STRATEGIC PLAN 2011-14April 2011

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Strategic Plan 2011-14Strategic Plan 2011-14

CONTENTS

Section One IntroductionandStrategicObjectives 1

Section Two BloodComponents 5

Section Three OrganDonationandTransplantation 11

Section Four SpecialistServices

•Tissues 14

•DiagnosticServices 16

•StemCellServices 17

Section Five NHSBTCorporate 19

Section Six FinancialSummary 22

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Section One: Introduction and Strategic Objectives

Introduction

NHSBTisaSpecialHealthAuthorityinEnglandandWales,withresponsibilitiesacrosstheUnitedKingdomfororgandonationandtransplantation.Ourcorepurposeisto‘save and improve patients’ lives’throughtheprovisionofasafeandreliablesupplyofbloodcomponents,solidorgans,stemcells,tissuesandrelateddiagnosticservicestotheNHS,andtotheotherUKHealthServiceswheredirected.

Thesupplyofthesecriticalproductsandservicesdependsentirelyontheloyaltyofourdonors.In2009-10theycontributed:

• 2millionunitsofblood

• 3,500organs

• 4,000tissuedonors

• 2,200bankedcordbloodunits.

Inperformingthisessentialactivity,NHSBTengageswithmillionsofpeoplethroughoutthecountryandconnectsdirectlywithmorepeopleonadailybasisthananyothersinglepartoftheNHS.InadditiontosupplyingthelifesavingproductsthatareneededbyNHSpatientsweareproudthatouractivitiessupporttheincrediblealtruismandgenerosityofourdonorsandbringcommunitiestogetheracrossthecountry.

IntheserespectsNHSBTisunique.OurpeerscanonlybefoundinsimilarservicesprovidedinothercountriesintheUK,Europeandacrosstherestoftheworld.Asaresult,comparingandbenchmarkingoureffectivenesswithothernationalservicesisamajorfocusofourstrategicprocess.Ourambitionissimple–tobedemonstrablythebestserviceofourtypeintheworld.

SECTION ONE:INTRODUCTION AND STRATEGIC OBJECTIVES

Inearly2008wegeneratedathree-yearStrategicPlanwhichestablishedaseriesofverychallengingobjectivesandreflectedtheambition,andfarreachingimplications,ofboththefirstOrganDonationTaskforce(ODTF)reportandtheNationalBloodServiceStrategyReview.

Theprogrammeofinitiativesandprojectsgeneratedbythe2008planiseffectivelycomplete.Ourobjectiveshavebeenmetandbenefitsfullysecured,including£30mpasavingstotheNHS,beforeinflation,throughreducingthepricesofredcellstohospitals.

Our2011-14planisfocusedon:

• continuingtomoderniseblooddonationandimprovetheinterfaceswithNHShospitalssothatourservicesareasaccessibleaspossible

• generatingthenextwaveofinitiativestoimprovetheeffectivenessofthebloodservice

• utilisingtheinfrastructurenowinplacetofurtheracceleratetherateoforgandonationacrosstheUKandreducethethreepeoplewhodieeverydayforthelackofasuitableorgantransplant

• buildingonouruniqueskillsandcapabilitiesintissues,stemcellsanddiagnosticservicesinsupportoftheprovisionoflifechangingtherapiesforNHSpatients.

ThenewplanalsorespondstotheGovernmentwhitepaper‘EquityandExcellence–liberatingtheNHS’publishedinJuly2010andthesubsequentreviewofArmsLengthBodies(ALBs)issuedshortlythereafter.

Strategic Plan 2011-14

ThereviewconfirmedthebenefitofretainingNHSBTintheALBsectoras:

• providingeconomyofscaleandsupply

• meetingpublichealthrequirementsinrelationtoquality,safetyandconsistencyacrosstheblood,tissueandtransplantservice

• critically,addressingpublicsensitivitiesregardingvoluntarydonationofblood,tissuesandorgans.

AsaresultofthereviewNHSBTcontinueswithintheALBsectorbutsees:

• theBioProductsLaboratory(BPL)transferredoutofNHSBTintoaDepartmentofHealth(DH)ownedlimitedcompany

• areviewofopportunitiestomaketheremaindermorecommerciallyeffective.

NHSBTwelcomestheconclusionsoftheALBreview.Webelievethattheresultsofthelasttwoyears,andournewplan,clearlydemonstratesourcommitmenttoimprovingefficiencywhilemaintainingsafetyandincreasingreliabilityofsupplyofarangeoflifesavingtherapeuticproducts.Thisisbasedonmaintainingastrongrelationshipwithourdonorsandtheircontinuedgoodwillinsupportofthevoluntarydonationofblood,tissuesandorgans.Theresultsofthecommercialreviewprocessareexpectedduring2011-12.

Ourplaniscommittedtocontinuousimprovementofour‘backoffice’functionssothatanyefficiencysavingsthatcanbegeneratedcontributetolimitingincreasesto,ifnotreducing,thepricesofourproductsandservices.AssuchwewillbefullyengagingwithGovernmentandDHpartnersinexploringallopportunitiestoimproveefficiencyandsharefunctions.

Themajorimpactofthereview,however,isthetransferofBPLoutofNHSBTwhichwascompleted,asplannedon31December2010.AsaresultthisplanmakesnofurtherreferencetothefuturestrategyandplansforBPL.

Anyprojects/initiativeswithinourdetailedworkplanarerelatedsolelytothetransitionprocessandthemanagementofthelimitedlegacyissuesthatexistposttransfer.

TheeconomicsituationintheUK,andtheresponsesmadebytheCoalitionGovernment,areleadingtoenormouschangesinthepublicsector.Asthesechangesareimplementeditisclearthat,outsideofNHSBT,thereisarelativelylimitedunderstandingofouractivitiesandachievements.AlthoughtheresultsoftheALBreviewreflectedpublicsensitivitiesaroundbloodandorgandonation,onapracticaldaytodaybasisourclassificationasanALBrequiresustocomplywithdepartmentalprocessesthatareofteninconsistentwithouroperationalroleasacriticalsuppliertotheNHS.Asaresultasignificantelementofourplanwillincludemorefocusonoverallstakeholderengagement,toensureaninformedcontextfordecisionmaking,especiallywithregardtopotentialfinancialimpactsonoverallhealthsystemcosts.

Giventhepressureonpublicsectorfinances,andtheinevitableprioritisationofhealthprogrammesthatwillberequired,wewillalsolooktofurtherpromotetheeconomiccasefororgandonation.Wewillensurethatstakeholdersarefullybriefedandrecognisethefavourableimpactofincreasedorgandonationonoverallhealthsystemcosts,sothatthisisreflectedasappropriatewithintheirfundingdecisions.

Inaddition,insomeareasofouractivity,privatesectorcompetitionisrapidlyincreasing.ThisrequiresNHSBTtoadoptamorecommercialresponseinamannerthatisnotdirectlyconsistentwithourlegalformasaSpecialHealthAuthorityandourassociatedDirections.Afurtherelementofourplanwillbetoconsider,withstakeholders,alternativelegalforms,andwhetheradifferentformwouldprovideamoreappropriateplatformfromwhichNHSBTcandeliveritsobjectives.

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Section One: Introduction and Strategic Objectives

Strategic Objectives: NHSBT

1. Blood Components: To deliver a modern, world class blood service that provides a sustainable and dependable supply of blood components that meet all safety, quality, compliance and service standards, as effectively as possible.

OurfirstconcernwillalwaysbethesafeanddependablesupplyofbloodcomponentstoNHShospitals,aswellasprovidingasafeandhighqualityservicetoourdonorswithoutwhomourservicewouldnotexist.

