Donation and Transplantation Plan 2021 to 2026: annual progress update - December 2025

3. Implementation of the plan - position update – December 2025

3.1 Priority 1: Implementation of the Human Tissue (Authorisation) (Scotland) Act 2019

3.1.1 Raise awareness across Scotland about the change in legislation, aiming to reach as many people as possible, including harder to reach groups.

Recommendation implemented (with ongoing monitoring of progress)

3.1.2 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. Also put in place wider general awareness raising for other NHS staff.

Recommendation implemented (with ongoing monitoring of progress)

3.1.3 Undertake an evaluation of the organ and tissue donation opt out system, as required by The Human Tissue (Authorisation) (Scotland) Act 2019 and seek to learn any lessons from the evaluation findings. The five year evaluation report is due in 2025.

Recommendation ongoing

3.1.4 Keep 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.

Recommendation implemented (with ongoing monitoring)

3.2 Priority 2: Increasing organ transplantation

3.2.1 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.

Recommendation implemented (with ongoing monitoring of progress)

3.2.2 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.

Recommendation implemented (with ongoing monitoring of progress)

3.2.3 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.

Recommendation implemented

3.3 Priority 3: Reducing missed opportunities for deceased donation

3.3.1 Ensure use of Specialist Requesters to approach families about organ donation in all donating hospitals to help improve authorisation and reduce overrides where the patient was on the NHS Organ Donor Register (ODR).

Recommendation implemented (with ongoing monitoring of progress)

3.3.2 Monitor and review use of Specialist Requester model.

Recommendation implemented

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

Recommendation implemented (with ongoing monitoring of progress)

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

Recommendation ongoing

3.4 Priority 4: Increasing living donation and reducing the wait for a kidney transplant

3.4.1 Ask renal units to make the default option for a first transplant for all patients needing a kidney transplant a living donor transplant.

Recommendation implemented (with ongoing monitoring of progress)

3.4.2 Subject to positive evaluation of the NHS Lothian Renal Education and Choices at Home (REACH) pilot, a community, nurse-led programme of home visits to or other direct engagement (such as video calls) with patients and their family should be encouraged throughout Scotland.

Recommendation implemented (with ongoing monitoring of progress)

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

Recommendation implemented

3.5 Priority 5: Transplant recipient support and aftercare

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

Recommendation implemented^[1]

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

Recommendation implemented

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

Recommendation implemented

3.6 Priority 6: Research and innovation

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

Recommendation ongoing

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

Recommendation implemented (with ongoing monitoring of progress)

3.7 Priority 7: Public health improvement

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

Recommendation implemented (with ongoing monitoring of progress)

3.7.2 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.

Recommendation implemented (with ongoing monitoring of progress)