Transparency data

Minutes of the meetings of the Technical Expert Group (September-October 2025) (HTML)

Updated 30 October 2025

17 Sept 2025 17:00 BST 

Attendees - Technical Expert Group (TEG):  Professor Sir Jonathan Montgomery (Chair), Professor Jane Anderson, Dr Ahmed Elsharkawy, Professor Graham Foster, Professor Patrick Kennedy, Dr Ian Williams, Dr David Asboe, Professor John Weinman, Professor Deborah Christie, Dr Susie Shapiro, Dr Lise Estcourt

Attendees - Browne Jacobson LPP  

Apologies: Dr Chloe Beale

Attendees - Infected Blood Inquiry Response Policy Team

Welcome 

The Chair welcomed members to the new TEG. Attendees introduced themselves.

Cabinet Office introduction to role and purpose of the TEG

• Cabinet Office officials led this item. They gave an overview of the development of the Infected Blood Compensation Scheme design and how the TEG will contribute to the Government’s response to the Inquiry’s Additional Report. 
• The TEG would now work on how it might work to address the recommendations within the scope of its Terms of Reference and development of proposals. It was noted that the upcoming public consultation would test proposals with the community, and determine the best way forward following the Inquiry’s Additional Report. 
• The TEG will need to consider what form of engagement the group may wish to conduct, per their terms of reference, to support completion of the TEG work programme.
• Following the consultation, the Cabinet Office will share analysis with the TEG prior to the TEG providing their Group’s final advice to the Government, which will be published alongside the Government’s decisions following the consultation. 
• Following the consultation, the Government will be in a position to finalise any changes to the Infected Blood Compensation Scheme, informed by the consultation findings and the TEG’s advice.
• The TEG is directly appointed by the Minister for the Cabinet Office (MCO). The group is accountable for providing robust, expert advice on policy options for MCO to consider. The Chair will provide regular updates to the minister on the group’s work.

Overview of Infected Blood Inquiry additional report and TEG work programme

• Cabinet Office officials summarised the recommendations made in the Inquiry’s additional report and which were the focus of the TEG in the work programme.
• TEG briefly discussed the sequencing of the work programme.
• The TEG agreed to meet weekly on Thursdays 1700-1830

Actions

• Cabinet Office to provide a briefing of the Inquiry’s Additional report recommendations and ownership between IBCA and the Cabinet Office
• Cabinet Office to arrange a briefing for TEG from IBCA at a future meeting to provide feedback on IBCA’s operational experience of the scheme to date
• Cabinet Office to share details of TEG induction programme for w/c 22 September. 
• TEG to familiarise themselves with background reading documents the TEG work programme as part of the induction.

25 Sept 2025 17:00 BST 

Attendees - Technical Expert Group (TEG):  Professor Sir Jonathan Montgomery (Chair), Professor Jane Anderson, Dr Ahmed Elsharkawy, Professor Graham Foster, Professor Patrick Kennedy, Dr Ian Williams, Dr David Asboe, Professor Deborah Christie, Dr Susie Shapiro, Browne Jacobson LPP  

Apologies: Professor Alexander Mcneil, Professor John Weinman, Dr Lise Estcourt, Dr Chloe Beale

Attendees - Infected Blood Inquiry Response Policy Team

Welcome

• The Chair welcomed the group to the meeting. He noted the compressed timeline for the group’s work in providing advice ahead of the public consultation on proposed changes to the Infected Blood Compensation Scheme (the Scheme).
• The Chair introduced the TEG’s external engagement process and outlined an initial approach to conducting engagement. The Chair proposed a series of targeted roundtables to address the questions set out in the TEG work programme. The roundtables would be chaired by Sir Jonathan in his capacity as Chair, with the TEG identifying relevant attendees (likely 6-7) and questions as the programme progressed.

Discussion on Recommendation 4a: Hepatitis core awards (Interferon)

• The Cabinet Office introduced the workshop paper for discussion. The Infected Blood Inquiry’s Additional Report recommended greater recognition for people infected with Hepatitis B or C who received treatment with interferon.
• The Government has accepted the need for change and proposed to introduce a new infection severity band within the core route, Level 2B, to recognise the impacts of interferon treatment. The group’s advice will inform proposals for the design of this new award, which will be tested during the public consultation.
• The TEG were asked to consider what impacts interferon treatment would have had on people’s care needs (care award) and their loss of earnings (financial loss award) and review the scheme’s current injury award

Duration of treatment and eligibility

• The group discussed the conclusion set out by the Inquiry’s Hepatitis Expert Group report, which stated that ‘Interferon-containing regimens have no predictable long-term effects that have been detected in the available published clinical trial follow-up data’. The group noted the limitations of reliable clinical data on long term impacts.

• The group discussed the Inquiry’s Hepatitis Expert Group conclusion that interferon treatment typically lasted for 48 weeks. 

