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The Secretary of State for Health, being a Minister designated[1] for the purposes of section 2(2) of the European Communities Act 1972[2] in relation to health protection measures regulating the use of material of human origin, in exercise of the powers conferred on him by the said section 2(2) and, with the consent of the Treasury, of the powers conferred by section 56(1) and (2) of the Finance Act 1973[3], hereby makes the following Regulations: - Citation, commencement and interpretation 1. - (1) These Regulations may be cited as the Blood Safety and Quality Regulations 2005. (2) Except for regulation 25(1), which shall come into force on 8th November 2005, these Regulations shall come into force on 8th February 2005. (3) In these Regulations -
(b) a Health Board or Special Health Board established under the National Health Service (Scotland) Act 1978, (c) a Health and Social Services Board established under the Health and Personal Social Services (Northern Ireland) Order 1972[10], (d) a special health and social services agency established under the Health and Personal Social Services (Special Agencies) (Northern Ireland) Order 1990[11], (e) the Common Services Agency for the Scottish Health Service established under the National Health Service (Scotland) Act 1978, (f) the Northern Ireland Central Services Agency for the Health and Social Services established under the Health and Personal Social Services (Northern Ireland) Order 1972, (g) a National Health Service trust established under the National Health Service and Community Care Act 1990[12], or the National Health Service (Scotland) Act 1978, (h) an NHS foundation trust within the meaning of section 1(1) of the Health and Social Care (Community Health and Standards) Act 2003[13], or (i) a Health and Social Services trust established under the Health and Personal Social Services (Northern Ireland) Order 1991[14];
(b) in the case of an independent hospital, the registered person;
(b) a nurse, or (c) a donor carer;
Designation of the competent authority and scope of the Regulations
(b) the processing, storage and distribution of blood and blood components when they are intended to be used for transfusion.
(3) The restriction in paragraph (1) shall not apply to -
(b) any person carrying out any of the activities referred to in paragraph (2), where that person carries out that activity on behalf of, and pursuant to a contractual arrangement with -
(ii) a person responsible for management of a hospital blood bank.
Authorisation of a blood establishment
(b) be accompanied by a fee of the amount prescribed in regulation 22(2)(a).
(4) The information referred to in paragraph (4) is -
(ii) a description of the activities which it wishes to carry out at each site, (iii) where it has or intends to enter into a contractual arrangement with any person to carry out any of the services in respect or which it is seeking authorisation, the name and address of that person and of the services which he will carry out, (iv) the name, qualifications and contact details of the responsible person for the establishment, (v) the list of hospital blood banks which it supplies; and
(b) a description of the quality system in place at each site for each activity in respect of which the application for authorisation is made, which shall include the following information -
(ii) documentation, such as a site master file or quality manual, describing the quality system and explaining how it meets the requirements of Part 5 of the Schedule, (iii) details of the number and qualifications of personnel, (iv) details of hygiene provisions, (v) details of premises and equipment, and (vi) a list of standard operating procedures for -
(bb) processing, testing, distribution and recall of blood and blood components, and (cc) the reporting and recording of serious adverse reactions and events.
(5) The Secretary of State may -
(b) grant such application -
(ii) subject to conditions.
(6) Where the Secretary of State grants an application for authorisation, he shall give notice in writing to the blood establishment specifying -
(b) the conditions which apply to the undertaking of those activities.
(7) Subject to the requirements of paragraph (8), the Secretary of State may at any time remove or vary any of the conditions referred to in paragraph (5)(b)(ii), or may impose additional conditions.
(b) give the reasons for his decision; and (c) specify the date, which shall be not less than 14 days from the date on which the notice is served, from which the removal or variation of any condition, or the imposition of any additional condition shall apply.
(9) A blood establishment may not make any substantial change in the activities which it undertakes without the prior written approval of the Secretary of State.
(b) which would result in breach of these regulations or of any condition specified by the Secretary of State pursuant to this regulation; or (c) to the quality system which is likely to have a substantial impact on the conduct of, or might compromise the safety of, any of the activities which the blood establishment has been authorised to undertake pursuant to this regulation.
Suspension or revocation of authorisation
(b) that the collection, testing, processing, storage or distribution of blood or blood components by the establishment cannot be carried out safely; (c) that any blood or blood components cannot be supplied to hospital blood banks in such a state that they could be safely administered for transfusion; or (d) that the information given by the blood establishment pursuant to regulation 4(3) was false or incomplete in any material respect.
(2) Subject to paragraph (3), before suspending or revoking the authorisation of a blood establishment, the Secretary of State shall serve a notice on the blood establishment stating that he intends to suspend or revoke its authorisation with effect from the date specified in the notice, which date shall be not less than 7 days from the date on which the notice is served.
