The Department has taken a number of measures to ensure the most appropriate use of blood, and to encourage the national health service to use less blood. Some of the key measures are set out as follows.
In 1998, the Chief Medical Officer (CMO) launched the Better Blood Transfusion initiative to promote and encouraged better/appropriate use of blood and alternatives to transfusion.
In July 2002, Health Service Circular (HSC) 2002/009 “Better Blood Transfusion—Appropriate Use of Blood” was issued. This has been placed in the Library and is available at:
This circular asked NHS trusts and primary care trusts to review and explore the use of effective alternatives to donor blood, and also using the patients own blood.
The CMO’s National Blood Transfusion Committee was established in 2002 to advise hospitals and the National Blood Service on best practice and performance monitoring, improving the safety and appropriateness of blood transfusion practice, listening to and informing patient concerns and promoting high quality and consistent transfusion practice.
The Department and the United Kingdom blood services produced a toolkit for practitioners on better blood transfusion, safe practice, appropriate use, education and training, and monitoring and traceability. The toolkit, which is available at www.transfusion guidelines.org.uk/, aims to help NHS trusts to make the most appropriate use of blood and its alternatives where possible.
A seminar was held on 16 March 2007 to discuss progress and identify ways to maintain or improve the safe and appropriate use of blood over the next three to five years. An HSC will be issued to the NHS on the outcomes.
The type of treatment offered to patients is a matter of individual clinical judgment and discussion with the patient concerned.
The National Institute for Health and Clinical Excellence is currently appraising erythropoietin for the treatment of anaemia induced by cancer treatment and expects to publish final guidance to the national health service in November 2007.
Patients have the right to refuse a blood transfusion and this will be respected. However, before refusing a blood transfusion, patients need to fully understand the consequences of doing so. Information is available at www.transfusion guidelines.org.uk/ on alternatives to blood transfusion.