Scottish Donation and Transplant Group minutes: August 2025

Attendees and apologies

Attendees and apologies

• Mr John Casey (Co-chair), Joint Chair and Clinical Advisor for Transplantation in Scotland
• Dr Iain MacLeod (Co-chair), Joint Chair and Clinical Advisor for Organ Donation in Scotland
• Dr Pauline Austin, Consultant in Anaesthesia and Intensive Care Medicine, NHS Tayside
• Dr Richard Baker, President, British Transplant Society
• Dr Andrew Bathgate, Consultant Hepatologist, NHS Lothian
• Lynne Beverage, Senior Charge Nurse, NHS Lothian
• Linda Blake, PJ Foundation
• Elaine Campbell, PJ Foundation
• Sumrah Chohan, Human Tissue Authority
• Anthony Clarkson, Director of Organ Donation and Transplantation, NHS Blood and Transplant
• Amanda Forbes, Scottish National Heart Failure Service Manager, Golden Jubilee National Hospital
• George Gordon, NHS Lothian Organ and Tissue Donation Committee (ODC) Chair and Scotland Regional ODC Chair
• Neil Healy, Lead Nurse for Tissues, Cells, and Advanced Therapeutics, Scottish National Blood Transfusion Service
• James How, Blood, Tissue and Organ Donation Team Leader, Scottish Government
• Mr Chris Johnston, Consultant Transplant Surgeon and National Organ Retrieval Service (NORS) Representative, NHS Lothian
• Jen Lumsdaine, Lead Nurse, Living Donation Scotland, NHS Lothian
• Donna McLeod, Unit Head, Blood, Organ and Tissue Policy and Funeral Sector Policy Unit, Scottish Government
• Neal Padmanabhan, Consultant Nephrologist, NHS Greater Glasgow and Clyde
• Mark Print, Patient Representative
• Ben Reynolds, Consultant Paediatric Nephrologist, NHS Greater Glasgow and Clyde
• Dr Lesley Ross, Patient Representative
• Rachel Rowson, Regional Manager for Scotland, NHS Blood and Transplant
• Dr Matthew Saunders, Public Health Consultant, Public Health Scotland
• Dr David Turner, Consultant Clinical Scientist, Scottish National Blood Transfusion Service
• Dr Helen Tyler, Consultant in Anaesthetics and Intensive Care Medicine and Regional CLOD, NHS Forth Valley
• Dr David Walbaum, Consultant Nephrologist, NHS Grampian
• Claire Williment, Accountable Executive, Organ Utilisation Programme, NHS Blood and Transplant
• Dr Sharon Zahra, Clinical Lead, Tissues, Cells and Advanced Therapeutics, Scottish National Blood Transfusion Service

Guests

• Angelica Cabello Araujo, Scottish Transplant Research Network Manager

Apologies

• Mr John Asher, Consultant Renal Transplant Surgeon, NHS Greater Glasgow and Clyde
• Simon Cuthbert-Kerr, Deputy Director, Public Health Capabilities, Scottish Government
• Dr Jonathan Dalzell, Consultant Cardiologist, Golden Jubilee National Hospital
• Professor Derek Manas, Medical Director, NHS Blood and Transplant
• Professor Lorna Marson, Honorary Consultant Surgeon, Royal Infirmary of Edinburgh and Non-Executive Director, NHS Blood and Transplant
• Dr Gerard Meachery, Consultant in Respiratory and Transplant Medicine, Freeman Hospital
• Jessica Porter, Head of Regulation, Human Tissue Authority
• Kirstin Robertson, Specialist Services and National Planning, National Services Directorate
• Moira Straiton, Associate Director, Specialist Services and National Planning, National Services Directorate
• John Stirling, Head of Operations, NHS Blood and Transplant

Items and actions

Welcome and introductions

John Casey welcomed attendees to the meeting. In particular, he welcomed Dr Richard Baker, President of the British Transplant Society who had replaced Mr Krishna Menon and Donna McLeod, Unit Head, Blood, Organ and Tissue Policy and Funeral Sector Policy Unit, Scottish Government who had replaced Sam Baker.

He also welcomed Angelica Cabello Araujo, Scottish Transplant Research Network Manager to present at agenda item five.

