Infected Blood Inquiry

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 National Health Service, in particular in executive positions and board members.

In May 2025, the UK Government stated that it was preparing its response to a consultation, held between November 2024 and February 2025 on options for regulating NHS managers, which sought views on whether to introduce a professional duty of candour for NHS leaders and hold them accountable for organisational candour (Cabinet Office response, May 2025). The record holds no update since the UK Government's response of May 2025 (Cabinet Office response, May 2025).

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 healthcare being provided, or the way it is being provided, where there reasonably appears to be a risk that a patient might suffer harm, or has done so. Any person in authority to whom such a report is made should be personally accountable for a failure to consider it adequately.

In May 2025, the UK Government accepted the recommendation in principle, stating that imposing personal accountability through secondary legislation is complex to implement and could be counter-productive to advancing a safety culture (Cabinet Office response, May 2025). It noted in May 2025 that it was preparing a response to a consultation on regulating managers and that the Department of Health and Social Care was consulting on an accountability pledge for the NHS Constitution (Cabinet Office response, May 2025). The record holds no update since the UK Government's response of May 2025 (Cabinet Office response, May 2025).

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 out in (a) above, and also by making leaders accountable for how the culture operates in their part of the system, and for the way in which it involves patients.

In its response presented to Parliament in May 2025, the UK Government stated that this recommendation on organisational culture change and leadership accountability for patient safety was accepted in principle alongside the Welsh Government, the Scottish Government and the Northern Ireland Executive (Cabinet Office response, May 2025). The record holds no update since the UK Government's response of May 2025 (Cabinet Office response, May 2025).

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 health jurisdictions of the UK, measuring at least the levels of patient access to their personal records, their ability to identify and correct apparent errors in them, their interoperability, and the confidence of health professionals in the detail, accuracy and timeliness of any record they enter, and that little material which should be recorded has been omitted. Next steps should be identified.

The Inquiry asked for a publicly reported audit of patient record digitisation by 2027. In minutes of a March 2026 meeting published in May 2026, Marion Logan of the Scottish Government stated that annual health board updates were being collected, a 2025 summary report was due, and Scotland would report on progress by late 2027 (Marion Logan, Mar 2026). In May 2025, the United Kingdom (UK) Government stated that National Health Service (NHS) England was using Digital Maturity Assessments to capture most audit elements for secondary care records, while planning how to capture professional views (Cabinet Office response, May 2025). In the same response, the Northern Ireland Executive stated that continuous monitoring meant a formal audit was not required, while the Welsh Government detailed work expanding records access through the NHS Wales App (Welsh Government response, May 2025; Northern Ireland Executive response, May 2025).

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 Service and Ministerial Codes, coupled with those legal duties which occur on the occasions when civil servants and ministers interact with courts, inquests and inquiries, as securing candour.

In May 2025, the UK Government accepted the recommendation in principle, stating that the Prime Minister had committed to introducing legislation for a statutory duty of candour with criminal sanctions for public authorities and public servants (Cabinet Office response, May 2025). It reported that it was consulting widely and drafting the bill ahead of its introduction to Parliament, while noting that an updated Ministerial Code had also been issued to emphasize openness and candour (Cabinet Office response, May 2025). The record holds no update since the UK Government's response of May 2025 (Cabinet Office response, May 2025).

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 accountability on senior civil servants for the candour and completeness of advice given to Permanent Secretaries and Ministers, and the candour and completeness of their response to concerns raised by members of the public and staff.

In May 2025, the UK Government accepted the recommendation in principle, stating that the Prime Minister committed to introducing legislation for a statutory duty of candour covering public authorities and public servants, which will include criminal sanctions (Cabinet Office response, May 2025). It added that it was consulting widely and drafting the bill ahead of its introduction to Parliament (Cabinet Office response, May 2025). The record holds no update since the UK Government's response of May 2025 (Cabinet Office response, May 2025).

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.

