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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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A working party of the British Medical Association noted that there was a need for more teaching time on transfusion in the medical undergraduate curriculum and in formal postgraduate courses.

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Sir Kenneth Calman described that there had been several recent high profile healthcare issues which focused on the safety and availability of blood.

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Sir Kenneth Calman wrote that "good evidence" had been produced that "significant unnecessary blood transfusion" could be avoided

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Sir Kenneth Calman thought the Serious Hazards of Transfusion report "raised the profile of blood safety amongst clinicians and the public".

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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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