2013-15 nba corporate plan - blood · web viewthe core focus of the nba corporate plan is...

CONTENTSINTRODUCTION............................................................................................................................1

THE NBA.......................................................................................................................................2

NBA STAKEHOLDERS.....................................................................................................................3

Australian governments...................................................................................................................3

Regulator..........................................................................................................................................3

Suppliers of blood and blood products............................................................................................3

Health professionals.........................................................................................................................4

Patients and non-government organisations...................................................................................4

FUTURE CHALLENGES....................................................................................................................5

Changes in demographics............................................................................................................5

Variations in clinical use...............................................................................................................5

Emerging clinical uses of existing products and new technical options.......................................5

Robust data..................................................................................................................................5

SCOPE...........................................................................................................................................6

PURPOSES.....................................................................................................................................7

Introduction.....................................................................................................................................7

Purpose 1: provide a safe, secure and affordable supply of blood and blood-related products and services to ensure access best meets clinical need in Australia.........................................................................8

Targets.............................................................................................................................................9

Purpose 2: drive performance improvement in the Australian blood sector through a national information management and data analysis capability.....................................................................................10

Targets...........................................................................................................................................11

Purpose 3: Promote a best practice model of management and use of blood and blood related products and services in Australia........................................................................................................................12

Targets...........................................................................................................................................15

Purpose 4: develop policy and provide policy advice on the sustainability of the blood sector in Australia, including financial sustainability...................................................................................................................16

Targets...........................................................................................................................................18

Purpose 5: The National Blood Authority is a high performance organisation..............................19

Targets..........................................................................................................................................20

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Introduction

This Corporate Plan for the National Blood Authority, has been prepared in accordance with Section 35 of the Public Governance, Performance and Accountability Act 2013 and Section 43 of the National Blood Authority Act 2003. It covers a three year planning period to 2018-19.

Since the establishment of the national blood arrangements in 2003, the National Blood Authority has driven major improvements in the following areas:

enhancing security of supply and achieving greater value for money; improving the appropriate use of blood and blood products; improving the safety and quality of blood and blood products; and designing and creating an information and data capability for the sector to support performance and

benchmark activities.

Despite these improvements and the substantial price savings achieved through contract negotiation and management, the following factors continue to place pressure on the national blood budget and the blood arrangements:

growth in demand for some products; increase in the cost of some products; clinical variability in the use of some products; and decrease in the number of available donors.

This Plan outlines strategies and targets that are designed to address these issues and further improve the national blood arrangements in Australia.

Central to the Plan is an ongoing commitment to drive improvements in the appropriate use and supply management of blood and blood products.

We welcome feedback on the Plan and encourage comments and suggestions at [email protected] if you have views or ideas for reform and improvement in the sector.

John CahillChief Executive

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mailto:[email protected]

The NBAOUR VISION Saving and improving Australian lives through a world-class blood supply.

OUR ROLE The National Blood Authority (NBA) is a statutory agency within the Australian Government Health portfolio that manages and coordinates arrangements for the supply of blood and blood products and services on behalf of the Australian Government and state and territory governments.

The key role of the NBA is to:

provide an adequate, safe, secure and affordable supply of blood products, blood related products and blood related services; and

promote safe, high quality management and use of blood products, blood related products and blood related services in Australia.

The NBA:

works with jurisdictions to determine the clinical requirements for blood and blood products and develop an annual supply plan and budget;

negotiates and manages national contracts with suppliers of blood and blood products to obtain the products needed;

assesses blood supply risk and develops commensurate contingency planning; supports the work of the jurisdictions to improve the way blood products are used - including developing

and facilitating strategies and programmes that will improve the safety, quality and effectiveness of blood usage, particularly in the areas of national standards, guidelines and data capture and analysis;

works collaboratively with key stakeholders to provide expert advice to support government policy development, including identification of emerging risks, developments, trends and new opportunities;

manages the evaluation of proposals for blood sector improvements, including proposals for new products, technologies and system changes; and

provides secretariat support to the Jurisdictional Blood Committee (JBC).