In May 2025, the UK Government accepted the recommendation in principle, stating that the Prime Minister had committed to delivering legislation for a statutory duty of candour with criminal sanctions covering public servants and authorities (Cabinet Office response, May 2025). It added in the same response that it was consulting widely and drafting a Hillsborough Law ahead of its introduction to Parliament, having already updated the Ministerial Code to emphasize candour (Cabinet Office response, May 2025). The record holds no update since the UK Government's response of May 2025 (Cabinet Office response, May 2025).

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 Inquiry recommended that transfusion-infected hepatitis patients with fibrosis receive the same care. In May 2025, the UK Government stated that it accepted the recommendation, balancing implementation against National Health Service (NHS) England's role to promote equitable access and clinical guidelines (Cabinet Office response, May 2025). It noted that consultant hepatologists would oversee patient care, while a framework was being developed to identify individuals needing fibrosis staging and a cirrhosis surveillance registry would be introduced (Cabinet Office response, May 2025).

All patients who have contracted hepatitis via a blood transfusion or blood products should receive the following care: Those who have had Hepatitis C which is attributable to infected blood or blood products should be seen by a consultant hepatologist, rather than a more junior member of staff, wherever practicable

The Inquiry recommended that patients infected with hepatitis C see a consultant hepatologist. In May 2025, the UK Government stated that all patients will have their care overseen by a consultant hepatologist, while balancing implementation against equitable access, practicability, and clinical guidelines (Cabinet Office response, May 2025). It reported that National Health Service (NHS) England had audited current pathways and was developing a framework alongside a cirrhosis surveillance registry to identify and monitor affected individuals (Cabinet Office response, May 2025).

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 Inquiry recommended surgical checklists and board reporting on tranexamic acid in England. In May 2025, the UK Government stated that an expert working group was considering plans to increase tranexamic acid use, though surgical checklists and board reporting were not mentioned, required funding had not yet been identified, and implementation would take several years (Cabinet Office response, May 2025). In June 2026, Sir Brian Langstaff, who chaired the inquiry, told the Public Administration and Constitutional Affairs Committee that discussions on tranexamic acid within the blood service were producing beneficial results, though these had not yet appeared publicly on the Cabinet Office dashboard (Sir Brian Langstaff, Jun 2026).

In Scotland, Wales and Northern Ireland offering the use of tranexamic acid should be considered a treatment of preference in respect of all eligible surgery.

The Inquiry asked Scotland, Wales, and Northern Ireland to prefer tranexamic acid for eligible surgery. Addressing Scotland, Dr Lorna McLintock of the Scottish National Blood Transfusion Service (SNBTS), as minuted by the Scottish Government in March 2026 and published in May 2026, reported that revised National Institute for Health and Care Excellence (NICE) guidance broadening the drug's scope was issued in February 2026 and circulated to hospital transfusion teams (Dr Lorna McLintock, Mar 2026). In May 2025, the Welsh Government reported that phased implementation across national programmes, including a surgical checklist incorporating the drug, was expected to conclude by 2026 (Welsh Government response, May 2025). Also in May 2025, the Northern Ireland Executive stated that health trusts were asked to ensure the treatment was offered while it sought assurance on current practice across the system (Northern Ireland Executive response, May 2025).

Review of progress towards the Transfusion 2024 recommendations: Progress in implementation of the Transfusion 2024 recommendations be reviewed, and next steps be determined and promulgated; and that in Scotland the 5 year plan is reviewed in or before 2027 with a view to determining next steps.

In March 2026, Dr Lorna McLintock of the Scottish National Blood Transfusion Service reported, in minutes published by the Scottish Government, that progressing a Scotland-wide transfusion strategy was paused while a new Chief Executive for Public Services Delivery Scotland is onboarded (Dr Lorna McLintock, Mar 2026). Earlier, in May 2025, the UK Government accepted the recommendation in principle, stating that progress against Transfusion 2024 had been reviewed by NHS England and NHS Blood and Transplant, with a full report expected in early 2025/26 to inform a wider Transfusion Transformation Strategy (Cabinet Office response, May 2025). The government noted that substantial funding would be required to design and deliver the transformation programme (Cabinet Office response, May 2025).

Transfusion laboratories: Transfusion laboratories should be staffed (and resourced) adequately to meet the requirements of their functions.