It was noted that Peter Wyman, Chair, NHSBT had asked Professor Lorna Marson, Honorary Consultant Surgeon, Royal Infirmary of Edinburgh and Non-Executive Director, NHS Blood and Transplant (NHSBT) to attend future Scottish Donation and Transplant Group (SDTG) meetings on his behalf.

Minutes of meeting of 24 April 2025

The minutes of the previous meeting was agreed as an accurate record.

It was noted that three actions arose from the previous minutes.

• Karen Quinn, NHSBT to convene a meeting or discussion with interested SDTG members (Neil Healy, Chris Johnston and John Casey) to explore options for increasing donation levels of pancreata - Completed.
• Scottish Transplant Research Manager to discuss joint working on increasing numbers of organs donated for research with the NHSBT lead nurses - Completed.
• Linda White to consider what further transplant centre specific information can be circulated to centres from the survey results. Ongoing – centre specific survey results had been sent to Glasgow Transplant Unit and other centre data is being collated.

NHS Blood and Transplant (NHSBT) update

UK strategy

Anthony Clarkson highlighted that NHSBT had seen an increase in organ donor numbers in the first half of this year and reported that they were 5% ahead of their target.

He reported that NHSBT were seeing a further decline in Donation after Brain Death (DBD) donors and an increase in Donation after Circulatory Death (DCD) donors and further work is underway with the Intensive Care Society and the Clinical Leads Organ Donation (CLODs) to explore how to get back to the DBD numbers reported in previous years.

It was noted that the increasing number and proportion of DCD donors in the UK has a significant impact on Scotland in terms of resources and costs in relation to the technology required.

Implementation Steering Group for Organ Utilisation (ISOU) update

Claire Williment provided an update on the ISOU and advised that the group is drawing to a close by the end of this year. She went on to summarise progress against each of the ISOU recommendations highlighting those which are ongoing and those which have closed and have been handed over to NHSBT and the Department of Health and Social Care (DHSC) business as usual teams.

In particular she advised that the Patient Engagement sub-group recommendations, the Histocompatibility and Immunogenetics sub-group recommendations and the Assessment and Recovery Centre (ARC) sub-group recommendations had been approved by ISOU members and DHSC Ministers and these reports are available on the ISOU website. Funding has been confirmed from DHSC to NHSBT to begin work on an ARC pilot in the current financial year.

ISOU and DHSC Ministers have also approved the Xenotransplantation sub-group recommendations and the report will be published soon. NHSBT and DHSC will continue work in this area in the longer term. The Trust Engagement sub-group recommendations and transplant utilisation strategy template have been approved by ISOU and DHSC Ministers and the report is available on the ISOU website. As part of the cardiothoracic transplant service review, DHSC ran an information collation exercise in summer 2023 and the findings were shared with NHS England. NHS England has since set up a transformation board structure to oversee this review. A symposium was held on 7 May 2025 to discuss the transplant workforce template. The report and template are being drafted by DHSC and will be shared with ISOU for sign off prior to publication.

With regards to the ISOU’s upcoming milestones, Claire advised that during August, DHSC plan to undertake an action mapping refresh to their handover plans. The twelfth ISOU meeting will be held on 14 September 2025, the Stakeholder Forum will meet on 2 October 2025 and a Digital Symposium will be held on 22 October 2025. The final ISOU meeting and report on plans to drive forward delivery of the Organ Utilisation Group recommendations will be held in November/December 2025.

Claire emphasised that a number of ISOU sub group recommendations are applicable to Scotland, for example the work on Trust engagement, patient pathways, and workforce provision.

John Casey agreed that SDTG should consider the recommendations relevant to Scotland and suggested an exercise is undertaken to decide how we take forward and apply these recommendations in Scotland and identify who owns them.

Organ Donation Joint Working Group/International Donation Action Forum (IDAF)

Anthony Clarkson advised that the role of the Organ Donation Joint Working Group, led jointly between NHSBT and DHSC, is to focus on the issues caused by falling authorisation and consent rates and falling numbers of eligible potential deceased donors.

The Working Group has undertaken a series of activities including a donor family survey, a clinical survey, clinical workshops and a series of discovery events. The IDAF was also established to bring together national and international experts and donor family representatives to explore international practice in organ donation and establish where there may be opportunities for driving further improvements in the UK.

