In January 2025, the Commonwealth on behalf of all Australian governments engaged Deloitte Touche Tohmatsu to undertake an independent Review of the National Blood Arrangements (Review). The Review will examine the key governance frameworks and administrative processes that underpin the national blood arrangements to ensure they are consistent, modern, and fit for purpose.
The Review is expected to be finalised in mid-2025 for consideration by all governments.
Purpose
The National Blood Authority Act 2003 (the Act) established the National Blood Authority (NBA), which commenced operations in 2003. The Act provides the legal framework for the management, governance, and accountability of the national blood arrangements.
It outlines the functions, powers and responsibilities of the:
- NBA
- NBA General Manager (Agency Head)
- NBA Board.
Additionally, the Act authorises the NBA to establish advisory committees to assist in executing its functions. The National Blood Agreement (the Agreement) sets out the primary and secondary policy objectives of all Australian governments concerning the Australian blood sector.
In 2002, the Commonwealth, state and territory governments entered into the Agreement, establishing a coordinated national approach to:
- policy setting
- governance and management
- administrative and financial arrangements of the Australian blood sector.
Both the Act and the Agreement were developed over 20 years ago and have remained largely unchanged since then.
A review of current provisions and arrangements is underway. This includes examining interactions between:
- the Act
- the Agreement
- other relevant legislation
- existing advisory and decision-making structures.
The goal is to ensure the national blood arrangements are aligned with contemporary legislative requirements and reflect the policy priorities of the national blood sector, as agreed by governments.
The Review will examine whether the governance and administrative arrangements established by the Act and Agreement remain appropriate and fit for purpose. It will also assess the impact of other relevant legislation and contemporary practices on these arrangements. Based on this assessment, the Review aims to enhance their effectiveness and ensure they are modern and responsive to current needs. Additionally, the Review will evaluate the suitability of the national blood arrangements, including relevant definitions, to support the assessment, funding and supply of both current and future blood, and blood related products and services.
Process
We will manage the Review. We will collaborate with state and territory governments and consult with the NBA and other key stakeholders.
The Review process will include:
- reviewing the current governance and administrative frameworks such as the Act, the Agreement, other relevant legislation. This includes reviewing the roles and responsibilities of governing bodies involved in the national blood arrangements such as the Health Chief Executives’ Forum (HCEF), the Jurisdictional Blood Committee (JBC), the NBA Board and the NBA. The Review will identify any actual or potential areas of duplication or conflict, as well as opportunities for improvement
- engagement with the JBC, the NBA, state and territory governments and a range of other key stakeholders such as patient advocacy groups. These discussions will focus on current issues, best practice, and improvement opportunities
- examination of financial structures established by the Act and the Agreement to ensure they are modern, agile and aligned with the broader health system funding and processes
- consideration of outcomes from other reviews relevant to the national blood arrangements. The Review will identify opportunities for further improvements, including addressing gaps, creating synergies and considering other Health Technology Assessment (HTA) frameworks.
Scope
Issues in scope of the Review are:
- the need for more modern and agile mechanisms to engage and resolve issues of national blood management
- actual or implicit conflicts between current arrangements and contemporary legislative, accountability and governance requirements, particularly in relation to the Act, the Public Governance, Performance and Accountability Act 2013 (PGPA Act) and the responsibilities of the NBA Board
- policy and funding issues, including in relation to the broader health system and architecture. The identification of clearer pathways to support timely decisions by governments on blood issues as required
- the process for assessing and determining applications from potential suppliers for funding under the national blood arrangements
- consideration of the Agreement’s current definitions of ‘blood products’, ‘blood related products’, and ‘blood related services’. The aim is to reduce ambiguity and ensure the arrangements remain current and adaptable to future needs.
Issues out-of-scope of the Review are:
- the operational or regulatory aspects of collection, distribution or provision of blood products or issues relating to their clinical use
- the operational execution of day-to-day NBA functions
- criteria and governance arrangements for access to blood and blood products (e.g., Criteria for the clinical use of immunoglobulin in Australia)
- consideration of whether specific blood and blood related products should be funded or continue to be funded under the national blood supply.
Policies, frameworks and processes in scope of the Review are:
- The National Blood Authority Act 2003
- The National Blood Agreement (inclusive of Schedules)
- The Public Governance, Performance and Accountability Act 2013
- The National Health Reform Agreement – Addendum 2020-25
- The Jurisdictional Blood Committee and its relationships with other ministerial committees and bodies, such as the Health Chief Executives’ Forum and the Health Ministers’ Meeting
- The HTA Policy and Methods Review and the National Health Reform Mid-term Review, for consideration and awareness only.
Expert Working Group
An Expert Working Group (EWG) has been established to support and guide the Review. The EWG includes two Commonwealth representatives, four state and territory government representatives, and one NBA Board member. This group developed the scope of the Review, and the JBC and HCEF endorsed it in 2024.
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