In March 2026, Dr Lorna McLintock of the Scottish National Blood Transfusion Service reported to the Scottish Government that a Strategic Needs Assessment for hospital blood banking had been completed and submitted to it for consideration (Dr Lorna McLintock, Mar 2026). Previously, the UK Government stated in May 2025 that work was ongoing to review staffing and build an evidence base, but noted that funding would be required to undertake full workforce modelling and develop minimum staffing level standards (Cabinet Office response, May 2025).

Training in Transfusion Medicine: That those bodies concerned with undergraduate and postgraduate training across the UK of those people who are, or intend to be, working in the NHS ensure that they are adequately trained in transfusion, that the standards by which sufficiency of training is measured are defined, and accountability for training in transfusion be defined.

An action log minuted by the Scottish Government recorded in March 2026 that funding had been agreed with NHS Education for Scotland to take forward parts of the recommendation (The action log, Mar 2026). Previously, in November 2025, Professor Emma Watson reported to that oversight group that an NHS England-led group addressing the recommendation had been disbanded due to funding constraints (Professor Emma Watson, Nov 2025). In May 2025, the UK Government had accepted the recommendation in principle, noting that curricula were undergoing review but funding was needed to address training gaps (Cabinet Office response, May 2025).

Implementing SHOT reports: That all NHS organisations across the UK have a mechanism in place for implementing recommendations of Serious Hazard of Transfusion (SHOT) reports, which should be professionally mandated, and for monitoring such implementation.

The Scottish Government reported in November 2025 that it had issued a Director letter and monitoring spreadsheet regarding recommendation 7(e) to NHS Board Medical Directors in August 2025, requesting that boards return the completed template by February 2026 (The Scottish Government action log, Nov 2025). Earlier, the UK Government stated in May 2025 that work was underway to develop governance practices for implementing Serious Hazards of Transfusion recommendations (Cabinet Office response, May 2025). It added that accreditation for SHOT to issue patient safety alerts through the Central Alerting System remained under consideration and dependent on funding, while SHOT was developing safety standards for NHS provider organisations (Cabinet Office response, May 2025).

Establishing the outcome of every transfusion: That a framework be established for recording outcomes for recipients of blood components. That those records be used by NHS bodies to improve transfusion practice (including by providing such information to haemovigilance bodies). Success in achieving this will be measured by the extent to which the SHOT reports for the previous three years show a progressive reduction in incidents of incorrect blood component transfusions measured as a proportion of the number of transfusions given.

The Inquiry called for a framework to record and monitor blood transfusion recipient outcomes. In May 2025, the UK Government stated that implementation requires substantial cross-nation investment, with a design team mapping clinical pathways, digitisation requirements, and standards (Cabinet Office response, May 2025). In the same month, the Scottish Government reported work to adapt its Account for Blood system, while the Welsh Government noted it had established a digital working group and roadmap (Scottish Government response, May 2025; Welsh Government response, May 2025). The Northern Ireland Executive stated in May 2025 that regional electronic pathology and tracking systems were being developed, alongside work to assess how far the recommendation is already being carried out (Northern Ireland Executive response, May 2025). The record holds nothing dated later than the response of May 2025 (Northern Ireland Executive response, May 2025).

Establishing the outcome of every transfusion: To the extent that the funding for digital transformation does not already cover the setting up and operation of this framework, bespoke funding should be provided.

The Inquiry recommended bespoke funding to establish the outcome of every blood transfusion. In May 2025, the UK Government stated that implementation requires substantial investment across the four nations, reporting that a design team is mapping clinical pathways, digitisation requirements, and standards (Cabinet Office response, May 2025). It noted that interdependencies still need to be mapped against other large digital systems (Cabinet Office response, May 2025). In the same month, the Scottish Government, Welsh Government, and Northern Ireland Executive each outlined regional work to identify digital gaps, map programme costs, and integrate electronic transfusion tracking systems (Scottish Government response, May 2025; Welsh Government response, May 2025; Northern Ireland Executive response, May 2025). The record holds nothing dated later than the response of May 2025 (Northern Ireland Executive response, May 2025).