AUTHORITY The NBA was established by the National Blood Authority Act 2003 following the signing of the National Blood Agreement by all state and territory health ministers in November 2002. As a material statutory agency, the NBA has a range of corporate and compliance responsibilities under the National Blood Authority Act 2003, the Public Governance, Performance and Accountability Act 2013 (PGPA), and the Public Service Act 1999, along with a responsibility to meet ministerial, parliamentary and financial reporting requirements.

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NBA stakeholdersThe NBA recognises that improvements in the blood sector require it to work collaboratively with all governments, suppliers, health professionals, patients and non-government organisations. The aim is to implement a blood supply system that is responsive to patient needs, is built on evidence based clinical practice, and ensure that Australia’s blood supply is safe, secure, adequate and affordable.

The nature of the relationships summarised below is largely determined by:

the National Blood Agreement and the National Blood Authority Act 2003; detailed contractual arrangements; and the generous commitment of time from clinical experts and community representatives.

AUSTRALIAN GOVERNMENTSUnder the National Blood Agreement, Australian, state and territory governments are responsible for:

jointly funding the national blood supply and the operating costs of the National Blood Authority (the Australian Government provides 63% of funding, the states and territories 37% collectively);

establishing the policy framework and specific policies relating to the national blood supply; oversighting the National Blood Authority’s management of the blood supply; fostering the development and implementation of best practice systems to promote efficient use,

minimal wastage and optimal patient outcomes; gathering and providing information in relation to demand for blood and blood products; and managing local issues such as those involving clinical practice.

REGULATORThe Therapeutic Goods Administration is responsible for:

regulating the sector in terms of the safety and efficacy of blood and blood products under the Therapeutic Goods Act 1989;

auditing of Good Manufacturing Practice and supervision of product recalls; and modifying safety standards and issuing directives such as donor deferral.

SUPPLIERS OF BLOOD AND BLOOD PRODUCTSThe volume and type of product required from suppliers is forecast through the National Supply Plan and Budget following consultations with clinicians, jurisdictions and patient groups. The National Supply Plan and Budget is approved by Health Ministers on an annual basis.

The Australian Red Cross Blood Service (Blood Service) is responsible for collecting fresh blood to meet clinical demand and plasma required to meet the National Supply Plan and Budget. The majority of the plasma collected by the Blood Service is provided to CSL Behring. The plasma is fractionated by CSL Behring to produce products required under the National Supply Plan and Budget.

A number of other pharmaceutical and diagnostic companies are responsible for the supply of a range of imported blood products not produced within Australia and/or where domestic supply cannot meet demand.

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HEALTH PROFESSIONALS Health professionals play a key role in providing advice and input on:

potential demand; managing demand; and developing and implementing evidence based guidelines and criteria for use.

PATIENTS AND NON-GOVERNMENT ORGANISATIONS Patients requiring blood products are central to the National Blood Authority’s activities. The NBA will continue to ensure work is informed by, and is responsive to, the needs of patients and the broader community.

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Future challengesThe ability of the National Blood Authority to ensure the adequate, safe, secure and affordable supply of blood and blood products will require the agency to address key areas including increasing demand, variability in usage, the development of new products and services, changes to existing products and services and supply issues.

Our priorities have been shaped by an analysis of our environment and the future economic, financial, and policy factors.

The following trends and drivers will influence our strategic planning over the next triennium.

CHANGES IN DEMOGRAPHICS An ageing population is expected to be a major driver of increased demand for blood and blood products

while also impacting on the available donor pool. New diseases and new clinical indications for use are expected to further increase demand. Strong growth in specific blood products is expected to continue (e.g. demand for immunoglobulin (Ig)

products continues to growing at around 12% per annum and is now the largest component of the blood budget).

