The tangible benefits of health policy

Guest blog post by Dr Iseult Roche.

With thanks to Jacqueline Rolf, specialist nurses in organ donation, Frimley Park Hospital. www. Nhsbt.nhs.uk

April was a good month for at least one area of the NHS as it achieved the challenge set by the Organ Donation Taskforce five years ago, back in 2008, which set out the plan to increase organ donation by 50% over five years. Prior to this, there had been almost no increase in the number of deceased donors over the previous decade.

Nationwide this landmark target was successfully achieved and thanks to this it is estimated that over 3,000 patients lives were transformed, by the actions donors , donors families and the dedicated teams which manage this complex and highly emotional issue.

The number of deceased organ donors throughout the UK reached 1212, in 2012/2013 and this was equivalent to a 50% increase since 2007/08.

Bill Fullagar, the  NHS Blood and Transplant Chairman, said “This is an outstanding achievement that few thought possible at the time this ambition was set. It is the result of the hard work and dedication of staff in hospitals and communities across the country,”

Although this has been an incredible success, there is still room for improvement. The UK is behind other EU countries including Spain and Portugal. The difference cannot alone be attributed to the ‘opt-out’ versus ‘opt-in’ protocol and the public’s understanding of being on the organ donor list.

It also also seems to be significantly impacted by Doctors early recognition of who would potentially be a suitable donor, should families be willing,  and importantly the availability of ITU beds, as without these, optimum conditions cannot be delivered for the donor’s organs to be preserved. Although this may sound grim to many, the reality is that optimum pathophysiology conditions must be met in order to ensure the donor organs are preserved and be successfully donated to save lives.

In situations of bed shortages, ITU consultants can be in the awful position of making impossible decisions to not use the beds in such a way.

Awareness and education among Doctors seems to vary between trusts, however training is improving this.

Specific training is making doctors more aware of how to recognize potential donors and to consider the concept of speedily liaising with the specialist nurses in organ donation, who support and discuss with families considering organ donation.

It is also felt that  family consent to organ donation may need to be reviewed, as family refusal rate in the UK is still one of the highest in Europe, currently, although a patient may be on the Organ Donor list, if the patient’s family refuse this is the overriding decision.

Never the less, achieving the 50% increase is a landmark.

Professor of Renal Transplantation Medicine at Barts and The London and President of the British Transplantation Society ( Anthony Warrens) said: “We salute the enormous effort of large numbers of people and the determined leadership given by NHS Blood and Transplant which has made this happen. There can be few greater achievements than to have given life to those who were on the verge of death but that is the reality of this achievement. Data show that an individual who donates his or her organs after death gives the recipients an aggregate of an additional 56 years of life. And despite the sadness of the moment, this usually becomes a major comfort to bereaved families as time passes.”

This is an outstanding success and the NHS must be proud of its’ achievement.

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