• The group considered 48 weeks a fair working assumption but noted that duration could vary significantly, for example treatment could be as little as one week. Discussion noted that drop out rates were high and treatment was discontinued for many after 12 weeks if they had not responded. 
• The group proposes introducing a qualification of  interferon treatment duration of 12 weeks  for a Level 2B uplift. This would help ensure Level 2B awards were made to those who were likely to have experienced substantive symptoms. The TEG agreed to consult on what other forms of evidence might be available in order to qualify. It was suggested that existing statements to the Inquiry might often provide the evidence required. It might also be found in patients’ medical records.
• The group reflected on availability of evidence for interferon treatment and challenges that this may present. The group agreed that self-declaration  purely for the purpose of obtaining compensation without any corroboration would not be sufficient due to the principle of verifiability. However, where statements had been made to the inquiry detailing personal experience interferon treatment and its impact they should be accepted as evidence that such treatment had been received without further inquiry as they had been made independently of any expectation of compensation.  
• Alternative forms of evidence were discussed. These could include letters from healthcare professionals (such as a hepatology nurse specialist), primary care records, or evidence already submitted to the Infected Blood Inquiry.
• The group considered whether it would be proportionate to establish separate award levels for different interferon regimens (including pegylated versus non‑pegylated interferon, and monotherapy versus combination therapy) or to distinguish between patients treated for HCV or HBV, given the generally better tolerance of HBV treatment. It concluded that such distinctions would not be proportionate within a tariff-based scheme. Accordingly, the award should reflect the effects of interferon when used in combination with ribavirin, where the impact is greater than interferon alone, and would be offered to those treated for either HCV or HBV.
• The group noted that interferon treatment would not be offered to those during the acute phase so there was no need to review awards for those who suffered an acute HCV or HBV infection.

Injury award

• The group discussed how the Injury award should be structured for the new Level 2B.
• The group agreed that case law relating to interferon should be re-reviewed before advising on whether the injury award should be amended. 

Care award

• The group discussed how the Care award could be adjusted to reflect the impact of interferon.
• The group agreed to a proposal to provide an additional period of ‘low care’ (16.5 hours per week) for one year. This would be on top of the 10 years of ‘domestic support and ad hoc care’ already provided for in the chronic Hepatitis award.
• This was considered a reasonable acknowledgement of the struggle many people experienced during the 48-week treatment period but that care needs for the majority were unlikely to extend this period or exceed the care already offered within the Chronic Level 2 Hepatitis award. 

Financial Loss award

• The group considered how to assess the financial impact on a person’s ability to work during and after interferon treatment.
• The group discussed a proposal to compensate people who had interferon treatment with a lump sum equivalent to one or two years of financial loss at a higher rate (for example, the 80% rate used for cirrhosis). This would be a simple and proportionate approach, recognising that while many people found it very difficult, some did continue to work. Extending the period of financial loss uplift to two years would reflect a judgement that individuals were unlikely to work full time during the 48 week course of interferon treatment and may not return to work immediately following treatment. 
• The group agreed that the Exceptional Loss award, available through the supplementary route, could provide a route for people who can evidence a lasting impact on their ability to work beyond two years.
• The group also agreed on the importance of using the public consultation to gather experiential data to shape the final proposal.

Impact on people with bleeding disorders

• The group discussed whether interferon treatment may have had any additional impacts on those with haemophilia or bleeding disorders. The group concluded that in general, interferon would not have had any different direct impacts on these groups.
• It was noted that interferon treatment may have meant that it was more difficult to administer their preventative treatment (prophylaxis) for bleeds which could lead to more joint bleeds and potentially long-term joint damage. The group agreed to undertake further work to understand if there was data on whether people with haemophilia and Hepatitis C experienced worse joint damage than those without Hepatitis C and if this needed to be considered through the Severe Health Condition supplementary route.

Forward look

• The Cabinet Office confirmed the schedule for upcoming TEG meetings in the lead up to the launch of the Government’s public consultation. 
• The Chair outlined how the planned TEG engagement would  operate to ensure transparency and engagement. This was likely to take the form of roundtables during the consultation period and while responses were being considered. A more  detailed plan would be drawn up for consideration.

Actions

• TEG to give further consideration to the interaction between interferon treatment and haemophilia, and whether reliable data exists on joint damage in people with haemophilia with and without Hepatitis C.

2 Oct 2025 17:00 BST 

Attendees - Technical Expert Group (TEG):  Professor Sir Jonathan Montgomery (Chair), Dr Ahmed Elsharkawy, Dr Ian Williams, Dr Chloe Beale, Professor John Weinman, Professor Graham Foster, Professor John Weinman, Dr Susie Shapiro, Browne Jacobson LPP 

Apologies: Professor Patrick Kennedy, Dr David Asboe, Professor Deborah Christie, Professor Alexander Mcneil

Attendees - Infected Blood Inquiry Response Team

Welcome 

• The Chair welcomed the group and updated on the clearance process of previous meeting minutes.

