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An estimated 15 million patients in England have at least one Long-Term Condition (LTC) or Chronic Illness (CI). The numbers of patients with multiple LTCs/CIs is set to rise from 1.9 million in 2008 to 2.9 million in 2018. Some patients cannot receive or refuse transfusion and there are no universally accepted treatment guidelines for managing care in such patients. Leadership, Management and Research relating to transfusion practices are intricate, however prospectively Scientists with transfusion care expertise will be called upon where an in-depth insight on the importance of where understanding renal health and sensitivity of laboratory tests are concerned. There is still a need to consider renal health in transfusion care and research practices to ensure effective and best practices are achieved across health spheres for patients with LTCs/CIs. The complexity of care plans should highlight the importance of better integration across laboratory practices and medicine in order to achieve formal consensus and help form robust guidelines.