FAQ

My Medical Choice is an online system of integrated healthcare services services and educational material to support members in managing their own medical choices.

Our comprehensive medical alert system has been designed to work both on and offline (offline in a limited capacity – just in case of a power cut or internet disruption) and to make clear any healthcare treatments and procedures you wish to reject in a legally binding format – just in case you are admitted to hospital and unable to communicate your wishes yourself.

The physical tools used in our alert system are medical alert jewellery tags and a printed Advance Decision Notice (ADN) – more commonly known as a Living Will. You can carry the ADN about with you, as it folds down to fit into your purse or wallet. By wearing your medical alert jewellery tags and carrying your ADN with you, you get double protection in case of an accident. First responders and A&E staff are trained to look out for these items in an emergency, and the login data printed on them allows emergency services access to your online medical profile.

In addition, both the medical alert tags and the ADN carry your ICE (In Case of Emergency) contact telephone number – meaning emergency services can let your ICE know that you’re in hospital and ask for your medical data over the phone, even if the internet is down or there’s a power cut.

The online service allows emergency services to access your online medical profile via the login data on your jewellery tags and ADN to view your healthcare instructions.

By using our private, secure database, you can create a medical profile page to:

1. Upload details of any medications you are taking
2. List any medical conditions you have
3. List allergies or food intolerances
4. List any previous operations or procedures you have had
5. List any implants or devices you have had fitted that may be significant in an emergency
6. List your medical care directives regarding treatments and procedures you may wish to reject
7. Name prearranged blood donors in the event you require a blood transfusion or need blood components
8. Appoint an Attorney(s) to oversee treatment if you are unable to communicate after an accident or illness using a court-approved Lasting Power of Attorney document
9. Save copies of your legal documents on your online profile as a backup for your paper documents should they become lost or damaged.

Furthermore, whenever your online medical profile is accessed via the NHS login, an SMS text message is automatically sent to your designated emergency contact alerting them to a potential crisis.

The Safe Blood system is for members who choose to reject NHS donated blood or any blood-related products should they require a transfusion. It comprises of:

• A Pre-op Consultation Pack designed specifically to use in surgical consultation appointments to support members’ wishes regarding the use of NHS donor blood.
• Educational material and a Reference Library for members regarding non-blood alternatives and bloodless surgery.
• Reference material for consultants regarding non-blood alternatives and bloodless surgery.
• A system designed to assist members in organising their own private compatible donors.
• A National Safe Blood Donor Database.
• Access to low-cost legal advice and advocacy service in case things go wrong

Members can use any or all of these services as many times as they need to.

Please note that, although the Safe Blood system is a national service, in Scotland the legal documents have slightly different names. The Lasting Power of Attorney document is called a Welfare Power of Attorney in Scotland and the Advance Decision Notice is known as an Advance Directive. For ease of use, we have referred to these documents by the names used in England and Wales.

Northern Ireland! Please note that there is no Health and Welfare Power of Attorney in Northern Ireland. Making decisions regarding the welfare of a person is the responsibility of the next of kin. Nor is an Advance Directive/Decision Notice officially recognised in law. However, even though an ADN is not officially recognised in law in Northern Ireland, if it has been completed properly the courts are likely to uphold your directives as stated in your ADN. MMC consulted the Jehovah’s Witnesses head office for advice on this matter and they have confirmed that they’ve been using their own version of an ADN in Northern Ireland for years without major issues.

What this means in practice is that you can use all the services provided by My Medical Choice except the Power of Attorney.

To compensate for not being able to appoint an Attorney, we suggest you discuss your directives for healthcare with your next of kin in great detail and ensure they understand why you wish to reject the treatments and procedures specified in your ADN before you add them as your ICE (In Case of Emergency) contact. This means they will receive the automated SMS text notification provided with the service if you are involved in a medical emergency.

It may be useful to have your next of kin witness the ADN document for additional protection, as it would be difficult for them to object to the directives in your ADN in a medical emergency if they have added their details to the document and signed it, for example.

Our Safe Blood system is a main feature of the My Medical Choice service and concentrates solely on blood-related issues, which are:

• How to find your blood group quickly and cheaply.
• What happens if you need a blood transfusion?
• How to legally reject NHS donated blood and blood products.
• What are the established non-blood alternatives to NHS donated blood and blood products?
• What are own-blood transfusion surgical procedures and how do they work?
• What is bloodless surgery?
• How to arrange private on-call compatible blood donors.
• How to use the Safe Blood National Blood Donor database.
• How to optimise your blood for surgery and overall health.

