The overall focus of the committee is to ensure donor, recipient and staff safety whilst SANBS continues to build on the iHEALTh strategy and strengthen their position as a cornerstone of healthcare.
Response to Covid-19
Monitored and reviewed the ongoing impact of the pandemic with regards to sustaining the requisite delivery of blood products and ensuring the safety of SANBS staff and stakeholders. This included the following:
- Continual assessment of red blood cell product utilisation during the pandemic. When lockdown commenced, all elective surgery had been cancelled and trauma decreased which dramatically decreased the demand for red blood cells. During the recovery in September/October 2020 when the demand for red blood cells increased, SANBS (for a short period) could not meet optimal demand. At the height of the second wave, the health sector adapted quicker and usage went down only -8%.
- Staff health and well-being was also a major concern, especially for frontline staff who faced increased risk during the second wave of the pandemic. SANBS staff and SANBS stakeholders working in clinics were registered onto the National Department of Health vaccine roll out database, ensuring access to vaccinations.The Committee acknowledges the unwavering dedication of all SANBS personnel in maintaining the continuity of SANBS operations and risking their lives to live up to our purpose of being trusted to save lives.
SANBS collection units experienced difficulties due to decreased access to schools and corporate companies’ widescale work from home policies. Innovative strategies will therefore need to be implemented to increase the future donor pool.
Human Centred Donor Care
Monitored and reviewed the ongoing impact of the change in donor questionnaire and deferral criteria changes on blood collections. The #ironstrong project culminated in improved donor care.
Patient Blood Management (PBM)
CGC supports and acknowledges the PBM unit’s ongoing efforts to ensure the evidence-based use of blood and blood products. In this regard, the unit is commended for its development of high-quality, patient-focussed reports targeted at healthcare professionals and managers.
The PBM unit successfully launched their “increased digital footprint” plan to support hospitals and train healthcare workers amidst the pandemic as well as interaction with multiple national focus groups.
Haemovigilance
Supported the development of a Haemovigilance App for electronic capturing and monitoring of patient adverse events.
Quality
Following successful completion of ISO 15189 accreditation throughout the organisation, CGC supports the Board approval to achieve ISO 9001 compliance which will ensure ISO standard quality systems in administrative areas.
Translational Research
Oversight of SANBS participation in several Covid-19 related research projects. Noteworthy was the level of commitment of the SANBS collaboration with the Western Cape Blood Service and the DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis where a sero-surveillance study was performed. This involved testing of almost 17000 blood donors to estimate the prevalence of antibodies to SARS-COV-2 which indicates past exposure to the virus. More frequent sampling, including linked repeat observations of frequent donors, could substantially improve the utility of blood donor surveillance for national decision making.
Platelet Strategy
The current platelet strategy of 55% apheresis/45% pooled platelets is not optimal in terms of stakeholder coverage and safety compared with benchmarked first world countries. CGC approved the SANBS Platelet Strategy to a stepwise increase towards 80% to 90% pooled platelet strategy with the concurrent pilot implementation of pathogen reduction technology. Although providing a better quality product is the right thing to do, the committee must carefully weigh up not only the benefits associated with this technology, but also the risks and associated costs.
Cellular Therapy
Work in the Cellular Therapy unit is continuing in creating and supporting new products. The CGC oversight role in cellular therapy is to ensure clearly defined research projects that include novel therapies and products. During the year under review, SANBS created human platelet lysate(HPL), a growth factor used to grow cells, to be used by laboratories in universities. The specialised laboratory will commence growing research grade mesenchymal stem cells for use in clinical trials.
Blood Establishment Computer System (BECS)
Continued oversight over the progress with BECS implementation. Despite challenges with delays, as a result of the pandemic, the project team were able to successfully deliver on most of the planned milestones for the year.
Infection Prevention Control (IPC)
Monitored oversight of IPC being operationalised across the organisation and reviewed reports indicating a marked decrease in bacterial contamination of platelets to <1%. Audit reports noting good compliance however, also identified areas for potential improvement. IPC awareness created a stepping stone and placed SANBS in a better position to manage Covid-19 requirements.
Regulations and NHI
SANBS approached the Parliamentary Committee who confirmed that they had received SANBS’s submission on NHI Bill to Parliament. No feedback has been received from SAPHRA with regard to regulating the blood services. Whilst awaiting the final NHI Bill and other regulatory changes, SANBS will continue to work towards complying with international standards and good GMP.
Medico-legal
The risk of litigation against management or the organisation did not increase and management is confident that effective preventative and mitigating controls are in place. There is cognisance of the increasing difficulty to obtain medical malpractice insurance. SANBS will maintain all current levels of insurance cover across the various classes and provide the insurer with comprehensive information to secure cover at the most competitive price, as there are significant increases in premiums and deductibles across most classes of insurance.