National Blood Supply Contingency Plan

The National Blood Authority (NBA) launched the National Blood Supply Contingency Plan (NBSCP) in November 2008.

This is an important document that provides a process for managing critical shortages in the supply of blood product.

This plan gives a defined structure for a coordinated national response to blood product shortages and other threats to the blood supply. The Australian Red Cross Blood Service participated in the development of the plan.

The plan should, however, be seen as a living document and regularly reviewed in conjunction with the Hospital Transfusion Committee and other key stakeholders.

The clinical community plays a central role in the NBSCP in ensuring appropriate clinical transfusion and optimal inventory management practices, and the prioritisation of available blood supplies to those patients with the greatest clinical need.

Therefore, it is imperative that institutions have in place appropriate arrangements to support the plan.

The NBA has produced annexes and quick reference guides to assist the clinical community in understanding the plan and develop approaches to prioritising red cell transfusions. 

Awareness of the document and its implications is essential for your laboratory and the facilities to which your laboratory supplies blood products.

It is important that your laboratory is familiar with the requirements of the NBSCP.

You can download electronic copies of the NBSCP requirements from the NBA web site.

The healthcare facilities to which you supply blood products must also be aware of the NBSCP and its implications.

Governance of transfusion activities is normally the role of a local Hospital Transfusion Committee (HTC) or another appropriate committee incorporating similar responsibilities, of which the laboratory must be an active participant.

If such a committee does not already exist, one should be convened.

The HTC (or its equivalent) should, therefore, assume responsibility for local implementation of the NBSCP and coordinating organisational preparedness for blood product shortages.

The NBSCP must be considered part of the organisational (or wider area) emergency planning framework and an organisational Emergency Blood Management Plan (EBMP) should be prepared accordingly.

Maintaining an adequate blood supply requires that the available blood product inventory is used appropriately and not wasted.

Proactive management of blood product stocks by the laboratory rather than a reactive response to shortage should be the primary focus.

At the organisational level, there should be policies directing appropriate blood product utilisation and minimisation of unnecessary wastage and these should be promoted by the HTC.

Details of your laboratory’s blood product stock levels will be required to be submitted daily to the Blood Service.

This is done by entering your stock levels into BloodNet, which is then emailed to the Inventory & Distribution department.

It is important that we have accurate daily jurisdictional and national figures showing blood product stocks and how the inventory is distributed between the various institutions and the Blood Service.

This data is used to populate the Blood Service's National Inventory Template (NIT) on which production and supply decisions, including interstate transfers, are made.

When blood product stocks are adequate, your institution’s orders will be met with little or no adjustment.

When Blood Service stocks drop below predefined levels, there will be restrictions on what can be supplied and, where necessary, this will be under the direction of Blood Service Medical Officers in consultation with the local clinician.

If stocks do not improve, the NBA will activate the NBSCP and you will be informed accordingly.

You will be expected to follow the requirements of the plan for managing use of blood products including appropriate prioritisation of transfusions.

The clinical response to blood product shortages and when the NBSCP has been activated, particularly at the more serious levels, will rely on clinicians and laboratories being able to reduce demand through strong triage and vetting of requests of blood products.

You will need to liaise with your local clinicians and, where necessary, Blood Service medical staff, as part of the decision making process.

In deciding whether or not to transfuse, clinicians will use their clinical judgement to assess product requirements based on the diagnosis of their patients and knowledge of what products (or alternatives) are available.

Reference
  1. National Blood Authority. National Blood Supply Contingency Plan (NBSCP). Australia, 2008.