Blood donation: It's good, but...

The audit was conducted on the NIK's own initiative. Its purpose was to examine whether the measures taken secured the country's blood and its components. Seven units were covered: NCK and six regional centers for blood donation and bloodletting (RCKiK, centers:) Gdansk, Katowice, Kielce, Lublin, Rzeszow and Wroclaw. The audit's findings were supplemented by the results of an online survey of blood donors and those who wanted to donate blood but failed to do so, and those who, for various reasons, did not try. More than 16,000 people took part in the survey - conducted using methods checked by the NIK.

Key findings of the audit

From 2019 to 2022, the country's blood and blood components were secured. The number of blood components produced exceeded the number of units issued for treatment. Thus, self-sufficiency was ensured and blood was not imported from abroad. Nevertheless, there were periodic shortages at individual RCKiKs, mainly during the summer, especially in Rh-negative blood groups.

According to the NIK, the year 2020 deserves special attention. Due to the outbreak of the COVID-19 pandemic, there was then a significant decrease in registered donors and those who came forward to donate blood or its components. As a result, there was a drop in donations of about 9%.

In 2019-2022, the number of potential registered donors reached about 1/10 of the Polish population, but only one in five of them reported to the RCKiK for blood donation in each year. The number of donors (who reported to the centers) clearly decreased in 2020 compared to the previous year, which was mainly due to the COVID-19 pandemic. In subsequent years, the number increased, but did not reach the pre-pandemic level (it was respectively: 717.5 thousand in 2019, 657.8 thousand in 2020, 705.6 thousand in 2021 and 711.3 thousand in 2022).

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One of the measures to encourage blood donation was the introduction of an extra day off for the donor in 2021. In the NIK survey, only one in ten donors or potential donors indicated this factor as a reason for donating blood. However, nearly 70% of respondents indicated that they do so because of a desire to help others. In contrast, almost one in five respondents who regularly donated blood or blood components indicated that the biggest incentive was that extra day off.

It is worth noting that more than 2/5 of those surveyed cited negative employer attitudes regarding their absence from work as one of the obstacles hindering or discouraging blood donations. In doing so, they pointed, among other things, to the need for public funding for at least a second day off.

In the opinion of the NIK, it is necessary to strive for a state in which collection points are easily accessible, collection hours are flexible, and blood can also be donated on holidays. The need for such standards is indicated by the fact that almost one in four respondents indicated that the hours of blood collection points were too short or inadequate and the distance to the point was long. More than one-third of respondents among those who do not donate blood regularly indicated that they would be encouraged to do so by better access to collection points, i.e. more points, longer operating hours or free parking.

The inspected centers had the required accreditations and permits. The premises and equipment of their headquarters, selected field branches, and the inspected mobile points (bloodbags) met technical and sanitary-hygienic requirements. However, at least periodic staffing problems were noted at each of the inspected RCKiKs, particularly in connection with the COVID-19 pandemic. In half of them, the size of the workforce affected the working hours at field branches or their temporary closure.

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The audited RCKiK and NCK conducted and coordinated campaigns to promote honorary blood donation, including those carried out as part of self-sufficiency programs. During the period under audit, a total of PLN 37 million of NCK funds were spent on such promotion. In addition, the audited centers allocated PLN 3 million of their own funds for this purpose. Although the promotion of honorary blood donation was carried out on a large scale, the effects of individual actions were not evaluated. Promotional activities were directed toward the strategic goal of self-sufficiency, and in situations of declining donations it was decided to intensify activities. In the opinion of the NIK, such an approach significantly limited the possibility of adapting the right tools, including the search for new forms, including systemic activities tailored to specific audiences.

The NCK and the controlled centers were involved in the work to establish the e-Blood system. The completion date for this project was postponed several times. The 2021 recovery program also failed to be implemented, as the project's completion did not take place by the end of 2023. The cost of the project nearly doubled, including due to salaries for IT specialists. The NIK notes that the e-Blood system was supposed to be not only a fulfillment of a statutory premise, but an important and long-awaited tool to improve the blood and blood donation system. Meanwhile, work on the project, which has been ongoing for several years, still has not resulted in a fully functioning system. In turn, the lack of its completion resulted, among other things, in the fact that the NCK was forced to abandon the implementation of another training project worth more than PLN 2 million, subsidized by EU funds.

Key findings

To the Minister of Health on:

• Verification of the measures taken to ensure the self-sufficiency of the state in blood and its components, for the introduction of solutions of a systemic nature that take into account emergency situations, especially those related to threats caused by armed conflicts;
• Ensuring that more inspections are carried out at the RCKiK and that the results of these inspections are used to improve the implementation of tasks in all units;
• Strengthening oversight of the implementation of the e-Blood system to ensure its full functionality;
• Adapt, in cooperation with the NCK and the organizational units of the public blood service, the principles of converting the volume of individual blood components into whole blood to current needs, taking into account the possible introduction of relevant changes in the law;
• To consider - in consultation with the Minister of Family, Labor and Social Policy - the introduction of changes to the additional day off for blood donation, taking into account its financing from public funds, and making this entitlement dependent on such factors as the amount of blood donated, different groups of people (such as those working physically).

To the Director of the National Blood Center o:

• Ensuring effective oversight of the proper conversion of the volume of individual blood components into whole blood by blood and blood donation centers;
• Ensure programming of current and prospective tasks on the basis of documents, taking into account the possibility of emergencies;
• Developing principles for measuring the implemented goals set in the self-sufficiency programs in such a way as to enable full and objective evaluation of the results achieved;
• evaluating the promotional activities undertaken in relation to the expected results, with the aim of adapting them to the requirements of different audiences;
• Targeting promotional activities to retain regular and attract new blood donors.

Entire report: TU

Source: NIK