(b) the information given by the blood establishment pursuant to regulation 4(4) was false or incomplete in any material respect,
and the Secretary of State considers that the failure in question is not sufficiently serious to warrant suspension or revocation of the authorisation of the blood establishment in the first instance, he may serve a notice on the responsible person of the blood establishment in accordance with paragraph (5).
(b) identify the action which the blood establishment is required to take; and (c) give the timescale within which the blood establishment shall take the action identified in sub-paragraph (b).
(6) If the blood establishment fails to comply with the requirements set out in the notice within the specified timescale, the Secretary of State may, by a notice served on the blood establishment, suspend or revoke the authorisation of the blood establishment.
(b) in all other cases, from a date specified in the notice.
(8) Any suspension pursuant to paragraphs (1) or (6) shall be for such period as the Secretary of State shall consider necessary having regard to the reasons for the suspension.
(b) ensuring that every unit of blood or blood components intended for transfusion has been processed, stored and distributed in accordance with the requirements of these Regulations; (c) providing information to the Secretary of State relating to the authorisation of the blood establishment for the purposes of regulation 4; and (d) the implementation in the blood establishment of the requirements of regulations 7, 8 and 14.
(2) A blood establishment shall not designate a person under paragraph (1) unless that person has -
(ii) a course recognised as an equivalent course by the Secretary of State; and
(b) practical post-graduate experience in areas of work relevant to the responsibilities of the responsible person under these Regulations for at least 2 years, in an establishment (or more than one establishment) authorised in any Member State in to undertake activities related to the collection or testing (or both) of blood and blood components, or to their preparation, storage and distribution.
(3) The Secretary of State shall from time to time publish details of courses recognised by him for the purpose of paragraph (2)(a)(ii).
(b) appoint a new responsible person in his place; and (c) notify the Secretary of State that it has appointed a new responsible person and provide details of the name and qualifications of the person appointed.
Blood establishment requirements
(b) establish and maintain a quality system for blood establishments based on the principles of good practice; (c) ensure that all testing and processes of the blood establishment which are referred to in Parts 2 to 5 of the Schedule are validated; (d) maintain documentation on operational procedures, guidelines, training and reference manuals and reporting forms so that they are readily available for inspection under regulation 15; (e) notify the Secretary of State of -
(ii) any serious adverse reactions observed during or after transfusion which may be attributable to the quality or safety of blood or blood components collected, tested, processed, stored or distributed by the blood establishment; and
(f) establish and maintain a procedure, which is accurate, efficient and verifiable, for the withdrawal from distribution of blood or blood components associated with any notification referred to in paragraph (e).
(2) A blood establishment shall, in relation to the donation of blood -
(b) obtain from all persons who are willing to provide blood or blood components, information in accordance with Part B of Part 2 of the Schedule; (c) put and keep in place procedures for the evaluation of donors; (d) apply eligibility criteria for all donors of blood and blood components in accordance with Part 3 of the Schedule; (e) maintain records of the results of donor evaluations and report to donors any relevant abnormal findings from the evaluations; (f) ensure that -
(ii) a qualified health professional is responsible for giving to and gathering from donors the information which is necessary to assess their eligibility to donate, and (iii) on the basis of that information, a qualified health professional assesses the eligibility of all donors to donate; and
(g) encourage voluntary and unpaid blood donations with a view to ensuring that blood and blood components are, in so far as possible, provided from such donations, in particular, by -
(ii) advertising for blood donors.
(3) A blood establishment shall ensure that, in relation to the blood and blood components which it collects, processes, stores or distributes -
(ii) any additional tests which may be necessary for specific components, types of donors or epidemiological situations;
(b) the storage, transport and distribution conditions of blood and blood components comply with the requirements of Part 4 of the Schedule; and
(4) A blood establishment shall, in relation to the activities specified in regulation 3(2) for which it is responsible, maintain records, for a minimum period of 15 years, of -
(b) the conduct of the tests referred to in paragraph (3)(a).
(5) The information specified in this paragraph is -
(b) the total number of donations; (c) an updated list of the hospital blood banks which it supplies; (d) the total number of whole donations not used; (e) the number of each component produced and distributed; (f) the incidence and prevalence of transfusion transmissible infectious markers in donors of blood and blood components; (g) the number of product recalls; and (h) the number of serious adverse events and serious reactions reported;
(6) The information specified in this paragraph is -
(b) information obtained from donors by the blood establishment in accordance with paragraph (2)(b); and (c) information relating to the suitability of blood and plasma donors in accordance with the eligibility criteria specified in Part 3 of the Schedule.
