Infected Blood Inquiry

The Infected Blood Inquiry was announced by the UK Government in July 2017 and started taking evidence in April 2019. It is one of the largest UK Public Inquiries conducted to date and has primarily focused on the transmission of Hepatitis B, HIV and Hepatitis C through blood components and plasma products during the 1970s, 80s and early 90s. 

• The Inquiry concluded its evidence phase in 2023, with its findings published on 20 May 2024 on the Infected Blood Inquiry homepage 

• Find out more in our news story, What is the Infected Blood Inquiry?

Professor Marc Turner, Director of the Scottish National Blood Transfusion Service, said:

"The Scottish National Blood Transfusion Service understands and empathises with the profound impact the tragic events that have been the subject of this Inquiry have had on infected and affected people.

"We acknowledge the findings of the Inquiry and sincerely apologise for the historical failings described.

"We would like to thank the Inquiry for its tireless work and will review the Final Report and its recommendations very carefully. 

"Modern safety standards are very strict to make sure it's safe for donors to give blood and that the donation is safe for patients to receive. Rigorous donor selection and testing focus on minimising the risk of passing on infection by blood transfusion.

"The safety and sustainability of our blood supply remains our utmost priority, along with our commitment to ensure lessons from that period have been learned."

Information, advice and guidance

An NHS Scotland helpline is available for people who have had historical transfusions and may have concerns.

• Phone: 0131 322 9131 (Mon-Fri, 9am-5pm; Sat 9am-1pm)

If you are keen to know more about compensation, here are some helpful resources

If your concern is around chronic Hepatitis C or HIV, please contact Scottish Infected Blood Support Scheme (SIBSS). 

• Phone: 0131 275 6754 (Mon-Fri, 9am-4:30pm)
• Email: nss.sibss@nhs.scot

If your concern is around Hepatitis B infection, please visit the UK Government Infected Blood Interim Compensation Payment Scheme pages; or their Infected Blood Compensation Scheme page.

• Phone: 0141 726 2397 (Mon-Fri, 9am-5pm)

Q&A

How has the Scottish National Blood Transfusion Service (SNBTS) supported the Infected Blood Enquiry?

SNBTS has supported the Inquiry through provision of documentation, written statements and submissions and fully accept that there are things that could have been done better in the past. 

Transfusion transmitted infections have had tragic consequences for those people infected and affected and for these shortfalls we have accepted moral responsibility and offered sincere apologies. 

What will SNBTS actions be following the publication of the Infected Blood Inquiry report? 

SNBTS will study the recommendations made by the Inquiry very carefully to ensure that lessons from that period have been learned.  

What does current blood safety look like? 

The safety and wellbeing of patients and donors is at the heart of everything SNBTS does. Modern safety standards are strict to make sure it's safe for donors to give blood, and that the donation is safe for patients to receive. SNBTS follows guidelines and advice from expert committees and bodies. Many of these groups have donor or patient members. We are also regularly inspected by independent regulators. 

How do you ensure donors are safe to donate today? 

Every time a donor comes to give blood or other blood components, they are asked to read our donor information leaflet, 'Giving blood: Process, risks and information' so they understand the importance of answering the donor health check accurately. The leaflet makes it extremely clear when a donor must not give blood or blood components. For example, it makes clear that individuals must never donate if they are HIV positive, have Hepatitis B, Hepatitis C, HTLV (human T-lymphotropic virus) or syphilis (or ever been treated for syphilis), or where a donor has ever injected, or been injected with, drugs. 

The donor must also fill in a donor health check. This questionnaire asks about medical history, lifestyle and recent travel. It helps us work out whether it's safe for the donor to give blood, and whether the blood is safe to be given to someone else.  If we identify a donor as being at higher risk of infection, they will not be able to give blood at that time. 

All new blood donors are sent a welcome pack, which signposts them to the donor information leaflet, 'Giving blood: Process, risks and information'. We encourage donors to check their eligibility before coming to donate by visiting the Scotblood website and taking the Can I give blood? quiz. 

Donors are selected according to UK wide guidelines set by JPAC - The Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee. 

After donation, the donor is given the 'After giving blood' post donation card. This asks donors to get in touch with us if they become ill within two weeks of their donation, or if they believe their blood should not be transfused to a patient. 

Donor selection criteria together with donation testing form the basis of blood safety. 