TEG roundtables

• The Chair provided an update on a proposal for the Technical Expert Group (TEG) to host a series of roundtables.
• The group discussed the purpose of the roundtables which would focus on specific areas where the group determines there is a need for further information on specific aspects of the lived experience to provide technical advice. This engagement will be separate from the Government public consultation.
• The group also considered the value of holding a separate roundtable with Recognised Legal Representatives (RLRs) to discuss legal aspects of the scheme

Recommendation 5a - Severe Psychological Harm

•  The chair set out that the group had now been asked to review the threshold and evidence criteria for the Severe Health condition award for Severe psychiatric disorders so as to ascertain (A) if there was a gap between this award and the severity of mental health issues compensated by the core route that needed to be filled by an intermediate category and (B) whether there are alternative markers of severity equivalent to that on which the Severe Health condition award for Severe psychiatric disorders had been designed. 
• The chair provided a summary of how the current scheme recognises severe psychological harms through the core route and supplementary route Severe Health Condition award.
• The group commented that more could be done through TEG roundtables to explain what level of psychological harm had already been considered in the core route. 
• The Chair updated the group on a meeting with Dr Sarah Helps (Infected Blood Psychological Service) regarding the Scheme’s recognition of severe psychological harm through the Severe Health Condition award. The chair informed the group that he expected a response from Dr Helps shortly on how she would advise the scheme could utilise formulation based opinions in assessing severe psychological harm based on her experience from the England Infected Blood Psychological Service. 
• The group discussed how to assess severe psychological harm separately from the psychological impacts already compensated in the core award. The group discussed complex challenges with identifying and standarding markers of severity for Severe Psychological harm including drawing conclusions on causative links. 

• The group noted that given the supplementary route was focussed on the care and financial loss award the aim in reviewing the criteria for the Severe Health Condition award was to identify individuals whose care and financial loss impacts were above that assumed by the core route i.e a reduction in ability to work greater than 40% and increased care needs beyond fluctuating ‘domestic support and ad hoc care’ totalling more than 10 years.

• With this in mind the group reflected that supplementary route assessment could focus on the impact of the harm, rather than a specific diagnosis, particularly where that impact resulted in financial loss beyond that assumed by the core route e.g. an inability to work. A method would then be required to determine who meets these criteria to move from a core to a supplementary award.
• The group discussed alternative forms of evidence which could be considered for a psychological harm awards, recognising that many people may not have sought medical help or were overlooked by services. It was suggested that this topic would be suitable for discussion at a TEG roundtable.
• The group discussed the merits of types of evidence such as sickness certificates, prescriptions, benefits and GP notes. It was recognised that different considerations may arise in relation to evidence relating to those who were deceased and those living.
• The group discussed alternative evidence for the severity that the Severe Psychiatric Disorder Severe Health condition award aimed to capture. No additional markers were identified that would be appropriate for a tariff-based scheme or that would not introduce safeguarding concerns. The group noted that the prescription of antidepressants was not considered a proxy for the severity of this band and was not an indication of an individual’s ability to work.
• It was observed that considerable overlap likely exists between the impacts considered for a lower threshold severe psychological harm award and those recognised by the IBSS ‘Special Category Mechanism’ (SCM) payment. The group determined that it would be beneficial to ascertain from IBSS the proportion of SCM individuals who qualified for SCM payment based on mental health impacts.
• The group agreed to review options for providing further recognition for psychological harm within a tariff based scheme following advice from Dr Helps. 

AOB - IBSS medical assessors meeting

• Cabinet Office officials updated on the upcoming TEG meeting with the EIBSS medical assessors to discuss the group’s advice on recommendation 4b - Recognition of Special Category Mechanism (SCM). 

Actions

• The chair to circulate proposal on TEG engagement roundtable structure and draft discussion paper on recommendation 4a - recognition of interferon 
• TEG members to share questions for discussion with EIBSS medical assessors in advance of the meeting on 8 October. 

3 Oct 2025 12:00 BST 

Attendees - Technical Expert Group (TEG):  Professor Sir Jonathan Montgomery (Chair), Professor Jane Anderson, Dr Ahmed Elsharkawy, Dr Ian Williams, Professor Deborah Christie, Professor John Weinman, Browne Jacobson LPP  

Apologies - Dr Chloe Beale, Professor John Weinman, Professor Graham Foster, Dr Susie Shapiro, Patrick Kennedy, David Asboe, Dr Lise Estcourt

Attendees - Infected Blood Inquiry Response Policy Team

Recommendation 8a: Affected supplementary route

• The Chair introduced the item and highlighted the overlapping nature of other recommendations. The Cabinet Office summarised the compensation already available to people affected through the scheme’s core route.