(7) The basic testing requirements with which blood establishments must ensure compliance pursuant to paragraph (3)(a)(i) are -
(b) testing to establish Rh D Group, except in respect of plasma intended only for fractionation; and (c) testing for the following infections of donors -
(ii) Hepatitis C (Anti-HCV); (iii) HIV 1 and 2 (Anti-HIV 1 and 2).
(8) The Secretary of State may issue guidance as to the additional tests referred to in paragraph (3)(a)(ii) which are necessary in relation to specific components, types of donor or epidemiological situations and blood establishments shall have regard to such guidance.
(b) details of the steps it has taken during that year to comply with paragraph (2)(g).
Labelling of blood and blood components and traceability
(b) the volume or weight or number of cells in the component, as appropriate; (c) a unique numeric or alphanumeric donation indication; (d) the name of the producing blood establishment; (e) the ABO Group, except in the case of plasma intended only for fractionation; (f) the Rh D Group, either Rh D positive or Rh D negative, except in the case of plasma intended only for fractionation; (g) the date or time of expiry, as appropriate; (h) the temperature of storage; (i) the name, composition and volume of any anticoagulant and any additive solution.
(2) A blood establishment shall keep such records of the information referred to in paragraph (1) above and such additional records as are necessary -
(b) to ensure full traceability to the point of delivery to a hospital,
for a period of not less than 30 years.
(b) establish and maintain a quality system for the hospital blood bank which is based on the principles of good practice; (c) ensure that all processes referred to in Part 4 of the Schedule which are applicable to activities carried out by the hospital blood bank, are validated; (d) maintain documentation on operational procedures, guidelines, training and reference manuals and reporting forms so that they are readily available for inspection under regulation 15; (e) maintain, for not less than 30 years, the data needed to ensure full traceability of blood and blood components, from the point of receipt of the blood or blood component by the hospital blood bank; (f) notify the Secretary of State of -
(ii) any serious adverse reactions observed during or after transfusion which may be attributable to the quality or safety of blood or blood components issued for transfusion by the hospital blood bank;
(g) establish and maintain a procedure, which is accurate, efficient and verifiable, for the withdrawal from distribution of blood or blood components associated with any notification referred to in paragraph (f); and
Requirement for hospital blood banks to provide information to the Secretary of State
(b) provide details of the systems which it has in place to ensure such compliance.
(2) The person responsible for management of a hospital blood bank shall without delay notify the Secretary of State of any changes to the matters in respect of which evidence has been supplied pursuant to paragraph (1) which might affect compliance with the requirements of these Regulations.
(b) the testing, storage or distribution of blood or blood components by the hospital blood bank is such that any blood or blood components cannot be safely administered for transfusion; or (c) the information given by the person responsible for management of a hospital blood bank pursuant to regulation 10 was false or incomplete in any material respect,
he may serve a notice on the person responsible for management of the hospital bank requiring that the hospital ceases to conduct any of the activities specified in the notice, or refrains from administering to patients any blood or blood components specified in the notice, until the requirements of paragraph (4) are met.
(b) that the hospital blood bank is able to show that the activity or product referred to in the notice given pursuant to paragraph (1)(b) may be safely carried out or, as the case may be, administered; or (c) that all necessary information has been supplied to the Secretary of State.
Objections to suspensions, revocations etc
(b) objects to the refusal of authorisation or the imposition of any condition pursuant to regulation 4(5),
may notify the Secretary of State of its desire to make written representations to, or be or appear before and be heard by, a person appointed by the Secretary of State for that purpose.
(b) the Secretary of State has informed the blood establishment or the person responsible for the management of the hospital blood bank concerned of his decision with regard to the recommendation pursuant to paragraph (8),.
(10) Subject to paragraph (11), where the Secretary of State is notified of an objection pursuant to paragraph (1)(a), within the period specified in paragraph (2), to a suspension, revocation or other notice which has already taken effect on the date the notification was made, the suspension, revocation or notice in respect of which the objection is made shall cease to have effect until -
(b) the Secretary of State has informed the blood establishment or the person responsible for the management of the hospital blood bank concerned of his decision with regard to the recommendation pursuant to paragraph (8).
(11) Paragraph (10) shall not apply -
(b) in any other case, where the Secretary of State determines that it is necessary in the interests of public safety for the suspension, revocation or notice to take effect on the date originally specified, and serves a notice in writing to that effect on the blood establishment or person responsible for management of the hospital blood bank concerned.
Import of blood and blood components into the United Kingdom
(b) not disclosed except -
(ii) where they have been rendered anonymous so that donors are no longer identifiable;
(c) subject to safeguards against unauthorised additions, deletions or modifications.