What infections are donated blood or blood components tested for? 

At every donation, blood samples from donors are tested for infections which we know can be passed on in blood. This includes tests for HIV, Hepatitis B, C and E, Syphilis and Human T-lymphotropic virus (HTLV). To meet the special needs of some patients we also test some donations for CMV (Cytomegalovirus). Extra tests can also be carried out depending on a donor’s travel history, for example, for the West Nile virus or malaria. We are not able to test for all infections, so the donor health check is crucial.  

What happens if a donor’s blood is found to have an infection? 

It's rare for a donation to test positive, but if it does, we discard the donation and contact the donor as soon as possible to offer confidential advice. However, if everything is in order, we label the donation and send it out for use across Scotland.  

Is it safe to give blood? 

For most people, giving blood is a painless and trouble-free experience. However, there are some potential risks, and it is important donors know about these before deciding to give blood. The donor information leaflet, 'Giving blood: Process, risks and information' provides information about the possible risks of giving blood and how to reduce these risks. Following donation donors receive an 'After giving blood' post donation card with advice on how to look after themselves after donation and how to contact us if they have any concerns. 

How much blood does Scotland need? 

In 2023/2024, around 150,000 blood products saved or improved the lives of around 30,000 patients in Scotland. NHS Scotland relies on the blood donations of people throughout Scotland to ensure there is enough blood, platelets and plasma available when patients need them. To achieve this SNBTS aims to welcome a minimum of 15k new donors per year. 

Can you reassure patients receiving transfusion today that blood is safe?  

Blood and blood component transfusions are common procedures that can save and improve lives. The benefits, risks, and alternatives should be discussed with patients before a transfusion. They should also be told of the option not to receive the transfusion. Most patients who receive a transfusion do so without problem.  

The donor health check and donation testing make the risk of passing on infection by blood transfusion very low. All blood donors are unpaid volunteers and the risk of an infected unit entering the UK blood supply continues to decrease. The current risk of an infectious donation entering the UK blood supply due to a recently acquired infection is now less than 1 in 1.2 million donations for Hepatitis B, less than 1 in 7 million for HIV and less than 1 in 28 million for Hepatitis C. 

There have been no reported and confirmed cases of transfusion transmitted Hepatitis C since 1997 and HIV since 2002 for any UK blood component.  

• More information on the risk of transfusion transmitted infection can be found in the Annual SHOT (Serious Hazards of Transfusion) Report 2022   

• You can also read more at NHS National Services Scotland 'Receiving a Blood Transfusion' leaflet or at NHS Inform’s Blood Transfusion page 

When did SNBTS start testing blood for HIV, Hepatitis B and Hepatitis C? 

All blood donations have been screened for HIV, Hepatitis B, and Hepatitis C since September 1991. Screening started in 1972 for Hepatitis B, in 1985 for HIV, and in 1991 for Hepatitis C. 

I had a transfusion in the past, should I be concerned? 

If you had a transfusion before 1996 and have not yet been tested for Hepatitis C, please speak to your GP practice about getting tested. Please be reassured that the risks of any individual blood donation being infected were still low.

In the Infected Blood Inquiry report, Sir Brian Langstaff recommends this date because some infections may have occurred after universal screening for hepatitis C was introduced in September 1991 and before SHOT (Serious Hazards of Transfusion) reporting scheme effectively began in 1996.

• Find out more about of chronic Hepatitis C symptoms at the NHS Inform website. 
• An NHS Scotland helpline is available for people who have had historical transfusions and may have concerns. The phone number is 0131 322 9131 and is open 9am-5pm, Monday to Friday; and from 9am-1pm on Saturdays.

Are there lots of people in Scotland who have been infected with Hepatitis C from blood transfusions who have not been diagnosed?  

In 2016, the Scottish Government issued public information notices to thousands of premises across Scotland, such as pharmacies, dentists, GPs and libraries, inviting people to seek a Hepatitis C test if they had had a transfusion. In 2015 and 2016 the Chief Medical Officer wrote to Health Boards and GP practices asking them to offer Hepatitis C testing to anyone who came forward who had had, or was likely to have had, a blood transfusion before September 1991.  

Many people did come forward then, but the Infected Blood Inquiry provided additional recommendations. If you believe you had a transfusion prior to 1996 and have not been tested for Hepatitis C yet, please contact your GP to arrange testing. Information about chronic Hepatitis C symptoms are available at the NHS Inform website. 