VARIATIONS IN CLINICAL USE Significant variability in usage rates for blood and blood products exists. The availability and analysis of

data is required to better understand the variations and inform responses. There remains considerable scope to embed contemporary clinical guidelines and criteria for use. There is a need to ensure existing guidelines are current and relevant products are covered by clinical

guidelines (e.g. Revised Patient Blood Management Guidelines). There is scope to further reduce wastage of blood and blood products through enhanced inventory

management and improved supply chain practices.

EMERGING CLINICAL USES OF EXISTING PRODUCTS AND NEW TECHNICAL OPTIONS The continual development of new and existing products and services to improve treatment where they

have demonstrated enhanced outcomes will be an ongoing challenge for the delivery of cost effective equitable care.

ROBUST DATA Despite significant progress, the disparate nature of health sector data systems presents significant

challenges in establishing supporting national data sets to support clinical practice performance analysis and benchmarks. The NBA will seek alternative methodologies, such as targeted clinical audits, to further improve the availability and veracity of blood sector data.

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ScopeThe Corporate Plan identifies the outcomes that the NBA will seek to deliver over the next three years, including supporting strategies and key activities. It is a strategic level document that draws heavily on, and is closely aligned with, the objectives identified in the Jurisdictional Blood Committee Strategic Plan 2016-18. It is also informed by the work plans of the various JBC and NBA consultative and technical committees. These committees include a range of stakeholders including governments, suppliers, health professionals, patients, non-government organisations, the National Blood Authority Board, and NBA staff. The Plan also takes into account wider health sector imperatives from:

The Statement on National Stewardship Expectations for the Supply of Blood and Blood Products; The priorities associated with the implementation of the National Safety and Quality Healthcare

Standard for Blood and Blood Products; Government Federation Review; Regulatory, legislative and policy requirements; Funding guidance; e-health standards; Medical Benefits Scheme (MBS) Review; and Health sector commitment to performance measurement.

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Purposes INTRODUCTIONThe core focus of the NBA Corporate Plan is ensuring the safe, secure and sustainable supply of blood and blood products to meet clinical demand. The Plan outlines a series of Purposes and strategic priorities and associated strategies supporting this focus and aligned to the JBC Strategic Plan.

Our delivery against these goals is reported regularly to the NBA Board and Jurisdictional Blood Committee and annually to all governments and the public. They are managed by a framework of internal governance and control mechanisms. Many projects are also supported and informed by external Committees.

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Strategic Priority 1.1 - Improve patient safety, supply security and efficiency through optimising inventory levels of all blood products and minimising wastage within the system. STRATEGIES Arrange for evidence-based National Inventory Management templates/guidelines to be

prepared on safe and efficient inventory management for AHP blood stocks. Oversee the development, implementation and review of product discards and wastage and

develop wastage benchmarks. Conduct National Blood Supply Contingency Plan (NBSCP) reviews to periodically consider supply

security throughout the full vein to vein supply line.

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PURPOSE 1: PROVIDE A SAFE, SECURE AND AFFORDABLE SUPPLY OF BLOOD AND BLOOD-RELATED PRODUCTS AND SERVICES TO ENSURE ACCESS BEST MEETS CLINICAL NEED IN AUSTRALIA.

TARGETS2016-2017 2017-18 2018-19

Review and develop an updated National Wastage Reduction Strategy for JBC approval.

Implement the National Inventory Management Framework (NIMF) for red cells.

Develop a NIMF for platelets.

Develop and progress agreed wastage benchmarks for incorporation into the approval process for the 2017-18 National Supply Plan and Budget.

Monitor and publish wastage levels of both public and private facilities, including comparative data aggregated to jurisdictional level.

Implement National Service Requirements and Standards according to agreed plan.

Implement the revised National Wastage Reduction Strategy.

Implement the NIMF in accordance with JBC guidance.

Undertake a review of Blood Service collection, manufacturing and distribution wastage and recommend appropriate benchmarks for JBC consideration.

Undertake a review of NBSCP and recommend appropriate benchmarks for JBC consideration.

Report against comparative international and national benchmarks.