Establishing the outcome of every transfusion: That funding for the provision of enhanced electronic clinical systems in relation to blood transfusion be regarded as a priority across the UK.

The Inquiry recommended prioritising funding across the United Kingdom (UK) for enhanced electronic transfusion systems. In May 2025, the UK Government stated that implementation requires substantial investment across the four nations, reporting that a design team is mapping clinical pathways, digitisation requirements, and standards (Cabinet Office response, May 2025). It noted that interdependencies with other large digital initiatives and systems must still be mapped (Cabinet Office response, May 2025). In the same month, the Scottish Government, Welsh Government, and Northern Ireland Executive outlined regional work to update tracking systems, prepare business cases, and develop digital roadmaps (Scottish Government response, May 2025; Welsh Government response, May 2025; Northern Ireland Executive response, May 2025). The record holds nothing dated later than the response of May 2025 (Northern Ireland Executive response, May 2025).

That NHS Trusts and Health Boards should be required to deliberate on peer review findings and give favourable consideration to implementing the changes identified with a view to ensuring comprehensive, safe, care.

The Inquiry recommended that trusts and health boards act upon peer review findings. In April 2026, Dr Zubir Ahmed, Parliamentary Under-Secretary of State at the Department of Health and Social Care, stated that a revised Haemophilia Service Specification requiring providers to act upon peer review findings was undergoing final approvals (Dr Zubir Ahmed, Apr 2026). The Minister added that publication of the final peer review report was expected imminently, alongside a letter asking integrated care boards and trust boards to confirm their commitment to implement findings (Dr Zubir Ahmed, Apr 2026). While the update described action regarding trust boards, health boards were not mentioned (Dr Zubir Ahmed, Apr 2026).

A peer review of each centre should take place not less than once every five years.

The Inquiry recommended that each haemophilia centre undergo peer review at least every five years. In April 2026, Dr Zubir Ahmed, Parliamentary Under-Secretary of State at the Department of Health and Social Care, stated that a formal five-year peer review cycle has operated since 2019 (Dr Zubir Ahmed, Apr 2026). The Minister added that publication of the final peer review report was expected imminently, while a revised service specification contractually requiring providers to participate was undergoing final approvals (Dr Zubir Ahmed, Apr 2026).

The necessary administrative and clinical resources should be provided by hospital trusts and boards, integrated care boards, and service commissioners to facilitate multi-disciplinary regional networks to discuss policy and practice in haemophilia and other inherited bleeding disorders care, provided they involve patients in their discussions.

In April 2026, Dr Zubir Ahmed, Parliamentary Under-Secretary of State at the Department of Health and Social Care, stated that work was in progress and that NHS England had drafted a proposed National Clinical Network Specification to establish multi-disciplinary regional networks (Dr Zubir Ahmed, Apr 2026). The Minister reported in that April 2026 response that the specification remains dependent on additional funding, which the UK Government previously noted in May 2025 had not yet been identified (Cabinet Office response, May 2025; Dr Zubir Ahmed, Apr 2026).

Recombinant coagulation factor products should be offered in place of plasma-derived ones where clinically appropriate. Service commissioners should ensure that such treatment decisions are funded accordingly.

In April 2026, Parliamentary Under-Secretary of State for Health and Social Care Dr Zubir Ahmed stated that all conditions with non-plasma alternatives are now addressed by commissioning policies or funding agreements, though funding required to implement a clinical policy for recombinant Von Willebrand factor prophylaxis across all ages has not yet been identified (Dr Zubir Ahmed, Apr 2026). The UK Government previously reported in May 2025 that NHS England had commenced funding recombinant Von Willebrand factor for managing bleeding episodes and surgical pre-treatment in August 2024 (Cabinet Office response, May 2025).

That the National Haemophilia Database, run by the UKHCDO, merits the support of additional central funding.

