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Reports from clinicians to the Serious Hazards of Transfusion scheme were initially voluntary.

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In England, a second circular was produced by the Department of Health which included advice for hospitals on how to implement best transfusion practice.

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From 2002, hospitals were required to participate in the Serious Hazards of Transfusion scheme by the Department of Health.

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Transfusion experts, clinicians, NHS managers and health authority chief executives from across the UK attended a symposium hosted by UK chief medical officers at St Thomas' Hospital.

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Following the conference at St Thomas' Hospital, a circular was published which recommended that from March 1999, all NHS Trusts where blood was transfused (i) should ensure that hospital transfusion committees were in place to oversee all aspects of blood transfusion and (ii) participate in the annual Serious Hazards of Transfusion scheme enquiry.

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The health service circular produced after the conference at St Thomas' Hospital required all NHS Trusts where blood was transfused to have agreed and disseminated local protocols for blood transfusion, based on guidelines and best national practice and supported by in house training and to have explored the feasibility of autologous blood transfusion and ensured that where appropriate, patients are aware of this option.

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Hospital transfusion committees had become sufficiently prevalent by 1998 for a Health Services Circular to set out a series of minimum requirements for these committees.

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Dr Contreras discussed her concern and disapproval of his practice with Professor Yacoub "on numerous occasions" but understood that he continued "bleeding members of staff, visiting doctors and members of the Armed Forces for his numerous 'emergencies'."

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Dr Contreras wrote that she was "aware of at least 2 cases of transfusion-transmitted AIDS in this country where the recipient received untested, non-NBTS, fresh, warm blood. The transfusion records for such patients are appalling, and it will be impossible to find the 'culprit' donor, since the source and the amount given are both unrecorded."

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Dr Contreras wrote to the Medical Defence Union seeking advice on her legal position if she complied with Professor Yacoub's requests regarding "fresh, warm blood".

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The "Handbook of Transfusion Medicine" noted that there was "little or no firm evidence supporting" the belief that a perioperative transfusion was required where haemoglobin levels were below 10g/dl.

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Professor Yacoub's practice of using fresh warm blood continued and remained an issue, and did so until he retired in 2001.

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A meeting was held to discuss Professor Yacoub's use of fresh blood.

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The Medical Defence Union wrote to Dr Contreras to indicate their support of her approach regarding her complaint of Professor Yacoub's practices and seeking legal advice.

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Dr Peter Jones, director of the Newcastle Haemophilia Centre, along with Sister Maureen Fearns called for a government campaign "to educate the medical profession in the recommended use of blood products".

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Dr Jean Grant noted that the decision not to give blood required a doctor to have "the strength of mind to make the unfashionable decision not to transfuse".

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The 1984 edition of "Notes on Transfusion" noted a preference for haemoglobin to be 10g/dl before major surgery and made express reference to post-transfusion hepatitis and the risks of Hepatitis B and non-A non-B Hepatitis.

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A 2017 study of two large maternity units in Texas and London found that from 1988 to 2000 obstetricians more commonly prescribed two units rather than one unit even when the estimated blood loss and pre-transfusion haemoglobin suggested that one unit would be sufficient.

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The risks of homologous serum jaundice transmissible via blood transfusion were noted in the 1951, 1956 and 1961 editions of Mollison's "Blood Transfusion in Clinical Medicine".

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Dr George Discombe's 1960 textbook highlighted the danger of hepatitis as one that "must never be forgotten when assessing the need for transfusion." He described the common use of blood transfusion for treating pre-operative anaemia as "inexcusable".

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