Business continuity in blood services: two case studies from events with potentially catastrophic effect on the national provision of blood components.

BACKGROUND AND OBJECTIVES: NHS Blood and Transplant (NHSBT) and the Australian Red Cross Blood Service (ARCBS) are national blood establishments providing blood components to England and North Wales, and Australia, respectively. In 2012, both services experienced potentially catastrophic challenges to key assets. NHSBT suffered a flood that closed the largest blood-manufacturing centre in Europe, whilst ARCBS experienced the failure of a data centre network switch that rendered the national blood management system inaccessible for 42 h. This paper describes both crisis events, including the immediate actions, recovery procedures and lessons learned. MATERIALS AND METHODS: Both incidents triggered emergency response plans. These included hospital reprovisioning and recovery from the incident. Once normal services had been restored, both events were subjected to root cause analysis (RCA) and production of 'lessons learned' reports. RESULTS: In both scenarios, the key enablers of rapid recovery were established emergency plans, clear leadership and the support of a flexible workforce. Product issues to hospitals were unaffected, and there were no abnormal trends in hospital complaints. RCA identified the importance of risk mitigations that require co-operation with external organizations. Reviews of both events identified opportunities to enhance business resilience through prior identification of external risks and improvements to contingency plans, for example by implementing mass messaging to staff and other stakeholders. CONCLUSIONS: Blood establishment emergency plans tend to focus on responding to mass casualty events. However, consolidation of manufacturing to fewer sites combined with a reliance on national IT systems increases the impact of loss of function. Blood services should develop business continuity plans which include prevention of such losses, and the maintenance of services and disaster recovery.

Going for gold: blood planning for the London 2012 Olympic Games.

The Olympics is one of the largest sporting events in the world. Major events may be complicated by disruption of normal activity and major incidents. Health care and transfusion planners should be prepared for both. Previously, transfusion contingency planning has focused on seasonal blood shortages and pandemic influenzas. This article is the first published account of transfusion contingency planning for a major event. We describe the issues encountered and the lessons identified during transfusion planning for the London 2012 Olympics. Planning was started 18 months in advance and was led by a project team reporting to the Executive. Planning was based on three periods of Gamestime. The requirements were planned with key stakeholders using normal processes enhanced by service developments. Demand planning was based on literature review together with computer modelling. The aim was blood-stock sufficiency complimented by a high readiness donor panel to minimise waste. Plans were widely communicated and table-top exercised. Full transfusion services were maintained during both Games with all demands met. The new service improvements and high readiness donors worked well. Emergency command and control have been upgraded. Red cell concentrate (RCC) stock aged but wastage was not significantly increased. The key to success was: early planning, stakeholder engagement, service developments, integration of transfusion service planning within the wider health care community and conduct within an assurance framework.

Erythropoietin responsive progenitors in anaemia of prematurity.

Circulating erythroid progenitors (BFU-E) in five anaemic preterm infants (haemoglobin less than 100 g/l) were about 2 and 4.4 times as abundant as in 10 preterm infants who were not anaemic and five healthy adults, respectively, and were significantly more responsive to low concentrations of recombinant human erythropoietin (rHuEpo) than those from healthy adults. These results encourage further studies in the use of rHuEpo for the treatment of the anaemia of prematurity.