The overall focus of the Committee is to ensure donor, recipient and staff safety whilst SANBS continues to execute the iHEALTh strategy and strengthen its position as a cornerstone of healthcare. Key matters considered include:

Human Centered Donor Care

• The #IronStrong project includes all aspects of donor iron that may impact on donor health and wellness. The Donor Iron Strategy places emphasis on providing donors with more tolerable iron tablets, improved communication with donors and staff, education on understanding the importance of iron testing and supplementation, and further research into factors associated with and the outcomes of iron deficiency among blood donors
  • The digital educational series has led to increased traffic on social media pages and the website
  • Cheliron Forte, a more tolerable iron tablet, was recommended as the appropriate iron replacement tablet
  • Donor uptake, tolerability and impact on donor iron status will be assessed for 18 months

Blood collections

• Noted the increase in whole blood collections from Black donors (41,3% to 43,3%). Blood collections from Asian and Coloured donor panels showed marginal reductions while the decrease in contribution from White donors was almost 2%
• Noted the above 60% collections from new Black donors, consistent with the performance of FY2023, indicating an increase in the Black donor panel. An increase in the donor panel assists in managing the pressure on donor iron levels while ensuring a sufficient blood supply

Blood Issuing

• Noted the implementation of the first SMART Fridge at Rahima Moosa Mother and Child Hospital
  • Network connectivity will be monitored with a plan to place an additional ten fridges over the next few years
• Noted an improved turn-around-times for blood being issued to patients
• Monitored causes of Blood Bank errors closely and noted the pilot programme implemented in Rustenburg to remove manual data capturing and improve efficiencies. The new processes were implemented nationwide
• Loadshedding remained a challenge when hospital generators fail. A plan was developed to place generators at Blood Bank sites
• Product loss due to the lack of backup generators for emergency hospitals is being managed with the placement of remote temperature monitoring systems in the fridges
• The Reveos automated processing instrument (a pilot project successfully completed) could enable the processing of blood in remote areas improving the time to service delivery. This is subject to operational need and budget

Blood Establishment Computer System (BECS)

• Continued oversight of the BECS implementation and change management initiatives, including training of staff and the plans to ensure the safety and sufficiency of the blood supply during the Go Live period
• Noted reasons for delays experienced with the service provider and actions taken to remedy and ensure progress within revised timelines
• Preparations for the Go Live in November ensured 7 days stock prior to the cut over period. However, the need to bed down systems in December and quarter 4 contributed to collections of red blood cells being below target leading to extended cutbacks of certain blood and blood products

Quality

• All SANBS collection sites and core laboratories are accredited to ISO 15189
• Compromised safety and quality of blood products risk is well controlled and assured by ongoing accreditation of the various SANBS sites to applicable local and international standards by independent accreditation bodies
• Deficiencies reported in the blood tracking audit related to manual processes and should be minimised through the eProgesa implementation
• Delays in HPCSA accreditation of laboratories where students are placed were noted and are being monitored
• Harmonisation of standards
  • New accreditations received
    • The Joint Accreditation Committee ISCT-EBMT (JACIE) (cellular therapies)
    • European Federation for Immunogenetics (EFI) (tissue immunology)
  • In progress
    • ISO 9001 – quality audit – November 2023
    • ISO 13485 – Reagents Laboratory addressed and completed non- conformances
    • ISO 20387 – Biorepository Laboratory audit for accreditation by the American Association for Laboratory Accreditation (A2LA) scheduled for November 2023 postponed and scheduled for March 2024

Medico-legal

• Reviewed and approved SANBS’ medical malpractice insurance placed in the international market
• Closely monitored potential medico-legal cases, including reported mortality cases and the potential impact on SANBS’ insurance and reputation
• Noted the needed role of the DoH in decision-making related to areas that impact blood safety
• Reviewed the risk rating of incidents which attempts to combine the clinical aspects and legal risk aspects
• Tracking and tracing of patients – management deliberated on the issue and sought a legal opinion on the SANBS role where SANBS was implicated in the error

Policies and Terms of Reference

• Considered/reviewed the following policies:
  • Integrated Blood Safety Policy
  • Risk Based Hierarchical Blood Issuing Policy
  • SANBS Research Policy
  • Infection Prevention Control Policy
  • A name change of the Donor Adverse Events Policy to speak to its purpose to limit donor financial hardship post an adverse event. (Name of policy amended in FY25 to Financial Support for Donor Adverse Events Policy)
• Reviewed and approved the committee terms of reference and annual work plan

SANBS RAD Academy

Noted:

• Progress made in operationalising the SANBS RAD Academy
• The learning and development arm of the RAD Academy is focused on resolving ongoing challenges with HPCSA training accreditation
• The placement of learners and interns is underway to place 30 intern medical technologists at accredited laboratories

Research and development activities

• The team authored/co-authored 14 scientific papers/publications/book chapters
• Expansion of the SANBS Mobile Stem Cell Transplant unit and their application for JACIE accreditation
• Various major research collaborations, including the blood genomics consortium which aims to develop affordable accurate and comprehensive molecular blood group, HLA, and HPA testing
• The testing for the longitudinal SARS CoV-2 Seroprevalence Study has been completed
• Ethics approval was obtained for the malaria study which aims to ultimately reduce the need for deferral of donors who visit malaria areas
• A “Big Data” collaboration with McGill University showed donors differences in donor return patterns following deferral for low haemoglobin levels. Those deferred at mobile clinics took longer to return, while South African donor returned earlier than those in the USA
• The Faecal Microbiota Bank Laboratory was completed and validation is in the final stage

The key focus areas for the CGC for the year ahead will be four strategic pillars namely:

• Meeting the demand for key blood components such as red cell units, specifically blood group O, and apheresis platelets while protecting donor health and wellness. Oversee rollout of new iron replacement formulation from new provider
• Monitoring of the new platelet strategy introduced in Q1 FY2025
• Adequate data and information life-cycle management and governance
• Maintaining adequate and appropriate stakeholder engagement and public confidence
• Maintain appropriate quality standards and systems assured through relevant accreditations and regulatory compliance audits

Other

• Monitor post implementation of BECS to ensure its impact on the safety and sufficiency of the blood supply is minimised
• Continue to provide guidance on workforce planning to ensure SANBS have a fit for purpose work force and place aligned with the changing demands and landscape of healthcare services in South Africa