blood donation campaign named campaign of the decade
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