Health Service Focus

‘We can’t do this on our own’

NHS Blood & Transplant’s Anthony Clarkson, assistant director of organ donation and nursing, tells NHE about the organisation’s message to staff working in healthcare.

National Transplant Week ran from 7 to 13 September this year, and many NHS trusts and foundation trusts across the country joined in its efforts to get the public saying ‘Yes I Donate’. 

But NHS Blood & Transplant (NHSBT), which has a responsibility to match, allocate, audit and analyse organ donations across the whole of the UK, wants to ensure that not just the general public but also NHS staff themselves have the full facts about organ donation. 

Its assistant director of organ donation and nursing, Anthony Clarkson, told us: “Organ donation, even in a large hospital, is still relatively rare. Of all the people who die in the whole of the UK annually – about half a million – only about 5,000 die in a way that [allows] organ donation. Those are generally in critical care areas. 

“Because it’s still a very rare event, for us it’s about education – to give staff the courage and knowledge to support the donation process, and to ensure they’ve got the right information. 

“If there is resistance from staff, it’s very rarely because they don’t support organ donation. It’s generally due to the fact that the process can be quite complex; even for healthcare professionals, it can be quite involved and emotional, and it might not be a process they’re familiar with. That’s why we get our specialist NHSBT nurses involved at a very early stage. They will help them and guide them through that process.”

Misconceptions 

Clarkson said most health organisations and royal colleges support organ donation, though do not necessarily actively promote it. NICE, the National Institute for Health & Care Excellence, has a guideline relating to donation, covering the referral and then the approach to the family about the option of organ donation after death. 

When people sign up to the organ donor register, they are not asked where they work – so there are not firm statistics on whether NHS workers are more likely than the general population to be on there. But Clarkson said: “When we have asked anecdotally and done smaller surveys, we have found that not all NHS workers are on the organ donor register. The [rate] is slightly better than the general population, but less than you would imagine. 

“Again, that’s probably due to a lack of knowledge around organ donation, so we want to work with the trusts to increase that knowledge. Some of the misconceptions that the general public might have about organ donation may also be seen in some parts of the NHS, particularly among non-clinical staff.” 

Family ‘over-ride’ 

One recurring problem is where families ‘over-ride’ the wishes of their dead loved one and do not want a donation to take place. About 100 families a year don’t support their relative’s wish to donate, Clarkson said.

Although registering as an organ donor means specifically giving your consent, and families have no legal right to veto it, he said there is “an acceptance that if a family feels strongly that donation shouldn’t go ahead, then in the clinical and donation community we would follow the wishes of the family in those cases”. 

Families sometimes worry their loved one might have made a mistake in signing up to the register, or not fully known what they were doing, or had changed their mind later. “The best way, we believe, to address that is to get the individual who signed up to tell their family that they have done it. It’s much better if they’ve had that conversation.” 

World-class service 

He urged NHS professionals and clinicians to “get behind” the campaigns being run by NHSBT, saying: “The key is that we have to work in partnership with the wider NHS, and for them to embrace organ donation. 

“We can’t do this on our own – we need the whole NHS to get behind us and to make organ donation a world-class service.”

FOR MORE INFORMATION

W: www.organdonation.nhs.uk/news-and-campaigns/national-transplant-week/

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