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

4. Priority 1 - Implementation of the Human Tissue (Authorisation) (Scotland) Act 2019

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

In the lead up to the change in legislation in March 2021 to an opt out system of deceased organ and tissue donation, a public information campaign ran to inform the general public about the change to the law. This included a leaflet sent to every household in Scotland as well as TV adverts and social and digital media making it clear why the law was changing and informing people that they will be considered to have agreed to be a donor when they die, unless they have chosen to opt out of donation.

A further marketing campaign ‘Don’t Leave Your Loved Ones in Doubt’ was launched in July 2022 to remind people of the new legislation and to encourage people to make a donation decision and share it with family and friends.

In 2023, the organ and tissue donation campaign was focused around PR and social media awareness raising activity.

During Organ and Tissue Donation Week in September 2024, a new national campaign, ‘Have the Chat’ was launched to encourage people to think about their organ and tissue decision, register it on the NHS Organ Donor Register and tell their loved ones what they’ve decided.

In 2025, the ‘Don’t Leave Your Loved Ones in Doubt’ campaign was rerun during Organ and Tissue Donation Week and into October. An organ donation debate was also held in the Scottish Parliament during the Week and this provided a useful means to raise awareness of organ and tissue donation.

The Kidney Research UK Peer Educator programme, funded by an annual Scottish Government grant, continues to help raise awareness of organ and tissue donation within the South Asian communities in Edinburgh and Glasgow and to engage with key charities and stakeholders.

The Organ and Tissue Donation Committees continue to raise awareness about organ and tissue donation and seek ongoing opportunities promote donation within their local communities.

Online resources were launched in October 2022 for primary and secondary schools to help educate children and young people about matters relating to deceased organ and tissue donation, living kidney donation and transplantation. The aim of the resources are to help raise awareness, to encourage discussion and empower young people make an informed, educated decision about organ and tissue donation.

4.2 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.

NHS staff across a number of professions have completed the TURAS e-learning modules on the Human Tissue (Authorisation) (Scotland) Act 2019 and continue refresher training on these modules. TURAS is a digital learning platform developed by NHS Education for Scotland. The modules explain the Act and include specific information about authorisation, duty to inquire and pre-death procedures.

4.3 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 Organ and Tissue Donation Opt out System: Five Year Monitoring and Evaluation Plan and The Human Tissue (Authorisation) (Scotland) Act 2019: Baseline Report were published on 2 February 2022.

These documents present data about various aspects of organ and tissue donation in Scotland prior to implementation of Act. Annual reporting to the Scottish Donation and Transplant Group on monitoring and evaluation will continue until 2026 to show trends in organ and tissue donation.

4.4 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.

There have been no requests for changes to the pre-death procedures to date. However, we stand ready to consider any proposals. Pre-death procedures are a set of procedures and tests that are carried out shortly before the death of a donor to check that transplantation is likely to be safe, successful and a suitable match for somebody on the transplant waiting list.

A report on the use of Type B pre-death procedures will be presented to the Scottish Donation and Transplant Group at the end of the five-year period of the monitoring and evaluation of the opt out system.