Public Inquiry Recommendations

AC-1a Accepted

Infected Blood Inquiry (2025)

Open Registration

The scheme be opened to registration to everyone who may be eligible.

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

AC-1b Accepted

Infected Blood Inquiry (2025)

Registration and Application Forms

There be forms (devised by IBCA) for people to register and apply for a core award and the supplementary awards with/without the necessary evidence and with/without calculation of compensation, and …

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

AC-1c Accepted

Infected Blood Inquiry (2025)

Legal Support Signposting

IBCA include a prominent reference to the availability of legal support paid by IBCA on all registration and application forms and in public information about the compensation scheme and that …

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

AC-1d Accepted

Infected Blood Inquiry (2025)

Three-Cohort Prioritisation

When IBCA opens up the service beyond people infected and registered with the support schemes, IBCA: (i) update the sequencing to three cohorts, people infected and never compensated, the deceased …

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

AC-1e Accepted

Infected Blood Inquiry (2025)

Oral Representations at Review

IBCA consider making provision, either generally or in specific cases, for oral representations to be made where a decision is reviewed internally, and for the individual concerned and/or their lawyer …

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

AC-1f Accepted

Infected Blood Inquiry (2025)

Written Reasons for Decisions

Written reasons for the original decision must be provided so that the review process can operate fairly.

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

AC-2a Accepted

Infected Blood Inquiry (2025)

Publish Guidance and Board Minutes

IBCA should publish: guidance, advice or instructions to claim managers; work undertaken by IBCA with the Cabinet Office's policy team to ensure that IBCA understands "in depth the policy intent …

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

AC-2b Accepted

Infected Blood Inquiry (2025)

Share Clinical Assessor Advice

In respect of any case in which the advice of a clinical assessor has been given, in relation to the person concerned (and no more widely except with the consent …

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

AC-2c Accepted

Infected Blood Inquiry (2025)

Community Advisory Body

A formal role be given within IBCA for an advisory body consisting of people infected and affected, covering a range of experience broadly representative of those groups, and (if those …

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

AC-2d Accepted

Infected Blood Inquiry (2025)

Structured Response to Community Input

To build confidence that IBCA is actively listening to people infected and affected, IBCA adopt more of a structured response to contributions from people infected and affected. Consideration should be …

- The Government stated in July 2025 that further detail on IBCA delivery recommendations would be set out by IBCA in due course (Infected Blood …

IBI-A-2e Accepted

Infected Blood Inquiry (2025)

Transparency of Scheme Design

The Government and IBCA establish a mechanism by which individuals or organisations may raise concerns which arise about any aspect of the scheme which from time to time is troubling …

- The Government stated in July 2025 that it would establish a mechanism allowing people and organisations to raise concerns about the compensation scheme and …

IBI-A-3a Accepted

Infected Blood Inquiry (2025)

HIV Eligibility Start Date

An amendment to the Regulations be made as soon as possible to remove the reference to 1 January 1982 from Regulation 3.

- The Government stated in July 2025 that it accepted this recommendation and would remove the 1 January 1982 start date for HIV eligibility, meaning …

IBI-A-4a Accepted in Part

Infected Blood Inquiry (2025)

Interferon Treatment Impacts

People infected with Hepatitis B or C who have received a course of treatment with or based on interferon should be recognised as entitled to core awards at Level 3.

- The Government stated in July 2025 that it accepted this recommendation in principle and proposed introducing a new severity band "Level 2B" for interferon …

IBI-A-4b Accepted in Part

Infected Blood Inquiry (2025)

Special Category Mechanism

The Government reconsider whether to maintain its rejection in February 2025 of the recommendations of Sir Robert Francis KC and advice from the Infected Blood Inquiry Response Expert Group of …

- The Government stated in July 2025 that it accepted this recommendation in principle, that the Severe Health Condition award would recognise impacts equivalent to …

IBI-A-4c Accepted

Infected Blood Inquiry (2025)

Effective Treatment - Earnings Floor

For the calculation of Financial Loss awards for Hepatitis B, people born after 1953 should be treated like those born in or before 1953 on provision of evidence that their …

- The Government stated in July 2025 that it accepted this recommendation and would remove the earnings floor on the Supplementary Route Exceptional Loss award, …