Wewillcontinuetodevelopandimprovethequalityofservicetodonorsandtheexperiencetheyundergowhendonatingwholebloodorplatelets.Wewillcontinuouslyreviewdonorsatisfactionandmonitorchangesintheprofile,valuesandexpectationsofourdonorbasetoensurethatwecananticipatetheirneedsandrespondaccordingly.

Weintendtofurtherstrengthentheinterfaceswithourcustomers,NHShospitals,toensurewedeliverourlife-savingproductsontimeandinfullwithoutfail.Wewilldevelopmodern,technologybasedprocessesthatmakeNHSBTeasytodobusinesswithandensurethatweareseenasasupplierofchoice,ratherthannecessity.

Inconjunctionwiththis,wewillcontinuetomoderniseprocessesandsystemsthroughouteachstageofthebloodsupplychain,fromthecollectionofbloodtotheprocessing,testing,issueanddeliveryofbloodcomponentstohospitals.Wewillworkwithhospitalstoimprovetheservicetopatientsandrealisebenefitsfromthedevelopmentofanendtoendsupplychain,fromdonortopatient.

Wewillbuildonourstrongcollaborationwithinternationalbloodservices.InparticularwewillcontinuetobenchmarkourperformanceagainstourinternationalpartnersandwillusethistoidentifyopportunitiesforimprovementwithinNHSBT.

2. Organ Donation and Transplantation: To maximise the number of organ donors, donated organs and registered supporters of organ donation and enable year on year increase to the number of life-saving transplants.

WearecommittedtocontinuingthedevelopmentofNHSBTastheUKwideOrganDonationOrganisationenvisagedbythereportofthefirstOrganDonationTaskforce(ODTF).Thereportcalledfora50%increaseindeceasedorgandonationintheUKby2012-13(versusa2007-08baseline).

WewilldelivertherecommendationsofthetaskforcethatrelatespecificallytoNHSBT.Wewillbuildontheinfrastructurethathasnowbeenputinplaceandwillworkwithourpartnerstocontinuallyimproveperformanceateachstageoftheclinicalprocessfrom(potential)donationthroughtotransplantation.

Wewillcontinuetoworkwiththepublictoinformandinfluencetheirperceptionsoforgandonation.WewillseekapprovalandfundingforappropriatemarketingcampaignsthatwillfacilitatethisandultimatelyleadtoincreasednumbersofregistrantsontheOrganDonationRegister(ODR).WewillparticularlyseektoworkwithBMEcommunitieswherethereisaproportionatelylowerprobabilityofreceivingamatchingorganthaninthegeneralpopulation.

SubjecttofundingbeingavailableweintendtoimplementtherecommendationsmadebyProfessorSirGordonDuffinhisreviewoftheOrganDonationRegister(October2010).ThiswouldrequireustoinvestinareplacementODRrecognisingthatthecurrentsystemwasnotdesignedtofulfilthefunctionforwhichitisnowusedandtechnologyhasadvancedgreatlysincetheODRwasoriginallyimplemented16yearsago.

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Strategic Plan 2011-14

3. Specialist Services: Isagroupofdistinctoperationalactivities.WehaveidentifiedthreestrategicobjectivesrelatingspecificallytoouractivitiesinTissues,DiagnosticServicesandStemCells.

Tissues:To develop an ‘NHS Tissues’ organisation, for the overall benefit of the NHS and its patients, that builds on the capability and capacity of the Speke tissue bank, and which is capable of generating a critical mass that would support investment in new products and technologies.

WeaimtoleveragethecapabilityofourstateoftheartSpeketissuebankanditshighlycapableandskilledteam.Wewillgrowoursalesandgenerateapositivefinancialcontribution,throughincreasingthevisibilityandrecognitionofourtissuesbusinesswithNHSclinicians,andsupportingthesewithhighqualitysalesandmarketingplans.

Wewilldevelopanappropriateandsustainablenewproductpipeline,deployingeffectiveevaluationtools,andsupportingagreedinvestmentswithprofessionallaunchandmarketingplans.

Diagnostic Services: To ensure the clinically effective use of blood, organs and stem cells through the provision of high quality diagnostic services.

Wewillcontinuetodevelopaportfolioofclinicallyrelevantandfinanciallyviablediagnosticservicessourcedfromourexistingnationalnetworkofworldclasslaboratoriesandhighlytrainedstaff.

WewillprovideserviceswheretheseareconsistentwiththecapabilitiesandobjectivesofNHSBTinsupplyingbloodcomponents,organs,tissuesandstemcells.WewilllooktoprovidesuchserviceswhereNHSBTisbestplacedtomeettheneedsofNHShospitalsandprovidethemwithvalueformoney.

Stem Cells: To work in partnership with third sector organisations and the UK Health Services in the provision of an efficient and effective source of donor haemopoietic stem cells for the treatment of UK patients.

NHSBTisthelargestUKproviderofhaemopoieticstemcellsforthetreatmentofbloodcancers.InthisrespectNHSBTaimstocontinuallyincreasethequalityandeffectivenessoftheBritishBoneMarrowRegistry(BBMR)andtheUKCordBloodBank(CBB)thatitoperatesonbehalfoftheDH.InparticularNHSBTiscommittedtogrowingtheCBBto20,000unitsofdonatedcordsby2012-13andmaximisingthedonationofcordsfromBMEcommunitiesandtheproportionofrarebloodtypes.

NHSBTwillcontinuetoleadtheimplementationoftherecommendationsoftheUKStemCellStrategicForum.

4. NHSBT Corporate: To be the advocate for the voluntary donation of blood, organs and tissues; to champion a culture of sustainability across all of our activities; to develop organisational capacity, capability and processes in support of our objectives; to identify opportunities for effective collaboration across our Operating Divisions and support them with an effective programme of research and development and an efficient operating infrastructure.

NHSBTisoneofthelargestandmostcomplexorganisationsofitstypeintheworld.Weaimtobethebest.Wewillcontinuetoreviewanddevelop,ourorganisationalstructureandleadershipcapabilitiesinordertomeetourambitiousobjectives.

Wewillseektoidentifyanddeliversynergiesbetweenouroperatingunits(BloodComponents,OrganDonationandTransplantation,Tissues,StemCellsandDiagnosticServices)andunderpinthemwithaneffectiveprogrammeofresearchanddevelopmentandefficientfunctionalservices.

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Section Two: Blood Components

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WehaveidentifiedfourstrategicthemesthatunderpinthestrategicobjectiveforBloodComponents:

Customer ServiceTobethe‘supplierofchoice’toourcustomersthroughtheintroductionofmodern,valueadding,serviceandsupplychainmodelsthatensurereliabilityanddependability,minimisewastage‘veintovein’andensuresthatNHSBTremainsatalltimestheirmostcosteffectiveoptionforprovisionofthecompleterangeofservicesandclinicaladviceneededfortransfusedpatients.

Sufficiency of SupplyToensurethereisasustainablesupplyofredcellsandplateletsthatwillbesufficienttomeetcurrentandfuturedemandthroughmodernisingbloodcollectionactivitiesandbyprovidingaservicetoourdonorsthatisbothaconvenientandhighlypositiveexperience.

Safety and ComplianceToproactivelyidentifynewrisksandtoimplementthehigheststandardsofsafetyandcomplianceacrossthefullrangeofNHSBTactivities.

Efficiency and EffectivenessTobeahighlycosteffectivesupplierofbloodandcomponentstoNHShospitalsthroughthecontinuousimprovementofprocessesacrossoperationalandsupportfunctions.Thisisunderpinnedbysystematicbenchmarkingofourperformancetoidentifyareasforimprovement.

