General Manager's Review

General Manager - Leigh McJames

2013-14 saw the NBA drive an array of outcomes across its portfolio of responsibilities. Of note, it was the first full year of delivery against a range of operational strategies intended to deliver governments’ agenda over the next three years, including the:

  • National Blood and Blood Product Wastage Reduction Strategy 2013-2017
  • National Patient Blood Management Guidelines Implementation Strategy 2013-2017
  • National Blood Sector ICT Strategy 2013-2016
  • National Blood Research & Development Strategic Priorities 2013-16
  • National Blood Sector Data & Information Strategy and Scorecard 2013-2016

As outlined in greater detail throughout this Annual Report, the organisation met or exceeded most of the objectives identified.

Ensuring supply

Ensuring an adequate, safe, secure and affordable supply of blood and blood related products remains a core role of the NBA for which the organisation again delivered significant outcomes. The headline performance indicator is the delivery of uninterrupted supply to meet clinical demand at a record saving of $138 million, or approximately 12.5 per cent, against the supply budget.

The key element of this outstanding budget result is an acceleration of improvements in appropriate use of fresh products resulting in a commensurate reduction in demand. In 2013-14, the demand for red blood cells decreased by more than eight per cent and platelets decreased by three per cent, compared to the previous year. This is in contrast to general hospital activity which has increased by approximately four to five per cent.

Australian Red Cross Blood Service (Blood Service) improvements in supply performance and efficiency under the current 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 $45 million and will return a 2013-14 saving of approximately $40 million to governments under the first year of the latest Output Based Funding Model agreed with the Blood Service.

On the commercial overseas supply contract front, the NBA undertook a highly successful tender or Recombinant Factor VIII and Factor IX products that will realise annual savings of approximately $50 million per year from 1 July 2014. The new contracts achieved a world value for money benchmark that also embeds a number of improved supply performance provisions.

The first new product to be added to the National Supply List since the establishment of National Blood Arrangements, subcutaneous immunoglobulin (SCIg), became available in September 2013. The availability of SCIg under the National Blood Arrangements significantly improves treatment options for a range of patients. Subsequently, the NBA successfully supported governments’ decision process for addition of another new product, fibrinogen concentrate for congenital fibrinogen deficiency, in March 2014.

Security of supply

The already comprehensive range of measures the NBA has in place to ensure the security of Australia’s supply of blood and blood products is being further enhanced following the completion of a number of risk related reviews. Of particular note was the completion of an exhaustive Review of Risk Management in the Blood Sector. Undertaken to support negotiation of a new Deed with the Red Cross, this Review recommended a number of areas where improvements can be made. It is worthy to note that the Review concluded that the overall level of risk in the blood sector has reduced over the last decade as a result of many factors, including some measures associated with the National Blood Arrangements. The NBA and Blood Service have commenced implementation of a range of recommended operational changes. Governments will consider the strategic level Review recommendations in 2014-15.

The NBA separately, as part of a reshaped risk management process, initiated a range of measures to improve the mitigation of risks associated with infectious diseases. This includes improved horizon scanning and strengthened contingency management arrangements with the Department of Health.

Implementing Blood Stewardship

The NBA made significant progress in supporting the implementation of the health ministers’ Statement on national stewardship expectations for the supply of blood and blood products. The Statement outlines expectations on health providers to contribute to the sustainability of the blood supply by improving the management and use of blood products. Significant 2013-14 outcomes included:

  • the development and implementation of the MyABDR App, which is a globally-unique smartphone app that enables people with bleeding disorders and their carers to record bleeds and their home treatments in real time. The innovation and collaboration between patients, carers, clinicians and governments in its development was recognised with MyABDR receiving three awards in the ACT 2014 iAwards (see Objective 2)
  • the development of national PBM Guidelines Module 5 on obstetrics for release early in 2015. The PBM Guidelines provide a key reference at health provider level that have underpinned the significant improvements in appropriate use of blood
  • an intensive programme of engagement, education and awareness promotion targeting key health provider and clinical stakeholders including:
    • the hosting of promotional stands and sponsored clinical presentations at a range of key clinical and sector conferences
    • the highly successful joint sponsorship with the Australian Commission on Safety and Quality in Healthcare of three Symposiums in Sydney, Melbourne and Adelaide supporting the implementation of the National Safety and Quality Healthcare Standard 7 dealing with blood and blood products (see Objective 3)
    • the joint sponsorship with the Western Australian Department of Health of the inaugural National Patient Blood Management Conference (see Objective 3).

Outlook for 2014–15

In 2014-15, the NBA will continue with the second year of the ambitious programme of work identified in the operational strategies approved by governments. In particular, we will build on the momentum already achieved to further reduce wastage and improve appropriate use of blood and blood products. We are also now well positioned to make significant new progress in the areas of education and training and immunoglobulin governance.

During 2014-15 the NBA will work with key stakeholders in the sector to also prepare for our merger with the Australian Organ and Tissue Donation and Transplantation Authority. The Government is establishing a single independent agency to streamline administrative activities, while maintaining the important work of the two agencies. The amalgamation of the two agencies will consolidate a range of national coordination and contracting activities, the benefits and opportunities for which are quickly becoming apparent.

I close this report with a special acknowledgement of appreciation for the many stakeholders across the sector who gave generously of their time, professionalism and passion. The outcomes we delivered were made possible because of their commitment. We look forward to working again with them in 2014-15.

Leigh McJames' Signature

Leigh McJames
General Manager
National Blood Authority