The Safe Blood system provides the means to warn emergency services that the member refuses NHS donor blood and blood products - even if they are unable to communicate due to accident or illness. This is done via our medical alert system which includes:

• The “No Blood!” directive in the Advance Decision Notice (ADN – or living will)
• Data stored on the member’s online medical profile
• The member’s ICE (who is alerted by automated SMS text as soon as the NHS logs into the member’s medical profile page via the details on the medical alert tag and/or the ADN)

First responders and A&E staff are trained to look out for medical alert jewellery and check purses/wallets for medical alert cards and legal/medical instruction documents.

In addition, the Safe Blood system gives members the option to make their own private arrangements for compatible donors for blood and blood products in the event of a serious accident where a blood transfusion and/or blood components are required. Contact details for private donors can be stored on the member’s medical profile page and given to their ICE for additional security. At the time of writing, there has been a certain amount of pushback from the NHS on the use of private blood donors (known as ‘direct donation’ by the NHS). However, private donors are being accepted by some trusts - and members have reported their consultants as saying they’re being asked more and more frequently about private donation at pre-op consultations, so it seems that the message is starting to get through!

Members who opt in to the National Blood Donor system can also access potential blood donors throughout the UK (see FAQ ‘What is the National Blood Donor Database’ for more details). We also provide a Help Sheet for members on how to safely use and get the most out of the Safe Blood donor database.

The Safe Blood system is also about education – such as our Help Sheet ‘Optimising blood for surgery’ – as well as providing reference material for consultants on blood transfusion alternatives and bloodless surgery techniques for use at pre-op consultation appointments.

My Medical Choice has recently produced a comprehensive Pre-op Consultation Pack to guide members through their appointment and help them achieve the treatments and procedures they prefer.

The Pre-op Consultation Pack also includes information on the established alternatives to donor blood in an easy-to-understand format, so that our members are fully informed about their options for ‘bloodless surgery’ prior to their appointment. See our FAQ ‘Alternatives to standard blood transfusion’ for more information.

It may surprise you to learn that there are a number of well-established available alternatives to standard NHS-donated blood transfusions – including the possibility to opt for certain types of surgical procedures that avoid blood loss almost completely. Perhaps we should be asking why these options are not made routinely available to all – whether the patient is a fully informed member of My Medical Choice, or a member of the public?

Our service provides members with fully referenced educational material to learn about their rights and to help them understand and use NHS policy regarding bodily autonomy. We also provide a reference library of studies and papers on blood alternatives, own-blood transfusions, and bloodless surgeries to present to consultants if needed.

To make the consultation appointment process as stress-free as possible, My Medical Choice members can use our Consultation Appointment Pack to learn about:

• The range of healthcare options available to them
• How to ask the right questions of their consultant in a way that vastly increases their chance of getting the type of surgery and medical treatment that is best for them
• How to follow up the appointment if a member and their consultant cannot reach an agreement.

The Consultation Appointment Pack also includes a PDF print-off guide to hand to the consultant or medical team during the appointment. This document gently explains our members’ stance on refusing NHS-donor blood transfusion and reminds them of patients’ rights. It also lists all the alternatives to blood transfusion that should be available to our members and informs them that, should the relevant equipment or staff expertise not be available at that hospital, then the member must be transferred to a hospital with the necessary medical equipment and experienced surgical team within the trust. If a member feels their rights are being abused, they can also use the services of our legal and advocacy partner organisation for advice and/or representation.

The following list gives an idea of some of the types of treatments and procedures that can be used to negate the need for a blood transfusion:

HAEMODIALYSIS

Diverts the blood into an external machine where it filters and cleans the patient’s own blood for return to the body. This procedure is suitable for Safe Blood users provided non-blood prime is used.

HAEMODILUTION

Intraoperative haemodilution is possible when the equipment is arranged so as to keep the patient’s own blood in a constant link to the patient’s circulatory system.

CELL SALVAGE MACHINES

Cell salvage technology systems, such as Hemosep, are a relatively new ultrafiltration and haemoconcentration system for concentrating residual bypass blood during or after surgery. The image below gives an idea of how these types of machine work in practice.

The image shows a continuous circuit in cell salvage, which can be requested by Safe Blood users.