Underlyingeachofthesethemesisaprogrammeofdetailedactionplansatvaryingstagesofimplementation,frominitialanalysisthroughtoimplementationandroll-out.

WithinthecustomerservicethemewearecurrentlyrollingouttheimplementationofourOnlineBloodOrderingSystem(OBOS)tohospitals.Thiswillbringmuchneededmodernisationtoourinterfacewithcustomersandrepresentsthecreationofanewwebportalonwhichfurtherinitiativeswillbedevelopedaspartofabroader‘customerfulfilment’initiative.AswellasbringingbettervisibilitytocustomerordersOBOSwillalsoallowustomeasureandreportour‘ontimeinfull’(OTIF)deliveryperformance.

SECTION TWO:BLOOD COMPONENTSStrategic Objectives and Themes for 2011-14

Strategic Objective: To deliver a modern, world class blood service that provides a sustainable and dependable supply of blood components that meet all safety, quality, compliance and service standards, as effectively as possible.

BLOOD COMPONENTS

Strategic Plan 2011-14

WealsointendtopartnerwithNHStransfusionlaboratoriestodevelop,pilotandevaluatealternativemodelsthatenableimprovementintheeffectivenessofthesupplychainand:

• providegreatervisibilityofusage

• enablebetterplanningofdemand

• minimisewastagethroughtheentiresupplychainfromdonortopatient.

Overthelasttwoyearsourfocusinblooddonationhasbeenonimplementingnewstandardprocesseswithinblooddonationsessions,optimisingthesizeofcollectionteamsandensuringthatwearemoreresponsivetoshort-termsupplyanddemandchanges.Thishasleadtosignificantimprovementinthestabilityofbloodstocks(forallbloodgroups)whilstdeliveringsubstantiallyhigherproductivityatthesametime.

Thenewplanwillinvolveasignificantupdateoftheblooddonationstrategy.Thiswillfundamentallyreviewthefutureshapeofdemandforbloodcomponentsandmatchthistothechangingprofileandbehavioursofourdonors.Insodoingwewillanticipateandplanfortheservicethatwillberequiredtoattractdonorswhocandonatetherequiredbloodtypes,attherighttime,toenableustomeettheneedsofourcustomersandtheirpatients.

Intheshort-termthisshouldseetheintroductionofchangestotheenvironmenton-session(e.g.theintroductionofinnovativenewdonorchairs)alongwithwebbasedtechnologiestoimproveon-sessioncommunicationsandreducethevolumeofpaperbasedprocesses.Wewillalsoinitiateaprogrammeofresearchintodonorhealth,beginningwithastudyofdonorironandanaemia,amajorcauseofdonordeferral.Inaddition,programmesareintraintoimprovethesafetyandexperiencefordonorson-sessionthroughreductioninfainting,bruisingandrebleeding.

Theintroductionofsafetyinitiativesintothebloodcomponentssupplychaincanhaveamajorimpactonbothoperationsandcosts.Wearecurrentlyimplementingbacterialscreeningofplateletsandhavemanagedtodothiswithoutanincreaseinprices.Ourothershort-termfocusisonreviewingtheprocessforthedonation,processingandsupplyofplateletswherewehavebeendirectedtoensurethat80%ofthesupplyisgeneratedthoughcomponentdonation.Weareclosetothislevelbutneedtomoveupfromthelevelsof78%thatwehavebeenoperatingatthrough2010-11,onasustainablebasis.

FollowingrecommendationsfromSaBTO,andpendinginstructionsfromDH,wearecurrentlyplanningforanumberofsafetyinitiativesincludingprionfiltrationofredcellsforchildrenyoungerthan16andadulthaemoglobinopathypatients,thereplacementofNHSBTmanufacturedandsuppliedcryoprecipitatewithfibrinogenconcentratesuppliedexternallyandtheimportationofallFreshFrozenPlasma(FFP).Thesewouldallhaveasignificantimpactonourabilitytomeetthepricetargetswehavesetwithinthisplan.

Inresponsetothisweintendtobemoreproactivewithregardtothecumulativeimpactofsafetyinitiativesonourprocessesandcosts.TothisendtheNHSBTBoardhasadoptedasafetyframeworktobeusedtoassessthebenefits,risksandcostsofanyproposedsafetysteps.Wewillcontinuetoreviewopportunitiestomakeourprocessesmoreefficientfromtheremovalofanystepsthatcanbeclinicallyproventobenolongernecessaryinthedeliveryofsafeproducts.

Inadditiontothepressureonourcostsfromtheimpactofsafetyinitiativesweareacutelyawareofthefinancialpressuresfacingpublicsectorservicesand,inparticular,ourcustomers,NHShospitals.Weworkonthebasisthatevery£1onthepriceofourproductsandservicesis£1thatisunavailableforthetreatmentofNHSpatients.Asaminimumwelooktoworktothesamefinancialplanningassumptionsandconstraintsasourcustomers.

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Section Two: Blood Components

Thisattitudehasunderpinnedouractionsofthelasttwoyearsandoureffortsinremovingovercapacityinthebloodsupplychain.AsaresultNHSBTisnowachievingproductivitylevelsinprocessingandtestingthatareworldclass.Themostvisibleoutcomeofthisisthetrendinthe‘headline’priceofredcells,whichhasreducedfromahighofc£140/unitin2008-09toapricein2010-11ofc£125/unit(lowerthanthepricethatwaschargedin2005-06).Wearenowplanningtomaintaintheredcellpriceat£125/unitorlowerinthethreeyearsto2013-14(assumingthatnonewbloodsafetyinitiativesaremandated).

Inordertoavoidpriceincreaseswewillneedtofindfurthersubstantialefficiencyimprovements,yearonyear,withinourplan.Wewilldothisthroughfurtherproductivityimprovementswithintheblooddonationstrategyandafocusoncontinualimprovementinconfigurationandprocesseswithinbothourotheroperationalandbackofficefunctions.Wewillunderpinthiswithcontinualreferenceto,andlearningfrom,benchmarkingofouroperationalperformancewithinternationalbloodservices,andalsoinbackofficefunctionsacrossbothpublicandprivatesectors.

Red Cell Prices (£/Unit)145

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Red Cell Price (actual) Red Cell Price (plan)

Strategic Plan 2011-14

Theinitiativesthatwillformthebasisofourefficiencyimprovementswillinclude:

• continuedfocusonprocurementsavingsinmanufacturingconsumablesthroughpartnershipwiththeotherUKbloodservicesandalsotheEuropeanbloodservices

• leveragingprocurementsavingsthroughfurtherengagementwithnewpublicsectorprocessesandframeworks

• furtheroptimisationoftheprocessesmodelsinblooddonationleadingtoimprovementinproductivityandpartialclosureofthegaptotheproductivitylevelsthatareseenintheEuropeanbloodservices

• size,configurationandgeographicprofileofbloodcollectionactivityfollowingthereviewofstrategy

• reviewofEuropeanmodelsforblooddonationandanassessmentofwhatelementscouldbeincorporatedintoNHSBTinthelongerterm

• continuousimprovementofcoreprocessandafocusonreducingpaperflowsandautomatingtransactions.

Development of the Supply Chain

Inparticularwewillcontinuetodeveloptheeffectivenessofoursupplychain.Betweenourblooddonorsandourcustomersweoperatewhatis,inmanyways,atraditionalsupplychainwithrelativelysimpleprocesssteps.However,itisasupplychainthathasanumberofuniquecharacteristics:

• thevoluntarydonationofcritical,lifesavingproducts

• limited/noclinicalsubstitutionispossible

• theverylimitedshelflifeandfastmovingnatureoftheproducts(redcellsandespeciallyplatelets)

• theeffectivetailoringofeachunittotheneedsofindividualpatientsthroughsupportingmatchingandreferenceservices

• theneedforrealtimetraceability,veintovein,andcloseintegrationwithclinicalprocessesforfeedbacktodonors,customersandpatients

• wherefailuretosupplywouldimmediatelyimpactapatientslife

• highlyregulatedenvironment,fromdonorthroughtopatient.