TEG discussion of an affected supplementary route

The chair and Cabinet Office officials provided an overview of  three potential broad approaches for introducing an affected supplementary route: 

• ‘Event’ based approach: This would provide additional compensation for specific traumatic events, for example children being placed into care.
  • In appraising this approach, the group considered the challenges of identifying all possible events that should qualify for an award and the potential inequity this could introduce. Individuals who suffered equally severe harm from an unlisted event would not receive compensation. This is of particular concern given that the IBCA lacks the ability to exercise discretion in decision-making, thus necessitating that all harmful events be stipulated in legislation.
  • The group expressed concerns regarding the provision of compensation for events and impacts already considered when advising on core awards (i.e double recovery), such as loss of opportunity to have children.
  • Consequently, the group concluded that they could not recommend this approach be adopted.
• ‘Impact’ based approach: This would provide compensation based on the level of harm a person suffered, such as developing a severe mental health condition, whatever the specific cause.
  • The Group concurred that whilst this approach closely aligned with the Inquiry’s recommendation, it presented considerable challenges regarding applicants providing verifiable evidence of the psychological harm suffered, and establishing a clear causative linked to the infected blood scandal, frequently decades after the event, without recent clinical assessment.
• ‘Category’ based approach: This approach would provide an award to specific groups of people who are assumed to have suffered a greater level of harm, for example, children whose parents were infected during their childhood.
  • TEG saw some merit in this approach as it could reduce the need for individuals to provide detailed, personal evidence of their suffering or causative link. However, the group raised concern on whether this approach would provide the targeted recognition which the community were looking for as it assumes a level of harm for everyone in a category, which may not reflect individual experiences.

Legal context and evidencing harm

• The Group discussed the significant challenges in designing a supplementary route for affected persons that is fair, evidence-based, and deliverable.
• TEG noted that any decision to extend this supplementary route for affected persons is a policy matter for the Government given the scheme’s current design extends beyond the common law.
• There was a detailed discussion about how affected people could prove they had suffered severe psychological harm.
  • The Group noted the diversity of experience and psychological impact. It was common in the Inquiry’s witness statements for people affected to have suffered severe psychological impacts, and that there was little to no professional support available to them at the time;
  • Unlike people with an infection, people affected were less likely to have medical records detailing their psychological state and be able to clearly evidence a causative link back to infected blood related impacts. Using access to healthcare as a measure of harm would likely therefore be unfair;
  • The Group considered other ways to measure harm, such as an impact on a person’s employment. However, it was noted that this could also be unreliable and hard to evidence a causative link. 
• The Group stressed the importance of ensuring that any new supplementary award for a person affected was proportionate relative to an infected person.
• The group agreed to consider approaches to the affected supplementary route following feedback from Dr Sarah Helps on the Serve Psychological award for infected persons. 

8 Oct 2025 11:00 BST 

Attendees - Technical Expert Group (TEG):  Professor Jane Anderson, Dr Ahmed Elsharkawy, Dr Ian Williams, Dr David Asboe, Professor Deborah Christie, Dr Chloe Beale, Dr Lise Estcourt

Attendees - Infected Blood Inquiry Response Policy Team; England Infected Blood Support Scheme (EIBSS) medical assessors and service leads

Apologies - Professor Sir Jonathan Montgomery (Chair),  Dr Susie Shapiro, Professor Patrick Kennedy, Professor John Weinman, Professor Alexander Mcneil, Professor Graham Foster

Welcome and introductions

• Cabinet Office officials introduced the meeting, explaining its purpose was to help the TEG understand the eligibility for the EIBSS Special Category Mechanism (SCM). The Cabinet Office provided a set of questions from the TEG for the medical assessors and EIBSS service leads to answer on the SCM prior to the meeting.

Evolution of the SCM

• The medical assessors provided a short overview on the introduction and purpose of SCM. It was discussed that the SCM was originally introduced to provide additional support for people with Hepatitis C who had experienced severe side effects from interferon treatment.
• The medical assessors set out that mental health impacts were the most common reason for an SCM award including depression and anxiety. Chronic fatigue syndrome was also discussed.
• The criteria for SCM equivalents evolved differently across the four UK nations after the original support schemes were devolved. England’s SCM criteria have been followed closely by Northern Ireland and Wales, while Scotland’s scheme includes an element of self-declaration. 
• Medical assessors noted that the availability of effective cures for Hepatitis C has changed the context of assessments, as SCM was initially developed when the treatment for chronic infection was not successful in some (dependent on viral & host factors).

SCM assessment process

• The medical assessors provided an overview of the EIBSS assessment process.  The Group was informed that all SCM applications in England are reviewed independently by at least two medical assessors. If there is agreement between the two medical assessors, then the decision reached will be communicated to the applicant. If there is disagreement, then the application will be reviewed by an independent 3rd assessor and this opinion will stand.
• Assessors make judgements based on the balance of probabilities, from confirming the cause of infection to assessing the impact of that infection and its treatment on an individual’s health.
• The assessment process includes a degree of discretion to allow assessors to judge the unique circumstances of each case. The TEG would need to consider this when designing criteria for a tariff based assessment which is unable to provide discretion on decision making. 
• All assessment outcomes and data for both approved and declined applications have been shared with IBCA. The Group stressed the importance of the IBCA using these historical assessments to ensure consistency and efficiency between applicants. 

