As we’ve refined the strategic focus of Canadian Blood Services over the past several years, our management structure and work processes have evolved to reflect the complex role we play in Canada’s health system. Our organization has many interconnected dimensions: we’re an advanced biologics manufacturer, a provider of clinical services and an innovative leader in research, education and professional practices. We address today’s difficult health-care challenges with multidisciplinary responses that draw upon the knowledge, skills and experience of people right across our organization.
As we once again tackled a wide range of issues in 2015–2016 — each of them, as the theme of this annual report suggests, with many moving parts — the unifying thread was our ability to manage complexity. The progress we’ve made is a testament both to the breadth of talent within Canadian Blood Services and the vision and complementary expertise of our partners throughout the health system.
Efficiency and productivity
Over the past year we continued to deliver value in three ways: by working constantly to improve patient outcomes with the products and services we provide; by helping to drive improvements in health-system performance across Canada; and by enhancing our capacity to create positive impact with optimum cost-efficiency.
We exceeded our target of realizing $13 million in efficiencies for the 2015–2016 fiscal year by maintaining our focus on improving systems and processes in every area of operations — from the automation of information gathering in blood donor clinics to the elimination of redundant procedures in production areas and labs.
These savings realized through productivity and efficiency improvements were complemented by our continued success in negotiating highly favourable contracts with key suppliers, most notably for the plasma protein products we purchase and distribute on behalf of Canadian health-care providers. At year- end we reached an agreement that we project will result in more than $60 million in cost savings and cost avoidance through 2017–2018. This is in addition to existing contracts that have yielded cost savings and avoidance totalling approximately $600 million over a five-year period.
Another highlight of our productivity journey has been a unique partnership with Toyota Canada at our manufacturing and distribution facility in Brampton, Ontario. For much of the past year, the automaker’s experts worked alongside our teams, sharing their proven approaches to streamlining processes and driving continuous improvement. As a result, we’ve achieved a series of remarkable productivity and efficiency gains, including a 40 per cent improvement in order fulfilment time. Now the insights we’ve gained are being extended to all of our other facilities as we roll out our Blood Supply Chain Excellence initiative nationwide.
The nuanced issues highlighted in this annual report — from our risk-based decision-making in response to the Zika virus to our repositioning of Canadian Blood Services’ Cord Blood Bank in light of changing medical practice — illustrate the value of our collaborations with other leaders in health care, nationally and globally.
One area where we made significant progress over the past year was in further evolving the blood donation criteria for men who have sex with men (MSM). In March 2016, we formally sought approval from Health Canada to reduce the ineligibility period for MSM from five years to one year after a donor’s last sexual contact with another man.
This is an important step forward in an incremental process that should be seen in its historical context. When the risk of HIV-infected blood donations came to light in the 1980s, blood system operators decided that the safest option, in light of available research, was to accept no MSM donations. In 2013, Canadian Blood Services, reassured by evidence-based assessments of potential risk, moved to a five-year deferral period. Our goal for 2015–2016 was to marshal further evidence confirming that a one-year deferral is in fact no less safe — and we achieved that goal. Now the evolution of our eligibility criteria continues, as we assess the latest research and consult patient advocacy and LGBTQ organizations with the aim of moving from a time-based deferral model to one that simply seeks to preclude all high-risk sexual activity.
Security of the plasma supply
Another discussion that dominated our agenda in 2015–2016 was the need to ensure a secure supply of plasma for fractionation, as well as the specialized products derived from this plasma. Currently 75 per cent of our requirements are fulfilled by U.S. manufacturers, whose plasma collection capacity may be reaching its limits in the next few years, as they seek to keep up with steadily growing worldwide demand for plasma protein products, particularly immune globulin. In this context, simply maintaining the status quo poses a significant risk — perhaps not imminent today, but with the potential to loom large quickly if changing patterns of global demand lead to disruptions in supply or insufficient supply to meet the world’s requirements.
Canadian Blood Services has therefore embarked on developing a comprehensive national plasma collection business plan. We plan to significantly increase the amount of plasma collected through our domestic blood system while maintaining the rigorous standards of quality and safety we've established on behalf of all Canadians. This will be a critical area of focus during the coming year.
An additional milestone of progress that should be highlighted here is the work by our board of directors in reviewing and updating governance policies and procedures to align with widely accepted best practices. Thanks to the committed efforts of all directors, guided by the expertise of outside consultants, we now have an exemplary governance framework for board-level oversight and decision-making, with clearly articulated guidelines enshrined in a completely revised board members’ manual.
This concern for sound governance also extends outward to the relationship between Canadian Blood Services and our funding partners. We continue to seek a pan-Canadian accountability agreement that better delineates our complementary roles. In 2016–2017, we hope for collaboration with our corporate members on clarifying the essential arm’s-length relationship, aiming for a national governance framework that will further protect both governments and the blood system from repeating the missteps of the past.
This overarching challenge mirrors those we face in every area where we work to deliver value to Canadians. The issues are complex and sometimes daunting — if only because they matter so much to so many people. In striving to improve patient outcomes, system performance and cost-efficiency, we must constantly weigh competing priorities, balance the interests of multiple stakeholders and manage the interconnections between myriad related factors.
As always, our success in driving change and delivering value depends on strong, effective partnerships — with our funders, with the other key players in Canada’s health system, and with other blood operators, biologics manufacturers and innovation leaders around the globe. Even more fundamentally, we could not hope to realize our vision without the continued support, commitment and engagement of Canadian Blood Services staff, our dedicated volunteers and, of course, our loyal and generous donors.
We look forward to making additional progress toward our strategic goals — while managing all of their complexities — in the months and years ahead.
Dr. Graham D. Sher
Chief Executive Officer
Chair, Board of Directors