Consent for Blood Transfusion

Audits presented to SaBTO have identified that the practice of obtaining any form of valid consent for the transfusion of blood components is highly variable in the UK.

The following issues were identified:

• Patients are not always given information on the risks, benefits, and alternatives to transfusion, or the right to refuse transfusion
• Patients are not always made aware that they have received a transfusion
• Patients who are unaware that they have received a transfusion may go on to donate blood when they should not
• There is inconsistent practice across the UK.

In March 2010 SaBTO initiated a public consultation on patient consent for blood transfusion. The purpose was to consult widely on the options for undertaking consent for blood component transfusion and the potential operational challenges if documented consent were to be mandated.

The consultation had the following key objectives:

• Identify the preferred option for recording consent
• Explore the potential operational impact of implementing a standardised form of consent for transfusion
• Confirm what type of information patients should receive.

This consultation process resulted in 14 SaBTO recommendations for consent for component blood transfusion:

1. Valid consent for blood transfusion should be obtained and documented in the patient's clinical record by the healthcare professional.
2. There should be a modified form of consent for long term multi-transfused patients, details of which should be explicit in an organisation's consent policy.
3. There should be a standardised information resource for clinicians indicating the key issues to be discussed by the healthcare professional when obtaining valid consent from a patient for a blood transfusion.
4. The consent standard developed by Health Improvement Scotland (formerly NHS Quality Improvement Scotland) should be adopted throughout the UK for consent for blood transfusion.
5. The Care Quality Commission (CQC), NHS Litigation Authority (NHSLA) and equivalent organisations in the Devolved Administrations will be made aware by SaBTO of this consent standard for blood transfusion.
6. A UK comparative audit of consent for transfusion should be carried out, facilitated by the National Comparative Audit of Blood Transfusion (a collaborative between the Royal College of Physicians and NHS Blood and Transplant).
7. Depending on the role envisaged for Healthwatch, the potential role of patient groups in providing an active oversight should be explored.
8. There should be a standardised source of information for patients who may receive a transfusion in the UK.
9. Patients who have received a blood transfusion and who were not able to give valid consent prior to the transfusion should be provided with information retrospectively.
10. SaBTO consent working group should produce good practice guidance to help identify the most effective way of providing information retrospectively when patients were unable to give prior consent.
11. UK Blood Services should have an ongoing programme for educating patients and the public about blood transfusion as part of their respective 'Better Blood Transfusion' strategies.
12. Use of the LearnBloodTransfusion e-learning package should be promoted by the UK Blood Services and Royal Colleges for all staff involved in the blood transfusion process.
13. The UK Better Blood Transfusion Network should explore the feasibility of developing a new module specific to consent and blood transfusion as part of its 2012/13 work plan.
14. Completion of the LearnBloodTransfusion e-learning package should be included in all undergraduate curricula. Reference to consent for blood transfusion should be included in the undergraduate curriculum as part of the learning objectives outlined for the principles of consent.

A SaBTO approved action plan to support the delivery of these recommendations is available here.

The full report of this SaBTO consultation process is available on the Department of Health website.