In an April 2026 parliamentary answer, Parliamentary Under-Secretary of State at the Department of Health and Social Care Dr Zubir Ahmed stated that NHS England provides approximately 40% of the National Haemophilia Database's annual costs and continues to work with the United Kingdom Haemophilia Centres Doctors' Organisation to assess requirements for increased funding (Dr Zubir Ahmed, Apr 2026). The Minister noted in April 2026 that while stakeholders agreed the registry remains immensely valuable for clinical care, further progress is subject to additional funding that "has not yet been identified" (Dr Zubir Ahmed, Apr 2026).

A clinical audit should as a matter of routine include measures of patient satisfaction or concern, and these should be reported to the board of the body concerned. Success in this will be measured by comparing the measure of satisfaction from one year to the next, such that the reports to the board concerned demonstrate a trend of improvement by comparing this year’s outcomes with the similar outcomes from at least the two previous years.

The UK Government accepted the recommendation in principle in May 2025, stating that NHS England was reviewing clinical audits to clarify gaps in patient involvement and satisfaction reporting (Cabinet Office response, May 2025). It noted in May 2025 that this work involves interdependencies with wider patient voice strategies and policy developments that require careful consideration (Cabinet Office response, May 2025). The record holds no update since the UK Government's response of May 2025 (Cabinet Office response, May 2025).

Particular consideration be given, together with the UK Thalassaemia Society and the Sickle Cell Society, to how the needs of patients with thalassaemia or sickle cell disease can best holistically be addressed.

The Inquiry recommended addressing the holistic needs of thalassaemia and sickle cell disease patients collaboratively. In May 2025, the UK Government stated that National Health Service (NHS) England established a programme reviewing care pathways and created advisory groups to work with the UK Thalassaemia Society and the Sickle Cell Society (Cabinet Office response, May 2025). It noted that while initial funding supports acute crisis care, additional funding needed to fully implement the programme has not yet been identified (Cabinet Office response, May 2025). Also in May 2025, the Scottish Government reported engaging networks under its Rare Disease Action Plan, the Welsh Government outlined existing hereditary anaemia services, and the Northern Ireland Executive reported exploring screening options while using London specialists (Scottish Government response, May 2025; Welsh Government response, May 2025; Northern Ireland Executive response, May 2025). The record holds nothing dated later than the response of May 2025 (Northern Ireland Executive response, May 2025).

That a minister should retain the power to call an inquiry as the minister sees fit, in accordance with the Inquiries Act 2005 – but where a minister does not choose to do so, then:

The Inquiry recommended ministers retain powers to call inquiries, with alternatives if they decline. The UK Government stated in May 2025 that Parliament must decide whether to adopt the recommendation, adding that if the recommendation is adopted, it accepts its obligation to publish detailed reasons when disagreeing with establishing an inquiry (Cabinet Office response, May 2025). In March 2026, Sir Brian Langstaff, Chair of the Inquiry, welcomed its acceptance in principle and commitment to provide a further update to Parliament (Sir Brian Langstaff, Mar 2026).

If there is sufficient support from within Parliament for there to be an inquiry, the question whether there should be one should be referred to PACAC for it to consider the question.

The Inquiry recommended referring supported inquiry proposals to the Public Administration and Constitutional Affairs Committee. In May 2025, the UK Government stated that it was for Parliament to decide whether to accept the recommendation and how to fulfil it alongside existing scrutiny mechanisms (Cabinet Office response, May 2025). In March 2026, Sir Brian Langstaff, Chair of the Infected Blood Inquiry, welcomed the Government's acceptance in principle of the recommendation and its commitment to provide a further update to Parliament (Sir Brian Langstaff, Mar 2026).

If it appears to PACAC that there is sufficient concern to justify a public inquiry, either because what happened and why has caused concern (as the committee sees it) or there are likely to be lessons learned which may prevent similar concerns arising in future, the committee may recommend to an appropriate minister that there be an inquiry.

The Inquiry recommended that the Public Administration and Constitutional Affairs Committee propose public inquiries. In May 2025, the UK Government stated that select committees already possess scrutiny powers, noting that Parliament must decide whether to accept the proposal alongside its existing mechanisms (Cabinet Office response, May 2025). In March 2026, Sir Brian Langstaff, Chair of the Infected Blood Inquiry, welcomed the Government's acceptance in principle and its commitment to provide a further update to Parliament (Sir Brian Langstaff, Mar 2026).