Asaresultitisdifficult,ifnotimpossible,toidentifyanysupplychainwiththesamecharacteristicsexceptforthebloodservicesoperatedinothercountries.

Oursupplychainstrategyisfollowingfourdistinctphases:

Phase 1 Startingin2008theremovalofthesignificant(40%+)overcapacitythatexistedatthattimeandwhichledtothe‘6+5’processingandtestingconfigurationbyend2010(and‘5+5’bytheendofMarch2011).

Phase 2 Theintroductionofleanmethodologiestoimprovetheproductivityoffunctionswithinthesupplychain.InparticularfurtherdevelopingFiltonasaworldclassleaderinproductivityandtransferringthelearningthroughtootherprocessingandtestingcentres.

Phase 3 Optimisationofprocessesacrossthesupplychainthroughintroductionofimprovedplanningprocesses,supportedbyappropriateITtoolsasnecessary.

Phase 4 Theextensionofsupplychainprocessesintohospitalsinordertosupportlocalconsolidationofbloodtransfusionservices.

Thejourneyisbroadlysequentialinnatureandtheoreticallyrequiressignificantcompletionofearlierphasessothatlaterphasescanbeimplementedeffectively.Wecanbeconsideredtobeinphase2butwithournewstrategyconsideringthewaysbywhichwecanimplementphase3andaccelerateourabilitytosupportthetransfusionservicesthatourcustomersareincreasinglydemanding.8

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Section Two: Blood Components

Againstthisbackgroundwewillcontinuetoconsider(tactical)opportunitiesforinsourcingservices.However,itiscriticalthatsuchopportunitiesdonotdamagepublicconsiderationswithregardtoaltruisticdonationanddonotdisrupttheoperationofouruniquesupplychain.Someservicesarealreadyinsourced(e.g.ourdonorcallcentre)whereweconsiderthatsuchservicesmeettheserequirementsandcanbeprovidedbyorganisationswiththenecessarypublicserviceethos.

Thepracticalimpactofthisoverallapproachtosupplychaindevelopmentinthisplanwillbeseenin:

• ongoingreviewoftheconfigurationofthesupplychainandoptimisationofourmanufacturing,laboratoryandofficeestatesfootprint(andincludingandtheproposedrationalisationoftestingintheNorth)

• furtherprojectstodevelopleanthinkingwithinthesupplychainbutalsotakingthisintoBloodDonationandGroupServicesasappropriate

• newlogisticalprocessesinsupportofthemovementofpeople,equipmentandconsumablestosessioninordertominimisewastageandreduceinfrastructurecosts

• optimisationoflogisticscoststhroughtheintroductionofmoderntoolsandtechnologyandbetterplanningofmovements

• respondingtotheincreasingdemandsfromcustomersforthelocalconsolidationoftransfusionservices.

Theobjectivesandthemesdescribedabovearereflectedinanumberofstrategictargets.Thesearedescribedopposite(page10).

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Strategic Plan 2011-14

Strategic Targets for 2011-14

Strategic Targets – Blood Components

2010-11 Plan

2010-11 Actual

2011-12 Plan

2012-13 Plan

2013-14 Plan

%ofproductrequestsmet >99.9% >99.9% >99.9% OTIF OTIF

%ofhospitalsscoring≥9/10forsatisfactionwithoverallservice

58% 57% 58% >60% >60%

Numberofoccasionswhereredcellstocks(foranybloodgroup)arebelowthethreedayalertlevelforthreeormoreconsecutivedays

0 0 0 0 0

Numberofoccasionswhereopeningstockofplateletsisbelowaveragedailydemandfortwoormoreconsecutivedays

0 0 0 0 0

%ofblooddonorsscoring≥9/10forsatisfactionwithoverallservice

66% 67% 67% 68% 69%

NumberofTRALIcases ≤3 2 ≤2 ≤2 ≤2

NumberofconfirmedTTIsfrombacterialcontamination(incidents)

≤2 0 ≤1 ≤1 ≤1

%ofplateletsproducedbycomponentdonation

80% 78.4% 80% 80% 80%

Numberof‘critical’regulatorynon-compliances

0 0 0 0 0

Unitpriceofredcells £124.21 £124.21 £124.85 £125 £125

Note

• TRALI=TransfusionRelatedAcuteLungInjury,TTI=TransfusionTransmittedInfection

• 2010-11actualperformanceisbasedonthepositionasatDecember2010

• unitpriceofredcellsassumesnofurtherinstructionstoimplementadditionalbloodsafetyinitiatives(andspecificallytheimportationofFFP)

• ‘%productrequestsmet’tobereplacedwithan‘OTIF’measurepostOBOSimplementation.

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Section Three: Organ Donation and Transplantation

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Thestrategyfororgandonationandtransplantationthatwasdevelopedin2007-08wasoriginallyconstructedaroundthoserecommendationsoftheOrganDonationTaskForce(ODTF)forwhichNHSBTareaccountable.ActivitieswerelargelyfocusedoncreatingtheinfrastructureidentifiedasbeingcriticaltoimprovingtheratesoforgandonationintheUK.

MuchofthatworkisnowcompleteandthefocusisnowonNHSBTdevelopingintotheUKOrganDonationOrganisationthatwasenvisagedbytheODTFandbuildingontheinfrastructurenowinplacetoimproveperformance.

SevenstrategicthemeshavethusbeenidentifiedinsupportofthestrategicobjectiveforOrganDonationandTransplantation:

Enable NHSBT to fulfil its role as the UK Organ Donor OrganisationEnableNHSBTtofulfilitsroleastheUKOrganDonorOrganisationensuringcompliancewithEUdirectives,implementationofanintegratedqualityandgovernancesystemanddevelopmentofmodernITsystemstosupportdonorregistrationandorganallocation.

Development support for organ donation throughout the wider NHSRemovetheobstaclestoorgandonationandeffectivelyperformancemanagetheidentificationandreferralofpotentialdonors.

Maximise conversion of potential organ donors into actual donors Maximisetheconversionofpotentialdonorsintoactualdonorsbydevelopingandimplementingarobust,sustainabledonorco-ordinationserviceandfurtherdevelopingthenetworkandeffectivenessofclinicalleadsanddonationcommittees.

Ensure organ retrieval services are sustained through a period of changeEnsureorganretrievalservicesaresustainedthroughaperiodofchangeincommissioningacrossEngland,andpotentiallytheotherUKhealthservices,andareabletorespondinaconstrainedfinancialenvironment.

Change public behaviour with regard to organ donation Changepublicbehaviourwithregardtoorgandonationthroughsocialmarketingstrategiestopromoteorgandonationas‘expectedbehaviour’amongstUKcitizens.

Develop living organ donationDevelopandimplementastrategyforincreasingLivingDonation.

Sustainable cornea donationDevelopandimplementarobust,sustainablecorneadonationservice.

SECTION THREE:ORGAN DONATION AND TRANSPLANTATION

Strategic Objective: To increase deceased organ donation by 60% in 2013-14 and sustain and improve thereafter. To seek opportunities to achieve self sufficiency in donation and transplantation across the UK, taking into account the changing donor pool. To change public behaviour with regard to organ donation, especially amongst BME communities.