(2) The requirements of this paragraph are -
(b) the disclosure is to an inspector appointed by the Secretary of State in accordance with regulation 15(10); or (c) the disclosure is for the purpose of tracing a donation from donor to recipient or recipient to donor.
(3) Where a disclosure is made to an inspector pursuant to paragraph (2)(b), the inspector shall not further disclose the information received unless -
(b) the disclosure is to another officer of the Secretary of State where this is necessary for the proper performance of the inspector or officer's duties; or (c) the information has been rendered anonymous so that that donors are no longer identifiable.
(4) Where a disclosure is made by an inspector to another officer of the Secretary of State pursuant to paragraph (3), that person shall not further disclose the information he receives other than in accordance with the requirements of that paragraph.
(b) problems relating to compliance with those requirements are identified.
(2) The Secretary of State may conduct such additional inspections of blood establishments sites as he considers necessary for the purpose of ensuring compliance with the requirements of these Regulations.
(b) problems relating to compliance with those requirements are identified.
(6) The Secretary of State may also serve a notice on the person responsible for managing a hospital blood bank requiring that he furnish him with such information concerning the compliance of the blood bank with these Regulations as shall be specified in the notice within such period shall be specified in the notice.
(b) the designation of responsible persons under regulation 6; (c) notification of serious adverse events and serious adverse reactions by such establishments pursuant to regulation 7(1)(e); (d) inspections or requests for information under regulation 15; (e) the operation, during the period from 8th February 1005 to 7th November 2005, of blood establishments licensed under section 8 of the Medicines Act 1968.
(2) The Secretary of State shall keep such records of information which he receives from persons responsible for management of hospital blood banks, or otherwise or relating to hospital blood banks, as he considers appropriate and shall, in particular keep records relating to -
(b) the information supplied by hospital blood banks pursuant to regulation 10; (c) inspections or requests for information under regulation 15.
Powers of entry, etc.
(ii) any premises of any person who carries out any of the activities referred to in regulation 3(2) on behalf of, and pursuant to a contractual arrangement with, a blood establishment or a person responsible for management of a hospital blood bank; and (iii) where any facilities for donor evaluation and testing are in the premises of any person other than a blood establishment or hospital blood bank, those facilities in that person's premises;
(b) to carry out at those premises during that visit inspections, examinations, tests and analyses as he considers necessary;
but nothing in this paragraph shall be taken to compel the production by any person of a document of which he would on grounds of legal professional privilege be entitled to withhold production on an order for disclosure in an action in the High Court or, as the case may be, on an order for production of documents in an action in the Court of Session.
(b) an application for admission, or the giving of such notice, would defeat the object of the entry; or (c) the premises are unoccupied or the occupier is temporarily absent and it might defeat the object of the entry to await his return,
the justice may, by warrant signed by him, which shall continue in force for a period of one month, authorise an inspector to enter the premises, if need be by force.
(b) that if the responsible person or person responsible for the management of the hospital blood bank so requests, the Secretary of State shall divide the sample of which an analysis is to be made into three equal parts and deal with those parts in accordance with the requirements of paragraph (8).
(8) The requirements of this paragraph are -
(b) that one part of the sample shall be sent to the responsible person of the blood establishment or person responsible for the management of the hospital blood bank; and (c) that one part of the sample shall be retained by the Secretary of State for a reasonable period in case of dispute.
Criminal offences
(b) regulation 7; (c) regulation 9; (d) regulation 13; (e) regulation 23(2),
shall be guilty of an offence.
(b) regulation 6, other than regulation 6(3); (c) regulation 8; (d) regulation 10; (e) regulation 15(4) and (7),
shall be guilty of an offence
(b) discloses any information referred to in regulation 14(1) to which they have access by virtue of these regulations, otherwise than in accordance one or more of the requirements specified in regulation 14(2) and (3),
shall be guilty of an offence.
(ii) without reasonable cause fails to comply with any requirements made of him by an inspector, in circumstances where that inspector is acting in pursuance of any of his functions under these Regulations; or (iii) any person who, in purported compliance with any such requirement as is mentioned in sub-paragraph (a)(ii), intentionally or recklessly furnishes information which is false or misleading in a material respect,
shall be guilty of an offence.
(b) on conviction on indictment, to a fine, or to imprisonment for a term not exceeding 2 years, or to both.
(2) A person guilty of an offence under regulation 18(2), (4) or (6) shall be liable on summary conviction to a fine not exceeding level 5 on the standard scale, or to imprisonment for a term not exceeding 6 months, or to both.
