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The UK Chief Medical Officers together hosted a symposium at St Thomas' Hospital, London addressing how better blood transfusion might be encouraged and supported

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A Standing Advisory Committee on Transfusion Transmitted Infections covered the topics of virological safety of plasma and the epidemiology of Hepatitis C.

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The Serious Hazards of Transfusion scheme had been calling for a unified body with overall responsibility for blood safety since their 1998-99 report.

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The Royal College of Physicians identified that of the 50 hospitals audited in their "National Audit of the Clinical Blood Transfusion Process", 87% of them had Maximum Blood Ordering Schedules and in 71% of these, they were regularly reviewed.

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Overall, autologous transfusions were not available for patients throughout the UK during the 1970s and 1980s. From the 1990s such transfusions were only available in a minority of centres and even they often did not inform patients about the service.

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Though in 1994 fewer than 50% of the 380 hospitals in England and Wales had a hospital transfusion committee, by January 1998 the Royal College of Physicians published a "National Audit of the Clinical Blood Transfusion Process", which found that of 47 hospitals across the UK, 79% had an HTC and audits of transfusion practice had been undertaken at 65% of those.

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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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