1. Introduction
2. Accountability
3. Framework Organisational Chart
4. Remit and Terms of Reference of JPAC
5. Remits and Terms of Reference of SACs and WGs
6. Reporting Arrangements
7. Main Outputs from JPAC
8. Budget
9. Summary
The structure and function of the Joint UKBTS Professional Advisory Committee (JPAC) and associated Standing Advisory Committees, originally created in 1987, have been subject to comprehensive review since 1998.
Changes in the organisation and management of the Transfusion Services throughout the UK, in 1997, resulted in the setting up of 4 National Services and the introduction of individual and statutory accountability vested in Chief Executives, for clinical governance and controls assurance. Devolution of governments has also empowered the individual Health Departments to make their own policy decisions.
The UK Forum, created in 1999, consisting of the Chief Executives and Medical Directors of the 4 Services, has taken a lead in these discussions and solid foundations and clear lines of accountability have been laid for the advisory committees which produce the professional guidelines for the Services.
In July 2000 the UK Forum agreed the terms of reference for the Red Book organisation:
Decisions on implementation and policy would be vested in the individual Chief Executives and their Service Boards and where appropriate their respective Health Departments.
To reflect this clarity of role the name of Joint UKNBTS/NIBSC Executive Liaison Committee was changed to Joint UKBTS/NIBSC Professional Advisory Committee on 14 June 2001. In 2013 the name was again changed to Joint UKBTS Professional Advisory Committee (JPAC) to reflect the inclusion of the MHRA and HTA, and that only the four UK Blood Services contribute financially to JPAC.
As in 1987, when the guidelines were first envisaged, they are produced to help ensure as far as possible and in the light of current knowledge the purity, potency, safety and efficacy of the donated blood in the UK without losing sight of availability.
Over the past years the guidelines have expanded to cover the safety of tissues and haemopoietic stem cells (1999) and the clinical use of blood and blood products (2000).
The guidelines aim to be evidence based as far as possible, although much of transfusion medicine is custom and practice based, and in many areas appropriate evidence by 21st Century standards cannot be obtained. Where this is the case, the lack of such evidence will be drawn to the attention of the reader.
The guidelines are published as the Red Book and support the good manufacturing standards against which the Regulatory Bodies inspect and licence the services.
The Services may deviate from these guidelines; however any such deviation will need to be substantiated and documented.
Guidelines for the clinical use of blood and blood products are published as the Handbook of Transfusion Medicine and will be reviewed at appropriate intervals.
The guidelines must take account of relevant Recommendations and Directives from the European Community.
The work of JPAC should be as transparent as possible. Unless there is a justifiable reason not to, papers on which recommendations from JPAC are based will be made publically available on the JPAC website after approval by JPAC. Reasons that this might not be possible include containing confidential information or that the paper may be published in a peer-reviewed journal. Confidential material might include, but is not limited to, data of commercial sensitivity. As a course of their duties members of JPAC and its SACs may view information that is confidential in nature. Papers that contain confidential information will be clearly marked as such, and members are expected to respect the confidentiality of such material and not discuss or distribute the material outside of JPAC or its SACs. In some instances it may be necessary to post JPAC papers on the web site prior to peer-review publication. This may be due to there being an urgent need to making data publically available. This should be discussed with the Professional Director of JPAC.The work of JPAC should be as transparent as possible. Unless there is a justifiable reason not to, papers on which recommendations from JPAC are based will be made publically available on the JPAC website after approval by JPAC. Reasons that this might not be possible include containing confidential information or that the paper may be published in a peer-reviewed journal. Confidential material might include, but is not limited to, data of commercial sensitivity. As a course of their duties members of JPAC and its SACs may view information that is confidential in nature. Papers that contain confidential information will be clearly marked as such, and members are expected to respect the confidentiality of such material and not discuss or distribute the material outside of JPAC or its SACs. In some instances it may be necessary to post JPAC papers on the web site prior to peer-review publication. This may be due to there being an urgent need to making data publically available. This should be discussed with the Professional Director of JPAC.
The work carried out by members of JPAC and SACs is considered to be part of their normal professional duties, which are carried out with the approval of their employing authority.
NHSBT is the legal and financial entity for JPAC governance and it has been confirmed that indemnity for members of JPAC is covered by the Liabilities to Third Parties Scheme under the NHSLA while undertaking activities for NHSBT.
All members will need to declare any interests. SAC Chairs will ask for such declarations in writing annually, declaring any new interests at each meeting. These annual declarations will be kept by the JPAC office.
All members are expected to partake in CPD as deemed appropriate by their professional bodies.
All members working for JPAC are entitled to up to 10 CPD credits annually, depending on their CPD scheme. It is left to the individual professional to claim the number they deem appropriate.
All members must participate in an annual appraisal process with their employing authority. The Chair of JPAC will appraise SAC Chairs, and SAC Chairs their members, covering the scope of their work with JPAC and provide them with written feedback to contribute to this process.