IBI-A-4d Accepted

Infected Blood Inquiry (2025)

Deeming of Severity Bands

Where the level of severity of a person's infection at Level 3 or more has been established to IBCA's satisfaction in relation to a given year, but it is not …

- The Government stated in July 2025 that it accepted this recommendation and would amend regulations so those with a Level 4 Hepatitis diagnosis who …

IBI-A-4e Accepted

Infected Blood Inquiry (2025)

Evidence of Diagnosis Date

Regulation 14(2)(c) be amended to remove the requirement for evidence of the date of diagnosis of Hepatitis B or C. An appropriate redraft to achieve this would be: "where the …

- The Government stated in July 2025 that it accepted this recommendation and would remove the requirement for Hepatitis B or C patients to evidence …

IBI-A-5a Accepted in Part

Infected Blood Inquiry (2025)

Severe Psychological Harm

The approach of the Infected Blood Psychology Service is adopted so that both a diagnosis made by a psychiatric professional and a formulation-based opinion of all qualified psychological and counselling …

- The Government stated in July 2025 that it accepted this recommendation in principle and would consult on evidence requirements and thresholds for severe psychological …

IBI-A-6a Accepted in Part

Infected Blood Inquiry (2025)

Financial Loss and Care

"x" be removed from the equation set out in Regulation 7.

- The Government stated in July 2025 that it accepted this recommendation in principle and recognised the need for change regarding past care and financial …

IBI-A-6b Accepted in Part

Infected Blood Inquiry (2025)

Exceptional Loss Evidence

The Cabinet Office consult on whether the evidential requirements for exceptional reduced earnings are likely to prove a barrier to people who have sufficient evidence that their eligibility for such …

- The Government stated in July 2025 that it accepted this recommendation in principle and would consult on the evidential requirements for Exceptional Loss awards …

IBI-A-7a Accepted in Part

Infected Blood Inquiry (2025)

Unethical Research Award

Where there is evidence that an individual was the victim of unethical research practices IBCA should be authorised to make an unethical research practices award to that individual.

- The Government stated in July 2025 that it accepted this recommendation in principle and would consult on providing an award for unethical research victims …

IBI-A-7b Accepted in Part

Infected Blood Inquiry (2025)

Wider Definition of Unethical Research

When considering the evidence IBCA applies the wider definition of research explained in the Infected Blood Inquiry Additional Report chapter on Unethical Research.

- The Government stated in July 2025 that it accepted this recommendation in principle and would apply the wider definition of research as explained in …

IBI-A-7c Under Consideration

Infected Blood Inquiry (2025)

Unethical Research Award Amount Review

The Minister consider whether the £10,000 (£15,000 for Treloar's pupils) should in justice be increased and further decides what sum he considers accords most closely with the general public's sense …

- The Government stated in July 2025 that it would consider whether the unethical research practices award amounts (£10,000 standard, £15,000 for Treloar's pupils) should …

IBI-A-8a Accepted in Part

Infected Blood Inquiry (2025)

Supplementary Route for Affected Persons

The Minister give consideration to there being a supplementary route for people affected. This could include opening the supplemental award for severe psychological harm to people affected. He should involve …

- The Government stated in July 2025 that it accepted this recommendation in principle and would consult on the feasibility of implementing a supplementary route …

IBI-A-8b Accepted

Infected Blood Inquiry (2025)

Affected Estates

The Regulations be amended such that where someone who would be an eligible affected person dies between 21 May 2024 and 31 December 2029, their claim does not die with …

- The Government stated in July 2025 that it accepted this recommendation and that estates of affected persons who died after 21 May 2024 may …

IBI-A-9a Accepted

Infected Blood Inquiry (2025)

Bereaved Partner Support Scheme

The IBSS cut-off date of 31 March 2025 be reviewed, that the scheme should as soon as possible reinstate support payments to partners bereaved after 31 March 2025 until such …

- The Government stated in July 2025 that it accepted this recommendation, and that partners bereaved after 1 April 2025, whose partner received no compensation, …

IBI-1 Accepted Urgent

Infected Blood Inquiry (2024)

Compensation Scheme

My principal recommendation remains that a compensation scheme should be set up now

- The Victims and Prisoners Act 2024 Part 3 established the Infected Blood Compensation Authority and the infected blood compensation scheme (Victims and Prisoners Act …

