The Open Forum was held at the end of the meeting and allowed attendees to raise questions about points addressed in the workshops or during the meeting, or any other issues about blood stock management.  The OPEN FORUM ARENA will enable all participants to learn from the topics raised and also to contribute to the discussion.

Questions raised:

1. What notification is given to the sending Blood Bank & receiving Blood Bank when sending blood to another hospital i.e do sending hospitals ring receiving lab?

Summary Answer:
Hospitals do not need to phone as VANESA will send an automatic message to both the sender and the receiver. Practically, outside of the BSMS, some hospitals/regions use a standard form and have a standard protocol, which may include phoning the hospital.

2. Is it best practice to have a 24-hours or 48-hours reservation period?

Summary Answer:
The 2001 Inventory practice survey data showed that hospitals with a 24-hour reservation period had a significantly lower O Pos ISI. This suggests that hospitals with a 24-hour reservation period hold less stock. It is recognised that a 24-hour reservation period may not be practical for all hospitals.

3. Does the BSMS consider travelling time from centre to hospital; and does the scheme know how this affects stock management?

Summary Answer:
There is a question on distance from NBS centre on the registration form. Some initial data analysis indicated that distance did have an effect on stock management. Further work is planned for the future.

4. Would the NBA consider selling short-dated blood at a reduced cost to encourage the hospital blood banks to order old blood for planned transfusions?

Summary Answer:
NHS costing principles are that the cost of the blood will equal the price. The principle upon which NBS prices are set is that the cost of collection, processing, testing and storage of the blood is reflected in the price. These costs are effectively the same if the blood is older as when it is more fresh. The NBS is not considering this.

5. Do all NBS centres have the same stock ordering policies? e.g. do some centres expect Monday stock orders to be in by Friday, or by Sunday?

How many hospitals have standing orders?

Can hospitals specify a mixture of expiry dates for large orders of particular blood groups?

Summary Answer:
There is some variation in ordering policies. NBS Issues is currently trying to rationalise all policies. Some hospitals do have standing orders, the number is not known. Some hospitals do ask for fresher blood in particular circumstances and their request is considered.

6. What is the current state of play with regards to vCJD testing and blood supply?

Summary Answer:
The NBS is actively monitoring developments in the field of vCJD testing and has developed contingency plans to offer some reassurance that we would be able to respond in a timely manner. One specific activity that has involved detailed working with MSBT (the DoH advisory committee on microbiological safety of blood and tissues) is planning for the establishment of an irreversibly anonymised panel of blood samples from healthy UK and US donors that would assist in assessing the specificity of candidate tests for vCJD.

7. You have recently changed the website with reference to impact, can you explain the change?

Summary Answer:
Impacts used to be recorded in two categories; patient and laboratory. The number of impacts recorded was minimal. It was therefore decided to amalgamate the impacts into one general category and three headings, no impact, short shelf life and supply shortage.

8. Will a drive for wastage reduction mean that hospitals will use more O Neg blood in an attempt to cover different patients?

Summary Answer:
The blanket use of O Neg blood is not recommended in the BCSH guidelines for pre transfusion testing. It is inappropriate use of a blood group that should only be used in "real" emergency situations. NBS O Neg stocks are the lowest of all of the blood groups and therefore should be used wisely. There is currently no evidence to suggest that hospitals are increasing O Neg usage to reduce wastage.

9. Please consider having a "partnership" category for hospitals that are in partnership for trying to reduce wastage

Summary Answer:
VANESA gives the BSMS team the opportunity to add new categories as required. A data collection exercise would be required before any new categories can go live. We will consider adding in this category.