(b) any person who was purporting to act in any such capacity,
he, as well as the body corporate or Scottish partnership, shall be deemed to be guilty of that offence and he shall be liable to be proceeded against and punished accordingly.
(b) in respect of an application for approval of a substantial change pursuant to regulation 4(10), the sum of £400; and (c) in connection with the holding of an authorisation under regulation 3, an annual fee of the sum of £304.
(3) Where the Secretary of State carries out an inspection at a site of a blood establishment he may charge the establishment and that establishment shall, if so charged, pay to the Secretary of State a fee calculated in accordance with the following sub-paragraphs -
(b) for a regular inspection of a standard site, the sum of £5,557; (c) for a regular inspection of a minor site, the sum of £2,698; (d) for any other inspection, where the inspector spends at least two hours but no more than one day at the site, £1,518; (e) for any other where an inspector spends more than one day but less than three days at the inspection site, £4,048; or (f) for any other inspection where the inspector spends three days or more at the site, £7,590.
(4) Where the Secretary of State carries out an inspection of a hospital blood bank he may charge the person responsible for management of the hospital blood bank and that person shall, if so charged, pay to the Secretary of State a fee calculated in accordance with paragraph (5).
(b) where an inspector spends more than one day but less than three days at the inspection site, £2024; or (c) where the inspector spends three days or more at the inspection site, £3795.
(6) In this regulation -
(7) Any fee payable under this regulation shall be payable at the following times -
(ii) the periodic fee payable pursuant to paragraph (2)(c) shall be payable on the first anniversary of the grant by the Secretary of State of authorisation to operate as a blood establishment, and whilst the blood establishment continues to be authorised to operate as such pursuant to these Regulations, annually thereafter; (iii) any other fee payable under this regulation shall be payable within fourteen days following written notice from the Secretary of State requiring payment of the fee.
(8) All unpaid sums due by way of, or on account of, any fees payable under this regulation shall be recoverable as debts due to the Crown.
(b) refund the whole or part of any fee paid pursuant to this regulation.
Specific epidemiological situations
(b) notify the Commission of -
(ii) the additional deferral criteria which blood establishments are required to adopt in relation to it pursuant to sub-paragraph (a).
(2) A blood establishment shall adopt and comply with any criteria for additional tests notified to them by the Secretary of State pursuant to paragraph (1).
(b) any hospital blood bank.
(2) From the date these Regulations come into force, a blood establishment licensed under section 8 of the Medicines Act 1968 may apply for, and the Secretary of State may grant, an authorisation under regulation 4 to have effect as from 8th November 2005.
(b) in section 8 (provisions as to manufacture and wholesale dealing), omit paragraph (a) of subsection (4)[19]; (c) in section 130 (meaning of "medicinal product" and related expressions) in subsection (5), after paragraph (b), insert the following new paragraph -
(2) The Medicines (Standard Provisions for Licenses and Certificates) Regulations 1971 shall be amended as follows -
(3) In the Medicines for Human Use (Marketing Authorisations Etc.) Regulations 1994[20], in regulation 1 (citation, commencement and interpretation), in paragraph (2), in the definition of "the 2001 Directive", after "as amended by" insert -
Definitions The following definitions apply for the purposes of this Schedule. 1. "Autologous donation" means blood and blood components collected from an individual and intended solely for subsequent autologous transfusion or other human application to that same individual. 2. "Allogeneic donation" means blood and blood components collected from an individual and intended for transfusion to another individual, for use in medical devices or as starting material or raw material for manufacturing into medicinal products. 3. "Whole blood" means a single blood donation. 4. "Cryopreservation" means prolongation of the storage life of blood components by freezing. 5. "Plasma" means the liquid portion of the blood in which the cells are suspended. Plasma may be separated from the cellular portion of a whole blood collection for therapeutic use as fresh-frozen plasma or further processed to cryoprecipitate and cryoprecipitate-depleted plasma for transfusion. It may be used for the manufacture of medicinal products derived from human blood and human plasma or used in the preparation of pooled platelets, or pooled, leucocyte-depleted platelets. It may also be used for re-suspension of red cell preparations for exchange transfusion or perinatal transfusion. 6. "Cryoprecipitate" means a plasma component prepared from plasma, fresh-frozen, by freeze-thaw precipitation of proteins and subsequent concentration and re-suspension of the precipitated proteins in a small volume of the plasma. 7. "Washed" means a process of removing plasma or storage medium from cellular products by centrifugation, decanting of the supernatant liquid from the cells and addition of an isotonic suspension fluid, which in turn is generally removed and replaced following further centrifugation of the suspension. The centrifugation, decanting, replacing process may be repeated several times. 8. "Red cells" means the red cells from a single whole blood donation, with a large proportion of the plasma from the donation removed. 9. "Red cells, buffy coat removed" means the red cells from a single whole blood donation, with a large proportion of the plasma from the donation removed. The buffy coat, containing a large proportion of the platelets and leucocytes in the donated unit, is removed. 10. "Red cells, leucocyte-depleted" means the red cells from a single whole blood donation, with a large proportion of the plasma from the donation removed, and from which leucocytes are removed. 11. "Red cells in additive solution" means the red cells from a single whole blood donation, with a large proportion of the plasma from the donation removed. A nutrient or preservative solution is added. 12. "Additive solution" means a solution specifically formulated to maintain beneficial properties of cellular components during storage. 