title: Business continuity in blood services: two case studies from events with potentially catastrophic effect on the national provision of blood components.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: NHS Blood and Transplant, Oak House, Reeds Crescent, Watford, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Morgan
authors.forename: R A
authors.initials: RA
authors.lastname: Rackham
authors.forename: S
authors.initials: S
authors.lastname: Penny
authors.forename: J R
authors.initials: JR
authors.lastname: Lawson
authors.forename: R J
authors.initials: RJ
authors.lastname: Walsh
authors.forename: S L
authors.initials: SL
authors.lastname: Ismay
mesh_terms: D001315:Australia; D001771:Blood Banks / Q000191:economics / Q000458:organization & administration*; D004189:Disaster Planning / Q000191:economics / Q000379:methods / Q000458:organization & administration*; D004190:Disasters; D004739:England; D005060:Europe; D006761:Hospitals; D014852:Wales; D000094902:Blood Banking / Q000379:methods
keywords: blood supply; business continuity; crisis management; emergency; incident management; risk assessment; supply chain; systems outage