Image courtesy of Medical Illustration Department, Wythenshawe Hospital, MFT

HEART BYPASS

Diverts blood away from the heart. This procedure is suitable for Safe Blood users provided that non-blood prime is used.

PREOPERATIVE AUTOLOGOUS COLLECTION

Our members can also consider preoperative collection and subsequent reinfusion – although we recommend members sign and date the blood bag label to ensure chain of authenticity.

EXPANDERS

Non-blood volume expanders to ‘pad out’ blood volume can be used, such as: saline, dextran, gelatin, Ringer's Solution, haemaccel, and hetastarch.

TRANEXAMIC ACID

This substance is used to control bleeding and helps blood to clot.

BLOODLESS SURGERY

In addition to the various choices available for alternatives to blood transfusion, members are also provided with information regarding the use of low blood-loss haemostatic surgical devices for so-called ‘bloodless surgery’.

Medical alert systems are nothing new. They’ve been used for decades to provide a warning to first responders and A&E staff that the patient has a serious medical condition or disability, and/or is taking certain medications, and/or for personal or religious reasons the patient wishes to reject certain treatments, medication, or procedures (as with Jehovah’s Witnesses, for example). Medical alert systems can be as simple as wearing a silicone band with only one word on it, such as: DIABETIC - or more complex information can be printed on a medical alert jewellery tag, to include In Case of Emergency (ICE) name and phone number, and login details to access online personal medical profiles.

The Safe Blood system is also a medical alert system and works by utilising the standard wearable medical alert tags but with emergency service login details printed on them. Where it differs greatly from the average medical alert systems is in the additional use of an Advance Decision Notice that folds down into purse/wallet size (Advance Directive in Scotland and Northern Ireland – or more commonly known as a living will).

First responders and NHS staff are trained to look out for medical alert tags and cards/documents, meaning they can access your:

• Login details to an online profile on our secure database (tag and ADN)
• Your emergency contact’s details (ICE) such as your next-of-kin or Attorney (tag and ADN)
• Details of allergies, medication, treatments you wish to reject, ICE details, GP contact details, a ‘pet at home alone’ alert, etc. (ADN)
• “No Blood!” warning sign (ADN)

This comprehensive alert system gives medical professionals the chance to provide you with the best possible care in an emergency in line with your health directives, and helps avoid contraindications from hospital administered drugs. The system also ensures staff responsible for your care understand any medical treatments or procedures you wish to reject, for example a blood transfusion or invasive test.

Another useful feature of the Safe Blood medical alert service is that your ICE (you can list up to two people as emergency contacts) will be sent an automated SMS text alerting them to the emergency as soon as the NHS accesses your online profile, so they can come to your aid and oversee your care.

For the best possible protection, we suggest you wear your medical alert jewellery at all times, keep your Advance Decision Notice in your wallet or bag, and keep your online medical profile up to date.

In England and Wales an Advance Decision Notice (ADN) is a legally-binding document that is probably better known as a ‘living will’. An ADN allows you to stipulate which medical treatments and procedures you wish to reject, and with the My Medical Choice version, you can also use it to: provide emergency contact details (ICE), provide GP surgery information, list any medications or other useful medical information, confirm that you have a Power of Attorney in place, and more.

In Scotland and Northern Ireland* an Advanced Directive is not considered legally binding. However, if one of your medical decisions were ever to be challenged in the courts, provided the Advance Directive was valid (that is, you’d completed it properly and had your signature witnessed) and applicable to the circumstances (meaning the situation being raised in court was one covered by the directives you’d written into your Advance Directive), it is likely a Judge would rule in favour of respecting it.

One of the general principles of the Adults with Incapacity (Scotland) Act 2000 is that if someone lacks capacity to make a decision for themselves and needs medical treatment, the wishes of the adult should be taken into consideration when making a decision on their behalf – so, you should be protected legally, since the Advance Directive allows you to stipulate your express wishes regarding your medical treatment in advance and whilst you have the capacity to do so.

* In Northern Ireland, the relevant NHS protocol is: the Northern Ireland Pathway for the Management of Adult Patients Who Decline Specified Blood Components or Blood Products (CG424).

View sample ADN

The My Medical Choice ADN is an easy to complete one-page, double-sided** document detailing your medication, allergies, or any other useful medical information you wish to include, such as: the rejection of blood transfusions, vaccines, and any other treatments you may want to refuse.

