BLOOD AVAILABILITY AND QUALITY

The immediate call for blood donors following the atrocities in Morocco, the Philippines, Spain, Turkey and Thailand has dramatically emphasised both the lifesaving properties of blood and the frequency when screened blood is unavailable. In many countries, there are major problems both with the quality of the local blood and also of its availability.

BLOOD BANKS

In 2003, the Trustees were delighted that the Singapore Blood Transfusion Service agreed to assist the Foundation, should a Blood Care Programme (BCP) member in that part of Asia need an emergency blood transfusion. This support is particularly valuable, as it considerably strengthens the services provided by the Foundation in this part of the world where Rhesus Negative blood is difficult to obtain, as that group is not indigenous to the local population.

The confidence shown in the Foundation's global services, by a number of national governments, now enables the Foundation to source blood from the National Blood Authorities in France, the Netherlands, Singapore, Switzerland and the United States either for direct courier delivery to the treating doctor or to supply, on a regular basis, the Foundation's own blood banks in Hong Kong and Nigeria.

ALARM CENTRE

On-going training of the Foundation's Alarm Centre staff continued throughout the year. This is an important part of the Foundation's Quality Assurance Programme, ensuring Members receive as rapid a response as possible when blood or rabies immunoglobulin is required in an emergency.

RABIES

The addition, in January 2002, of the delivery of human rabies immunoglobulin and rabies vaccine, to the Foundation's Stand-by services is very popular with corporate members. Although they recognise this may only be needed occasionally, the knowledge this cover is available to their employees who have been bitten or even licked by a possibly rabid animal provides management with considerable peace of mind, as symptomatic rabies in humans is invariably fatal.

DELIVERIES OF BLOOD AND RABIES IMMUNISATION

The routine blood supplies to the Foundation's blood banks in Hong Kong and Nigeria are sent by air. The temperature of these deliveries is monitored in transit by a highly sophisticated computer system. All emergency blood deliveries are hand-carried by the Foundation's couriers. These are usually anaesthesiologists, who have specialised in emergency medicine. With their training, they are able to assess the facilities and skills available in the clinic or hospital where the patient is located and to advise the company, family or medical assistance company concerned on whether these are adequate for the proposed intervention.

The provision of high quality blood for a patient is not simple. The sourcing centre must conform to the highest international standards, the temperature of the blood in transit must be continually monitored and the documentation has to be of a standard to allow full traceability. Finally, the courier must ensure the patient is transfused with the actual blood provided for him.

Similar standards of temperature control apply to the transportation of the rabies vaccine and immunoglobulin.

CONSULTANCY

As Transfusion Medicine becomes more complex, many doctors treating BCP members take advantage of the Foundation's Consultancy Service, to discuss the transfusion management of their case. This service gives them access to the latest techniques, with direct benefit to the member concerned.

FINANCE

Each year the Foundation strives to increase its services without compromising standards of quality. 2003 was no exception, as income from membership and donations again enabled the Foundation to end the year with a very small surplus.

The considerable upward trend of the fees charged by expatriate medical and travel insurance companies in Europe during the past two years enabled the market to settle at these new levels in late 2003. Although still facing stiff competition, some companies have indicated their intention to re-instate BCP membership as a standard benefit, as they and their clients perceive this to be an invaluable enhancement of their policies.

Growth of the Foundation's services is directly linked to its membership base. In addition to its Corporate Stand-by membership programme, the Foundation was invited to tender for the establishment and regular provision of blood for a dedicated blood bank. It is expected this contract will become operational in 2004. Requests have been received for the establishment of similar blood banks in four other parts of the world.

INSURANCE

During the annual Quality Assurance Review the Foundation sought the advice of the FSA concerning its Full Membership programme. The Foundation wished to know whether this Programme fell under the definition of providing an 'insured' product. Although the FSA was unable to provide a definitive ruling on this question, the Trustees have decided to withdraw this form of membership, thereby avoiding any possibility of breaking the law by acting as an 'insurer'. As people in small groups still need the protection of the BCP, an alternative strategy is being created, which is expected to become operational in 2004.

STANDARD OPERATING PROCEDURES

Standard Operating Procedures (SOPs) detail every action carried out by the Foundation. They ensure all procedures conform to the highest possible standards and are fully documented. They are an essential part of the Foundation's Quality Assurance Programme and were regularly revised throughout the year. As new activities were undertaken, so the Foundation's library of some 330 SOPs was enlarged. As in previous years, the Foundation's Quality Assurance Manager carried out an Internal Audit of all aspects of the Foundation's activities, identifying areas in need of improvement and supervising their implementation.

TRAINING

Regular training sessions form a very important and time-consuming part of the Foundation's Quality Assurance activities. In 2003, these included Alarm Centre staff, the teams of Couriers, laboratory staff responsible for maintaining the Foundation's blood banks and those responsible for looking after its network of Regional Supply Points (RSPs) and Corporate RSPs (CRSPs).

RSPs / CRSPs

In 2002 it was decided to gradually phase out general RSPs in favour of CRSPs, which are located on the premises of corporate members and therefore more readily available in an emergency This continued throughout 2003. During the year, the Foundation donated all CRSP supplies to the corporate members concerned, whilst maintaining free replacement of these supplies within 6 months of their expiry date. This placed management of the supplies as close to the likely point of use as possible, thereby improving their appreciation and perceived value. Despite this change, the CRSP supplies continue to be available for all individual members in emergency.

MARKETING

With the growing interest in medical and health issues in mainland China, the Foundation was very pleased to appoint the only existing Chinese medical assistance company as its representative in China, whilst searching for new ways to co-operate with and support other life-saving organisations.

COMMUNICATIONS

The Occasional Newsletter provided by the Foundation's Clinical Director to its Corporate Members continued to be very well received. The variety of its articles, pertinent to the medical and human relations staff responsible for expatriates, their family members and for those travelling on company business, highlight some of the dangers they face and suggest ways in which some of them can be avoided or the risks reduced.

The Foundation fundamentally re-designed its website (www.bloodcare.org.uk) during 2003. More work is required, such as the establishment of a Roll of Honour. Hot-links with Corporate Members and 'on-line' membership registration are also planned for the site.

No Charity can function without the selfless support of its Trustees and dedicated service of their colleagues. I should like to express my sincere appreciation for all the support they have provided throughout 2003. It has been a very challenging year for the Foundation as a whole and has clearly demonstrated the vital part each has played in striving to maintain its aims and objectives. The maintenance of these high standards provides BCP members with the assurance and knowledge that the life-saving services of the Foundation have been and continue to be there to support them in any emergency, regardless of it being due to an accident, illness or terrorist atrocity.

Michael G. Bruce
Chairman of the Trustees