If the minister disagrees with the recommendation, they must set out in detail and publish reasons for this disagreement which are sufficient to satisfy PACAC that the matter has been carefully and properly considered.

The Inquiry recommended that ministers publish detailed reasons if they disagree with a recommendation. The UK Government stated in May 2025 that if Parliament adopts the recommendation, it accepts its obligation to publish detailed reasons when disagreeing with a proposal to establish an inquiry, and committed to update Parliament on wider inquiry reforms, though satisfying the Public Administration and Constitutional Affairs Committee (PACAC) was not mentioned (Cabinet Office response, May 2025). In March 2026, Sir Brian Langstaff, Chair of the Infected Blood Inquiry, welcomed the Government's acceptance in principle and its commitment to provide a further update (Sir Brian Langstaff, Mar 2026).

The Public Administration and Constitutional Affairs Committee (“PACAC”) should review both the progress towards responding to the Inquiry’s recommendations and, to the extent that they are accepted, implementing those recommendations.

The Inquiry asked that a parliamentary committee review progress on responding to and implementing recommendations. Nick Thomas-Symonds, Paymaster General and Minister for the Cabinet Office, stated to the House of Commons in July 2025 that he had asked the Public Administration and Constitutional Affairs Committee (PACAC) to scrutinise implementation of recommendations, describing action on implementation but not on progress towards responding to recommendations (Nick Thomas-Symonds, Jul 2025). Sir Brian Langstaff, Chair of the Infected Blood Inquiry, stated in oral evidence to the committee in June 2026 that following up recommendations was a role for a body such as the committee rather than an inquiry itself (Sir Brian Langstaff, Jun 2026). The Minister stated that it is for the committee to outline how it will approach that work (Nick Thomas-Symonds, Jul 2025).

PACAC should accept the role in respect of any future statutory inquiry of reviewing government’s timetable for consideration of recommendations, and of its progress towards implementation of that inquiry’s recommendations.

The Inquiry asked the Public Administration and Constitutional Affairs Committee to review future inquiry recommendations. In May 2025, the UK Government stated that it accepted the principles behind the proposal, noting that the role is for Parliament to consider (Cabinet Office response, May 2025). It added that it is actively considering wider inquiry reforms, including examining how to ensure effective transparency and accountability around recommendation responses and implementation (Cabinet Office response, May 2025). It stated that it will provide updates as this work progresses and publish progress on an accessible dashboard in due course (Cabinet Office response, May 2025). The record holds nothing dated later than the response of May 2025 (Cabinet Office response, May 2025).

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 Inquiry recommended Level 3 core awards for people treated with interferon. In July 2026, the Cabinet Office stated that regulations would introduce a Level 2B award reflecting interferon side effects, with compensation provided for each round of treatment (Cabinet Office, Jul 2026). This followed its April 2026 consultation response confirming that the new severity band would provide higher injury, financial loss, and care payments than Level 2 (Cabinet Office, Apr 2026). The department had initially proposed creating Level 2B rather than adopting the recommended Level 3 band in July 2025 (Cabinet Office response, Jul 2025).

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 August 2024, which was expressly accepted at the time by the Government, to introduce (as one of six health impact groups which would justify a severe health condition award) the following for people infected with Hepatitis B and Hepatitis C: "Other Hepatitis C associated extra hepatic disorders resulting in long-term severe disability. This includes those currently assessed as the following category on IBSS: Hepatitis Special Category Mechanism (EIBSS); 'Severely Affected' Hepatitis C (SIBSS); Hepatitis C Stage 1 Plus (WIBSS); Hepatitis C Stage 1 Enhanced Payments (NIIBSS)"

The Inquiry asked the Government to recognise Special Category Mechanism impacts in severe health condition awards. In July 2026, the Cabinet Office explained that regulations ensure anyone eligible for the Special Category Mechanism (SCM) or equivalent Infected Blood Support Schemes (IBSS) payments receives additional financial loss and care compensation backdated to 2017 (Cabinet Office, Jul 2026). The department stated that living individuals not previously assessed as eligible can also apply, though Hepatitis B is not mentioned (Cabinet Office, Jul 2026). Earlier, the department announced in April 2026 that it would create this supplementary route, following its July 2025 acceptance that the severe health condition award should recognise SCM impacts (Cabinet Office response, Jul 2025; Cabinet Office, Apr 2026).