Our updated ADN also:

• Allows you to add your login details for your online medical profile (if you feel secure doing so) and reminds first responders to look out for medical alert tags.
• Has a “pet at home alone” checkbox
• Has an additional page – the Addendum – that provides a legal/medical explanation for officially-named treatments and procedures members may wish to refuse. The Addendum is a powerful addition to the ADN because it reinforces your declaration of mental competence at the time of signing, as it makes clear that you fully understood the medical terminology and implications of refusing the procedure or treatment before you included it in your directives.

**The ADN folds down to purse/wallet size to show the medical alert icon making it easier to catch the attention of a first responder. There is no need to carry the Addendum page around with you - just ensure it is stored on your personal account page and that a copy was sent to your GP with your main ADN page (that is, all 3 pages should be uploaded to your account page and also sent to your GP). We’ve provided a cover letter template to use to notify your GP that your ADN needs adding to your records.

The advantages of the ADN for the purpose of the Safe Blood medical alert system are that it is easily updated, and it is a portable document and can therefore be found by emergency services in the event of an accident, for example, (as long as you carry it with you). For maximum legal protection a copy of your ADN should be provided to your ICE or Attorney, as well as your GP.

IMPORTANT!

A Lasting Power of Attorney (LPA), (Welfare Power of Attorney in Scotland) (WPA) is a more detailed and complex legal document than the ADN and serves a different purpose.

View LPA

An LPA allows you to name one or more Attorneys* to oversee your care in the event you are not competent to make healthcare decisions, such as when unconscious after a serious accident. Once you’ve nominated an Attorney, they must uphold your wishes for medical treatment (as stipulated in your ADN).

It should be noted that the LPA has no further reach than as described and you would need to set up other types of Power of Attorney documents if you require additional protection – to deal with your property or finances, for example.

In the LPA document you are referred to as the Donor (not to be confused with blood donor), because you are ‘donating’ the responsibility for your care to an Attorney in the event you lack capacity due to an emergency. Attorneys must be over 18.

The LPA must also be witnessed (called the Certificate Provider’s Statement in the document) to state you are of sound mind, which makes it very difficult for family or medical personnel to challenge your directives later on.

Being taken to hospital (even a ‘private’ hospital) puts you firmly in the public domain, and because you will be in the public domain – whilst also at your most vulnerable - we recommend members only use the government’s version of the LPA. Members should also register their completed LPA with the appropriate court of protection for their country.

In case of an emergency, first responders and A&E staff will have been made aware that you have an LPA document via your ADN and personal account data on our database. If they wish to verify the validity of the LPA with the court, they can do so quickly and easily, so from that point on, they must take instruction from the medical directives expressed in your ADN and also your Attorney(s).

*An ‘Attorney’ in this sense, is a person who is legally appointed to make medical decisions for someone else. They require no legal or medical experience but it’s important to choose someone like-minded, trustworthy, and reliable. Your Attorney should be listed as your ICE in the Safe Blood medical alert system, and you can nominate up to two Attorneys to receive the automated SMS text alert in an emergency.

If you’ve had a major operation in recent years, or given birth, your GP should have this information on your medical records, so check with them first. If you have donated blood, you are normally told your blood type about a week after donating.

What if your GP doesn’t have your blood type on record?

One option is a home test kit. It’s really quick and easy to do a finger prick test in the privacy of your own home. The most popular home testing kits is the Eldon Blood Typing Kit from ZoomHealth *.

The most professional option is to use a private medical ABO blood typing test. It is more costly, but it is something that you will only ever need to do once in your life. You will need to have a blood sample taken, which is sent off to a lab for analysis.

If you choose the ABO blood type testing, we suggest the Medichecks Blood Group Test for professional accuracy and a 4 working days turnaround time. The test costs £82, and Medichecks has a range of clinics nationwide should you need to have your blood taken by a healthcare professional.**

Please note that, whichever blood type test you use, the NHS may still insist on using their own ABO blood type test for you and your donors.

* Please note that ZoomHealth doesn’t recommend their tests be used for the purpose of blood donation. If used correctly, however, the ZoomHealth test should give you your blood type for the purpose of organising compatible donors.

** If you need to have your blood taken by a medical professional, or a nurse, there will be an additional cost depending on the option you choose.

It may shock you to know that, in the event you are rushed into A&E, the hospital will not necessarily have medical records for you. This is because the NHS is broken up into individual trusts – usually by county. They each have their own computer system, and they don’t share the information between trusts – and they can’t access each other’s records, either.

