NHS Blood and Transplant: life-saving training

Organ donation rates in the UK are amongst the lowest in the developed world, with three people awaiting transplantation dying each day, says Lesley Logan. NHS Blood and Transplant 's regional manager for donor care and co-ordination adds that this is why her programme, which has been nominated for the 2010 Guardian Public Services Awards, is so important. The project aims to facilitate the process through which clinical staff champion the cause of donation within their hospitals. It has provided more than 350 NHS consultants and organ donation chairs with clinical expertise, leadership and management skills required to improve organ donation. "The professional development programme is a mixture of different modes of education and we had to be very careful about how it was taught because it was being carried out UK wide," Logan says. "So bringing people together hasn't necessarily always been the first choice of how we might do things. It has a mixture of masterclasses, podcasts, online discussion forums and an online depository for information that they want to cascade out." Although she was not able to provide exact figures, Logan said that the programme has cost the equivalent of the amount saved by recruiting one extra donor. It costs around £225,000 to keep a patient on kidney dialysis for a decade, and most donors donate both kidneys. In 2008, the Organ Donation Taskforce published a report which called for a 50% increase in organ donation rates by 2013. It also highlighted the need for clinical staff to receive training to deal with potential organ donors and to be supported by a donation committee. The programme was given the go-ahead after the Department of Health and the Scottish Government agreed that something had to be done to tackle the problem across the UK. Since the NHS Blood and Transplant project began in February 2010, it has helped increase organ donation by 20%. However, Logan says that there have been some major challenges, not least the differences in the backgrounds of those running hospitals' donation committees. "Because of the change management and the leadership skill element of the programme, we've had to pitch it at a level which we think the majority of individuals will understand," she says. "You have a non-executive director of a trust or a member of staff from a strategic health authority who understands how hospitals work, and on the other hand you've got a family who are in fact parents of someone who died and he was a donor. They wanted to give something back, but they had no real understanding of how hospitals work. They've got a very different view because of their experiences." Logan says that implementing such a project with just two other colleagues, Dr Paul Murphy, national clinical lead for organ donation, and Dan Aldridge, implementation lead (who has now left NHS Blood and Transplant), has been a struggle at times. However, she believes the support they've received from other NHS organisations and consulting firm Deloitte have been a huge help. She adds: "Collaborating with organisations has kept the costs down, we've used their time and information." The project has also faced some practical problems. "The programme has had to cover the whole devolved administration and therefore we're dealing with a few laws for example. The Human Tissue Act is different for example in Scotland and England. There are different regulatory frameworks within the health service," explains Logan. This, coupled with bringing people from different parts of the country together, has also proved difficult. "What we didn't want is take those clinical experts away from their ITUs (intensive therapy units)," she adds. Despite these difficulties, Logan says the programme is progressing well and has received great feedback. She picks out the publication of pathways of care, which have been taken from the programme's masterclasses, as one of her proudest moments so far. Hospitals that do not undertake regular donations can also view the pathways online to give them a clearer idea of the process involved. "The pathways are also on the website, and there are details of pathways of best practice that anyone can see and view at any time through a web based tool." Although still relatively new, the programme has caught the attention of health services outside the UK, with Canada and Australia expressing an interest in using elements of it for similar projects. Logan says that ultimately she wants the programme, which faces one final review in January, to continue to improve donation numbers – and believes the principle can be applied elsewhere in the NHS. "What we're doing is to some extent innovative and groundbreaking, but it's applicable to other parts of healthcare too, which I think makes it a very good thing to be involved in. It means that other people learn from something that has gone before," she adds. Wythenshawe: a hospital on green alert