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Patients who had given autologous blood pre-operatively were found to be more likely to require per-operative transfusion because they arrived at surgery more anaemic than if they had not donated blood.

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Uptake on autologous blood transfusion was not high as the practice was of very limited benefit to the patient, and it was discontinued in the 1990s.

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Audits on blood use often resulted in a fall in blood component usage.

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At the Freeman Hospital in Newcastle, the role of transfusion nurses was introduced and one of their roles was to investigate reports of adverse reactions to blood transfusions.

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HTCs were multi-disciplinary committees which sought to draw together different medical specialities to improve transfusion standards, discuss national and local guidelines and audits.

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SHOT was a model for haemovigilance organisations worldwide.

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In his written evidence to the Inquiry, Dr Jonathan Wallis noted that although there has been a considerable reduction in the use of red blood cells in the last 25 years, there is still considerable work to be done as 20-30% of transfusions in major specialisms are currently given outside the national guidance.

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Dr Gillon carried out a controlled clinical trial of autologous cell salvage in cardiac surgery in Scotland and was the Chairman of the Working Party on Autologous Transfusion in the mid 1990s.

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Only 133 patients had been referred for autologous cell salvage in Scotland, resulting in 90 patients donating 171 units of blood for their own use by 1996. Although the number of referrals briefly doubled in 1997 due to clinical referrals, demand for the services became low and the autologous transfusion service was reduced to a single provider in Scotland.

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Red cell salvage became more widely available. A study of intraoperative cell salvage in cardiac surgery at The Edinburgh Royal Infirmary found the procedure was shown to be feasible and safe and it became an accepted part of surgical practice.

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Senior individuals working in the transfusion services focused on the issue of blood transfusion after the establishment of the Consumer Protection Act 1987 and the introduction of the European Directive on blood.

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In his written evidence to the Inquiry, Professor Michael Murphy noted that "best transfusion practice" meant that a transfusion should only occur when the benefits outweigh the risks, and that alternatives should be considered and used where appropriate.

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The NHS Executive funded a national audit initiative relating to two blood transfusion protocols.

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Red cell salvage was not widely available or commonly used in the 1970s to 1990s as it specialist equipment and knowledge.

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The first meeting of the NBTC took place.

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SHOT published its first report covering 1996-97, which noted that 8 out of 169 reported serious hazards involved a viral or bacterial infection.

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The National Blood Transfusion Committee produced an online toolkit to implement the Better Blood Transfusion initiative.

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Although progress had also been made in relation to the Better Blood Transfusion Initiative, further progress was required for the training of staff, the development of hospital transfusion teams, the development of protocols for the appropriate use of blood, the provision of information to patients and intra-operative cell salvage.

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A Department of Health circular set out the Better Blood Transfusion Action Plan, and anticipated progress in all areas by the time of the first audit of compliance was to be undertaken.

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In Electronic identification systems reduce the number of wrong components transfused, it was noted that the implementation of electronic transfusions systems in the UK was patchy.

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