23 May 2024

Infected Blood Inquiry (Final Report) – BOA Statement

The Final Report of the Inquiry is rightly critical of the attitudes and practice within the NHS and government and the BOA is sorry for the suffering and distress of all those affected.

Much has changed in trauma and orthopaedic surgery in the time since the failings first came to light. There is now much improved pre-operative optimisation and treatment of patients who have anaemia, extensive use of tranexamic acid to reduce blood loss, improved surgical techniques to minimise peri-operative blood loss, improved cell salvage and a better understanding of low haemoglobin tolerance - all of which have dramatically reduced the need for blood transfusion.

Along with these advances, the threshold for transfusion is now higher in all types of orthopaedic surgery, however transfusions are sometimes necessary and can (and do) save lives. The NHS Blood and Transplant service now screens blood for infectious diseases (HIV 1 & 2, Hepatitis C, Hepatitis B, Hepatitis E, Syphilis, HTLV I/II and others) and cross matches for each individual patient. We must ensure that the risks and benefits are properly understood by patients as well as the surgical team so that any transfusion is undertaken with appropriate consent and care.

The BOA will immediately review the standards and guidance that inform best practice in accordance with the Inquiry recommendations and will be seeking to work with patient organisations, other professional bodies (such as the BOA’s affiliated Specialist Societies, the Royal Colleges of Surgeons and Anaesthetists) and with the wider NHS. We will ensure that the best practice of our members and the trauma and orthopaedic community is not compromised, and that our surgeons remain vigilant advocates for their patients.