Authorisation of Blood Components by Non-Medical Authorisers Policy

Authorisation of blood components includes making the clinical decision to transfuse a blood component and providing the written (or otherwise documented) instruction to administer a blood component to a recipient in line with local and national policy and guidelines.

In 2022 a revised framework to support the authorisation of blood components by non-medical healthcare professionals in the UK was published: Clinical Decision-Making and Authorising Blood Component Transfusion (transfusionguidelines.org) This revision of the original framework (Green J and Pirie E (2009) A Framework to Support Nurses and Midwives Making the Clinical Decision and Providing the Written Instruction for Blood Component Transfusion) reflects the expansion of staff groups for whom authorising blood components has an acknowledged benefit for their professional role and for the patient experience.

This NHS Lothian policy is based on a national SNBTS template reflecting the guidance provided in the UK framework. The policy is limited to the authorisation of blood components and excludes prescribing of medicines, including blood products (as distinct from blood components).

The policy describes the roles and responsibilities of experienced registered and regulated healthcare professionals who need to extend their role to authorise blood component transfusion. This may potentially include, but is not limited to, nurses, midwives and (upon becoming a role registered with the General Medical Council) physician associates. The policy is also designed to inform and support clinical services, managers, practice supervisors and assessors. The associated governance structure in NHS Lothian, designed to ensure safe blood component authorisation practice, is defined.

Overall, this policy supports development in line with service need where patient care is improved, without compromising patient safety. It also recognises the importance of multidisciplinary contribution and collaboration to the development of this advanced role.