Targeting organ donations

 NHSBT is the Special Health Authority responsible for the provision of a reliable, efficient supply of blood and associated services to the NHS, as well as being the organ donor organisation for the UK responsible for matching and allocating donated organs. Earlier this year the Authority published it latest strategic plan, designed to save and improve more lives through blood provision and organ donation. As well as planning to maintain the price of blood at the same rate until 2014, NHSBT is also pledging to increase the number of organ transplants to more than 4,000 per year. Currently it is already half way to its target of increasing organ donation by 50% by 2013 and according to NHSBT chief executive Lynda Hamlyn, the organisation now hopes to further improve on this. Speaking at the launch of the plan, she said: “NHSBT makes a unique contribution to saving and improving patients’ lives. Every day thousands of ordinary people do something extraordinary and donate to help someone else, often a complete stranger. “It is NHSBT’s professional expertise and knowledge that takes these precious donations and turns them into products that can be used safely for the benefit of patients. Our plans will hopefully help to save and improve more patients’ lives than ever before, as well as releasing £30 m a year in savings to the NHS to reinvest into frontline patient care”. A major factor of the NHSBT target is the removal of any barriers that could prevent further increases in organ donation. However, there are still many significant obstacles to overcome if this is to be achieved.

Progress in organ donation

Currently there are almost 18 million people on the NHS Organ Donor Register (ODR) which is equivalent to 29% of the UK population. There has also been a steady increase in the number of UK transplants in over the past seven years, with 3,708 transplants recorded in 2009-10 – a 7% increase on the previous year. Unfortunately, this is still far below the current demand for organs as the UK has one of the lowest organ donation rates in Europe. Currently, people must sign up to the ODR, or their families must agree before their organs can be used. More than 10,000 people are awaiting an organ transplant in the UK, with an average of three patients a day dying. The donor pool itself is changing as a result of the increasing age profile and relative body mass index of donors, this adversely impacts on the number and quality of organs that can be retrieved. As an initial response to UK organ donation issues, the Government set up the Organ Donation Taskforce (ODTF) in 2006 comprising of medical professionals, NHS managers and patient representatives to identify existing barriers to organ donation and to recommend actions needed to increase the numbers of available organ donors. The ODTF published its first report Organs for Transplants in January 2008 which made recommendations aimed at increasing organ donation rates. In its second report The potential impact of an opt out system for organ donation in the UK released November 2008, the ODTF concluded that an “opt out” consent system should not be implemented in the UK at the current time as there was no convincing evidence that this would deliver significant increases in the number of donated organs. Other considerations in rejecting the opt out, such as cost of implementation and the erosion of trust between the NHS and the public, were all highlighted in the report, as was the need to improve public awareness of organ donation. The ODTF report also recommended the creation of a UK-wide network of Donor Transplant Coordinators (DTCs) comprising of specialist healthcare professionals. DTCs would then be embedded within critical care areas to ensure a comprehensive, highly skilled, specialised and robust service is available to liaise with bereaved families, to explain organ donation and to ensure that donors’ wishes are respected. A key component to achieving the latest NHSBT targets within organ donation and transplantation , therefore, been the recent formation of teams of specialist “organ donation champions” combined with the commissioning of a network of dedicated organ retrieval teams across the country to ensure timely, high-quality organ removal.