Evidence for SCM applications

• The Group discussed the evidence required for SCM applications and the challenges involved in its assessment.
• The medical assessors set out that applicants are responsible for providing their own evidence. Assessors sometimes request further specific records, but it was noted that applicants have the right to refuse to provide them.
• The Group acknowledged the problem of missing medical records, particularly for those infected decades ago via blood transfusion. It was noted that this lack of historical documentation can make it very difficult for people to prove their case and creates a risk that they are unfairly disadvantaged.
• The assessment of psychological reports was discussed.

Declined applications

• EIBSS confirmed that the reason and the evidence for declined SCM applications is documented, and shared with applicants upon refusal.

Actions 

• NHSBSA to share with the TEG any medical assessor guidance for SCM applications
• NHSBSA & medical assessors to follow up in correspondence on any further questions from the TEG 

9 Oct 2025 17:00 BST 

Attendees - Technical Expert Group (TEG) - Professor Jonathan Montgomery (Chair), Dr Ahmed Elsharkawy, Professor Jane Anderson, Professor Alexander Mcneil, Dr Chloe Beale, Dr David Asboe, Professor Deborah Christie, Dr Ian Williams, Professor Jane Anderson, Dr Lise Estcourt, Dr Susie Shapiro, Browne Jacobson LLP

Apologies - Professor John Weinman, Professor Graham Foster

Attendees - Infected Blood Inquiry Response Policy Team

Discussion on modelling assumptions for interferon treatment

The Chair opened the meeting by reiterating that while the TEG provides advice on the structure of the compensation scheme, decisions regarding cost and affordability are matters for the government. To enable the Government to provide delivery and scheme cost estimates for Ministers, Cabinet Office officials are attending today’s TEG meeting to ask questions on cohort sizes to inform modelling assumptions. 

The Cabinet Office introduced the discussion, noting the need to understand how many people would be eligible for an award related to interferon treatment.

The TEG discussed the key factors that would influence the proportion of people who were likely to have received interferon treatment:

• Timeline of availability and use: The group noted that the interferon treatment for Hepatitis C became available in 1995. It was generally not used to treat people who had already progressed to decompensated cirrhosis. The group concluded that it was likely reasonable to assume that anyone who died before 1995, or who developed decompensated cirrhosis before 1995 would not have received interferon treatment. 
• It was noted the treatment was not suitable for everyone. People with a history of mental health conditions or autoimmune conditions would likely not have been offered interferon. Similarly, people with certain clinical indicators, such as low platelet counts, would likely have been excluded. 
• The group noted that due to side effects it was a common treatment approach to monitor individuals with chronic infections for progression before recommending interferon treatment.
• TEG noted that interferon was used less frequently prescribed to treat Hepatitis B than Hepatitis C. For people with a Hepatitis B infection, repeated courses were in general not administered, unlike for Hepatitis C. People co-infected with HIV were also less likely to have received interferon, as it was less effective and had higher toxicity for this group. The group recommended that the largest cohort for the interferon award would likely be people with a mono-infection of Hepatitis C.
• There was no official upper age limit for receiving interferon. However, TEG advised it would have been uncommon for it to be administered to people over the age of 65-70.
• The Group confirmed that interferon is unlikely to have been prescribed for treatment of Hepatitis C after 2016 or for Hepatitis B after 2008, following the introduction of more effective treatments with less side effects.

Roundtable Discussion Planning

• The TEG discussed their objectives for round table discussions and how this was distinct from the Government’s public consultation.
• The TEG discussed what material might need to be shared in advance of a roundtable to provide background information for the scheme and proposals. 
• TEG would consider the attendee list once topics of roundtables had been agreed. 
• The chair sought the group’s feedback on the most effective ways to ensure the roundtables adopted a trauma-informed approach.

Comms guidance

• Cabinet Office officials provided guidance for TEG members on handling press and external stakeholder engagement to ensure all engagement of the TEG is accurately captured and logged. 

Actions

• Add roundtables to the next TEG agenda (Cabinet Office)
• TEG to consider planning for the roundtables for the next meeting
• Update modelling assumptions for the interferon recommendation as per TEG discussion (Cabinet Office)

10 Oct 2025 17:00 BST 

Attendees - Technical Expert Group (TEG):  Professor Sir Jonathan Montgomery (Chair), Professor Jane Anderson, Dr Ahmed Elsharkawy, Dr Ian Williams, Professor Deborah Christie, Professor John Weinman, Browne Jacobson LPP, Dr Chloe Beale, Professor John Weinman,  Dr David Asboe, Dr Lise Estcourt, Dr Susie Shapiro,  Professor Patrick Kennedy, Professor Graham Foster

Apologies - Professor Alexander Mcneil

Attendees - Infected Blood Inquiry Response Policy Team

Discussion on Recommendation 4a: Hepatitis core awards (Interferon)

• The group discussed the proposal for an uplifted award for individuals with Chronic Level 2 Hepatitis B/C infections who had received interferon treatment. 
• The group discussed how the award could be implemented for individuals who received multiple treatments over 12 weeks in duration. 
• The group discussed the injury award for Level 2B - interferon.
  • The group discussed that permanent side effects, such as impotence, could attract higher awards in the courts. 
  • Given side effects highlighted by the Inquiry were in general more significant than those noted in case law comparators the group advised on an injury award of £10,000. 
  • It was agreed that any person applying for an uplift would need to meet a minimum duration threshold for each course of treatment.
• The group noted that it is unlikely that individuals would have received interferon treatment after developing liver cirrhosis and where this is the case care and financial loss awards are higher than the interferon proposal. The group discussed how the award would work for individuals who received interferon treatment before progressing to Level 3 Cirrhosis and that progression through Level 2B should work in line with the structure for the other severity bands i.e Individuals receive highest level of injury and care award for which they are eligible and financial loss relevant to severity band in a given year.

