<scp>FAIRly</scp> deferred: Low impact of the individualised risk assessment policy on blood donor deferrals in England

OBJECTIVES: To assess the impact of the individualised risk-based donor selection guidelines on deferral of blood donors at donation sessions in England. BACKGROUND: From June 2021, the 3-month deferral for sex between men was replaced by an individualised risk assessment known as FAIR (For the Assessment of Individualised Risk). Assessing the impact of deferral at donation informs donor and policy management. METHODS: Data were obtained from the NHS Blood and Transplant donor management system for deferrals associated with FAIR deferral codes or injecting drug use after FAIR implementation, 14 June 2021 to 13 June 2023. Rates for each deferral category were estimated by age group, sex, ethnic group, and donor type. Pre-donation forms were reviewed for evidence of multiple deferrable behaviours, and return rates were calculated for temporarily deferred donors. RESULTS: Over 2 years, 286 donors were deferred on-session due to FAIR (9.0 donors per 100 000 donations made). Highest adjusted incidence rate ratios of deferral were seen in first-time, male, 17- to 24-year-old, and Mixed and Other ethnicity donors. Multiple FAIR deferrals were observed in 10 donors. Of 220 temporarily deferred donors, 56.8% returned to donate within 6 months. CONCLUSION: The impact of FAIR on donation session appears low, supported by good return rates. First-time, male, and younger donors were most affected. Multiple FAIR deferrals in a donor were rare, suggesting donors at higher risk were not attending to donate. Clarity on deferral application may aid donors and staff to defer appropriately. Further investigation is needed to determine levels of ineligible donation.