In reality, the NHS only has medical records for you if:

1. You have been a patient at the hospital before, and
2. You have provided detailed information when you attended
3. Or you are admitted into a hospital within the same Trust as the hospital to which you provided medical information in the past

If you have an accident in another county, the NHS has no way of accessing your records. And if you’ve never been to hospital before, the NHS can’t access your records unless you can provide GP details. This will not work if you are in hospital when your GP surgery is closed or you are unable to communicate your GP’s details.

So, you can see why a medical alert service is a good idea!

The best way to get the most out of our service is to think of the worst-case scenario, one in which you are seriously ill or have been involved in an accident and are unconscious or unable to communicate. Then consider what information would help those caring for you to achieve the best possible outcome for your health.

The following list of details will help emergency services and A&E staff give you the most appropriate care for your needs:

• List any medical implants, such as: pacemaker, neurostimulator, aortic valve, and so on.
• List any conditions you may have: diabetes (Type 1 or 2), autoimmune conditions, COPD, asthma, etc.
• List any previous operations, or state if you have received a donated organ.
• List any serious allergies – in particular, anything that may cause anaphylaxis: peanuts, penicillin, wasp or bee stings, latex, dairy, and so on.
• List any medication or procedures you need to avoid: aspirin, ibuprofen, blood transfusions, MRI scans, invasive testing, etc.
• List medication you take regularly, including the dose and frequency (1 a day, 2 a day, etc.)
• List medication you take as and when needed: painkillers, diuretics, sleeping tablets, etc.
• List medication or devices you carry on you: steroid inhaler, EpiPen, anti-anxiety medication, etc.

And remember… if you forget to add a medication or condition to your personal medical profile, or you develop an illness and start taking medication after signing up to the My Medical Choice service, you can update your profile and legal documents as often as you need to.

As long as you act responsibly, then yes, your data is quite safe, as only you have access to it.

Of course, in the event of an emergency, first responders have access to your personal health profile via the login details on your medical alert jewellery tag and ADN – although on a read-only basis. This means they can check the relevant medical details they need for your care, but cannot make any changes to the information on your profile – only you can do that.

To keep your data as safe as possible, the emergency services must complete a 3-stage login process, which includes a unique 9-digit computer-generated login code. This is designed to ensure that people who know you well cannot access your data just by knowing personal details about you.

Keeping your login details safe:

It is important that you take sensible precautions to keep your login details safe, such as:

• Avoid taking off your medical alert bracelet or jewellery or leaving them lying around where others can access the login details
• Ideally, you should wear your medical alert jewellery at all times, as it’s there for your protection in case of emergency
• If you lose your medical alert jewellery, change the passcode immediately to keep your data safe
• Your Advance Decision Notice should be kept in your purse/wallet at all times as back up. If you choose to add your login details to your ADN, then take extra care not to leave it lying around
• Your ADN has your emergency contact’s (ICE) details on there, so it may be a good idea to share login details with your ICE or Attorney, and also provide them with hard copies of your ADN and LPA in case of a power outage.

There is always a slight chance that this could happen with any online system. Banks, airlines, the NHS – even US military organisations – have been accessed by unauthorised users in the past. So it is not impossible for the database to be compromised and it would be misleading to tell members it can’t be done, despite our security features and secure web hosting.

However, the information you store on your personal medical profile is nowhere near as detailed as that held by GPs and the NHS – information which is increasingly being shared with government departments and sold to private outside agencies.

With My Medical Choice, you are in charge of how much detail you add to your profile. Remember, you need only include medical information that will help save your life and improve your care outcome in the case of emergency. Sensitive mental health information, for example, is not necessary or required. So, unless you’ve lived your entire life without ever having registered with a GP or used a hospital, you’ll find that far more of your information is being accessed by medical and NHS-associated private organisations than is being held on our database.

You will need to store your full name and address for NHS verification purposes (they need to know the information on your medical alert jewellery matches that on your profile to ensure you’re the same person), but this data is nothing that can’t be found on a recycled or discarded letter.

Most importantly, we will never ask that you store financial details on the database, or information that can be used to access your bank account – such as your mother’s maiden name, for example.

We use a secure external payment system provider, and we never hold or store payment details or have access to them at any time.

Finally, no one at My Medical Choice has access to your personal medical profile. Indeed, should you lose your medical alert jewellery, it is your responsibility to go into your profile and change the computer generated password required for NHS login. We cannot do that for you, as we have no access to your private information.