Implement National Service Requirements and Standards according to the agreed plan.

Implement the revised National Wastage Reduction Strategy.

Implement NIMF in accordance with JBC guidance.

Progress the outcome of the NBSCP review through JBC.

Implement initiatives from the review of Blood Service collection, manufacturing and distribution wastage.

Implement National Service Requirements and Standards according to the agreed plan.

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Strategic Priority 2.1 - Support the development and implementation of national systems for data collection.

STRATEGIES Advocate and support provision of data by public and private sectors through national systems. Maintain an enhancement program for national systems. Implement the new Ig Governance system, BloodSTAR. Complete implementation of Laboratory Information System (LIS) interfaces to BloodNet. Effectively forecast demand for blood and blood products in accordance with agreed timetables

and processes.

Strategic Priority 2.2 - Improve our evidence base to better understand blood and blood product management and use and identify opportunities for improvement.

STRATEGIES Review the national data strategy for the blood sector as the basis for ongoing data analysis and

feedback to JBC. Develop a schedule of data reports addressing key JBC requirements. Expand data activities to targeted clinical audits to address key JBC requirements. Investigate and publish the wider associated costs of blood use. Develop a responsive and comprehensive data capture and analysis capability, including improved

reporting in relation to immunoglobulin product use. Develop and implement a new national haemovigilance system in accordance with JBC guidelines.

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PURPOSE 2: DRIVE PERFORMANCE IMPROVEMENT IN THE AUSTRALIAN BLOOD SECTOR THROUGH A NATIONAL INFORMATION MANAGEMENT AND DATA ANALYSIS CAPABILITY.

TARGETS2016-17 2017-18 2018-19

Develop an updated National ICT Strategy for JBC approval.

Develop an updated National Data Strategy for JBC approval.

Implement the BloodSTAR system, including the publication of regular reports.

Develop and implement hospital laboratory information system interfaces with BloodNet.

Develop an ordering and receipting of product from commercial suppliers capability in BloodNet.

Develop and publish data reports, based on targeted clinical audit samples in accordance with the JBC approved schedule.

Develop a new National Haemovigilance framework in accordance with JBC guidelines.

Develop guidance on national standard and minimum data sets for JBC consideration.

Implement the revised National ICT Strategy.

Implement the revised National Data Strategy.

Finalise the implementation of BloodNet interfaces with hospital laboratory information systems.

Establish Ig governance benchmarks for appropriate prescription and authorisation performance indicators.

Progress further phases of the BloodNet interface with the Blood Service Enterprise Service Bus.

Implement an ordering and receipting of product from commercial suppliers capability in BloodNet.


Implement the new National Haemovigilance framework in accordance with JBC guidelines.

Implement JBC approved guidance on national standard and minimum data sets.

Establish routine morbidity/blood use/pathology linkage.

Implement the revised National ICT Strategy.

Implement the revised National Data Strategy.

Progress further phases of the BloodNet interface with the Blood Service Enterprise Service Bus.


Implement the new national haemovigilance framework in accordance with JBC guidelines.

Implement JBC approved guidance on national standard and minimum data sets.

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Strategic Priority 3.1 - Identify opportunities to support implementation of the National Safety and Quality Health Standards (NSQHS) Blood Standard.

STRATEGIES Develop tools and strategies that support health providers to implement the NSQHS Blood

Standard.

Strategic Priority 3.2 - Support appropriate use of blood and blood products through encouraging and promoting the integration of Patient Blood Management (PBM) programs in health care provider systems.

STRATEGIES Continue the development of Patient Blood Management guidelines and a program to support

their dissemination and uptake. Continue the development and implementation of a national PBM program.

Strategic Priority 3.3 - Ensure that nationally consistent and effective clinical governance and authorisation arrangements are in place for high cost blood products.

STRATEGIES Develop and implement new blood and blood products governance arrangements and

supporting oversight processes. Clarify access and review criteria for standardised assessment of eligibility for access to Ig.