The IDAF came together for a week at the beginning of June to look at four key areas of activity:

• Marketing, communications and societal action
• Clinical practice
• Family approach
• Maximising the potential from legislative changes

A set of recommendations from the IDAF have been set out in a report and this will inform the wider work of the Organ Donation Joint Working Group. The report will be presented to the NHSBT Board for approval at the end of September before being issued to the UK Health Departments to gain Ministerial support. James How requested that NHSBT gives the Scottish Government a clear steer on which recommendations it would be taking forward at UK level and which recommendations should be taken forward by other Scottish partners.

Sharon Zahra asked whether tissue donation was represented in the report. Anthony confirmed that tissue was not specifically included however the recommendations could extend to tissue donation. He agreed to give some further consideration to the inclusion of tissue donation in the report.

Deceased organ donation – Scotland

Rachel Rowson updated on the year to date deceased organ donation numbers in Scotland, noting that there had been 35 proceeding donors in Scotland with 114 organs retrieved. The referral rate remained high, at 97% however the neurological death testing was low at 46%. NHSBT has set up a neurological death testing working group to interrogate the data and review the cases that are not being tested. The DBD authorisation rate was 93% and the DCD authorisation rate was 51%. DBD donors can donation more organs and at a older age resulting in higher eligibility of DBD donors.

Rachel also advised that an Authorisation Working Group had been established in Scotland to review the authorisation process and authorisation form five years post implementation of the deemed legislation. She outlined that the rationale for this is having more evidence and research than ever before from families on the donation process. The NHSBT Consent Working Group has already undertaken a review of the consent form and the evidence and recommendations will be shared to identify commonalities across processes. This includes a forward-looking aim to digitise both consent and authorisation forms, ensuring consistency, efficiency, and improved user experience across systems.

Scottish Transplant Research Network (STRN)

Angelica Cabello Araujo provided a mid-year update on the STRN and outlined the activities of the network during 2024/25 which included building cross-Scotland collaboration in transplant research and the delivery of webinars, including a perfusion-focused session. Angelica also highlighted a number of research opportunities that are on the horizon and provided an overview of the next four webinars that are scheduled. A patient and public engagement social media campaign is planned for the autumn and the first pan-Scotland transplant annual meeting is being organised to bring researchers, clinicians, stakeholders, and key opinion leaders together to showcase research, foster collaboration, and set Scotland’s transplant priorities.

Public health prevention

It was noted that public health prevention was a key recommendation in the Donation and Transplantation Plan for Scotland: 2021-2026 where it set out that SDTG work with Public Health Scotland to ensure its work to improve public health can help us to reduce organ failure across Scotland.

Matthew Saunders gave a presentation on preventing transplant need in Scotland and outlined the current population health trends and the projected increase in the total burden of disease in Scotland. He referred to the data in the Future Burden of Disease (ScotPHO) report which highlighted the main causes of the projected disease burden increase.

He also focussed on specific conditions with growing annual disease burdens which included obesity, diabetes, smoking and alcohol and advised that there are a wide range of primary prevention activities that could be strengthened across core risk factors working with Public Health Scotland Leads.

Matthew outlined some options for preventing the need for organ transplant and disease-specific actions including chronic kidney disease as well and heart, lung and liver disease. It was suggested that it may be useful to continue discussions on these options with the policy leads covering these diseases in the Scottish Government.

James How thanked Matthew for the presentation and reminded SDTG colleagues that Matthew’s presence at these meetings and his ability to take questions and comments, was the vehicle for meeting priority seven of the Scottish Donation and Transplantation Plan, which focusses on public health improvement.

Any other business

Marketing update 2025/26

Linda White advised that a small marketing budget had now been confirmed for 2025/26. Work is underway to develop a PR-led campaign for Organ and Tissue Donation Week (22 – 28 September 2025) which would be followed by a wider campaign during October using the existing creative ‘Don’t Leave Your Loved Ones in Doubt’ assets and messaging from the 2022 marketing campaign.

Written updates

John referred the group to the written updates circulated with the papers.

Next meeting

The next meeting will take place on 11 December 2025, 14:00 to 16:00, and will be a Microsoft Teams meeting.

Summary of action points

Action 1: James How and Linda White to consider the ISOU recommendations relevant to Scotland and action with National Services Directorate and NHSBT colleagues and bring a paper to the December SDTG meeting.