Donation and transplantation: plan 2021 to 2026

Proposed Timeline

Short Term 2021 – 2022

Raise awareness across Scotland about the change in legislation, aiming to reach as many people as possible, including harder to reach groups. Regular awareness raising will continue following introduction of deemed authorisation.

Ensure key staff likely to be involved in approaching families about deceased donation receive training and guidance on the new legal requirements in relation to deemed authorisation and pre-death procedures - to be delivered by March 2021. Also put in place wider general awareness raising for other NHS staff.

Raise awareness among relevant staff across NHS Boards to seek to ensure all those patients who would be likely to benefit from a transplant are offered the opportunity.

Ensure use of Specialist Requesters to approach families about organ donation in all donating hospitals. Implementation has already started.

Ensure a robust eye retrieval service for Scotland is in place and continue to monitor and review progress on increasing eye donation.

The Living Donation Scotland Board will prepare guidance for referring Renal Units on recommended staffing levels to support living donation.

Ensure NHS Board staff know where to access advice from transplant unit staff and can access expert advice within a reasonable timescale.

Short to Medium Term 2021 – 2023

Keep the pre-death procedures regulations under review. If changes to either Type A or Type B regulations are proposed, ensure these proposals can be considered and, if appropriate, amendments can be made.

Work to ensure sustainable, patient-centred transplant services, including exploring options for increased shared services between Renal units, in particular to avoid the need for patients to miss out on any suitable organs offered for them.

Via opt out implementation and longer term, increase awareness raising among NHS staff about referring potential tissue donors.

Work to establish telemedicine support for those patients who need it to supplement local NHS Board support.

Where appropriate, provide additional guidance to NHS Boards/GPs to help build their expertise on and ability to support patients locally post-transplant.

Increase public awareness about the benefits of donating organs or tissue for research.

Medium Term 2023 – 2025

Undertake an evaluation of the deemed authorisation system and seek to learn any lessons from the evaluation findings by late 2025.

Increase the number of viable organs for transplantation by using novel technologies, such as rolling out use of machine perfusion. Subject to the findings of initial feasibility work, consider moving ahead with development of a Scottish Assessment and Recovery Centre.

Monitor and review use of Specialist Requester model.

Ask Renal Units to make the default option for a first transplant for all patients needing a kidney transplant a living donor transplant.

Continue to monitor and review progress on increasing eye donation.

Subject to positive evaluation of the NHS Lothian REACH trial, a community, nurse-led programme of home visits to or other direct engagement with patients and their family should be encouraged throughout Scotland.

Monitor progress and consider if further action is needed to increase donation and utilisation of organs or tissue for research.

Longer Term 2026 - 2030

Work with Public Health Scotland to ensure its work to improve public health can help us to reduce organ failure across Scotland.

The Scottish Government will also ensure its prevention policies on diet and healthy weight, physical activity, and alcohol, tobacco and drugs focus on health inequalities to help reduce organ failure across Scotland.