The committee consists of the Professional Director of JPAC, Deputy Professional Director of JPAC, JPAC Manager, Scientific Lead Safety Policy (JPAC/SaBTO), chairs of the Standing Advisory Committees, Medical Directors of the 4 UK Blood Services, a UK Blood Service Quality Manager and representation from the Human Tissue Authority (HTA), the Irish Blood Transfusion Service (IBTS), the Medicines and Healthcare products Regulatory Agency (MHRA), the National Institute for Biological Standards and Control (NIBSC) and Public Health England (PHE)
Nominated deputies may attend meetings.
The Chief Executives of the Services may attend any meeting as observers or, if requested by JPAC, as participants.
The guidelines for the UK also need to take account of the regulatory framework in this area, in particular that of the European Union and the UK Blood Safety and Quality Regulations.
Any expansion of JPAC has to be approved by the UK Forum.
It is the responsibility of JPAC to ensure that all relevant aspects dealing with the safety of blood and tissues in the UK are covered, and that the professional advice emanating from JPAC is communicated in a timely fashion to the UK Forum for further decision making if required.
JPAC is not concerned with implementation issues, nevertheless, as JPAC is responsible for producing the guidelines it is important that JPAC is kept informed of implementation arrangements and dates within the UK Services.
To deliver this remit JPAC needs to:
There will be at least 3 meetings annually.
The agenda items are submitted by members of JPAC and the UK Forum.
If a member of JPAC is unable to attend they may appoint a deputy who should be fully briefed.
If fewer than 2 Medical Directors are able to attend a particular JPAC meeting, then approval of any decisions made by the committee members present will be sought from the Medical Directors following the meeting and prior to distribution of the draft minutes.
The secretary to the JPAC meeting will take minutes and circulate the draft version to committee members for any corrections. The minutes will then be formally approved at the next meeting and then posted on the JPAC website.
Vacancy of the Professional Director position will be advertised through the Medical Directors, and if deemed appropriate by the UK Forum, by external advertisement.
The post is funded through the JPAC budget and is 0.6 WTE
Application will be by Curriculum Vitae and a covering letter, outlining the reason for application and key attributes which make the candidate suitable for the post.
Appointment will be made by the Medical Director of NHSBT in conjunction with the UK Forum and will include an interview process determined by the UK Forum.
To avoid any conflict of interest the Medical Directors, Chief Executives or individuals who hold national functional lead roles for implementation within their respective services, will not be eligible to stand as Professional Director.
The Deputy Director should have experience of work for JPAC, or one of its SACs, and current or previous experience of Chairing an SAC is desirable.
The post is not remunerated by JPAC, but time to undertake the role should be negotiated with his / her employer and recognised in their job plan.
The remits of the SACs delineate the fields of transfusion medicine and tissue banking covered by the particular SAC, the terms of reference detail the workings of a particular SAC.
Standing advisory committees and sub-committees are established and disbanded according to the needs of the UK Services following JPAC and UK Forum approval.
Working groups are “ad hoc” groups set up by SACs, with JPAC approval, to consider a specific issue within a clearly defined time span and report back to the parent SAC; following completion of the task they will be disbanded.
Although the remits of the SACs vary, the general broad terms of reference apply to all. All SACs have written terms of reference which detail their manner of working: meetings, minutes, distribution of minutes, membership.
All SACs report to JPAC through their Chairs.
All SACs are under an obligation to maintain the appropriate section of the Red Book to ensure that the guidance is up to date and based, wherever possible, on evidence. If the evidence on which guidelines should be based is not available, as may be the case with time honoured custom and practice, the SAC should suggest to JPAC the best way of obtaining such evidence. Where it is clear that evidence for practice does not exist, and cannot be obtained, this must be clearly acknowledged.
All SACs have to take account of the regulatory framework (UK and European) for their field of practice.
All SACs are under an obligation to comment, when requested, on consultation documents relevant to their field of practice.
The Chairs and SAC members serve in a personal capacity due to their own expertise and not as representatives of any group, although account has to be taken of the needs of the 4 Services in the UK.
The chairs are appointed for by the Medical Directors and the Professional Director of JPAC. They are accountable to the Professional Director of JPAC, and their appointment will be reviewed every 3 years.
During the appointment process efforts should be made to ensure continuity of the work of a SAC.
Vacancy of a Chair position will be advertised through the Medical Directors and expressions of interest sought from potential candidates within JPAC and the 4 UK Blood Services.
Application will be by Curriculum Vitae and a covering letter, outlining the reason for application and key attributes which make the candidate suitable for the post.
Appointment will be made by the Professional Director of JPAC in conjunction with members of the UK Forum, and will include an interview process.
To avoid any conflict of interest the Medical Directors and Chief Executives of the Services will not be eligible to stand as Chairs of SACs, they are however eligible as members of SACs.