Strategic Priority 3.4 - Provide advice to Health Ministers on proposed benchmarks and national performance measures for appropriate use of blood and blood products.

STRATEGIES Develop benchmarks and national performance measures on appropriate use, which leverage

information already collected or available, for JBC approval and referral to Health Ministers.

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PURPOSE 3: PROMOTE A BEST PRACTICE MODEL OF MANAGEMENT AND USE OF BLOOD AND BLOOD RELATED PRODUCTS AND SERVICES IN AUSTRALIA.

Strategic Priority 3.5 - Build and promote sharing of knowledge and identify and promote effective governance and best clinical practice.

STRATEGIES Develop of blood-related education materials for the health workforce and promote their

national uptake and evaluation. Implement the revised PBM Guidelines and 3rd Edition of Criteria for Clinical Use of IVIg.

Strategic Priority 3.6 - Promote the best practice use of clotting factors.

STRATEGIES Build evidence on variations in clinical practice, develop tools, resources and strategies to reduce

variations or departures from best practice and engage clinicians and the community of users and carers, on the best use of clotting factors.

Strategic Priority 3.7 - Improve private sector engagement to promote a better understanding of blood issues, including capacity for more efficient and appropriate use, in particular within the context of the broader health system.

STRATEGIES Maintain a specific program to support private sector improvement, including:

o direct formal written engagement at a CEO level highlighting blood usage that is outside acceptable parameters;

o the conduct of private sector forums; ando direct consultancy support to individual private sector hospitals in support of improvement.

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TARGETS2016-17 2017-18 2018-19

Develop and promote an expanded suite of tools to support health providers to implement the NSQHS Blood Standard.

Develop an updated PBM Guidelines Implementation Strategy for JBC approval.

Develop an enhanced PBM Guideline development process based on a pilot to update Module 1.

Revise and publish an updated edition of the PBM Guidelines Module 1.

Undertake a programmed evidence based review of the Criteria for the clinical use of Ig in Australia in accordance with JBC approved governance arrangements.

Develop an Ig Governance education and training program.

Progress a proposal to embed BloodSafe e-learning in routine funding arrangements.

Finalise National Haemophilia Guidelines.


Implement the revised PBM Guidelines Implementation Strategy.

Revise and publish updated editions of the PBM Guidelines Modules 2 and 3.

JBC to consider NBA proposals for implementation and dissemination of the PBM guidelines.

Implement the revised Criteria for the clinical use of Ig in Australia in accordance with JBC approved governance arrangements.

Implement an Ig Governance education and training program.

Develop a program of benchmarking appropriate clinical practice in relation to Ig at an individual clinician level.

Implement the National Haemophilia Guidelines.


Implement the revised PBM Guidelines Implementation Strategy.

Revise and publish updated editions of the PBM Guidelines Modules 4 and 5.

Implement the revised Criteria for the clinical use of Ig in Australia in accordance with JBC approved governance arrangements.

Implement an Ig Governance education and training program.

Implement a program of benchmarking appropriate clinical practice in relation to Ig at an individual clinician level.

Undertake a review of the effectiveness of the strengthened Ig governance arrangements.

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Strategic Priority 4.1 - Ensure reliable, consistent and well-informed decision-making about risks and proposals to address these risks in the blood sector.

STRATEGIES Explore the feasibility of a national integrated risk management framework for the sector.

Strategic Priority 4.2 - Provide advice on improving value for money for governments under the Deed of Agreement with the Blood Service, including strategies to address risks for governments and the Blood Service.

STRATEGIES Oversee continued refinements to the Output Based Funding Model (OBFM) arrangements to

deliver better value for money for governments.

Strategic Priority 4.3 - Guide long-term policy and planning priorities, including in the broader context of health reform.

STRATEGIES Undertake research to guide the development of a strategic policy and research agenda for the

blood sector. Advise and report on the feasibility of integrating blood into the wider health sector

arrangements and opportunities to strengthen the evidence base for blood use and costs.

