Page 18 - Support Magazine Autumn 2017
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SUBMISSION TO THE

        PUBLIC CONSULTATION PROCESS



                                UNITED KINGDOM                 The Taskforce Conclusion:
                                The Department of Health in    “Taskforce members had a wide range of views at the
                                the UK created an organ        outset. However, after examining the evidence, the
                                donation task force which      Taskforce reached a clear consensus in recommending
                                reported its findings in January  that an ‘opt-out’ system should not be introduced in the
                                2008 after 10 months’ work.    UK at the present time. The Taskforce concluded that such
                                  The taskforce was greatly    a system has the potential to undermine the concept of
                                encouraged by the evidence it  donation as a gift, to erode trust in NHS professionals and
                                considered, from across the    the government, and negatively impact on organ
                                world, and believed that a 50%  donation numbers. It would distract attention away from
                                increase in organ donation was  essential improvements to systems and infrastructure and
               possible and achievable in the UK within 5 years.  from the urgent need to improve public awareness and
                  The UK made many changes to their            understanding of organ donation. Furthermore, it would
               management and work practices surrounding       be challenging and costly to implement successfully. Most
               organ donation and have achieved their objective  compelling of all, we found no convincing evidence that it
               of 50% increase in organ donation and           would deliver significant increases in the number of
               transplantation.                                donated organs”.
                  The organ donor co-ordination changes were     The Taskforce recommends that the government
               key to the success of the project. All their changes  considers working with NHS Blood and Transplant to
               were perceived not to be particularly difficult or  agree target increases in numbers on the Organ Donor
               even costly to resolve. They required leadership,  Register and a suitably expanded budget for promotion of
               boldness and willingness to change established  the Register.
               practices. Very significant cost savings were   The UK has had a potential donor audit in place over 10
               envisaged compared with the cost of dialysis.   years. This audit is the main tool for identifying gaps and
                  During the preparation of the main report of the  problems in the organ donation process in every donating
               taskforce the Secretary of State asked the taskforce  hospital. The graph below is from the most recent audit
               to consider whether a change to presumed consent  and clearly identifies the success of the Specialist Nurses
               would increase the number of organ donors. So   for Organ Donation (SNODS) in converting potential organ
               the taskforce was asked to submit a second report  donors in to actual organ donors.
               in 2008.
                                                               DBD = Donors after Brain Death  DCD = Donors after Cardiac Death

                                 Summary of key percentages,  1 April 2016 to 31 March 2017
                 Table 13.1

                                                                               DBD          DCD          ALL
                 Neurological death testing rate                              85.7%
                 Referral rate                                                97.4%        85.6%        88.2%
                 Proportion of approaches involving a SN-OD                   93.0%        80.4%        85.8%
                 Consent/authorisation rate                                   69.0%        58.1%        62.7%
                 - when SN-OD not involved in approach                        38.7%        24.5%        27.5%
                 - when SN-OD involved in approach                            71.3%        66.3%        68.6%
                 - when patient had not expressed a wish to donate or the     54.1%        41.5%        46.7%
                 patient's ODR status was not known at the time of
                 potential donation
                 - ZKHQ SDWLHQW¶V ZLVK RQ 2'5 DQG NQRZQ DW WLPH RI            93.7%        88.0%        90.5%
                 potential donation*
                 - ZKHQ SDWLHQW¶V ZLVK  E\ DQ\ PHWKRG  LV NQown at time of    94.0%        89.0%        91.2%
                 potential donation**
                 - when SN-OD involved in approach and patient known to       94.3%        91.3%        92.6%
                 be on ODR at time of potential donation
                 - when deemed consent applied***                             66.7%        57.1%        60.6%

                 *89 families overruled their loved one's known ODR decision to be an organ donor
                 ** 100 families overruled their loved one's known decision (by any method) to be an organ donor
                 *** 13 families did not support deemed consent (of 33 cases where deemed consent applied)

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