Individuals who hold national functional lead roles for implementation within their respective services should not normally hold chairs of SACs relevant to their main functional area of responsibility, but may serve as members.
Appoint members according to the rules as outlined in the JPAC constitution.
Perform annual reviews with members as part of their appraisal or performance review.
Set agendas for meetings; ensure that relevant topics are discussed.
Ensure that horizon scanning in the relevant area is a standing item on every SAC meeting agenda.
Ensure that SAC recommendations are presented to JPAC and endorsed in a timely manner prior to incorporation in guidelines.
Ensure timely update of relevant chapters and supplements.
Ensure that the time of the experts is used most effectively. (E.g. using audio conferencing facilities, asking a small group from the SAC to undertake the practical updating of the guidelines).
Ensure that relevant European Documents are read and commented on as requested. This task may need to be delegated to a few members, which should include the Chair.
Ensure that appropriate communication takes place with other relevant groups within the 4 UK Blood Services.
Members of SACs will be appointed by the SAC Chair in consultation with their SAC and the Professional Director of JPAC. The number of members will be left to the discretion of the Chair, but generally no more than 10 would be expected. Overlap of membership should be ensured by the Chair to avoid turnover of the whole committee at the same time.
Although members are appointed for their personal expertise the Chair should ensure that there are members from at least 2 of the Services on their committee to bring wider experience to the SAC. It is advisable that there be some cross representation between SACs.
It is also advisable that there are members from outside the UK Blood Transfusion Services to give the SACs more authority throughout transfusion medicine. For some SACs lay representation is encouraged.
In view of the complexity of the guidelines and increased workloads maximum flexibility should be allowed and all SACs need to work efficiently and effectively.
Appropriate succession planning and encouragement of younger members to serve on the Advisory Committees is encouraged.
Observers can attend SAC meetings at the discretion of the SAC Chair.
The remits of the SAC are reviewed annually.
All chairs of the SACs will report on the progress of their previous year’s activities at their annual SAC review meeting. These will form part of the formal reporting process of the Professional Director of JPAC to the Medical Directors and the UK Forum.
All SACs and the Professional Director of the JPAC will produce work plans annually, indicating the topics they hope to cover during the year. The collated JPAC work plan is submitted to the UK Forum annually.
New developments during the year may arise and take precedence on the agendas of all groups.
Due to the complexity of the organisation it is clearly important that all the work carried out by the different groups is documented, considered and appropriate recommendations forwarded. The parent SAC is responsible for considering the work of any sub-committees and working parties and, where appropriate, bring issues to JPAC.
Considered, timely, and documented professional advice to the Medical Directors, and UK Forum on issues relevant to transfusion medicine and the safety of blood transfusion and tissue transplantation in the UK.
The content of the Red Book is reviewed regularly. Systems are in place to ensure that new guidelines, appearing in between editions of the Red Book, are communicated to the Services and appear formally in ensuing editions.
The guidelines for the clinical use of blood, consistent with advice emanating from other professional organisations. The published book is the fundamental document but a version also appears on the website. This version is constantly improved and contains further explanations.
These guidelines are issued separately as they change frequently. Systems are in place for controlling and documenting changes.
The website, www.transfusionguidelines.org.uk, is maintained by the JPAC Manager in conjunction with the software providers.
JPAC actively encourages members of its SACs to publish work that has been conducted on behalf of JPAC, where relevant. This will facilitate:
The lead author of the article identifies all others that have made a contribution to the work and decides whether they meet ALL of the following criteria to be a co-author:
The lead author is responsible for ensuring that all co-authors have seen and approved the final article.
If there are too many authors to list, then consideration should be given to the lead author publishing the article on behalf of the UK Joint Professional Advisory Committee and listing contributors as collaborators.
Most journals ask authors to assign copyright to the publishers. To avoid issues with copyright, substantial elements of the publication should therefore not be reproduced on the JPAC website. Therefore, the usual sequence of events for material that is suitable for publication should be as follows:
In some instances it may be necessary to post JPAC papers prior to peer-review publication. This may be due to there being an urgent need to making data publically available. This should be discussed with the Professional Director of JPAC.
A budget has been identified for JPAC. The 4 UK Blood Services contribute to this budget pro rata, as follows (March 2019):
The budget also provides for the hosting and maintenance of the website www.transfusionguidelines.org.uk.
Should an increase in the budget be required the Professional Director of JPAC will approach the UK Forum.
This document aims to outline the agreed constitution, lines of accountability and working methods for the professional advisory machinery responsible for producing the Red Book and supplements (all the Donor Selection Guidelines, including the Geographical Disease Risk Index) and the Handbook of Transfusion Medicine.
The rapid advance of knowledge in transfusion medicine makes it inevitable that the various advisory committees, subcommittees and working parties are flexible and so they can respond to new challenges. The basic mechanisms for such change are outlined in this constitution.
Updated March 2020