ORGAN DONATION AND TRANSPLANTATION

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Strategic Plan 2011-14

Therearecurrently17.7millionpeople–29%oftheUKpopulation–ontheNHSOrganDonorRegister,withjustunderonemillionnamesaddedinthelastyear.Therehasbeenasteadyincreaseinthenumberoftransplantsinthiscountryoverthepastsevenyears,with3,708transplantsrecordedin2009-10,a7%increaseonthepreviousyear.

Progressonorgandonationoverthelastthreeyears,sincethecreationofODTwithinNHSBT,hasalsobeenveryencouraging.AsatDecember2010deceasedorgandonationhadincreasedby26%overthe2007-08baselineandisoncoursetodeliverthe50%increaseby2012-13targetedbytheODTFreport.

Nevertheless,UKdonorratesaresignificantlybelowthoseofourEuropeancounterparts,suchasPortugalandSpain.Currently10,000peopleinthiscountryneedanorgantransplant.Putsimply,thistranslatesintomorethan1,000people(threeeachday)whodieeveryyearwaitingforatransplant.

Inadditionthedonorpoolischangingasaresultoftheincreasingageprofileandrelativebodymassindexofdonors.Thisadverselyimpactsthenumberandqualityoforgansthatcanberetrievedsuchthatgrowthintransplantationisproportionatelylowerthanthegrowthindonation.AsaconsequencetheneedtodeliverthetargetsoftheODTF,andbeabletosustainfurtherincreasesbeyondthetimeperiodthatwasset,becomeevenmorechallenging.

Inadditiontosavingandimprovinglivesthereisaneconomiccasefororgantransplantation.Theexistingtransplantationprogrammerealisesgrossannualsavingsinexcessof£300mversusalternativemedicaltreatments.

Theimpactofincreasingthenumberoforgansavailableby50%fortransplantby2013wouldincreasethesavingstotheNHSbyanadditional£200mp.a.(refreportbytheSpecialisedCommissioningTeam,WestMidlands–October2010).

Ourunderlyingbroadactionplansthereforeinclude:

• promotingmorewidelytheeconomiccasefororgandonationandtransplantation

• derivingthebenefitsfromthedeploymentandongoingdevelopmentofthe12RegionalSpecialistNurse(OrganDonation)TeamsandtheClinicalLeadsforOrganDonation(CLOD)nowinplace,andbuildingontheCLODProfessionalDevelopmentProgramme

• creatingandsustainingregionalcollaboratives,bringingtogethercliniciansfromallpartsofthedonationandtransplantationpathway,withidentifiable,accountableRegionalClinicalLeadsineachRegion.Partofthisisthecreationandroll-outofsupportive,visibleperformanceimprovementsystemsonaquarterlybasis

• drivingperformanceimprovementthroughreportingabalancedscorecardofperformancedatathatmeasuresnational,regionalandteamperformanceateachstageofthepathway

• continueddevelopmentandoptimisationofthecommissioningoforganretrievalandsupportingprocesses.Beginexploringoptionsforintegratingthecommissioning/fundingofretrievalandtransplantationacrosstheUK

• reviewofthecurrentODRinfrastructure,followingpublicationoftheDuffreport,leadingtothedevelopmentandimplementationofamodern,fitforpurposeODR

• developingastrategyfordatacollectionandprocessingandthedevelopmentofsupportingITsystems

• continueddevelopmentoftheEOSsystemfortheofferingofdonororgansandreviewofthecollectionandanalysisofPDAdata

• developingstrategiesandprocessesaimedatincreasingtherepresentationofBMEcommunitieswithintheODRandassistingthedonationprocess

Section Three: Organ Donation and Transplantation

13

• implementationofaresearchanddevelopmentframeworkandapprovalprocess,leadingtodevelopmentofanagreedprogramme,andreflectingourintenttoworkwithhospitalpartnerstoassessnovelmethodsforimprovingthequalityandnumberoforgansavailablefortransplant

• subjecttoCabinetOfficeapproval,marketingplanstosustainandfurtherdevelopthepublicawarenesscampaignthatwaslaunchedinNovember2009

• optimisingtransplantactivityfromlivingdonorsinordertoenablefurtherexpansioninlivedonation.Optimisingpre-emptivelivingdonorkidneytransplantation.Optimisingtransplantactivityfromnon-directedaltruisticdonation.Facilitatingappropriateexpansioninotherformsoflivingdonation.EncouragingpairedpooledlivedonationandfacilitatingdevelopmentofABOincompatibleandantibodyincompatibletransplants.

Strategic Targets for 2011-14

Strategic Targets – Organ Donation and Transplantation

2010-11 Plan

2010-11 Actual

2011-12 Plan

2012-13 Plan

2013-14 Plan

NumberofDeceasedOrganDonors 1,104 1,000 1,095 1,214 1,297

Cumulativepercentageincreaseindeceasedorgandonation(froma2007-08baselineof809donors)

36% 26% 35% 50% 60%

NumberofpeopleregisteredontheOrganDonorRegister(ODR)

20.0m 17.9m 18.9m 20.3m 21.6m

NumberofLivingOrganDonors 1,100 996 1,050 1,081 1,112

NumberofOrganTransplants 4,308 3,754 4,108 4,488 4,843

Note:2010-11actualsbasedonNovember2010datawith%varianceprojectedtofullyear.

ThetargetsforimprovingtherateoforgandonationandtransplantareasharedobjectiveofallstakeholderswithintheDH,theotherUKHealthServicesandpartnersacrossGovernment.TheyhavebeenincorporatedintotheTermsofReferenceoftheDHProgrammeDeliveryBoard,andreflectedinthestrategictargetsofNHSBT.

14

Strategic Plan 2011-14

FourstrategicthemeshavebeenidentifiedinsupportofthestrategicobjectiveinTissues:

Visibility and RecognitionTodevelopthevisibilityandrecognitionofthebusinessbyadoptingandleveraging‘NHSTissues’asthebusinessname,buildingasupportingbrandandvisionsupportedbyadetailedsalesandmarketingplanwitheducationasacoreentrypoint.

New Product DevelopmentTodevelopanewproductpipeline,underpinnedbyappropriatetoolsandevaluationprocesses,targetedonappropriatemarketsandcustomersandwithaprofessionallaunchplan.

Capability and CapacityTobuildthecapabilityandcapacityofthetissuesorganisationanditssupportingprocessesinsupportofthestrategicplan.

Safety and ComplianceToproactivelyidentifyandimplementthehigheststandardsofsafetyandcomplianceacrossthefullrangeofthetissuebusinessactivities.

Aswithblood,organsandstemcellsthealtruisticdonationoftissuesisatthecoreofwhatwedo.

ThisisfacilitatedbyateamofdedicatedseniornursesinournationalreferralcentreatSpekewhoeverydaytalktothegrievingfamiliesofpotentialdonorswhomaybeinterestedindonatingtissuestothoseinneed.

AtthispointitiscriticalthatNHSBTcoordinatestheconsentingprocessfororganandtissuedonationsothatitisasinglediscussionandlimitsthepotentialstressonthefamiliesofgrievingdonors.

OnceconsentforatissuedonationhasbeenreceivedourthreeretrievalteamsaroundthecountryretrievethedonatedtissueandtransportittoSpekeforprocessing,instateoftheart,purposebuiltfacilities,toproducethelifesavingandenhancingproductsneededbyNHSpatients.

OthertissuebankingactivitiesexistinNHSTrustsbutthesearesmallerandthereforedonothavethescale,capabilityandnationalreachofSpeke,northeobvioussynergywithouractivityinorganretrieval.Inadditionthereisexcessdemandforsometissues(e.g.heartvalves)andhenceaconcernthatallocationofsupplywithintheNHSoverallisnotoptimal.However,thecapabilityandskillswepossessatSpekeareverypoorlyrecognisedbythewiderNHSandprovideanopportunityformuchimprovedutilisation.

