Guidance for healthcare practitioners

A patient should give valid consent before receiving a transfusion of blood components. Obtaining consent for any procedure involves discussing the benefits, risks and any available alternatives with the patient (or person with parental responsibilities, if applicable).

The Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) guidelines on Patient Consent and Shared Decision-Making for Blood Transfusion, published in 2025, stipulate what information must be given to a patient who may be exposed to blood transfusion to help them make an informed decision. A summary of the recommendations made in these guidelines can be found on the SaBTO report page of the Department of Health and Social Care (DHSC) website.

The 2024 Infected Blood Inquiry (IBI) report detailed the serious harm blood transfusion has caused in the past, and the lasting impact this had on patients and their families. This underlines the importance of a full, open and honest discussion prior to transfusion. More information about the IBI can be be found on the Infected Blood Inquiry page of this website.

Healthcare practitioners obtaining consent for transfusion must be appropriately trained to do so. For more information, see Training for consent for transfusion.

Key requirements in consent for transfusion

Shared decision making

Ensure shared decision-making discussion with the patient (or parent, guardian or advocate, if applicable) takes place wherever possible, and that this is documented in the patient’s clinical record.

Patients who have been given a blood transfusion and were not able to give informed nd valid consent prior to the transfusion must be informed of the transfusion prior to discharge.

Discharge summary

Patients who receive a transfusion should have the details (including any related adverse events) clearly documented in their hospital discharge summary, ensuring both the patient and their family doctor or GP are aware.

Discussion of appropriate alternatives

Transfusion should be considered when there is no appropriate alternative, and the benefit for the transfusion outweighs the risks. Many patients can safely tolerate not having a transfusion.

Having an informed consent discussion

The following is a generic checklist covering the SaBTO guidance recommendations. You will need to tailor your discussion to cover what is important to your individual patient.

Download a printable version of the consent checklist (PDF 264KB).

Important

Before going on to authorise blood components, check whether the patient has any specific transfusion requirements.

▢ Benefits

Red cells

  • Relieve symptoms of anaemia
  • Prevent complications of anaemia (tissue ischaemia, organ damage)
  • Earlier mobilisation/ quicker recovery after illness or surgery

Platelets and plasma

  • Stop or prevent bleeding

▢ Risks

(and actual or potential consequences; consider materiality of these risks to your patient)

▢ Alternatives

(as relevant/appropriate to the clinical situation)

Red cells

  • Iron therapy (oral/IV)
  • Other haematinic replacement (vitamin B12, folate)
  • Erythropoietin
  • Cell salvage (surgery)

Plasma

  • Factor concentrates, if applicable

Platelets

  • Tranexamic acid

▢ Informed patient

Give the patient written information, with sufficient time to read and consider it, and an opportunity to ask questions. If written information is not available then provide verbal information.

There may be particular considerations to take into account for specific patient groups, such as paediatrics, multi-transfused etc.

▢ Consent (or refusal)

Document your discussion and the outcome in the patient’s care records. If the patient is refusing the proposed treatment (transfusion), try to explore why this is and contact a transfusion expert if required.

Make sure the patient understands the possible consequences of not having a transfusion, and ensure any Advanced Directive is applicable and valid.

For more detailed information about the risks of transfusion which may not necessarily need to be part of your consent discussion, please see Serious Hazards of Transfusion (SHOT) reports with cases, figures and supplementary information.

All staff involved in consent for transfusion have a duty to give honest and accurate information, and to answer patients' concerns in full.

For further information and guidance on consent for transfusion, contact your local transfusion team or see NHS Blood Assist website.

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