The numbers of blood transfusion recipients in Scotland who may have Hepatitis C and do not know about it is likely to be extremely low. In 2016, a short-life multi-stakeholder working group estimated the number of those not yet traced was likely to be very small. 

Why were there changes to Hepatitis B testing in April 2022? 

Safety of the blood supply is our top priority. SNBTS have been testing donations for Hepatitis B since 1972. Enhanced testing for Hepatitis B was introduced in April 2022, following a review of two cases of transfusion-transmitted Hepatitis B infection identified elsewhere in the UK. The virus level in the donor was so low, it was not detected by the screening tests in place at the time.    

We have introduced an additional test, called an anti-Hepatitis B core (anti-HBc), which is a test for antibodies against Hepatitis B and tells us if donors have previously had Hepatitis B infection. The UK Government advisory body for the Safety of Blood Tissues and Organs (SaBTO) has advised using this extra test to further enhance the safety of the blood supply.  

I had a transfusion after 1st January 1980 and I’ve been told I can’t give blood. Why is this? 

This is a precautionary measure. From April 2004, following the report of the first presumed case of transmission of variant Creutzfeldt-Jakob Disease (vCJD) by blood transfusion, individuals who had themselves received a transfusion of blood components since January 1980 were excluded from donating blood. 

From October 1999, white blood cells (which may carry a risk of transmitting vCJD have been reduced in all blood used for transfusion, by a process known as leucodepletion or leukoreduction. 

There is no evidence of any UK clinical cases of vCJD being linked to a blood transfusion given after 1999. 

 

SNBTS, regulators and governance 

Who regulates SNBTS? 

SNBTS is part of National Services Scotland (previously known as the Common Services Agency). 

The Medicines and Healthcare products Regulation Agency (MHRA) is responsible for the regulation of medical devices and medicinal products used in healthcare and the regulation of blood establishments. 

The Human Tissue Authority (HTA) regulates the removal, storage and use of tissue and cells and organs for transplantation.  

SNBTS is also compliant with the Blood Safety and Quality Regulations 2005 (BSQR) and with recommendations from the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO). 

SNBTS is regularly inspected by both the MHRA and HTA. 

SNBTS hospital transfusion laboratories are also inspected by the United Kingdom Accreditation Service (UKAS).  

What is SHOT? 

SHOT (Serious Hazards of Transfusion) is the independent, professionally-led haemovigilance scheme. Since 1996 SHOT has been collecting and analysing anonymised information on adverse events and reactions in blood transfusion from all healthcare organisations that are involved in the transfusion of blood and blood components in the United Kingdom. 

Where risks and problems are identified, SHOT produces recommendations to improve patient safety. The recommendations are put into its annual report which is then circulated to all the relevant organisations including: the four UK Blood Services; the Departments of Health in Scotland, England, Wales, and Northern Ireland; and all relevant professional bodies, as well as circulating it to all of the reporting hospitals. 

As haemovigilance is an ongoing exercise, SHOT can also monitor the effect of the implementation of its recommendations. The SHOT scheme is a UK wide body introduced in the 1990s. From 2005, it sat alongside the Serious Adverse Blood Reactions and Events (SABRE) reporting scheme operated by Medicines and Healthcare Products Regulation Agency in compliance with the Blood Safety and Quality Regulations 2005. 

• Find out more on the SHOT website 

What is SaBTO? 

The Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) advises UK ministers and health departments on the most appropriate ways to ensure the safety of blood, cells, tissues and organs for transfusion or transplantation. 

• Find out more on the SaBTO pages of gov.uk 

What is JPAC? 

The Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC) has two distinct remits:  

1. To prepare detailed service guidelines for the UK Blood Transfusion Services  
2. To be an Advisory Committee to the UK Blood Transfusion Services, by reporting to the Medical Directors of the four individual Services, who are themselves individually accountable to the Chief Executives of those Services. 

Decisions on policy and implementation would be vested in the individual Chief Executives and their Service boards and, where appropriate, their respective Health Departments. 

• Find out more on the JPAC website. 

What is UKAS? 

The United Kingdom Accreditation Service (UKAS) is the national accreditation body for the United Kingdom, appointed by government, to assess organisations that provide certification, testing, inspection and calibration services. 

• Find out more on the UKAS website