Introduction
The Infected Blood Inquiry (IBI) report, published 20 May 2024, recommended:
8a. When doctors become aware that a patient has had a blood transfusion prior to 1996, that patient should be offered a blood test for hepatitis C.
8b. As a matter of routine, new patients registering at a practice should be asked if they have had such a transfusion.
The UK government accepted these recommendations in full. In its published response on 17 December 2024, it confirmed that NHS England would update the online GP registration service to support delivery of these recommendations.
This online service has now been updated to support the identification of patients who may have been infected by a blood transfusion prior to 1996, and this will go live by the end of May 2025. The paper registration form (PRF1) will also be updated for those who cannot or do not wish to register online.
This publication provides further guidance on GP practice actions in support of their use.
Important actions
All GP practices are requested to note that:
- only new patients, born before 1996, will be invited to complete the new question(s) when registering with a new GP practice (and only those patients will see these question(s) if using the online GP registration service)
- patient responses using the online GP registration service will not be filed automatically and will need to be reviewed and actioned from the patient registration email, under the section titled ‘Important information’ (highlighted in blue)
- where new patients indicate a history of blood transfusion and infection risk at registration, processes need to be in place to discuss, offer or signpost to hepatitis C testing, as part of the new patient (health check) consultation (or opportunistically before this)
- free home self-tests are available for patients to order from the NHS.UK website
Online GP registration service changes
From 16 June 2025, all patients born on or before 31 December 1995, registering via the online GP registration service, will be invited to answer the following question and receive the following information after submission:
The image above shows 2 screenshots of mobile views of the online GP registration service.
Image 1
The first image shows step 3 of 3 – health questions.
Heading: Blood transfusions
Text reads: NHS England is committed to identifying all those infected with a bloodborne illness no matter how it is transmitted. You may have received infected blood if you had a transfusion because of:
- an accident
- complications during childbirth
- surgery or medical treatment
The information you give will be used by your GP surgery to consider suitability for blood screening, in the unlikely event you were given infected blood.
Question: Did you receive a blood transfusion before 1996?
Options:
- Yes
- No
- I don’t know
A link below the options reads ‘Why are you asking this?’
A green ‘Continue’ button appears at the bottom.
Image 2
The second image shows the information provided after submission.
Heading: Infected Blood Inquiry
Text reads: In response to the Infected Blood Inquiry, NHS England wants to identify anyone that may have received infected blood through a blood transfusion before 1996.
Evidence shows it is extremely unlikely that anyone would get a bloodborne illness through infected blood after the introduction of universal blood screening in September 1991.
If you have any concerns, you should contact your GP surgery directly.
The information you have provided will be shared with your GP surgery and they may offer you a blood test.
A green ‘Continue’ button appears at the bottom.
Subject to monitoring and assessment of the take-up of this question, the intention is to add a further question asking whether the patient has previously been tested for hepatitis C. The PRF1 paper form update will also follow in 2025/26.
New patient (health check) consultation
GP practices are required in their contracts to offer patients a new patient consultation within 6 months of registration.
Where this is accepted by the patient, there is an opportunity to support the identification of patients who may have hepatitis C from infected blood, in line with the Infected Blood Inquiry recommendation.
Equally, this may be raised opportunistically, for example, at the patient’s next appointment if this is sooner.
Where patients indicate that they have had a blood transfusion before 1996 and have not previously been tested for hepatitis C, GPs and health care professionals should follow this up.
Until the additional hepatitis C testing question is added to the online GP registration service, practices may need to discuss with patients during a consultation (or check the patient record beforehand) to establish if they have been previously tested for hepatitis C.
Patients should be offered information and support and signposted to testing routes, such as the free home self-test.
Patient information about hepatitis C is available on the NHS.UK website.
Triple testing for blood-borne viruses
It is almost certain that based on the presentation of hepatitis B and HIV, a patient who contracted infection through an infected blood transfusion prior to 1996 will have already been tested, diagnosed and in treatment.
However, where new patients indicate that they may have had a blood transfusion before 1996 and have not been tested (or do not know if they have been) and there are concerns about other possible clinical presentations, it may be clinically appropriate to complete a blood-borne virus screen and test for hepatitis C, hepatitis B and HIV.
Clinical audit among GPs registered lists
We are committed to identifying all those infected with a bloodborne disease, however it is transmitted.
As part of the work, we would like to remind practices that it is possible and encourage colleagues who have not yet done so to undertake hepatitis C case finding, using embedded GP IT clinical searches among registered patients.
To generate lists of patients with hepatitis C codes or risk factor codes:
EMIS practices – in the Population Reporting module, EMIS Library – SNOMED Searches >EMIS Clinical Utilities > Third Sector Partnerships > Elimination Programme
SystmOne practices – email hepcsearches@vipc.co.uk to request the searches.
For assistance managing the search results, please contact england.hepc-enquiries@nhs.net where we can link you to your local HCV operational delivery network.
Classification: official
Publication reference: PRN01966