1.1 General Manager’s review

It is now five years since the National Blood Authority was established, during which time we have put together an impressive portfolio of achievements. The small size of our agency has not limited the quantity and quality of our work and I would like to share our achievements with you in this, our fifth annual report.

This year, the NBA has made some significant contributions to both the national and international blood sector through the publication of a number of major guidelines, reports and papers. The Criteria for the Clinical Use of Intravenous Immunoglobulin (IVIg) in Australia, a major and significant piece of work, was endorsed by Health Ministers. An international benchmarking report Fresh Blood Products – Production Benchmarking and Demand Drivers was also published and a poster was presented at the International Society for Blood Transfusion annual conference in Macau.

These publications have been a result of the increasing focus the NBA is placing on the dissemination and exchange of good-quality national and international data. In that vein, the year has seen the development of a national blood sector data strategy, which we will use to guide our work in this space. I am pleased to report excellent progress of a number of data system initiatives, which will contribute to data quality in the sector.

In conjunction with haemophilia groups, the NBA has managed the design and redevelopment of the Australian Bleeding Disorders Registry (ABDR). The ABDR will provide a clinical tool for clinicians and improved data capture and quality nationally. This will lead to an improved understanding of product use, more effective demand modelling, supply planning and forecasting for products used in the treatment of haemophilia.

A significant step towards understanding patient safety within the blood sector was taken in 2007–08 with the publication of the NBA’s Initial Australian Haemovigilance Report. Knowing the incidence and understanding the circumstances of adverse events is crucial to facilitating changes in clinical and hospital practices to improve patient safety around blood transfusion. Jurisdictions voluntarily reported agreed adverse events and this information was compiled into a national report. Ongoing work will refine and expand this process, with the aim of being able to publish further national haemovigilance reports against a consistent reporting framework in the future.

The Criteria for the Clinical Use of Intravenous Immunoglobulin (IVIg) in Australia was endorsed by Health Ministers and implemented in 2007–08. This is a significant piece of work that provides guidance to clinicians on the conditions for which intravenous immunoglobulin (IVIg) can be accessed under the national blood arrangements. Demand for IVIg continues to increase steadily and it is important that supply of IVIg is available to the patients most in need. To support the implementation of the Criteria for the Clinical Use of Intravenous Immunoglobulin (IVIg) in Australia, the Jurisdictional Blood Committee (JBC) endorsed work to design and develop a National IVIg Management System (NIMS). The NIMS will capture national information around the orders, use and treatment outcomes of IVIg, and will inform demand models and supply planning in addition to furthering clinical knowledge. Work on NIMS is well under way and it is anticipated that a pilot project will be undertaken in 2009.

In trying to gather good-quality national data, the NBA recognises the different systems and processes that are used across the jurisdictions. In conjunction with the Australian Red Cross Blood Service (ARCBS), the NBA is undertaking another initiative that recognises these differences and focuses on data definitions and standards rather than new information technology (IT) solutions. This project, called ‘Blood Measures’, aims to develop a set of standard measures and data collection points that can be included in any investigation of blood and blood-related products. The project strives to facilitate good-quality research by getting expert agreement on these measures, which can lead to comparable national data.

Internally at the NBA, this year has seen significant progress on the development and implementation of the Integrated Data Management System (IDMS). IDMS will streamline the NBA’s operations, improving functionality by centralising the information we need to undertake our core business. In addition, IDMS will serve as a database that will also allow us greater capacity to collect and disseminate national data. Jurisdictions see the NBA’s dissemination of data as one of the most important value-adding activities of the NBA.

Patient blood management is the appropriate use of blood and blood components with the goals of optimising patient outcomes and reducing unnecessary exposure to allogeneic transfusion, thereby also contributing to optimum use of blood supply. This is achieved by:

In February 2008, the NBA started work to develop a framework for consideration of how to increase the knowledge and uptake of patient blood management techniques and strategies. The NBA and JBC see this work as a major focus of our activities over the next several years and it may involve the NBA in research and change management projects with the clinical community, other government bodies, clinical colleges and training institutions.

In addition to our new initiatives, we have continued to maintain our excellent work in supply planning and contract management. This financial year has seen the successful negotiation of two new contracts. First, the new imported IVIg contract offers significant value for money by shifting the risk for holding inventory to the suppliers and improving product delivery times to within 24 hours for hospitals. Second, a new standing offer for diagnostic reagents has provided public pathology laboratories with a wide choice of products and the ability to procure the most appropriate diagnostic blood products at competitive prices, quality and service levels. This contract also gives laboratories the flexibility to incorporate cutting-edge products as they become available.

Our work in ensuring supply of blood and blood-related products to Australians relies heavily on our relationship with the ARCBS. Following the successful signing of the ARCBS Deed of Agreement last financial year, this year has focused on an independent business study of the ARCBS, which aimed to, among other things, inform the basis of government funding to the ARCBS, and identify cost options for any  improvements to the efficiency and effectiveness of the provision of those products and services. It also makes recommendations on an output-based funding model for the ARCBS.

This year also saw the opening of the ARCBS’s new principal site in Brisbane (in Kelvin Grove) which was funded by governments. Negotiations are well under way for the redevelopment of ARCBS principal sites in Melbourne and Sydney.

Our work in contingency planning was recognised this year when we received a highly commended award for risk initiatives in the 2007 Awards for Excellence in Risk Management from Comcover. This award recognises our continuing strength in contingency planning which was demonstrated in reality when our Business Continuity Plan was successfully implemented following a severe storm last year.

The NBA is also involved in contingency planning on a broader level and I am delighted that Health Ministers endorsed the National Blood Supply Contingency Plan (NBSCP) in April of this year. The NBSCP provides clear governance and a decision-making framework for the management of product shortages.

I would like to thank the NBA Board for their guidance during the year. Under their stewardship, the NBA embarked on a number of new initiatives and was able to achieve good progress on all core deliverables

Lastly, I would like to sincerely thank the staff of the NBA whose enthusiasm, commitment and professionalism allows us to deliver all these excellent outcomes.

Dr Alison Turner
General Manager and CEO
National Blood Authority

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