IBI-2a Accepted

Infected Blood Inquiry (2024)

UK and Devolved Memorials

A permanent memorial be established in the UK and consideration be given to memorials in each of Northern Ireland, Wales and Scotland. The nature of the memorial(s), their design and …

- The Government stated in December 2024 that a steering committee would be established to oversee permanent memorial creation, with Terms of Reference and a …

IBI-2b Accepted

Infected Blood Inquiry (2024)

Treloar's School Memorial

A memorial be established at public expense, dedicated specifically to the children infected at Treloar’s school. The memorial should be such as is agreed with those who were pupils at …

- The Government stated in December 2024 that a memorial at Treloar's school would be established at public expense, as agreed with former pupils (Government …

IBI-2c Accepted

Infected Blood Inquiry (2024)

Community Support Events

There should be at least three events, approximately six months apart, drawing together those infected and affected, the nature and timing of which should be determined by a working party …

- The Government stated in December 2024 that community events would be facilitated with central funding (Government Response to the Infected Blood Inquiry, Cabinet Office, …

IBI-3a Accepted

Infected Blood Inquiry (2024)

Medical Education - Curriculum

The General Medical Council, and NHS Education for Scotland, Health Education and Improvement Wales, Northern Ireland Medical and Dental Training Agency and NHS England, should take steps to ensure that …

- The Government stated in December 2024 that a combined working group including NHS England, four-nation blood services, and statutory education bodies had been established …

IBI-3b Accepted

Infected Blood Inquiry (2024)

Medical Education - Training Materials

They should look favourably upon putting together a package of training materials, with excerpts from oral and written testimony, to underpin what can happen in healthcare, and must be avoided …

- The Government stated in December 2024 that a Patient Safety Syllabus would incorporate Inquiry testimony through case studies and workshops, and that four-nation statutory …

IBI-3c Accepted

Infected Blood Inquiry (2024)

Inquiry Website Preservation

The Inquiry website is maintained online

- The Government stated in December 2024 that the transfer of the Inquiry website to The National Archives was underway, and that options to maintain …

IBI-4a(i) Accepted

Infected Blood Inquiry (2024)

Duty of Candour - Northern Ireland

Duty of candour: A statutory duty of candour in healthcare should be introduced in Northern Ireland.

- The Northern Ireland Health Minister Mike Nesbitt committed to advance proposals for an organisational duty of candour, and to consider a statutory individual duty …

IBI-4a(ii) Accepted

Infected Blood Inquiry (2024)

Duty of Candour - Scotland and Wales Review

Duty of candour: The operation of the duties of candour in healthcare in Scotland and in Wales should be reviewed, as it is being in England, to assess how effective …

- The Scottish Government stated in December 2024 that the organisational duty of candour under the Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016 …

IBI-4a(iii) Accepted

Infected Blood Inquiry (2024)

Duty of Candour - England Review

Duty of candour: The review of the duty of candour currently under way in England should be completed as soon as practicable.

- The Government stated in December 2024 that the review of the statutory duty of candour in England had been completed, with findings published on …

IBI-4a(iv) Accepted in Part

Infected Blood Inquiry (2024)

Individual Duty of Candour for Leaders

Statutory duty of candour: The statutory duties of candour in England, Scotland, Wales (and Northern Ireland, when introduced) should be extended to cover those individuals in leadership positions in the …

- The Government stated in December 2024 that it had accepted this recommendation in principle and launched a 12-week consultation on regulating NHS managers in …

IBI-4a(v) Accepted in Part

Infected Blood Inquiry (2024)

Leadership Accountability for Safety

Statutory duty of candour: Individuals in leadership positions should be required by the terms of their appointment and by secondary legislation to record, consider and respond to any concern about …

- The Government stated in December 2024 that it accepted this recommendation in principle, referencing the Learn from Patient Safety Events service and the importance …

IBI-4b Accepted in Part

Infected Blood Inquiry (2024)

Organisational Culture Change

Cultural Change: That a culture of defensiveness, lack of openness, failure to be forthcoming, and being dismissive of concerns about patient safety be addressed both by taking the steps set …

- The Government stated in December 2024 that it accepted the recommendation in principle, and that leaders would be accountable for organisational culture through the …

