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The 1954 edition of Notes on Transfusion noted that a transfusion should never be given without a definite indication

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Expert Report to the Infected Blood Inquiry on Bleeding and Blood Disorders noted that tranexamic acid is effective in major trauma and was sometimes used in the 1970s in dental extractions and peri-operative settings for the treatment of people with bleeding disorders.

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Department of Health's Notes on Transfusion for 1973 noted that a transfusion should never be given without a definite indication. The same text was published in the earlier Notes on Transfusion for 1963.

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Williamson et al's editorial titled 'A SHOT in the arm for safer blood transfusion' outlined a new surveillance system for transfusion hazards

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The NHS Wales Blood Health Plan laid out its ambition that it would centre on good blood health and the use of blood components.

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In Wales, a Blood Policy Group was created in 2005 to replace the initial forum which had encountered difficulties in exerting real influence on the NHS.

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Letter from D Jones set out the minimum requirements for Hospital Transfusion Committees.

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Counsel Presentation on Hospital Transfusion Committees noted that it was difficult to conclusively establish when each HTC within a sample across the UK was set up, though the broad picture was that they had spread to most major hospitals by the end of the 1990s.

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The 1963 edition of "Notes on Transfusion" reiterated the statement that a transfusion should never be given without a definite indication, adding that this was in "the patient's interests" and due to unlimited blood supplies and an ever-growing demand for blood it must not be used unnecessarily.

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The 1963 edition of "Notes on Transfusion" highlighted that the use of blood transfusion to correct "moderate or slight degrees of anaemia" was "unjustifiable" where there were slower but safer methods available.

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The Advisory Committee on the Safety of Blood, Tissues and Organs' planned to set up a working group to agree principles for future lookback investigations.

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The bulk of the guidance governing best transfusion practice in the UK was produced in the 1990s onwards with the main publication, known as the "Red Book", being first published in 1989.

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As at 2000, there was no published data about the frequency of autologous transfusion in the UK.

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National bodies, rather than just individual clinicians, began to produce guidelines on transfusion to address specific scenarios in particular specialities.

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Part of the Standing Advisory Committee on Transfusion Transmitted Infections' remit involved commissioning, conducting and coordinating trials for new technology involved in screening blood.

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The 1984 "Textbook on Surgery" highlighted that "blood transfusion carries some risk and alternative methods should be chosen whenever possible."

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"Principles and Practice of Surgery", described the transmission of viral hepatitis as "the most serious and frequent complication of the administration of blood and blood products ... The best preventative measure is to avoid unnecessary transfusion."

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The establishment of the Consumer Protection Act 1987 and the introduction of the European Directive on blood led senior individuals working in the transfusion services to focus on the issue of blood transfusion.

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Dr Contreras reported that Hospital transfusion committees were "now being established" in five major hospitals which the North London Blood Transfusion Centre supplied, following an audit which had shown very disappointing results.

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In 1989, a working party of the British Medical Association recognised that there was a need for further research into the indications for transfusion to develop professional consensus on the indications for prescribing blood.

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