Discussion on Recommendation 5a: Severe Health Condition Award - Severe Psychological Harm

• The group considered a submission from Dr Sarah Helps and Dr Victoria Miller on using a formulation-based opinion to assess severe psychological harm. The Cabinet Office asked the group for advice on whether this approach is compatible with a tariff-based compensation scheme.
• The group discussed the core principles of the tariff based scheme, which are designed to avoid new individualised assessments to ensure awards can be made without delay.
• It was noted that Dr Helps’ submission states that formulations are not designed to be categorised or banded on the basis of severity and that historical evidence which would enable banding of severity or understanding of impacts on financial loss and care needs is unlikely to exist for most people who have been infected or affected. This could mean new expert assessments would be needed to gather this information , which would conflict with the principles of the tariff-based scheme.
• The group observed that psychological harm was considered a universal experience for all infected individuals; consequently, a significant degree of psychological injury had already been acknowledged within the scheme’s core route (the injury, social impact, and autonomy awards).
• The TEG discussed the challenges for people trying to provide evidence of a historical psychological state using the formulation based opinion approach. It was also noted that certain diagnoses, such as PTSD were not recognised in the same way during the periods in question. The group also examined the various avenues through which individuals may have accessed psychological services, including those provided to patients with HIV or Hepatitis B/C.
• The group reflected on what alternative approaches could be considered within the structure of a tariff based scheme if the formulation-based model is not compatible with the scheme. 
• The group discussed the intersection of psychological harm with impacts acknowledged by the IBSS SCM payment category (and its equivalents in Devolved Government), considering that the core award already recognises a 20-40% reduction in work capability and a total of ten years of domestic care needs, likely accessed on a fluctuating basis. The group noted that most EIBSS SCM beneficiaries had qualified based on mental health impact.
• The group discussed alternative evidence types for the Severe Psychiatric Disorder Severe Health Condition award. However, no new evidence criteria could be recommended that would not necessitate a new clinical assessment or introduce safeguarding risks.
• The group discussed an appropriate approach for affected individuals. It was agreed that a proposal should first be developed for infected persons prior to determining the process for those affected.

13 Oct 2025 17:00 BST 

Attendees - Technical Expert Group (TEG):  Professor Sir Jonathan Montgomery (Chair), Dr Ahmed Elsharkawy, Dr Ian Williams, Professor Deborah Christie, Dr Chloe Beale, Professor John Weinman, Professor Graham Foster, Professor John Weinman, Dr Susie Shapiro, Professor Patrick Kennedy, Browne Jacobson LPP 

Apologies - Dr David Asboe, Dr Lise Estcourt, Professor Jane Anderson, Professor Alexander Mcneil

Attendees - Infected Blood Inquiry Response Team

Discussion on recommendation 4b: Special Category Mechanism (SCM)

The Cabinet Office provided an overview of the Special Category Mechanism (SCM), which was an award available under the Infected Blood Support Schemes (IBSS). The discussion focused on how to create a mechanism within the compensation scheme to recognise the impacts covered by the SCM. This would need to apply to people already registered with support schemes and those who were not, including people with Hepatitis C who were infected outside the support schemes’ cut-off dates, or who have died.

Discussion on SCM award Eligibility and Assessment

The Group discussed the eligibility criteria for an award equivalent to the SCM.