13. "Red cells, buffy coat removed, in additive solution" means the red cells from a single whole blood donation, with a large proportion of the plasma from the donation removed. The buffy coat, containing a large proportion of the platelets and leucocytes in the donated unit, is removed. A nutrient or preservative solution is added. 14. "Buffy coat" means a blood component prepared by centrifugation of a unit of whole blood, and which contains a considerable proportion of the leucocytes and platelets. 15. "Red cells, leucocyte-depleted, in additive solution" means the red cells from a single whole blood donation, with a large proportion of the plasma from the donation removed, and from which leucocytes are removed. A nutrient or preservative solution is added. 16. "Red cells, apheresis" means the red cells from an apheresis red cell donation. 17. "Apheresis" means a method of obtaining one or more blood components by machine processing of whole blood in which the residual components of the blood are returned to the donor during or at the end of the process. 18. "Platelets, apheresis" means a concentrated suspension of blood platelets obtained by apheresis. 19. "Platelets, apheresis, leucocyte-depleted" means a concentrated suspension of blood platelets, obtained by apheresis, and from which leucocytes are removed. 20. "Platelets, recovered, pooled" means a concentrated suspension of blood platelets, obtained by processing of whole blood units and pooling the platelets from the units during or after separation. 21. "Platelets, recovered, pooled, leucocyte-depleted" means a concentrated suspension of blood platelets, obtained by processing of whole blood units and pooling the platelets from the units during or after separation, and from which leucocytes are removed. 22. "Platelets, recovered, single unit" means a concentrated suspension of blood platelets, obtained by processing of a single unit of whole blood. 23. "Platelets, recovered, single unit, leucocyte-depleted" means a concentrated suspension of blood platelets, obtained by processing of a single whole blood unit from which leucocytes are removed. 24. "Plasma, fresh-frozen" means the supernatant plasma separated from a whole blood donation or plasma collected by apheresis, frozen and stored. 25. "Plasma, cryoprecipitate-depleted for transfusion" means a plasma component prepared from a unit of plasma, fresh-frozen. It comprises the residual portion after the cryoprecipitate has been removed. 26. "Granulocytes, apheresis" means a concentrated suspension of granulocytes obtained by apheresis. 27. "Statistical process control" means a method of quality control of a product or a process that relies on a system of analysis of an adequate sample size without the need to measure every product of the process. Part A - Information to be provided to prospective donors of blood or blood components 1. Accurate educational materials, which are written in terms which can be understood by members of the general public, about the essential nature of blood, the blood donation procedure, the components derived from whole blood and apheresis donations, and the important benefits to patients. 2. For both allogeneic and autologous donations, the reasons for requiring an examination and health and medical history, and the testing of donations, and the significance of "informed consent". 3. For allogeneic donations, the criteria for self-deferral, and temporary and permanent deferral, and the reasons why individuals are not to donate blood or blood components if there could be a risk for the recipient. 4. For autologous donations, the possibility of deferral and the reasons why the donation procedure would not take place in the presence of a health risk to the individual whether as donor or recipient of the autologous blood or blood components. 5. Information on the protection of personal data, including confirmation that there will be no disclosure of the identity of the donor, of information concerning the donor's health, and of the results of the tests performed, other than in accordance with the requirements of these Regulations. 6. The reasons why individuals are not to make donations which may be detrimental to their health. 7. Specific information on the nature of the procedures involved either in the allogeneic or autologous donation process and their respective associated risks. For autologous donations, the possibility that the autologous blood and blood components may not suffice for the intended transfusion requirements. 8. Information on the option for donors to change their mind about donating prior to proceeding further, or the possibility of withdrawing or self-deferring at any time during the donation process, without any undue embarrassment or discomfort. 9. The reasons why it is important that donors inform the blood establishment of any subsequent event that may render any prior donation unsuitable for transfusion. 10. Information on the responsibility of the blood establishment to inform the donor, through an appropriate mechanism, if test results show any abnormality of significance to the donor's health. 11. Information as to why unused autologous blood and blood components will be discarded and not transfused to other patients. 12. Information that test results detecting markers for viruses, such as HIV, HBV, HCV or other relevant blood transmissible microbiologic agents, will result in donor deferral and destruction of the collected unit. 13. Information on the opportunity for donors to ask questions at any time. Part B - Information to be obtained from donors by blood establishments at every donation Identification of the donor 14. Personal data uniquely, and without any risk of mistaken identity, distinguishing the donor, as well as contact details. Health and medical history of the donor 15. Health and medical history, provided on a questionnaire and through a personal interview performed by a qualified health professional, that includes relevant factors that may assist in identifying and screening out persons whose donation could present a health risk to others, such as the possibility of transmitting diseases, or health risks to themselves. Signature of the donor 16. Signature of the donor, on the donor questionnaire, countersigned by the qualified health professional responsible for obtaining the health history confirming that the donor has -
(b) had an opportunity to ask questions; (c) been provided with satisfactory responses to any questions asked; (d) given informed consent to proceed with the donation process; (e) been informed, in the case of autologous donations, that the donated blood and blood components may not be sufficient for the intended transfusion requirements; and (f) acknowledged that all the information provided by the donor is true to the best of his knowledge.