SECTION FOUR:SPECIALIST SERVICESStrategic Objectives and Themes for 2011-14

Strategic Objective: To develop an ‘NHS Tissues’ organisation, for the benefit of the NHS and its patients, that builds on the competencies and capabilities of the Speke tissue bank, and with the critical mass to support investment in new products and emerging technologies.

TISSUES

14

15

Section Four: Specialist Services

InadditiontothefragmentedtissuebankingactivitieswithintheNHStherearealsoverylargeprivatesectorcompetitors.

HenceourchallengeistoleveragethecapabilityforthebenefitoftheNHSanditspatients,whileoperatingwithinNHSBTasa‘nonprofit’organisation,butadoptingamuchmorecommercialapproachandcompetingonlyinsectorswhereitisappropriateforustodoso.

Insupportofthiswehavesoughtprivatesectorexpertiseinproductmanagementandhavegeneratedastrategyandplanfordrivingourtissuesbusinessforwardovertheshort/mediumterm.AttheheartofthisplanistheopportunitytobuildonexistingcapabilitiesandpromotetheseacrosstheNHStogenerateincrementalsalesincome.

InparallelwewillthenadoptamoreprofessionalprocessforreviewingnewproductopportunitiesanddefiningthosethatcanmeetarealneedwithintheNHSwhilstbeingfinanciallyviable.

Hencethekeyactionsunderpinningthestrategicobjectivesandthemesdescribedaboveinclude:

• developingafullyNHSbrandedservice,ideallyevolvingintoaformal‘NHSTissues’business

• generationofanappropriatecustomersegmentation,focusedonclinicalspeciality,anddevelopmentoftargetedsalesandmarketingplanspersegment

• adoptinganeducationleadapproachtomarketingwithdevelopmentofhighqualitysupportingmaterialsandresourcesandpresenceatnationalconferencesandexhibitions

• establishmentofadirectsalesteam,initiallybasedontheexistingcustomerservicesanddonorteamsandeventuallysupportedbyspecificfieldpersonnel

• developmentofaproductdevelopmentroadmapwithbiologicalproductsasatheme(naturaltissue,enhancedbybiologicalprocessingandpotentiallycombinedwiththerapeuticadditions)

• introductionofprofessionalnewproductevaluationtoolsleadingtohighquality,targetedlaunchplans

• identifyingtheneedsforimprovedcustomermanagementandorderfulfilmentprocessesandbuildingtheseintoanNHSBTITapplicationstrategy

• continuedfocusondevelopmentoftheGMPcapabilityatSpekeandpotentiallypartneringwithnewstartupsthroughofferingsparecapacityinprocessingservices.

Strategic Plan 2011-14

Ourredcellimmunohaematology(RCI)andhistocompatabilityandimmunogenetics(H&I)servicessupportbloodtransfusion,organtransplantationandstemcelltransplantation.Theseservicesaredeliveredasanationallymanagedpathologynetworkfromlaboratoriesmanagedbyahighlyskilledanddedicatedworkforce,supportedbymodernequipmentandanationalITsystem.

Ourfocusinthepastthreeyearshasbeenonfinancialviabilityandreducingthesignificantcrosssubsidythatbloodpriceswereprovidingtotheseservices.Theresponsehasincludedatacticalmixofvolumegrowth,priceincreases,costreduction(viaconsolidationoffacilities)anddivestmentofroutineantenatalscreening.Theseprogrammesarenowmostlycomplete.

However,therearenowenormousstructuralchangestakingplaceacrosstheHealthService.Modernisationandconsolidationofpathologyservicesisamajorelementofthesechangesandisstartingtoseetheentranceofprivatesectorserviceproviders.InadditiontheimpactofDNAbasedtechnologiesforextendedbloodgrouptypingiscapableofbringingsignificantchangestotheservicelandscape.AsaresultofournationalreachandveryhighlevelsofcapabilityNHSBTisextremelywellplacedtoparticipateinthesechangesbutafundamentalreviewofdiagnosticservicesprovisionisnownecessary.Atthistimeourspecificstrategicresponsesarestillunderdevelopmentandarereflectedinalimitedsetofunderlyingstrategicthemes:

Strategic DevelopmentToconductfundamentalreviewsofservicesandcustomerrequirementsinthecontextofthesignificantchangestothepathologyserviceslandscape.

Service Delivery and EffectivenessToreviewanddevelopexistingservicemodelsandensurethesearefitforpurposeandmeetdevelopingcustomerneedsforqualityandcosteffectiveness.

EfficiencyTocontinuethefocusonefficientdeliveryofservicessothatallservicesarecapableofmakinganappropriatefinancialcontributiontoNHSBTandavoidanyneedforcrosssubsidy.

Theactionsthatwewillundertakeinsupportofthesethemesinclude:

• greaterengagementwithcustomersinordertobetterunderstandthechanginglandscapeinpathologyservicesandtheappropriatepositioningofNHSBT

• engagementandconsiderationofpartnershipswiththeprivatesectorprovidersinordertobetterdeliverefficientandeffectiveservicestohospitals

• introductionofproductmanagementandenhancedsalesandmarketingcapabilitieswithintheorganisation

• areviewofthescopeofthecurrentnationalcommissioningprocessforbloodandtheneedtoadoptacommercialpricingapproachinsomeofourservices

• areviewofthespecificpricingmethodologyforRCIservices

• areviewofexistingITapplicationsfordiagnosticservices(Hematos)tobettersupporttheintegrationofend-to-endprocessesbetweenhospitalsandNHSBT

• introductionofelectronicreportingofpathologyresults

• ongoingreviewofreagentssupply.

Strategic Objective: To ensure the clinically effective use of blood, organs and stem cells through the provision of high quality financially viable diagnostic services.

DIAGNOSTIC SERVICES

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17

Section Four: Specialist Services

OurStemCellsserviceprocessesandstoreshaemopoieticstemcellsforapproximately50%oftransplants.NHSBTprovidesstemcells,fromunrelateddonors,forthetreatmentofpatientswithleukaemiaandotherhaematologicalmalignanciesthroughouroperationoftheBritishBoneMarrowRegistry(BBMR)andtheNHSCordBloodBank(CBB).Similarservicesareprovided,orareunderdevelopment,byAnthonyNolanTrustandtheUKHealthServices.

Some440patientsperyeararedeniedaccesstoatransplantofstemcellsand200livesarelostasaresultofthelackofsuitabledonors.ThislossoflifedisproportionatelyaffectstheBMEcommunityduetotheparticularchallengeofidentifyingdonorsinthesecommunities.

AsaconsequencetheMinisterofStateforPublicHealthaskedNHSBTtoestablishaUKStemCellStrategicForuminJanuary2010.SubjecttothenecessaryfundingbeingmadeavailabletheNHSBTstrategyisgearedtowardsimplementingtherecommendationsmadebytheForuminJuly2010.

Assuchthestrategicthemesthatcurrentlyunderpinthestrategicobjectiveare:

Improved Provision of Donor Stem CellsToincreasethenumberofUKpatientsfindinganacceptablematchwithinaclinicallyappropriatetimescale.

Improved Provision of Cord Blood Stem CellsContributetothedevelopmentofaUKinventoryof50,000cordbloodunitswith30-50%of

donationsfromBMEwomenandhighresolutiontypingofnewandselectedunits.

