Transfusion Committees and Tranexamic Acid - England
In England, Hospital Transfusion Committees and transfusion practitioners take steps to ensure that consideration of tranexamic acid be on every hospital surgical checklist; that hospital medical directors be required to report to their boards and the chief executive of their Trust as to the extent of its use; and that the board report annually to NHS England as to the percentage of eligible operations which have involved its use. If the percentage is below 80% or has dropped since the previous year, this report should be accompanied with an explanation for the failure to use more tranexamic acid and thereby reduce the risk to patient safety that comes with using a transfusion of blood or red blood cells.
- The Government stated in December 2024 that a four-nation working group had been established to consider an "opt out" approach requiring documented reasoning when tranexamic acid is not used in surgical checklists (Government Response to the Infected Blood Inquiry, Cabinet Office, December 2024).
- The Centre for Perioperative Care was being engaged for provider guidance, with communication activities to support implementation (Government Response to the Infected Blood Inquiry, Cabinet Office, December 2024).
- No published guidance mandating tranexamic acid on every hospital surgical checklist has been identified to March 2026.
How was this evidence gathered?
Response
Accepted in Part
Response
Accepted in PartUK’s governments
Recommendation 7 includes an especially complex set of sub recommendations. To ensure a joined up approach across the four nations, experts from across the four nations NHS bodies, blood services and external bodies such as the National Blood Transfusion Committee and Serious Hazards of Transfusion (SHOT) have formed a working group to take this forward carefully. Given this complexity, it is likely to take several years to fully work through these sub recommendations. Funding will also be required to implement these clinical policies, and this has not yet been identified.
Whilst we agree with the Inquiry’s recommendation for the increased use of tranexamic acid, further work is needed to ensure its safe and smooth implementation into patient care. The working group, with engagement from four nations stakeholders, is currently considering plans to increase use of tranexamic acid. Work is underway with professional bodies and specialists to consider provider guidance and give careful consideration to the needs of local organisations. Planning is underway for associated communications activities to support implementation with minimal disruption to patients.
Published Evidence
Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.
As of 13 January 2026: 3,721 people asked to start claims, 3,546 begun process, 3,074 received offers totalling £2.47bn, 2,861 paid totalling £1.89bn. Third compensation regulations in force 31 December 2025.
View detailed findings
IBCA exceeded initial expectations. Three sets of regulations now in force covering infected persons, affected persons, and supplementary routes. £11.8bn committed in October 2024 Budget. Independent review found "very creditable progress."