The My Medical Choice system was created in such a way as to ensure you are fully protected even during a power outage or if the hospital’s computer systems are down – which is an important and reassuring feature of the Safe Blood medical alert service.

The Safe Blood system uses a combination of online services and stand-alone physical tools and accessories to protect you at all times. The system was set up to include different layers of protection that insulate our members from external issues, such as electrical outages, the NHS computer system issues, and internal problems, such as unforeseen technical glitches affecting your online profile.

We’ve left nothing to chance.

Here’s how the service works on a physical level…

We’ve already provided information about how the service functions when everything is working as it should. This is how it works in the event something goes wrong that’s beyond our control:

• You wear a medical bracelet or pendant at all times that includes the contact number of your Emergency Contact or ICE (In Case of Emergency) contact. Should the NHS be unable to access your online medical profile, they can contact your Emergency Contact/ICE for instructions on how to proceed with your care.
• You carry a hard copy of your Advance Decision Notice in your purse/wallet that holds details of your conditions, medication, allergies, ICE or Attorney’s details, what treatments and procedures you wish to refuse, your GP surgery details, and so on.
• You may have an Attorney who can give directions on your treatment and oversee your care to ensure your medical wishes are met. This can be done entirely via phone if there is no alternative. Please note that family or friends have limited powers compared to an Attorney, but they can still ensure your directives are carried out.
• Your Attorney or ICE is encouraged to keep a hard copy of your ADN and LPA somewhere safe, along with your list of potential donors. Your Attorney or ICE should keep a list of your Safe Blood Donor contact details somewhere easily accessible for rapid emergency access - for example: a print off kept on the fridge or a notice board, and/or a screenshot of the list saved to their mobile phone, or adding them into their mobile contacts list whilst ensuring they are clearly identifiable as your donors. This means that even without access to the online database, Safe Blood services can still be used successfully, as donors can be contacted and put on standby for emergency donation.
• And finally, should there be any resistance to your prearranged choices regarding your care and treatment, you have your ADN lodged with your GP, and the original Lasting Power of Attorney hard copy document – both of which can be used in a court of law should your wishes be challenged.

So, should the worst should happen, we’ve still got you covered!

The national blood donor database was set up in response to members’ demands for access to uncontaminated blood in the event of an accident or serious illness.

Ideally, members will organise their own private, compatible, on-call blood donors from within their friends and family network, but at My Medical Choice we appreciate that this isn’t always possible. Besides, there may be a time when the worst happens – for example, whilst a member is away on business or holiday in another part of the country and therefore too far from their prearranged donors. So, for members who are struggling to find compatible private donors themselves, or who fear they may need a transfusion when away from home, we created the national Safe Blood Donor Database.

The database can be accessed via a simple search facility in your personal account page that allows you to find people local to you or the hospital in which you are being treated. Either you, your ICE, or attorney can locate donors by area and blood type and call them to see if they are available. Any treatments or medication taken by donors will be listed on their profile to help you choose the best donor(s) for your situation.

Why contact members from the national Safe Blood donor database before you actually need to?

Consider that potential blood donors may be in the same situation as you and not know any like-minded people in their area. Or they may be already active in local campaign groups and happy to meet potential new members. By establishing contact before you actually need a donor, you could gain the following advantages:

• Peace of mind; you get a sense of how trustworthy, contactable, and reliable they are before you need them
• If you are compatible with the donor, you may also be able to donate blood if they ever need it, which is convenient for you both
• Get to know them personally – their diet, lifestyle, health issues
• You can broaden your horizons and meet other people like you
• It’s a way of making friends who have similar beliefs to you regarding medical autonomy
• If you make a friend or friends you can trust, you could arrange to be emergency contacts for each other
• You could come together to build your own campaign group if there are none available

We also ask members to consider safety before making arrangements to contact strangers. After all, the use of the national donor database is a private arrangement between members and is to be used at their own risk. We suggest our members read our help sheet ‘Using the National Safe Blood Database’ before registering to use the database.

To make the national donor database service as fair as possible to all members, anyone signing up with a view to using the service to receive blood in an emergency must, in turn, agree to donate to others in need should the situation arise.

Thankfully, it is very unlikely members will need to use the national donor database – but just knowing the service is available if you need it, gives you extra peace of mind.

No. There are a number of exclusions, and the NHS provides a comprehensive list of those who should not donate blood.