Quality and Efficiency

Toworkwithourpartnersinconsolidatingandstandardisingoperationalcentresandprocessesanddrivetheefficiencyandeffectivenessoftheservicetopatients

Theactionsthatwewillundertakeinconjunctionwithourpartners,andsubjecttofunding,include:

• developingtheprovisionofaUKStemCellRegistry,aUKCordBloodBankof50,000unitsandadatabaseofpatientoutcomes

• increasingthelevelofcontactwithdonors

• furtherincreasingeffortstoimprovetherepresentationofBMEcommunitiesinregistriesandcordbanks

• developingeducationaltoolsandplatforms

• implementingstandardisedcommissioningframeworks

• consolidatingresourcesandexpertiseforcordbloodtransplantationintoregionalcentresofexcellencewithminimumlevelsofactivity

• implementingstandardiseddatacollectionandoutcomemonitoring

• prospectiveuseofhighresolutiontypingandinrespectofnewcordbloodunitsandselectedexistingunits

• implementingpredictivesearchtechnologiestoincreasethechanceofmatchingacrossinternationalregistries

• definingaprogrammeofresearchopportunities.

Strategic Objective: To work in partnership with third sector organisations and the UK Health Services in the provision of an efficient and effective source of donor haemopoietic stem cells for the treatment of UK patients.

STEM CELL SERVICES

18

Strategic Plan 2011-14

Strategic Targets for 2011-14

Strategic Targets – Specialist Services Group

2010-11 Plan

2010-11 Actual

2011-12 Plan

2012-13 Plan

2013-14 Plan

Salesincome–Tissues(£m) New New 7.6 8.2 9.1

ContributiontoO/Heads–Group(£m) New New 2.4 3.5 5.0

Numberof‘critical’regulatorynon-compliances–Group

0 0 0 0 0

CordBloodstock(unitswithhighTotalNucleatedCount)

New New 9,100 10,400 11,900

CordBlood–proportionofBMEunits New New 40% 40% 40%

Percentageofhospitalsscoring≥9/10forsatisfaction–RCI

New New 55% >60% >60%

Percentageofhospitalsscoring≥9/10forsatisfaction–H&I

New New 55% >60% >60%

19

Section Five: NHSBT Corporate

ThePlanidentifiessixstrategicthemesinsupportoftheaboveobjective:

Structures and GovernanceToensureNHSBTcorporateandaccountabilitystructuresenableeffectiveandefficientdeliveryofitsstrategyandmanagementofrisk.

Capacity, Capability and LeadershipTodevelopNHSBT’scapacityandcapabilitytodeliverstrategicchangethroughthedeploymentofappropriateresource,leadershipandskills.

Stakeholder EngagementTomaintainNHSBT’spositionandreputationasthesupplierofchoiceandensureeffectiveengagementwithourworkforce,theirrepresentativesandkeystakeholders.

Research & DevelopmentToensurethestrategicobjectivesandtargetsofourOperatingDivisions(BloodComponents,Tissues,DiagnosticServices,StemCellServices,STSandODT)aresupportedbyatargetedprogrammeofR&D.

Group Systems and ProcessesToensureourOperatingDivisionsaresupportedbyhighlyeffectiveandefficientgroupsystemsandprocesses.

Sustainable DevelopmentTobeastrongadvocateforsustainabledevelopmentacrossNHSBT,promotingiteffectivelyacrosstheorganisationandworkforceandmeeting,asaminimum,alltargetssetbyourstakeholders.

TheimpendingchangestotheDHlandscape,drivenbythewhitepaper‘EqualityandExcellence:LiberatingtheNHS’andthesubsequentreportontheALBsector,willcreateenormouschallengesforNHSBT.InadditiontothechanginglandscapeNHSBTwillbeimpactedbyboththeannouncedreviewofourcommercialeffectivenessandtheintentiontoconsolidateandaggregatebackofficeservicesacrossgovernment.Thisrepresentsanopportunitytoenhanceandaccelerateourexistingstrategyandplansbutthereisalsoariskthatitcutsacrossandcreatesalternativepriorities.

SECTION FIVE:NHSBT CORPORATEStrategic Objectives and Themes for 2011-14

Strategic Objective: To be the advocate for the voluntary donation of blood, organs and tissues; to champion a culture of sustainability across all of our activities; to develop organisational capacity, capability and processes in support of our objectives; to identify opportunities for effective collaboration across our Operating Divisions and support them with an effective programme of research and development and an efficient operating infrastructure.

NHSBT CORPORATE

20

Strategic Plan 2011-14

Ourbroadactionplansthereforeinclude:

• anintenttofullyassessandreviewtheopportunitiesandriskscreatedbytheimpendingchangesandensureourplansrespondandaremodifiedaccordingly

• anintenttoconsideralternativelegalstructuresforNHSBTwherethesewouldgenerateaclearadvantageinensuringNHSBTisbetterplacedtodeliveritsdirectionsandstrategicaimsandoperatemoreeffectivelywithinanincreasinglycommercialandcompetitiveenvironment

• ongoingreviewandidentificationofoperationalsynergiesacrossNHSBT(e.g.marketing,donorconsentingetc)

• ongoingdevelopmentofperformancemanagementandintegratedgovernancestructures,adherencetoregulation,riskmanagementcapabilityandbusinesscontinuitymanagement

• continuedfocusonleadershipdevelopmentandourcapacityandcapabilityformanagingchange

• aprogrammeofeffectivestakeholderengagementthatsupportsdeliveryofourcorporatestrategyandensuresourpurpose,opportunitiesandachievementsareclearlyunderstood

• developmentofanoverallITapplicationsstrategyinsupportoftheobjectivesandplansoftheindividualoperatingdivisionsutilisingcommonstandardsandfitforpurposeplatforms

• ongoingoptimisationofourEstatesfootprintandstrategies

• targetingareductionof10%inournon-frontlinemanagementcosts(band7andabove)

• continuousimprovementtosupportinggroupsystemsandprocessesbasedonreducingtransactionalactivityandincreasingautomation

• ongoingassessmentoftheopportunitytooutsourcebackofficeprocesses

• ongoingpartnershipwiththeCarbonTrustandimplementationofadetailedsustainabledevelopmentactionplan.

Research & DevelopmentInbloodcomponentswewillfocusoureffortsandinvestinresearchintodonorhealthandthebehaviouralfactorswhichleadpeopletodonate.Wewillcontinuetoinvestigateemerginginfectiousthreatsandthepossibilitiesforscreeningandinactivationofsuchthreats.Inadditionwewillcontinuetoinvestinresearchwhichdefinestheoptimaluseofbloodcomponentsandpotentialalternatives.

Insupportofdiagnosticserviceswewillexploreanappropriateportfolioofnextgenerationdiagnosticsusinggenotypingandrecombinantproteinswiththeaimsof:

• improvingclinicaloutcomes,includingalloimmunisation,byimproveddonor/patientmatching

• increasingavailabilityofextendedgenotypestocktohospitals.

WewillcontinuetodevelopourstrongresearchprogrammeinTissues.Thiswillseeusdeveloppartnershipswithafocusedsetofacademicpartners.ThiswillhelpidentifythenextgenerationofproductsandserviceswhereNHSBTcanaddvalueandsupporttotheNHSanditspatients.

InODTwewilldrivetheimplementationofaresearchanddevelopmentframeworkandapprovalprocess.Thisisintendedtoleadtodevelopmentofanagreedoverallprogramme,andwillreflectourintenttoworkwithhospitalpartnerstoassessnovelmethodsforimprovingthequalityandnumberoforgansavailablefortransplant.WewillinparticularlooktosupportthedevelopmentofABOincompatibleandantibodyincompatibletransplants.