1. Acceptance criteria for donors of whole blood and blood components Under exceptional circumstances, individual donations from donors who do not comply with following criteria may be authorised by a qualified healthcare professional in the blood establishment. All such cases must be clearly documented and subject to the quality management provisions in Articles 11, 12 and 13 of Directive 2002/98/EC. The criteria in this paragraph do not apply to autologous donations. 1.1 Age and body weight of donors
1.2 Haemoglobin levels in donor's blood
1.3 Protein levels in donor's blood
1.4 Platelet levels in donor's blood
DEFERRAL CRITERIA FOR DONORS OF WHOLE BLOOD AND BLOOD COMPONENTS Deferral criteria for donors of whole blood and blood components The tests and deferral periods indicated by an asterisk (*) are not required when the donation is used exclusively for plasma for fractionation. 2.1 Permanent deferral criteria for donors of allogeneic donations
2.2 Temporary deferral criteria for donors of allogeneic donations 2.2.1 Infections Duration of deferral period After an infectious illness, prospective donors shall be deferred for at least two weeks following the date of full clinical recovery. However, the following deferral periods shall apply for the infections listed in the table:
2.2.2 Exposure to risk of acquiring a transfusion-transmissible infection
2.2.3 Vaccination
2.2.4 Other temporary deferrals
2.3 Deferral for particular epidemiological situations
2.4 Deferral criteria for donors of autologous donations
1. STORAGE 1.1 Liquid storage
1.2 Cryopreservation
2. TRANSPORT AND DISTRIBUTION Transport and distribution of blood and blood components at all stages of the transfusion chain must be under conditions that maintain the integrity of the product. 3. ADDITIONAL REQUIREMENTS FOR AUTOLOGOUS DONATIONS 3.1 Autologous blood and blood components must be clearly identified as such and stored, transported and distributed separately from allogeneic blood and blood components. 3.2 Autologous blood and blood components must be labelled as required by regulation 8, and, in addition, the label must include the identification of the donor and the warning "FOR AUTOLOGOUS TRANSFUSION ONLY". 1. THE BLOOD COMPONENTS
2. QUALITY CONTROL REQUIREMENTS FOR BLOOD AND BLOOD COMPONENTS 2.1 Blood and blood components must comply with the following technical quality measurements and meet the acceptable results. 2.2 Appropriate bacteriological control of the collection and manufacturing process must be performed. 2.3 For autologous donations, the measures marked with an asterisk (*) are recommendations only.
