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Dr Rejman commented in his written statement that his understanding was that national implementation of Hepatitis C screening should be coordinated to avoid possible medico-legal complications in the future, which was a common view.

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Dr Gunson and others were working on a journal article reporting on the pilot study.

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Dr Perry identified a number of shortcomings in the decision-making process with regard to the introduction of routine testing.

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In his written statement to the Inquiry, Dr Lloyd stated that had he seen the ACVSB meeting notes of 21 November 1990, he might have considered starting testing at Newcastle RTC earlier than they did.

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Dr Lloyd described the "extended test" as a "face saving exercise".

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Dr Lloyd's evidence to the Inquiry was that running a trial on the more effective second-generation tests instead of starting general screening was illogical.

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In his written statement to the Inquiry, Dr Lloyd commented that the RIBA II assay "appeared to substantially remove the issue of lack of specificity. Once the RIBA II test was available, the lack of specificity with the first-generation test would have been much more manageable".

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Dr Gunson noted that Chiron had announced that it was working on a recombinant immunoblot assay confirmatory test, but that it was not yet available.

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Dr Barbara's written evidence to this Inquiry was that the second-round comparative evaluation of test kits needed to be completed and to gain more experience in confirmatory assays before reliable and more accurate and specific testing could begin with workable methods for determining the infection status of the donor.

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The Chief Medical Officer endorsed the recommendation that routine screening should be introduced as a public health measure.

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A draft circular on changes to blood handling charges circulated to recipients in the Department of Health stated: "Ministers have agreed that screening for HCV should be introduced as a public health measure. A starting date of 1 July has been set".

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Dr Harrison was supportive of the coordinated national start date.

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Dr Gunson wrote to Graham Hart, then director of operations of the NHS Management Board in the Department of Health, outlining the development of the Chiron/Ortho test.

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Following a meeting of ACVSB, Dr Metters wrote to Dr Rejman, outlining that it would be far more difficult to demonstrate the practical benefits from the introduction of the Chiron test.

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Dr Metters wrote to Mike Malone-Lee outlining prior warning of the likely cost if the ACVSB were to recommend introducing Hepatitis C screening for all blood donations.

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According to John Canavan, the suggestion that assessment of the relative merits of the two tests could have been undertaken concurrently with the implementation of the screening would have raised significant operational considerations for the RTCs in terms of staffing, equipment and donor counselling arrangements.

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The Glasgow RTC, the largest in Scotland, was evaluating the Abbott test.

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Dr Gunson estimated that the annual costs of routine anti-HCV tests on blood donations in England and Wales would amount to (at least) £5,620,000.

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Dr Gunson followed up on the £25,000 grant of funding by writing to Dr Kennedy at the NHS Procurement Directorate submitting a draft protocol for a pilot study in Birmingham, Sheffield and Brentwood.

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Dr Metters wrote a briefing for the Chief Medical Officer, Sir Donald Acheson, informing him of the ACVSB's recommendations and the funding (an estimated £150,000) that would be required for the pilot study.

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