General Manager's Review

2015-16 has again seen the delivery of significant projects and outcomes by the NBA in relation to the provision of secure and affordable supply of blood products, improving immunoglobulin governance, development and implementation of guidance and programs for appropriate management and usage and reduction of wastage of blood products, and ICT and data collection development.

Highlights of the year included:

• Publication of PBM Guidelines Module 6 on Neonatal and Paediatrics – this completes the set of six modules begun in 2008 which are now a key reference at health provider level and have underpinned the significant improvements in appropriate use of blood
• Finalisation of the negotiations for a new nine year Deed of Agreement with the Red Cross – this represents the culmination of a number of years of collaborative work between Blood Service and NBA teams to work through all aspects of the service and funding arrangement
• Release of BloodSTAR - the new national ICT system to support improved Ig authorisation and governance – and the continuing work between the NBA and the national network of Immunoglobulin Governance committees on developing an improved model of policy, guidance and process for the authorisation and management of immunoglobulin products
• Completion of a project with the Australian Haemophilia Centre Directors' Organisation (AHCDO) to develop the Guidelines for the management of haemophilia in Australia as a local adaption of World Federation of Hemophilia guidelines to describe the standard of care, including appropriate use of clotting factor blood products, for haemophilia in Australia
• Successful conduct of the first funding round under the National Blood Sector Research and Development Pilot – this is an exciting initiative which initially has a focus on key areas of potential research to support the patient blood management and immunoglobulin governance programs.

Ensuring supply of blood products

The NBA's primary responsibility is to ensure Australia has an adequate, safe, secure and affordable supply of blood and blood related products to meet clinical demand. The clinical demand for blood and blood related products in Australia was met without interruption and at a saving of $90.6 million. This saving brings the total amount of funding returned to governments over the last four years to $446.5 million.

The year saw further improvement in the appropriate use of fresh blood. The 2015 -16 demand for red cells decreased by 3.4 per cent. This result builds on the progress already made in this strategic planning cycle to bring the total reduction in red cell demand over the last four years to 21 per cent, realising significant improvements in patient outcomes and financial savings of $94 million.

Australian Red Cross Blood Service (Blood Service) improvements in supply performance and efficiency under the previous NBA Deed of Agreement with the Australian Red Cross Society (Red Cross) also played a major role in the savings outcome. The Blood Service achieved a surplus of approximately $47.4 million and will return a 2015-16 saving of approximately $42.4 million to governments under the Output Based Funding Model (OBFM) agreed with the Blood Service.

The NBA oversaw the transition of supply under a highly successful tender for imported Ig products concluded in 2014-15 that will realise annual savings of approximately $30 million per year from 1 January 2016. The new contracts achieved a world value for money benchmark that also embeds a number of improved supply performance provisions.

The NBA completed its annual Supply Risk and Mitigation Project to review supply security arrangements for all plasma and recombinant products. This included the validation of existing stock and contractual supply reserves.

The NBA implemented the second phase of the national service requirements and standards (NSRS) project as part of the new Deed of Agreement negotiations. The NSRS set out the Blood Service's relationships with health providers and the NBA. This includes business rules and standards for ordering, delivery, and receipt of products.

The NBA also progressed the implementation of strategies to improve management of strategic product supply risks for the National Blood Supply Contingency Plan as endorsed by JBC.

Improving the management and use of blood products

Throughout the year the NBA maintained a focus on governments' priorities for the Blood Sector through activities under the key sector policies and strategies agreed by all governments, particularly the National Blood and Blood Product Wastage Reduction Strategy 2013-17 and the National Patient Blood Management Guidelines Implementation Strategy 2013-17. An ongoing program of activities also supports the implementation of the health ministers' Statement on national stewardship expectations for the supply of blood and blood products. These programs contribute to the sustainability of the blood supply by improving the management and use of blood products.

Building upon successes from 2014-15, the 2015-16 outcomes included the:

• publication of national PBM Guidelines Module 6 on Neonatal and Paediatrics. The completion of this set of PBM Guidelines provide a key reference at health provider level and have underpinned the significant improvements in appropriate use of blood
• implementation of a health provider Charter requiring a formal commitment at a CEO level to measures that improve the management and use of blood and blood products
• conducting a pilot during 2015-16 for Phase One of a Business Case to test new strategies to update the PBM Guidelines on Module 1 – Critical Bleeding/Massive Transfusion, undertaken in consultation with the Clinical Reference Group
• promotion and stakeholder engagement program with participation at multiple national conferences and events
• collaborative work with the Australian Commission on Safety and Quality in Health Care (ACSQHC), including through the 2015-16 a review of the National Safety and Quality Health Service (NSQHS) Standards, Standard 7: Blood and Blood Products, via a working group of Standard 7 implementers and clinical nurse consultants convened to review the comments for inclusion in the resources and tools that support the implementation of the revised standard
• constructive collaboration with the ACSQHC on the National Patient Blood Management Collaborative, focussing on identification and management of pre-operative anaemia and iron deficiency
• work with states and territories and all suppliers to finalise the nationwide implementation of BloodNet-Laboratory Information System interfaces, to allow real time inventory and wastage monitoring
• work with jurisdictions on implementation of setting up Information Framework Agreements with each state and territory.

In 2015, the Government decided not to proceed with the merger of the National Blood Authority and the Organ and Tissue Authority (OTA), as announced in the 2014-15 Budget. However, some efficiencies were achieved through the NBA commencing provision of certain corporate services and ICT functions to OTA through a shared services arrangement.

Mr Leigh McJames ended his term as NBA General Manager in February 2016, after commencing the role in March 2012. On behalf of NBA staff and sector stakeholders I would like to take the opportunity to recognise the vision, drive and enthusiasm Leigh brought to this role. In leaving the position Leigh can take great credit for initiating and supporting major programs in recent years including many new and expanding areas of NBA activity and success, working effectively with many stakeholders, and contributing to the NBA's vision of Saving and improving Australian lives through a world-class blood supply. Leigh worked closely with the Board and was a very effective leader of the Authority.

I close this report by again recognising the contribution of the many stakeholders across the sector who gave generously of their time, professionalism and passion in working with the NBA each year. We look forward to working with you again in 2016-17.

Michael Stone
Acting General Manager
National Blood Authority