The Organ Donation Taskforce (ODT) has 14 recommendations which aim to increase the number of transplants by 50% over the next 5 years.

The outline of the 14 recommendations agreed by ministers in relation to the Organ Donation Taskforce report are discussed below – ministerial approval for the recommendations was given in January 2008. All Chief Executives of Acute Trusts were sent a letter from Sir Bruce Keogh (Medical Director of the NHS) on 17th April 2008. (Gateway reference 9693) recommending “wide reaching action” to implement the following recommendations:

Recommendation 1

A UK-wide Organ Donation Organisation should be established.

The number and location of donor coordinators is being completely overhauled. The intention is to employ donor transplant coordinators (DTC's) through a national organisation. New employment contracts will move DTC's from the responsibility of individual acute trust hospitals to the national Organ Donation Organisation (ODO).A restructured NHS Blood and Transplant is responsible for running the Organ Donation Organisation.

Recommendation 2

The establishment of the Organ Donation Organisation should be the responsibility of NHS Blood and Transplant.

There has been a major restructuring of the organisation and management roles within the NHS BT in terms of activities carried out by the Blood Service and UK Transplant.

Recommendation 3

Urgent attention is required to resolve outstanding legal, ethical and professional issues in order to ensure that all clinicians are supported and are able to work within a clear and unambiguous framework of good practice. Additionally, an independent UK-wide Donation Ethics Group should be established.

Recommendation 4

All parts of the NHS must embrace organ donation as a usual, not an unusual event. Local policies, constructed around national guidelines, should be put in place. Discussions about donation should be part of all end-of-life care when appropriate. Each Trust should have an identified clinical donation champion and a Trust donation committee to help achieve this.

Recommendation 5

Minimum notification criteria for potential organ donors should be introduced on a UK-wide basis. These criteria should be reviewed after 12 months in the light of evidence of their effect, and the comparative impact of more detailed criteria should also be assessed.

Recommendation 6

Donation activity in all Trusts should be monitored. Rates of potential donor identification, referral, approach to the family and consent to donation should be reported. The Trust donation committee should report to the Trust Board through the clinical governance process and the medical director, and the reports should be part of the assessment of Trusts through the relevant healthcare regulator. Benchmark data from other Trusts should be made available for comparison.

Recommendation 7

Brain Stem Death testing should be carried out in all patients where BSD is a likely diagnosis, even if organ donation is an unlikely outcome.

Recommendation 8

Financial disincentives to Trusts facilitating donation should be removed through the development and introduction of appropriate reimbursement.

Recommendation 9

The current network of Donor Transplant Coordinators should be expanded and strengthened through central employment by a UK-wide Organ Donation Organisation. Additional co-ordinators, embedded within critical care areas, should be employed to ensure a comprehensive, highly skilled, specialised and robust service. There should be a close and defined collaboration between DTCs, clinical staff and Trust donation champions. Electronic on-line donor registration and organ offering systems should be developed.

Recommendation 10

A UK-wide network of dedicated organ retrieval teams should be established to ensure timely, high-quality organ removal from all heartbeating and non-heartbeating donors. The Organ Donation Organisation should be responsible for commissioning the retrieval teams and for audit and performance management.

Recommendation 11

All clinical staff likely to be involved in the treatment of potential organ donors should receive mandatory training in the principles of donation. There should also be regular update training.

Recommendation 12

Appropriate ways should be identified of personally and publicly recognising individual organ donors, where desired. These approaches may include national memorials, local initiatives and personal follow-up to donor families.

Recommendation 13

There is an urgent requirement to identify and implement the most effective methods through which organ donation and the ‘gift of life’ can be promoted to the general public, and specifically to the Black & Minority Ethnic population. Research should be commissioned through Department of Health research and development funding.

Recommendation 14

The Department of Health and the Ministry of Justice should develop formal guidelines for coroners concerning organ donation.

To be continued.