National blood supply contingency plan (NBSCP)

The National blood supply contingency plan (NBSCP) is an important document produced by the National Blood Authority (NBA) and provides a national process for managing critical shortages in the supply of blood product.
The plan gives a defined structure for a coordinated national response to blood product shortages and other threats to the blood supply.
Lifeblood 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 (HTC) 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 plan also contains annexes to assist key stakeholders in responding to a supply demand or crisis.
Awareness of the document and its implications is essential for your laboratory and the facilities to which your laboratory supplies blood products.

What your laboratory should be doing in response to the NBSCP

It’s important that your laboratory is familiar with the requirements of the NBSCP. 
You can download electronic copies of the NBSCP requirements from the NBA website.

Increase awareness of the NBSCP

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 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 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.

Appropriate usage of blood products

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.

Blood product inventory levels

Details of your laboratory’s blood product stock levels will be required to be submitted daily to Lifeblood.
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 Lifeblood.
This data is used to populate Lifeblood's National inventory template (NIT) on which production and supply decisions, including interstate transfers, are made.

Availability of blood products

When blood product stocks are adequate, your institution’s orders will be met with little or no adjustment.
When Lifeblood stocks drop below predefined levels, there will be restrictions on what can be supplied and, where necessary, this will be under the direction of Lifeblood 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.

Clinical consequences of activating the NBSCP

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, Lifeblood 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.