(This note is not part of the Regulations) These Regulations impose safety and quality requirements on human blood collection and storage. The requirements apply to blood transfusion services in England, Scotland, Wales and Northern Ireland. Many of the provisions of the Regulations also apply to hospital blood banks. The Regulations implement Directive 2002/98/EC of the European Parliament and Council of 27 January 2003 setting out the standards of quality and safety for the collection, testing, processing, storage and distribution of human blood and blood components ("the Directive") - see OJ L 33, 8.2.2003, p30. They also implement Commission Directive 2004/33/EC - see, OJ L91, 30.3.2004, p25, which contains certain technical requirements relating to blood standards. Regulation 2 provides that the Secretary of State is to be the competent authority for the purposes of the Directive and outlines the scope of the Regulations. Regulation 3 prohibits the carrying on of certain activities relating to blood, unless they are a person authorised by the Secretary of State to act as a blood establishment or carried out by hospital blood banks or persons acting on behalf of an authorised blood establishment or a hospital blood bank. Regulation 4 sets out the procedures to be followed in respect of an application for authorisation and regulation 5 sets out the circumstances tin which the Secretary of State may suspend or revoke such authorisation. Regulations 6 to 8 impose requirements on blood establishments, including requirements relating to "responsible persons" at blood establishments (regulation 6) and the labelling of blood (regulation 8). Regulations 9 and 10 impose requirements on persons responsible for management of hospital blood banks, including requirements to provide information to the Secretary of State (regulation 10). Regulation 11 provides for the service of notices on hospital blood banks by the Secretary of State requiring them to undertake certain actions where they contravene the requirements of these regulations or where there are concerns as to safety. Regulation 12 makes provision for objections to suspensions and revocations of blood establishment authorisations and to notices served on blood establishments and hospital blood banks by the Secretary of State under regulations 5 and 11. Regulation 13 prohibits the import of blood or blood components which do not meet the standards of safety and quality equivalent to those specified in Part 5 of the Schedule to the Regulations. Regulation 14 imposes restrictions on the disclosure of information obtained under the Regulations. Regulations 15 to 21 provide for enforcement and related matters, including powers of inspection notices to provide information, offences and penalties for breaches of the Regulations. Regulation 22 provides for fees payable in relation to blood establishment authorisations and inspections of blood establishments and blood banks. Regulation 23 provides that in the event of a specific epidemiological situation such as a disease outbreak, which necessitates the adoption of deferral criteria additional to those specified in Part 3 of the Schedule, the Secretary of State is to notify the Commission and blood establishments, who are to adopt any additional deferral criteria specified by the Secretary of State. Regulation 24 makes transitional provision for blood establishments and hospital blood banks so that they may continue to operate under existing provisions until 8th November 2005. Regulation 25 makes consequential amendments. A Regulatory Impact Assessment and a Transposition Note have been prepared for these Regulations and a copy of each has been placed in the library of each House of Parliament. Copies of the Regulatory Impact Assessment and the Transposition Note are published on the Department of Health's website (www.dh.gov.uk) and can be obtained from room 631B SKH, Department of Health, Skipton House, 80 London Road, London SE1 6LH. Notes: [1] S.I. 2004/3037.back [2] 1972 c.68. Under section 57(1) of the Scotland Act 1998 (c.46), despite the transfer to Scottish Ministers of functions in relation to implementing obligations under Community law in relation to devolved matters, the functions of the Secretary of State in relation to implementing these obligations continues to be exercisable by him as regards Scotland.back [4] O.J. No. L33, 8.2.2003, p.30.back [5] The National Blood Authority was established by the National Blood Authority (Establishment and Constitution) Order (S.I. 1993/585), as amended by S.I. 1994/589 and 2001/1745.back [6] The Scottish National Blood Transfusion Service is managed by the Common Services Agency established by section 10 of, and Schedule 5 to, the National Health Service (Scotland) Act 1978 (c.29). The Common Services Agency was designated for this purpose by the NHS (Functions of the Common Services Agency)(Scotland) Order (S.I. 1974/467).back [7] The Northern Ireland Blood Transfusion Service was established under Article 10(1)(d) of the Health and Personal Social Services (Northern Ireland) Order (S.I. 1972/1265) (N.I. 14).back [8] The Welsh Blood Service is provided and managed by the Velindre National Health Service Trust. The Velindre NHS Trust was established, and designated for this purpose by the Velindre National Health Service Trust (Establishment) Order (1993/2838), as amended by S.I. 1999/826 and 2002/442 and 2199.back [9] 1977 c.49; the definition of "health service hospital" has been amended by sections 1 and 2 of, and paragraph 77(d) of Schedule 1 to, the Health Services Act 1980 (c.53), section 26(2)(c) of the National Health Service and Community Care Act 1990, section 65 of, and paragraphs 4 and 38(1) and (2)(a) of Schedule 4 to, the Health Act 1999 (c.9) and by section 34 of, and paragraphs 23 and 42 of Schedule 4 to, the Health and Social Care (Community Health and Standards) Act 2003 (c.43).back [10] S.I. 1972/1265 (N.I. 14).back [11] S.I. 1990/247 (N.I.3).back [14] S.I. 1991/194 (N.I.1).back [18] Subsection (6A) was inserted by S.I. 1992/604 and amended by S.I. 1994/276.back [19] Subsection (4) was substituted by S.I. 1992/604 and amended by S.I. 1994/276.back [20] S.I. 1994/3144; relevant amending instruments are S.I. 2001/795, 2002/236, 2003/2321 and 2004/3224.back
ISBN 0 11 051622 2
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