• Cabinet Office officials presented the current eligibility criteria for SCM and equivalent payments for Devolved Government IBSS and how the SCM category was developed. The Cabinet Office set out what impacts of SCM were currently recognised by the Severe Health Condition awards, namely autoimmune diseases caused by or exacerbated by interferon treatment. 
• It was noted that some living individuals, particularly people with Hepatitis B mono infections, had not been able to access support schemes and therefore had not been able to previously apply for SCM payments. The group agreed on the need to ensure the compensation scheme addressed provided a route for living individuals not registered with an IBSS to apply for an SCM Severe Health Condition. The scheme would therefore need to introduce its own assessment criteria for an SCM award. 
• TEG discussed the eligibility criteria for SCM and equivalent payments in the Devolved nation IBSS. The TEG noted the differences between these in particular, the use of self-declaration as the main form of evidence for SIBSS. The group reflected that the EIBSS assessment process for SCM was closest aligned to that of the scheme principles of verification but that amends would be needed to reflect the requirements of a tariff based scheme. The group discussed the challenges in doing so, in particular for assessing mental health impacts. The TEG would provide follow up advice on how these assessment criteria could be applied in slower time. 
• It was noted that significant numbers of SCM applications to EIBSS were rejected, which suggests a detailed assessment process is necessary to ensure fairness and consistency. Community representatives have also raised concerns that self-declaration without any evidence could be problematic (such as at stakeholder meetings with IBCA). 
• The Group discussed whether individuals who had been rejected for SCM payments by the support schemes should be eligible to apply under the new scheme. It was agreed that while existing IBSS beneficiaries should be ‘passported’ into the scheme, previous rejection does not automatically exclude an application for an SCM-equivalent award and an opportunity to present evidence would be required. Regard should be given to their previous application however and reasons for their application rejection. 
• There was a discussion about the challenges and possibility of assessing eligibility for deceased victims, given the holistic nature of an SCM assessment process which was designed to provide support to living infected people. The group discussed the reliability of retrospective diagnoses and/or labels of historical mental illness.
• The Group considered the benefits of a tariff-based system against a more bespoke assessment process which would require a new clinical assessment of an individual. It was noted that an assessment process would be slower and could be traumatic for applicants. It was noted that it had not been suggested by the Inquiry’s Additional Report that the principle that the scheme was tariff-based should be re-visited.
• The Group concluded that review of applications for SCM would require medical assessors to review evidence similar to EIBSS SCM assessments and would need to ensure assessors were experienced in relevant mental and physical disciplines. 

Discussion on Recommendation 5a: Severe Health Condition Award - Severe Psychological Harm

• Given the mental health impacts recognised by SCM, the group discussed how a Severe Health Condition award would interact with other areas of the scheme which recognise psychological harm.
• The Group reflected that the core awards already contain recognition for psychological harm, but that this may not have been clearly explained to the infected and affected community. The group also noted there may be impacts between the core route and the Severe Psychiatric Disorder Severe Health Condition award and that these individuals were likely identified through SCM.
• Introduction of a Severe Health Condition award for SCM could therefore help  address psychological harm impacts that the Inquiry felt were not sufficiently recognised by the scheme.

Discussion on SCM award level

• The Group discussed the complexity of setting a start date for the SCM award given SCM impacts (with the exception of autoimmune conditions) have no diagnosis date or reliable clinical marker. The group discussed whether an impact date could be established for SCM but concluded the most reliable dates would likely be the date of SCM assessment. 
• The Group noted the importance of understanding the impact of any changes on the final award amount an individual would receive and not considering individual elements without regard to the total award.
• It was noted that where existing support scheme beneficiaries believed the compensation offered within the scheme was inferior to continuing to receive support scheme payments, they could elect to do so.

TEG Roundtables

• It was agreed that roundtables would be a good way to ensure the group has not missed any important issues when considering the IBI’s additional report’s recommendations.
• The purpose of the roundtables would be to hear different perspectives to enable the group to answer questions set out within the group’s work programme .
• It was suggested that a plenary session could be held at the start and end of the series of roundtables to provide an introduction to the process for stakeholders and to present a summary of the discussions.

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The Cabinet Office asked the TEG to provide advice on the appropriate percentage for the financial loss award level for those eligible for an SCM-equivalent award. The Group agreed to provide advice on a range between 40-80% within 24 hours but noted that more detailed advice would depend on resolving the eligibility criteria.

16 Oct 2025 17:00 BST 

Attendees - Dr Ahmed Elsharkawy, Professor Alexander Mcneil, Dr Chloe Beale, Dr David Asboe, Professor Deborah Christie, Dr Ian Williams, Browne Jacobson LLP, Professor Sir Jonathan Montgomery, Professor Patrick Kennedy, Dr Susie Shapiro, Professor Jane Anderson

Apologies - Dr Lise Estcourt, Professor John Weinman, Professor Graham Foster

Attendees - Infected Blood Inquiry Response Team

Discussion on proposals for consultation

The Cabinet Office explained that the purpose of the meeting was to update on the final proposals for the public consultation on the Infected Blood Compensation Scheme.

Discussion on Recommendation 4a: Hepatitis core awards (Interferon)

• The Group confirmed its advice that a minimum of 12 weeks of interferon treatment should be required to be eligible for a Level 2B interferon award to ensure the award was proportionate. The group acknowledged that the Government would need to consider the operational impacts including evidence burdens for eligibility when making decisions on proposals for consultation. 

Discussion on recommendation 4b: Special Category Mechanism (SCM)

• The group confirmed its advice on the proposal for the Severe Health Condition award. The group’s initial advice was that eligibility criteria will be based on those used for the Special Category Mechanism (SCM) in the England Infected Blood Support Scheme (EIBSS) given this the scheme through which the majority of IBSS recipients will have been assessed and was closest aligned to the scheme’s principles of verification. The TEG will develop these criteria further following roundtables.
• The group agreed with the proposal that anyone already registered as a beneficiary of the SCM would be automatically eligible for this award without needing to provide further evidence.
• The group agreed it would be beneficial for the government to consult on the position for eligibility of those who have never been registered with an IBSS in terms of living and deceased infected persons separately. 
• The Group discussed the proposal to provide a financial loss award of 60% for pre effective treatment and 70% for post effective treatment (using dates and position on age of current scheme). It was noted that the criteria for the EIBSS SCM were less specific, and some people may have qualified for SCM with less impact on their ability to earn. 
• The Group therefore agreed it would be beneficial for the government to consult on the proposed percentage uplifts for the financial loss award. 
• The Group agreed that this is an area where more work is needed but was comfortable for the Government to consult on proposals that start from the EIBSS criteria.