Some medical conditions, cancer, for example, preclude people from donating blood, as does taking certain medications. The NHS excludes potential donors that have had a blood transfusion in the past (from 1980 onwards).

Users of the Safe Blood service require donors to have had no vaccines at all since mid-2018 onwards.

If in doubt, check on the NHS website to see if your medical condition(s) or the medication you are taking means you cannot give blood. The donor form gives you the option to list any conditions you may have and/or medication you take in order to give those that need blood an informed choice.

For members who have surgeries pending and have concerns about the potential need for a transfusion, we have created the Pre-op Consultation Pack to support them in their choices for alternatives to NHS donor blood and to educate them regarding their rights to absolute bodily autonomy. The following material is sent out to members as part of their Welcome Pack and is therefore available to use as soon as they subscribe to the service.

The Pack, which should be printed off and taken to the appointment with a copy of the member’s ADN, includes:

• A Pre-op Guide for Members
• A Pre-op Guide for Consultants
• The NHS policy document for patients who refuse blood

Supporting information also includes:

• Access to an advocacy and representation helpline if things go wrong
• A follow up template document to email to the consultant in case matters are not resolved during the consultation appointment

We also provide educational help sheets and reference material to ensure our members have access to information about all the available alternatives to NHS donor blood transfusion, and we also provide a useful help sheet ‘Optimising blood for surgery’ that can enable members to improve their overall blood health.

Obviously, it is beyond My Medical Choice to cover all situations and medical procedures – but we’ve done our best to provide members with a reasonable choice of reference material links for common surgeries and treatments, as well as a source of further information for private research.

Please note that all NHS trust CEOs have been notified that the My Medical Choice medical alert system is currently operating in their hospitals. This was in order to prepare staff for occasions when they’d be dealing with patients who are members and, therefore, fully informed of their rights under NHS Patient Policy.

Yes.

In the event of an accident you will normally be taken to A&E. Private hospitals do not offer that facility, generally speaking and, where they do, they do not offer the service for children.

However, if you have elected to have surgery in a private hospital, you can make them fully aware of your treatment requirements in advance and allow them access to your personal health profile in case of an emergency.

This is an important and detailed subject, so it’s covered step-by-step in the user guides supplied with the Advance Decision Notice (ADN) and Lasting Power of Attorney (LPA) documents on the member’s Personal Account page. The Personal Account page is accessible once you sign up to be a member of My Medical Choice.

In brief, understand that with an LPA you will be giving a great deal of power to your Attorney in the event of a serious accident or illness where you are incapacitated – so choose your Attorney(s) wisely and, before you appoint them, talk them through your wishes regarding the healthcare treatments and procedures you prefer to reject. We provide a help sheet called ‘About My Healthcare Decisions’ to help our members deal with this difficult step.

You will also need a Witness to state that you are of sound mind, and separate Witnesses to sign off on certain segments of the LPA. This is all explained in the user guides on a step-by-step basis. Although a lengthy and comprehensive document, the LPA does NOT require legal expertise to complete and does not require the use of a solicitor. You simply fill in your personal details and arrange Witnesses to verify the details as being true.

The ADN, however, is a much simpler document to complete, being only 2-pages long, and can be Witnessed, copied, then used right away for immediate protection.

This is an important and detailed subject, so it’s covered step-by-step in the user guides supplied with the Advance Decision Notice (ADN) and Lasting Power of Attorney (LPA) documents on the member’s Personal Account page. The Personal Account page is accessible once you sign up to be a member of My Medical Choice.

In brief, understand that with an LPA you will be giving a great deal of power to your Attorney in the event of a serious accident or illness where you are incapacitated – so choose your Attorney(s) wisely and, before you appoint them, talk them through your wishes regarding the healthcare treatments and procedures you prefer to reject. We provide a help sheet called ‘About My Healthcare Decisions’ to help our members deal with this difficult step.

You will also need a Witness to state that you are of sound mind, and separate Witnesses to sign off on certain segments of the LPA. This is all explained in the user guides on a step-by-step basis. Although a lengthy and comprehensive document, the LPA does NOT require legal expertise to complete and does not require the use of a solicitor. You simply fill in your personal details and arrange Witnesses to verify the details as being true.

The ADN, however, is a much simpler document to complete, being only 2-pages long, and can be Witnessed, copied, then used right away for immediate protection.

Unfortunately, no. The law throughout the UK does not allow children to use Advance Decision Notices and appoint Attorneys and they cannot join My Medical Choice as members in their own right.

