Policy

Below are the national and international policy initiatives and changes that we contribute evidence to:

For the Assessment of Individual Risk (FAIR) Project

The FAIR (For the Assessment of Individual Risk) project is a unique collaboration of epidemiological and behavioural sciences. It is chaired by Professor Susan Brailsford and supported by her team at NHSBT and UKHSA (Katy Davison, Claire Reynolds). Professor Brailsford’s team provides the epidemiological input and analyses, and we have led the behavioural science arm. These approaches were complementary, and the evidence was triangulated to give strong correspondence of evidence. The FAIR project is focused on increasing equality, diversity and inclusion in blood and organ donation/transfusion/transplantation. FAIR started in 2018. Three FAIR initiatives have been completed (FAIR I, II & III), and FAIR IV is underway. Each of these FAIR projects is described below.

FAIR I

FAIR 1 was set up in 2018 by the four UK Blood Services at the request of the Health Minister at the time and had the specific focus of exploring if all donors could be assessed on their individual risk linked to sexual behaviour. Before this, men who had sex with men (MSM) were unable to donate blood unless they had abstained from sexual behaviour for 3 months. We presented our recommendations to the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) in September 2020, which approved the policy change. This policy change was given ministerial approval and officially accepted by the Department of Health and Social Care in December 2020. It was implemented across the UK in June 2021. Now, all blood donors in the UK are selected on the grounds of their sexual behaviour and not their sexuality. Since the UK changed its policy, over 30 other countries have followed suit (e.g., USA, Canada)

The FAIR 1 Steering Group And Organizations: Naim Akhtar: NHSBT; Su Brailsford, Chair NHSBT; Katy Davison, Deputy Chair NHSBT/UKHSA Epidemiology Unit; Claire Reynolds NHSBT/UKHSA Epidemiology Unit; Eamonn Ferguson, University of Nottingham; Luke Foster, NHSBT; Joe Flannagan. Secretariat, NHSBT/UKHSA Epidemiology Unit; Stuart Blackmore, Welsh Blood Service; Angus Wells, Standing Advisory Committee on the Care and Selection of Donors (SACCSD); Josh Bradlow, Stonewall, Dan Costen, Freedom to Donate; Gareth Humphreys, NHSBT: Kat Davies, NHSBT: Stephen Bailey, NHSBT; Heli Harvala, NHSBT: Kat Smithson (previously Natasha Dhumma), National AIDS Trust; Paul Harvey, Donor representative; Gemma Room, Patient representative; Roanna Maharaj, Patient representative UK Thalassaemia Society; Michael Brady, Terrence Higgins Trust; Deborah McNaughton, Scottish National Blood Transfusion Service; Kathryn Maguire, Northern Ireland Blood Transfusion Service.

Conversation Article on FAIR I: https://theconversation.com/why-blood-donation-rules-have-finally-been-relaxed-for-gay-and-bisexual-men-152113

Full FAIR 1 report: The full PDF of the report is available at https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/21001/fair_sabto_20201211.pdf

Podcast on FIAR work at Nottingham: https://www.buzzsprout.com/1870242/episodes/10875984-what-s-fair-in-blood-donation-w-eamonn-ferguson?t=0

Policy Award Video: https://x.com/UoN_Institute/status/1491753149106900999

FAIR II

Following FAIR I, FAIR II was instigated to change UK donor selection to make it fairer on the grounds of ethnicity. We provided the behaviour science lead. This work explored donor selection questions that discriminated against people from ethnic minority communities by differentially deferring people from minority communities from donating blood. Our work, funded by NHSBT, directly addressed this issue and contributed to the recommendation to remove a screening question that discriminated against people from ethnic minority communities. This recommendation was approved by SaBTO and implemented in October 2021.

Fair II Steering group: Naim Akhtar: NHSBT; Su Brailsford, Chair NHSBT; Mark Croucher NHSBT; Katy Davison, Deputy Chair NHSBT/UKHSA Epidemiology Unit; Claire Reynolds NHSBT/UKHSA Epidemiology Unit; Sian Edwards NHSBT; Eamonn Ferguson, University of Nottingham; Luke Foster, NHSBT; Stuart Blackmore, Welsh Blood Service; Gareth Humphreys, NHSBT: Kat Davies, NHSBT: Stephen Field ISBT; Heli Harvala, NHSBT: Paul Harvey, Donor representative; Roanna Maharaj, Recipient representative UK Thalassaemia Society; Lorna McLintock SNBTS; Ibrahim Magzoub, NIBTS; Dunstan Nicol-Wilson, Sickle Cell Society; Rachel Newton, NHSBT; Harriet Summerhayes NHSBT; Gemma Room, Recipient representative; Melissa Thermidor, NHSBT; Tali Yawitch – secretariat NHSBT

Full FAIR 2 report: The full PDF of the report is available at https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/26907/fair-ii-hrp-ssa.pdf

FAIR III

FAIR III looked at whether FAIR I principles could be applied to tissue and cell donors using the FAIR I evidence base with an option to carry out further work if required. The group agreed that the FAIR I data collected from blood donors and members of the wider general population could be mapped to living donors. It was recommended that for living tissue donors - surgical bone donors, the FAIR principles be implemented in full and for deceased organ donation.