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 professionals are accepted as sufficient evidence of severe psychological harm and that such evidence should qualify a person for a supplementary Severe Health Condition award without the additional need to demonstrate a period of consultant-led secondary mental health treatment or assessment/treatment as an inpatient.

The Inquiry recommended accepting psychological formulations for severe health condition compensation awards. In July 2026, the Cabinet Office stated that new regulations introduce an award enabling supplementary route applications for those experiencing psychological harm (Cabinet Office, Jul 2026). The department previously confirmed in April 2026 that this award would provide additional financial loss and care compensation (Cabinet Office, Apr 2026). It had committed in July 2025 to consult on evidential requirements and thresholds, but accepting psychological formulations without secondary mental health treatment is not mentioned in the sources (Cabinet Office response, Jul 2025; Cabinet Office, Jul 2026).

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

The Inquiry asked the UK Government to remove variable x from the equation in Regulation 7. In July 2026, the Cabinet Office stated that amendment regulations would remove the 25 per cent deduction applied to past care compensation for individuals who choose to receive support scheme payments for life (Cabinet Office, Jul 2026). The department had confirmed in April 2026 that it would remove the deduction following a consultation (Cabinet Office, Apr 2026). In July 2025, it accepted the need for a change to the scheme but planned to consult, stating that the recommended alteration affected past care rather than past financial loss (Cabinet Office response, Jul 2025).

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 an award could with confidence be established on a balance of probabilities, and if so to consider what if any provision might be introduced to enable them to access an award.

The Inquiry asked for consultation on evidential barriers to exceptional loss awards. In July 2026, the Cabinet Office stated that it will work with the Infected Blood Compensation Authority (IBCA) to communicate the broad range of alternative evidence eligible people can use, ensuring that lacking historic payslips is not a barrier (Cabinet Office, Jul 2026). The department previously announced in April 2026 that a new £60,000 award would be introduced for infected people who had entered or had an offer for a higher-paying career but lacked evidence of actual higher earnings (Cabinet Office, Apr 2026).

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 Inquiry recommended authorising compensation awards for victims of unethical research practices. In July 2026, the Cabinet Office explained that new regulations make anyone treated for a bleeding disorder before 1986 eligible for an unethical research award without having to prove participation in a specific trial (Cabinet Office, Jul 2026). This followed its April 2026 consultation response confirming broad eligibility for individuals treated in the UK before 1986 (Cabinet Office, Apr 2026). The department had previously stated in July 2025 that it would consult on establishing an award requiring minimal evidence and consistent criteria (Cabinet Office response, Jul 2025).

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

The Inquiry asked the UK Government to apply a wider definition of unethical research. In July 2026, regulations made by the Secretary of State and signed by Louise Haigh, First Secretary of State, established that an eligible person was subject to unethical research practices if treated for a bleeding disorder before 1986 (The Infected Blood Compensation Scheme Regulations 2026, Jul 2026). The Cabinet Office had stated in April 2026 that people would not need to prove participation in a specific medical trial (Cabinet Office, Apr 2026). The department previously announced in July 2025 that it would consult on an award requiring minimal evidence (Cabinet Office response, Jul 2025).

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 parents, children, siblings, partners and carers, and their legal representatives if wished, in this consideration.

The Inquiry asked the Minister to consider a supplementary compensation route for affected people. In July 2026, the Cabinet Office stated that regulations introduced a 50% uplift to core injury awards for eligible bereaved parents, bereaved partners, and certain children and siblings, though carers were not mentioned (Cabinet Office, Jul 2026). This followed the department's April 2026 consultation response confirming higher compensation for some affected individuals (Cabinet Office, Apr 2026). In July 2025, it had agreed to consult affected family members and carers on whether a route for severe psychological harm was feasible without causing significant delay (Cabinet Office response, Jul 2025).