To complicate matters, children under the age of 18-years (16-years in Scotland) CAN be deemed competent to make certain medical decisions that may not meet their parents’ approval. The issue of competence involving minors is a very grey area and beyond the scope of My Medical Choice membership. However, we do provide members with access to an experienced advocate should they require it.

Although minors under the age of 18-years cannot join My Medical Choice in their own right, they benefit from having parents that are members. This is because our members are well informed on patient rights regarding healthcare decisions, as well as the law regarding bodily autonomy and informed consent.

The annual subscription is just £25. Access to all the services detailed above is included and you can access and make changes to your profile and documents as often as you need to.

You can sign up here to begin using the service.

Medical alert jewellery tags

Please note that the cost of medical alert jewellery is not included in the subscription.

Although we offer a selection of sellers* and types of suitable jewellery tags on your Personal Account page, you are free to choose whatever medical alert jewellery you like from any supplier you prefer. Just ensure the tag has a large enough surface to hold your login credentials – although the seller should let you know if the jewellery you have chosen is suitable or not before they engrave it.

Please be aware that medical alert jewellery tags can hold only limited amounts of data. For their ‘Display Name’ (the name used on their medical alert tag), members with long names are advised to use their first name initial plus surname, or in cases where both the first and surname contain too many characters to fit onto the jewellery tag, we suggest using the first name or surname.

The cost of medical alert jewellery varies tremendously. It really depends on your budget and whether you favour functionality or style. For example, you can choose simple coloured silicon bands that cost a couple of pounds, or choose a bespoke designer option in precious metals for a much higher cost. It’s entirely up to you. Both options will do the same job.

For those on a tight budget, the updated ADN can now be used to hold your login details. There are other accessories you can buy, such as key rings and plastic holders for your ADN, but they aren’t necessary to using the service.

* My Medical Choice does not receive commission from any of the sellers listed. The sellers are suggested solely for your convenience.

Below you will find links to further information regarding the topics covered on this website.

Legal Documents:

Advance Decision Notice (England and Wales):

https://www.nhs.uk/conditions/end-of-life-care/advance-statement/

Advance Directive (Scotland and Northern Ireland)

https://mydecisions.org.uk/help/scotland-and-northern-ireland

Lasting Power of Attorney (England and Wales):

https://www.gov.uk/power-of-attorney

Welfare Power of Attorney (Scotland)

https://www.gov.scot/publications/code-practice-continuing-welfare-attorneys-second-edition-updated-february-2018/pages/3/

Enduring Power of Attorney (Northern Ireland):

https://www.nidirect.gov.uk/articles/managing-your-affairs-and-enduring-power-attorney#toc-3

Refusing Blood Transfusions and Blood Components

St George’s University Hospitals Trust produced the document in this link – however, all NHS hospital trusts have very similar policies in place for refusing blood transfusions and blood products.

https://www.stgeorges.nhs.uk/wp-content/uploads/2019/09/CLH_BTRA_02.pdf

Children and Young Adults

Minors and Gillick Competence

https://www.nhs.uk/conditions/consent-to-treatment/children/

Children, and Young Adults (over 16-years but under 18-years) and Consent to Treatment

https://www.nhs.uk/conditions/consent-to-treatment/children/

Office of the Public Guardian

customerservices@publicguardian.gov.uk

Telephone: 0300 456 0300

Textphone: 0115 934 2778

Monday, Tuesday, Thursday and Friday, 9.30am to 5pm

Wednesday, 10am to 5pm

Donating Blood

Blood given via the NHS is routinely tested for: infection with hepatitis B, hepatitis C, hepatitis E, HIV, HTLV, and syphilis. Blood may also test for malaria or West Nile virus.

https://www.scotblood.co.uk/about-blood/blood-transfusions/

Scotland already has a system in place in which blood donors register to be on standby to give blood within 24 hours:

https://www.scotblood.co.uk/giving-blood/blood-donor-24/

Donating in Wales:

https://www.welsh-blood.org.uk/giving-blood/

Who Can Give Blood?

NHS blood and transplant website:

https://www.blood.co.uk/who-can-give-blood/can-i-give-blood/

NHS Wales:

https://www.welsh-blood.org.uk/giving-blood/can-i-donate/

NHS Scotland:

https://www.scotblood.co.uk/giving-blood/can-i-give-blood/

NHS Northern Ireland:

https://nibts.hscni.net/donating-blood/can-i-donate/