FAIR III: Steering Group and Advisors:
Katy Davison (UKHSA); Sharon Zahra (NHS Scotland); Tali Yawitch (UKHSA); Akila Chandrasekar (NHSBT); Alasdair MacInnes (Department of Health, Northern Ireland); Angus Wells (NHSBT); Claire Reynolds (NHSBT); Dan Costen (Freedom to Donate); Danny Beales (National Aids Trust); Diana Comfort (Public Contributor); Eamonn Ferguson (University of Nottingham); Eirnin Jefford (Stonewall) ; Eloise Stonborough (Stonewall) Gordon, Lesley (Department of Health, Northern Ireland); Hannah Ward (National Aids Trust); Ines Ushiro-Lumb (NHSBT); James Griffin (NHSBT); John Richardson (NHSBT); Kalinga Perrira (NHS Wales); Kirstie Johnson (NHSBT) ; Kyle Bennett (NHSBT); Liz Redmond (Department of Health, Northern Ireland); Luke Foster (NHSBT) ; Lynn Manson (NHS Scotland); Michael Brady (NHS); Neil Healy (NHS Scotland); < Olive McGowan (NHSBT); Parkhill, Laura (Department of Health, Northern Ireland); Rachel Pawson (NHSBT); Richard Lomas (NHSBT); Sian Edwards (NHSBT); Sonia Beard (Public Contributor); Su Brailsford (NHSBT: Chair); Tamara Manuel (National Aids Trust); Ulrike Paulus (NHSBT); Leah Mclaughlin (University of Bangor); Jane Noyes (University of Bangor)

The Full FAIR III report: The full report can be found at: https://www.transfusionguidelines.org/document-library/documents/fair-iii-report-may-2022

FAIR III Changes Approved: he changes were approved by Ministers in September 2023 (https://hansard.parliament.uk/commons/2023-09-18/debates/23091814000016/TissueAndCellDonation#:~:text=This%20change%20will%20provide%20equity,the%20NHS%20Long%20Term%20Plan; and https://www.gov.wales/changes-cell-and-tissue-donation-be-introduced-wales)

FAIR IV

FAIR IV is currently underway and focuses on evaluating the impact of FAIR and in particular, explores issues associated with polyamory and U=U (Undetectable equals Untransmittable).

Other Policy Impacts and Initiatives

We also regularly contribute to wider policy initialise and strategies in the area of blood and organ donation. Some of the recent ones are listed below:

SaBTO Lookback Group

Eamonn Ferguson is a member of the SaBTO (The Advisory Committee on the Safety of Blood, Tissues and Organs) lookback group. SaBTO advises UK ministers and health departments on the most appropriate ways to ensure the safety of blood, cells, tissues and organs for transfusion/transplantation. This lookback group will examine previous policies and outcomes of donor selection for families, recipients and donors in light of the Infected Blood Inquiry (IBI). This SaBTO group has been set up at the request of the UK Department of Health and Social Care (DHSC).

Blood Donation in the EU: Exploring Behavioural Insights for Inoperative Interventions

This EU Insights report provides a literature review and an overview of the blood donation landscape in the EU as of 2023. This Science for Policy Report contributes to the debate on the importance of securing enough blood and blood products to maintain a functional healthcare system. It outlines recent progression in blood donation research, offering new perspectives on factors associated with blood donor motivations, intentions, and behaviour. It summarises the findings from social and behavioural sciences research agendas covering the blood donation field, including theoretical models and evidence on motivation that leads to blood donor intentions and behaviour. Additionally, it encompasses studies testing the effects of behavioural interventions to increase blood donations, such as reminders, active decision elicitation mechanisms, pledges to donate blood made public, and similar. Finally, it describes and reports on the current practices used in blood services across the EU 27.

Citation: Vuletić Čugalj, D., Ferguson, E., Baggio, M. and Bruns, H., Blood donation in the EU: exploring behavioural insights for innovative interventions, Publications Office of the European Union, Luxembourg, 2023, doi:10.2760/335203, JRC134207.

The full PDF of this report can be downloaded from the following link: https://publications.jrc.ec.europa.eu/repository/handle/JRC134207

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