Section Five: NHSBT Corporate

21

Strategic Targets for 2011-14

Strategic Targets – Corporate 2010-11 Plan

2010-11 Actual

2011-12 Plan

2012-13 Plan

2013-14 Plan

CorporateServicecostsasapercentageoftotalcosts(IT,HR,Finance&Procurement,asperVFMdefinitions)

8.0% 8.3% 7.4% 7.3% 7.2%

Estatecostsasapercentageoftotalcosts(AsperVFMdefinitions)

8.7% 8.5% 8.5% 8.3% 8.2%

ReductionofCO2emissions(tonnes)(estatebasedemissionsaspertheCarbonReductionCommitment)

New New 6.3% 11.5% 16.5%

Note:2010-11actualperformancebasedonNovember2010-11.

22

Strategic Plan 2011-14

RevenueNHSBTisanSHAandisthereforerequiredtoplanforabalancedincome/expenditureposition.

Incomeforbloodcomponentsandmuchoftissuesanddiagnosticservicesderivesfromthesaleoftheseproducts/servicestoNHShospitals.Pricesaresettorecovercostsandareagreedviaanationalcommissioningprocess.

IncomeforODTcomesfromgrantinaid(GIA)providedviatheDepartmentofHealthalongwithcontributionsfromtheotherUKHealthServices.

ItisanticipatedthatexpenditureinBlood,Tissues,DiagnosticServicesandStemCellswillremain

SECTION SIX:FINANCIAL SUMMARY

broadlyflatovertheperiodoftheplan.Thisprimarilyreflectstheintentiontomaintainredcellpricesatamaximumof£125/unitanddriveefficiencyinitiativesthatwilldeliverthisoutcome.TheplandoesnotincludethefundingneedsidentifiedbytheUKStemCellReview.Howeveritdoesincludeanadditional£1.4mnon-recurringfundinginsupportofthisactivityaspartthe£4mfor2011-12recentlyannouncedbytheMinister(withthe£2.6mbalancegoingtoAnthonyNolan).

ItisalsoanticipatedthatODTcandeliveritscoreobjectiveswithintheexistingfinancialenvelope.Provisionhasbeenmade(inpart)forinvestmentinanewODR.

NHSBT Revenue Statement

2011-12 £ million

2012-13 £ million

2013-14 £ million

Change £ million

Opening Expenditure Position 442.9 432.1 437.5 442.9

Estimatedvolumeimpacts (7.3) 7.5 0.3 0.5

Inflation 3.5 3.4 6.9 13.8

Estimatedcostpressuresanddevelopments 5.9 3.9 5.9 15.7

Estimatedcostreductionprogramme (12.9) (9.4) (9.4) (31.7)

Net Expenditure (reduction)/increase (10.8) 5.4 3.7 (1.7)

Estimated Total Expenditure [A] 432.1 437.5 441.2 441.2

Funded By2011-12 £ million

2012-13 £ million

2013-14 £ million

Change £ million

Incomefromproductandservicesales 361.2 368.0 371.7 371.7

GrantinAidfunding 65.4 64.0 64.0 64.0

IncomefromDevolvedAdministrations 5.5 5.5 5.5 5.5

Estimated Total Income [B] 432.1 437.5 441.2 441.2

Net Income & Expenditure Surplus [B-A] 0.0 0.0 0.0 0.0

23

Section Six: Financial Summary

Revenue Investment PlanThe2011-12pricesforbloodcomponentsandspecialistserviceshavebeenagreedwiththeNationalCommissioningGroupforBloodandwillresultinareductiontoourcostbaseof2.0%inoverallterms(includinginflation).TheheadlinepriceforBloodof£124.85willbeachievedbydeliveringefficiencysavingsof3.4%onourcostbasefor2010-11.Theseincludeamixofproductivityimprovements,cashreleasingconsolidationsandoperationalefficiencies.

Thebloodpricealsoincorporatesanumberofmaterialcostpressures,includingtheincrementalimpactofVATat20%,anadditional1%inemployersNationalInsurancecontributionsandalsocostsassociatedwithmeetingpayscaleincrementsdrivenbyAgendaforChange.

TheimpactofinflationismostlyconfinedtoNon-PayandisbasedontheforecastTreasurydeflatorof2%.Payinflationissettozeroforallbutthoseemployeesbelowasalaryof£21,000.

ThelevelofGIAtobereceivedfromtheDHhasbeenreducedandwillbe£2.3m/3.5%lowerthanthe2010-11allocation.Therevisedallocationhasbeensetat£64.0mandisexpectedtoremainflatforthedurationoftheplan2011-14.

Thereareanumberofuncertaintiesatthepointofpreparingtheplan.Itshouldbenotedthat:

• thetargetredcellpriceassumesthereisnodirectionfromtheDHtoimplementabloodsafetyinitiativein-year.Inparticularadecisionontheimportationof100%FreshFrozenPlasmaisimminent.Ifthisweretohappenduring2011-12itisassumedthattheimpactwouldbeabsorbedinyearbutwouldresultina£5/perunitincreasetothepriceofredcellsin2012-13andbeyond

• thereismaterialuncertaintyinthelevelofcoststhatwouldbenecessarytoimplementandmaintainanewOrganDonationRegister

• ourGIAassumption(andstrategictargets)includesnoprovisionatthisstageformeetingtherecommendationsoftheUKStemCellForumreport.Asnotedabove,however,anadditional£1.4mofagreednon-recurringfundingisincludedin2011-12toassistimprovedoutcomesinthisarea.

24

Strategic Plan 2011-14

Capital Investment PlanDuring2011-14,weareplanningtodeliveracapitalinvestmentprogrammetotalling£26.2m.Theseplansarelargelycentredonmaintainingourprocessing,testingandlaboratoryfacilities,ITandsystemdevelopment,plusrollingequipmentreplacementandrenewalprogrammes.Largelydrivenbyregulatoryrequirements.

Theallocationrequestedfor2011-12includesc£3mtomeettherequirementforanewmodernandfitforpurposeODRandalsoc£0.8mforaTransportManagementSystem,whichwillbeintegraltoimprovingefficienciesinlogisticsandsupportingthedevelopingBloodDonationstrategy.

Summary of Capital Investment Plans

Plan Initiative 2011-12 2012-13 2013-14

EstatesInvestmentProgramme £1.6m £0.8m £0.8m

ITandsystemdevelopmentprojects £5.5m £1.0m £0.8m

MinorCapitalProgramme–assetreplacementprogramme £4.3m £5.6m £5.8m

Total £11.4m £7.4m £7.4m

Performance and AssuranceWeadoptanintegratedapproachtoplanning,performance,governanceandassurance.Thismeansthateachstrategicobjectiveissubjectedtoriskevaluationandassessmentandthatsupportingactivitiesandworkplans(andtheirrespectivecontrols)havebeendevelopedtomitigatetherisksoffailingtoachievetheseobjectives.SuchrisksarecapturedwithinourStrategicRiskRegisterandformsakeyelementofourAssuranceFramework.

ProgressagainstdeliveryofthisplanwillbereportedeachmonthtotheNHSBTExecutiveManagementTeamandNHSBTBoardusingourPerformanceManagementFramework.ThisconsolidatesreportingofprogressagainstourstrategictargetswithotherkeyoperationalKPIs,progressagainstkeymilestones,keyperformancetrendsandrisks.

Riskstodeliveryofourworkplan,whicharisein-year,arecapturedwithinourProgrammeGovernancearrangementsandaspartofeachFunctionalManagementTeam’songoingreviewofperformanceandmanagementofrisk.Risksareescalated,asappropriate,forresolutionviathemonthlyperformancereviewprocess.

TheperformancereportwillformthebasisfortheformalNHSBTaccountabilityreviewarrangementswiththeUKHealthDepartments.

TheprocessandreportingissubjecttoscrutinybytheGovernanceandAuditCommittee(GAC)andbyourInternalAuditors.

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Section Six: Financial Summary