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A meeting was held between the Department of Health, CDSC, and NBTS. It was confirmed that 90% of all traceable HIV positive donors had been informed of their HIV positivity, and told not to donate again. NBTS was in a position to trace the donors with the donation number from the hospital.

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Dr Kenneth Calman, Chief Medical Officer, wrote to a wide range of clinicians and public health professionals about recipients of infected donations. This direct involvement and direction by the CMO marked a distinction from the earlier approach and, according to Dr Patricia Hewitt, "provided considerably more weight than Dr Gunson trying to convince clinical colleagues by persuasion."

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Dr Patricia Hewitt, consultant haematologist of the North London Transfusion Centre, managed the HIV lookback programme and covered Central and Northwest London, and Bedfordshire, Hertfordshire and parts of Berkshire.

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Regarding Dr Wallington's abandoned study to gather epidemiological data from HIV lookbacks, Dr Patricia Hewitt noted resource difficulties and the lack of directive from the Department of Health or Chief Medical Officer to undertake the study.

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The National Blood Transfusion Service was only able to screen donations from active blood donors. The HIV status of the self-excluded donors remained unknown and the NBTS relied on clinians and/or seropositive individuals to inform the blood service voluntarily for lookback to be done on those donations.

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According to Dr Patricia Hewitt's evidence to the Inquiry, when the main thrust of HIV lookback in England took place, there was no national organisation of the English blood services nor national mechanism for collecting data or ensuring uniformity of practice.

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According to Dr Jack Gillon's evidence to the Inquiry, unlike the HCV lookback which put no time limit on retrospective identification of recipients, the UK HIV lookback was limited to five years prior to the index positive donation.

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Dr Kieran Morris conducted an initial review of documents that had been identified as potentially relevant to the Inquiry. He was not able to find any trace-back notifications for the period 2000-2006 nor records related to the plasma recall by the Scottish National Blood Transfusion Service of batch pools containing plasma from two donors who subsequently developed vCJD. However, upon detailed review, Dr Morris discovered a trace-back file dated 2001 and concluded that nothing was missing.

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According to Dr Vanessa Martlew, the counselling process at the Mersey & North Wales Regional Transfusion Service for donors found to be carrying an infection was to "gently inform, advise and refer" rather than to provide therapeutic support.

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Catherine Nalty

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Dr Vanessa Martlew conducted HIV lookback exercises in Manchester following the introduction of routine donor screening.

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According to Dr Vanessa Martlew, the Department of Health insisted that, when conducting lookback, the prescribing clinician or the GP must be invited to approach the patient before a clinician from the regional blood centre. However, Dr Martlew recalled that usually both treating hospital clinicians and GPs declined and the transfusion centre consultants would see the recipients.

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According to Professor Marcela Contreras, the North London Blood Transfusion Centre was the first centre to introduce HIV lookback, based in their region. The centre also kept its own list of HIV positive donors.

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Catherine O'Brien told the Inquiry that a search in Wales had failed to identify specific documents relating to an HIV lookback. Documents identified by the Penrose Inquiry suggest a lookback exercise was undertaken in Wales upon the introduction of screening for HIV.

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A diagram was produced setting out the "WBS pre testing HIV Donor Seroconversion look backs".

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Dr John Napier told the Inquiry that the introduction of HIV screening did not have any significant impact on the operation of the Welsh Regional Blood Transfusion Service, as positive donations were exceptionally rare.

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A donor was tested positive for HIV at the Oxford Blood Transfusion Centre. After discussion with her, Dr Colin Entwistle referred her to the GP and to a local haematologist. No lookback was undertaken because Dr Entwistle concluded "her case was very clear cut in identifying the time of infection."

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The Yorkshire Regional Transfusion Centre relied on the blood bank to trace recipients of blood and blood products because hospital records were insufficient for this purpose.

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When computerisation took place at the Yorkshire Regional Transfusion Centre, those donors who had not donated in the past five years were not transferred onto the computer system. Instead, their paper records were archived.

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In his witness statement to the Inquiry, Dr Stanislaw Urbaniak stated that he was not directly involved in the HIV lookback procedure but he noted that for the first four years after testing was introduced they did not have anything to look back on because there were no HIV positive donors identified.

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