IBI-4c(i) Accepted

Infected Blood Inquiry (2024)

Simplify External Regulation

Regulation: That external regulation of safety in healthcare be simplified. As a first step towards this, there should be a UK wide review by the four health departments of the …

- The Government's implementation dashboard records this recommendation as: Accepted in full by the UK Government and the Welsh Government. Accepted in principle by the …

IBI-4c(ii) Accepted

Infected Blood Inquiry (2024)

Safety Management Systems Coordination

Regulation: That the national healthcare administrations in England, Northern Ireland, Scotland and Wales explore, and if appropriate, support the development and implementation of safety management systems (“SMS”s) through SMS coordination …

- The Government's implementation dashboard records this recommendation as: Accepted in full by the UK Government and the Welsh Government. Accepted in principle by the …

IBI-4d Accepted

Infected Blood Inquiry (2024)

Patient Records Audit

Patient Records: Before the end of 2027 there should be a formal audit, publicly reported, of the extent of success of digitisation of patient records in each of the four …

- The Government's implementation dashboard records this recommendation as: Accepted in principle by the UK Government, Welsh Government and the Northern Ireland Executive. Accepted in …

IBI-4e Accepted

Infected Blood Inquiry (2024)

Cross-Administration Patient Safety Coordination

Coordination of patient records with devolved governments: Consideration should be given by the national healthcare administrations in England, Scotland, Wales and Northern Ireland, to further coordination of their approaches particularly …

- The Government stated in December 2024 that a working group had been established to improve patient safety coordination across the four nations, with an …

IBI-5a Accepted in Part

Infected Blood Inquiry (2024)

Civil Service Statutory Duty of Candour

The Government should reconsider whether, in the light of the facts revealed by this Inquiry, it is sufficient to continue to rely on the current non-statutory duties in the Civil …

- The Government stated in December 2024 that the Prime Minister had committed to legislation introducing a statutory duty of candour for public authorities and …

IBI-5b Accepted in Part

Infected Blood Inquiry (2024)

Monitoring Non-Statutory Duties

If, on review, the Government considers that it is sufficient to rely on the current non-statutory duties in the Civil Service Code, it should nonetheless introduce a statutory duty of …

- The Government stated in December 2024 that it accepted this recommendation in principle and was considering the extent of statutory duties for senior civil …

IBI-5c Accepted in Part

Infected Blood Inquiry (2024)

Ministerial Duty of Candour

The Government should consider the extent to which Ministers should be subject to a duty beyond their current duty to Parliament under the Ministerial Code.

- The Government stated in December 2024 that it would consider the extent to which Ministers should be subject to a duty beyond the Ministerial …

IBI-6a(i) Accepted

Infected Blood Inquiry (2024)

Hepatologist Oversight and Fibroscan Access

All patients who have contracted hepatitis via a blood transfusion or blood products should receive the following care: Those who have been diagnosed with cirrhosis at any point should receive …

- The Government's implementation dashboard records this recommendation as: Accepted in full by the UK Government, the Scottish Government and the Welsh Government. Accepted in …

IBI-6a(ii) Accepted in Part

Infected Blood Inquiry (2024)

Specialist Hepatology Centre Access

All patients who have contracted hepatitis via a blood transfusion or blood products should receive the following care: Those who have fibrosis should receive the same care

- The Government's implementation dashboard records this recommendation as: Accepted in principle by the UK Government, the Welsh Government, the Scottish Government, and the Northern …

IBI-6a(iii) Accepted

Infected Blood Inquiry (2024)

Uncertainty About Fibrosis

All patients who have contracted hepatitis via a blood transfusion or blood products should receive the following care: Where there is any uncertainty about whether a patient has fibrosis they …

- The Government's implementation dashboard records this recommendation as: Accepted in full by the UK Government, the Scottish Government and the Welsh Government. Accepted in …

IBI-6a(iv) Accepted

Infected Blood Inquiry (2024)

Fibroscan for Liver Imaging

All patients who have contracted hepatitis via a blood transfusion or blood products should receive the following care: Fibroscan technology should be used for liver imaging, rather than alternatives

- The Government's implementation dashboard records this recommendation as: Accepted in full by the UK Government, the Scottish Government and the Welsh Government. Accepted in …