Donation and transplantation: plan 2021 to 2026

Ministerial Foreword

The Scottish Government is committed to increasing organ and tissue donation and transplantation to enable more of those people who desperately need a transplant to access one. There are so many inspiring stories of transplant recipients which show us how much of a difference a transplant can make in saving people's lives or significantly improving them. Often, a transplant not only allows people to survive, but to live a full and active life.

Over the last ten years, a great deal of progress has been made, including since our previous Donation and Transplantation Plan was published in 2013. However, there is still a lot more to do. Too many people are still tragically dying waiting for a transplant and too many others are still waiting too long for their transplant, which is not only frustrating for them, but can also have a long-term impact on their health.

There is a high level of public awareness of and engagement with donation in Scotland and public attitudes have changed. Our public consultation in 2016 sought views on increasing numbers of successful donations in Scotland and informed our decision to

bring forward an opt-out system of deceased organ and tissue donation. We know the great majority of people in Scotland support organ donation, but sadly many families still don't feel able to support donation when their loved one dies, for a wide range of reasons. As only a very small proportion of people die in circumstances where they could donate organs, every single potential donor is precious.

This new opt-out ('deemed authorisation') system will mean that most adults will be considered to be a potential donor after their death unless they have opted out of donating. There will of course be safeguards to check with family and friends to ensure donation would not have been against their wishes. However, this move should help support a long-term culture change in favour of donation. We want to encourage everyone to think about donation, make a decision and discuss this with their family or friends. This is the best way to ensure everyone's decision can be respected if they sadly die unexpectedly.

Ensuring we can increase the number of deceased donors is part of the solution, but this Action Plan recognises there are many others which, collectively, could make a difference. Improving access to transplants will involve many people and teams across hospitals and the health service more widely, both to increase numbers of donors and to ensure we make best use of all the organs and tissue that are donated. In particular, we need to take advantage of the novel technologies which can really help ensure more organs can be used and are more likely to work effectively for longer once transplanted.

For kidney patients, it's also vital to remember that a living donor will normally offer the best outcomes for a person's long-term health. So we want to support patients and their families and friends as much as possible to find a suitable living donor for them. There has already been good progress in increasing numbers of living donors coming forward, but we want to see this continue to grow. While opt-out should help reduce waiting times, there are so many people waiting for a kidney transplant that we need living donors, as well as deceased donors, to support all those needing a transplant.

I am very grateful to colleagues in the Scottish Donation and Transplant Group and more widely across NHS Boards in helping to develop this action plan. The Scottish Government is confident that, through the package of measures described in the plan – both new recommendations and initiatives already started – we can significantly increase the numbers of transplants over the next five years.

Mairi Gougeon MSP, Minister for Public Health and Sport