Discussion on Recommendation 5a: Severe Health Condition Award - Severe Psychological Harm

• The Group summarised its conclusions following the Chair’s discussions with Dr Sarah Helps. 
• The group noted that an award for psychological harm based on a formulation-based opinion would not be workable, as this would require a new, individual assessment for each applicant, far beyond what will occur for SCM.  The extent of trauma and its impact are difficult to categorise in a tariff scheme that aims to avoid individual assessments.
• The Group’s advice is that the criticisms of the Inquiry on the threshold for the Severe Health Condition for ‘Severe Psychiatric Disorders’ were largely covered by the proposal to introduce a Severe Health Condition award for SCM. Therefore, instead of introducing a new, separate award, the Scheme should make clear that these impacts are recognised within the Severe Health Condition award, core route, and new SCM proposal. 
• The group advised that the government must clearly explain why and how the core and supplementary routes recognise the psychological harm experienced by infected and affected people in the current scheme.

Discussion on Recommendation 7: Unethical research award proposal

• The Cabinet Office provided an update on this proposal to the Group for information.
• The Group discussed a new proposal for an additional award for victims of unethical research, as recommended by the Infected Blood Inquiry.
• The Group discussed the scope of eligibility, including whether people who received blood transfusions (not just blood products for bleeding disorders) should be included.
• The Group noted that the idea that everyone treated for a bleeding disorder during a certain period was part of research was not consistent with the definition of research that had been set out in the Addendum to the first Expert Group’s report and endorsed by the Inquiry. It considered that this definition remained sound.
• The Group noted the difficulties of identifying those included in research and that recognition of these challenges had led to the advice that those treated in research-active centres should be presumed to have been included in research. Similar evidential challenges would arise in relation to research on those with bleeding disorders outside of these centres.
• The Group discussed the start and end dates for eligibility for this award. It was noted that a new definition of eligibility could mean that some people who were eligible under a previous proposal may no longer be eligible, and vice versa.

Discussion on Recommendation 8a: Affected supplementary route

• The Group agreed that any award for affected people through a supplementary route should be a flat rate payment. Using a scale based on age or impact would add significant complexity to making an award. The Group noted that bereavement can have a significant developmental impact on children and adolescents.
• The Group agreed it was reasonable for the government to consult on an eligibility age of 18, but that the Group would consider whether this age should be increased.
• The Group advised against changing the approach to an ‘injury award’ process for affected people with severe psychological harm. This would be difficult to do within the current structure of the Scheme and would require individual assessments, which the Scheme is designed to avoid.
• The Group’s advice is that the government should not commit to a specific proposal at this stage, but should commit to listening to the community on how these significant impacts should be recognised.

TEG Roundtables

• The Chair explained the difference between the government’s public consultation and the separate roundtables that the TEG will hold with the community.
• The chair shared a proposal document for the TEG roundtables. The group was invited to offer comments by correspondence before the next meeting. 

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• The chair to review the consultation document.
• TEG members to provide feedback on the proposed paper for the roundtables in correspondence

23 Oct 2025 17:00 BST 

Attendees - Technical Expert Group (TEG):  Professor Sir Jonathan Montgomery (Chair), Professor Jane Anderson, Dr Ahmed Elsharkawy, Professor Graham Foster, Dr Ian Williams, Professor Deborah Christie, Dr Susie Shapiro, Professor Alexander Mcneil, Dr Lise Estcourt, Professor Patrick Kennedy

Attendees - Browne Jacobson LPP  

Attendees - Infected Blood Inquiry Response Policy Team

Apologies: Dr David Asboe, Professor John Weinman

How the Technical Expert Group’s advice is articulated in the consultation

• The Cabinet Office presented the consultation document to the group.
• The group discussed the importance of the consultation document being clear about the distinction between the TEG’s advice and the Government’s decisions.
• The group also discussed the accessibility of the consultation and the language used in the proposals.
• The Chair shared a draft letter to the Minister regarding the group’s advice. The group confirmed they were content with the structure and agreed to provide comments.

Roundtables

• The group agreed that roundtables to discuss some of the wider consultation proposals should not take place until after the consultation closes in January. The group noted that this would avoid pre-empting the consultation response.
• It was agreed that roundtables on the Special Category Mechanism (SCM) could be set up during the consultation period to refine and test proposals with the community.
• The group discussed holding a specific roundtable for people affected by Hepatitis B regarding the Special Category Mechanism.
• The group discussed the sensitivity around evidence requirements for Hepatitis B infection.