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

8. Priority 5 – Transplant recipient support and aftercare

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

The coronavirus (COVID-19) pandemic has changed the way services are delivered, with many transplant teams offering video (Near Me) or telephone consultations as an alternative to attending a clinic. Remote consultations can improve access to services for some transplant patients and reduce the need for travel to appointments.

Transplant Recipient Support and Aftercare Working Group was tasked with looking at ways of improving aftercare for transplant patients and to better understand the variation in the use of remote consultations across different NHS Boards.

In 2023, a survey was sent to all transplant teams and referring clinicians to explore the use of telemedicine for transplant patient consultations.

There were 47 responses to the survey. The survey asked clinicians questions such as ‘What factors influence whether a patient is offered a remote consultation or a face-to-face appointment?’, ‘What are the benefits of remote consultations for clinicians and patients’, ‘What are the barriers to extending the use of remote consultations and what can be done to overcome these barriers?’.

The findings from the survey have shown that the current use of remote consultations is variable, with less than half of clinicians using Near Me and the majority of the clinicians using remote consultations for <25% of their consultations. Clinicians reported that remote consultations benefitted the patient however they were not a replacement for in person consultations. A number highlighted service limitations to using remote consultations including securing clinic rooms and administrative support.

The co-chairs of SDTG sent a report of the survey findings and a covering letter to transplant units and referring clinicians in June 2024 which highlighted that the findings and recommendations demonstrate that many patients do value the option of remote consultations as a method of facilitating local care and, as such, it is important to have the ability to provide remote consultations for appropriate patients.

8.2 Transplant patient survey

A key focus of the Transplant Recipient Support and Aftercare Working Group work was to review whether existing aftercare services need to be improved for some or all organs to ensure appropriate support across Scotland.

The group launched a Transplant Patient Survey in late 2023, targeted at adults, aged 16 and over, to capture an up-to-date picture of patients’ views on transplant services in Scotland.

A total of 569 transplant recipients completed the survey. The respondents represented a wide range of transplant recipients, from age 16 to over 80 years old. Transplant patients from all health board areas of Scotland were represented. The respondents provided feedback on the transplant services for all solid organs (liver, kidney, heart, pancreas, islet cell, simultaneous pancreas and kidney). However lung recipients were under represented with only four responses received from these patients.

Overall, the majority of responses were positive; however some respondents felt that more could be done to improve access to online communication and education, and some said that they would have benefited from more psychological and emotional support post-transplant.

The survey recommendations were approved at the SDTG meeting in December 2024.

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

This recommendation has been taken forward as part of priority 5.3.

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

The key focus of the ‘Clinicians have the Right Expertise to Support Patients Locally’ Working Group was to identify how transplant units interact with primary and secondary care and whether any additional guidance was required to help them support patients post-transplant. The group held six focus groups with referring clinicians and transplant units including four with cardiology, one with hepatology and one with nephrology (non-transplant centre kidney pancreas nephrologists also attended this session).

The findings from the focus groups did not identify any particular recommendations, apart from identifying an unmet need for psychological support in some services. As the patient survey has also highlighted an unmet need for emotional/psychological support for transplant recipients in general, there will be detailed recommendations in this area in the survey report.