Strategic Priority 4.4 - Provide advice on improving value for money for governments under the contract with CSL Behring, including strategies to address risks for governments.

STRATEGIES Define the policy parameters for, and negotiate, the new contractual agreement with CSL

Behring for the domestic manufacture of agreed plasma derived products.

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PURPOSE 4: DEVELOP POLICY AND PROVIDE POLICY ADVICE ON THE SUSTAINABILITY OF THE BLOOD SECTOR IN AUSTRALIA, INCLUDING FINANCIAL SUSTAINABILITY.

Strategic Priority 4.5 - Determine the appropriate strategy for ensuring that the private sector is accountable for its use of blood and blood products, ensuring that all use maximises appropriate clinical use and minimises wastage.

STRATEGIES Support development of JBC policy options paper/s for Health Ministers which address the key

levers influencing private sector behaviour.

Strategic Priority 4.6 - Ensure financial sustainability of Ig supply.

STRATEGIES Support development of JBC policy options paper for health ministers.

Strategic Priority 4.7 - Determine the effective use of plasma by-products.

STRATEGIES Investigate the humanitarian / commercial use of plasma by-products.

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TARGETS2016-17 2017-18 2018-19

The NBA to negotiate revised OBFM principles with the Blood Service.

Develop an updated Statement of National Research and Development Priorities for JBC approval.

Establish the policy parameters for negotiation of a new contractual agreement with CSL Behring.

Support the development of JBC proposals to integrate blood arrangements into wider health sector reform.

Negotiate a new contract with CSL Behring in accordance with JBC approved policy parameters.

Develop key parameters underpinning the 4th Blood Service Output Based Funding Model for JBC approval.


Build evidence of blood and blood product use in private sector.

Implement the new contract arrangements with CSL Behring.

Negotiate the 4th Output Based Funding Model with the Blood Service.


Support the development of a paper investigating the humanitarian and commercial options for the use of plasma by-products.

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Strategic Priority 5.1 - The National Blood Authority is respected by stakeholders for knowledge and professionalism.

STRATEGIES Attract and retain high quality staff for the range of required disciplines across the agency. Strengthen the capability of staff. Provide professional and personal development opportunities for staff. Drive innovative and professional practices. Maintain strong internal and external relationships. Introduce electronic business processes to enhance performance, governance and compliance. Maintain enhanced assurance and control framework. Maintain strong internal and external communications arrangements.

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PURPOSE 5: THE NATIONAL BLOOD AUTHORITY IS A HIGH PERFORMANCE ORGANISATION.

TARGETS2016-17 2017-18 2018-19

Continue the migration to electronic workflows to enhance and improve efficiency of work practices and timely decision-making.

Review NBA business process architecture as basis for continuing business process improvement activity.

Review the NBA assurance and control framework.

Continue the sentencing and digitisation of legacy paper records.

Continue implementation of the Digital Service Standard.

Undertake a residential leadership/planning workshop for the wider management group.

Undertake an all staff residential leadership/planning workshop.

Establish an expanded program of Knowledge Management Forums and health sector familiarisation visits for NBA staff.

Complete the introduction of electronic workflows to enhance and improve efficiency of work practices and timely decision making.

Seek strategic learning through partnerships, peer and other relationships to inform the sector.

Implement new arrangements to the NBA business process architecture.

Implement agreed recommendations of internal human resource policy review.

Continue implementation of the Digital Service Standard.

Complete the sentencing and digitisation of legacy paper records and cease offsite storage of sentenced records.

Continue implementation of the Digital Continuity 2020 Policy.

Complete implementation of the Digital Continuity 2020 Policy.

Implement an enhanced Performance Assessment Framework for all NBA staff.

Complete implementation of the Digital Service Standard.

Develop 2019-22 Corporate Plan.

Undertake a residential leadership/planning workshop for the wider management group.

Undertake an all staff residential leadership/planning workshop.

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2013-15 nba corporate plan - blood · web viewthe core focus of the nba corporate plan is...

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