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At a meeting of the regional transfusion directors meeting it was anticipated that a DHSS working group might be set up to consider the legal implications of the advice of the Medical Defence Union.

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A letter was sent by Dr Michael Barnes, Deputy Medical Director of the Wessex Regional Transfusion Centre, to the haemophilia centre directors in the Wessex region to recall unused Factor 8 from batch HL3186.

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Dr Barnes wrote to all directors of haemophilia centres in Wessex re-emphasising his request for information to be kept quiet.

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At the first meeting of the Advisory Committee on the National Blood Transfusion Service Working Group it was agreed that donors should be told that their donations would be tested for HTLV-3, and that those whose donations tested positive should be informed, but there was no unanimity on how to do this.

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A paper was produced by the Expert Advisory Group on AIDS Screening Sub-Committee: "Follow Up of Blood Donations Previously Given by Donors who are Identified as Positive for HTLV III Antibody".

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Dr Smithies wrote a memo to Dr Alderslade noting that funding had been allocated to the Public Health Laboratory Service to follow up recipients on the Wessex batch, as well as batches of US-derived Factor 8 known to be associated with donors with AIDS.

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The covering letter to "Epidemiological Study of the HTLV III/LAV Virus based on the Blood Transfusion Service" noted that there were "instances in which patients infected by blood transfusion have brought the problem to light and a donor can be found by back tracing."

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DHSS/CDSC/NBTS meeting at which it was noted that about 90% of all HIV positive donors who could be traced had been informed of their HIV status and told not to donate again.

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A review of the lookback scheme at the North London Blood Transfusion Centre was undertaken by Dr Hewitt. Dr Hewitt explained that "Sometimes the RTC has written to five or six doctors in an individual case (haematologist, surgeon, physician, referring physician, GP) without any of them wishing to take responsibility for notifying the recipient." This created not only an increased workload but also a delay in reaching the patient.

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Dr Harold Gunson wrote to Dr Spence Galbraith noting that regional transfusion centres "already have systems available for the follow-up of donors who are implicated in patients who develop Transfusion Associated Hepatitis" and he did "not see that fundamentally the proposal to follow-up donors implicated in patients who develop AIDS or the follow-up of donations given by persons who subsequently develop AIDS is significantly different."

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Sue Knowles wrote to Dr Andrzej Rejman noting that the South Thames Blood Transfusion Service carried out a lookback in which out of 23 implicated donors, 11 were "lost to follow-up."

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Dr Robb-Smith at the Radcliffe Infirmary, Oxford, wrote to the Ministry of Health regarding "follow-up of plasma and blood transfusion with regard to the development of jaundice".

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Dr Harold Gunson and his colleagues were advising that screening of blood donations for anti-HTLV-3 could start in October 1985.

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Professor Arthur Bloom produced an AIDS advisory document which summarised recommendations made at a recent meeting of haemophilia reference centre directors.

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At a meeting of the Haemophilia Centre Directors AIDS Group it was noted that there had been "frequent complaints via the Haemophilia Society about apparently appalling low standards of counselling at some Centres." A counselling day for haemophilia staff was therefore arranged.

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Dr John Craske wrote a letter to haemophilia centre directors explaining the CDC believed that the incubation period for AIDS could be five years. He provided lists of batch numbers of Factor 8 used over the previous five years by two patients who were subsequently diagnosed with AIDS. Blood samples were requested from patients who had received those batches of Factor 8.

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Dr John Craske wrote a letter to haemophilia centre directors noting that facilities for testing HIV were "in short supply", so it was decided that further investigations should focus on those with clinical features suggestive of AIDS and on prospective studies involving batches of Factor 8 "possibly contaminated" with HIV.

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Dr John Craske produced a paper making recommendations for the future monitoring of infections transmitted by Factor 8 and 9 concentrates.

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The Medical Ethics Expert Group was asked if there were circumstances in which it would be ethical for a clinician to withhold a test result from a person with capacity. The approach of the Medical Ethics Expert Group to the Inquiry was that the patient's autonomy should be respected.

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Dr Colin Entwistle, director of the Oxford Blood Transfusion Centre, described an "ad hoc system" in place for carrying out investigations into HIV as this was "not a regular routine activity. On the other hand, obviously, when a positive case turned up, it would be necessary to go back and see what we can find by way of further information about the same donor."

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