Scottish Donation and Transplant Group written update: August 2025

NHS Blood and Transplant update 

Update given by:

• Anthony Clarkson, Director of Organ and Tissue Donation and Transplantation

Performance

We are ahead of plan with 956 deceased organ donors year to date against a target of 904, keeping performance green at around 106 percent.

Transplants per deceased donor remains high at 2.55 per donor, showing strong utilisation across the pathway.

Living donation is also ahead of plan with 180 donors year to date against a target of 167.

Overall authorisation is 59% against a 62% target, which remains the primary constraint on conversion. Where a patient has opted in, consent remains very high at around 90%, demonstrating strong public support when wishes are known. However, we are seeing higher out-out rates than anticipated. Opt-outs remain elevated at just over 52,000 in quarter one, a 122 percent increase on quarter one 2024, likely driven by negative media and social media narratives.

Research collaboration remains active, with 92 organs offered for research in June and higher acceptance during core weekday hours, which we are leveraging to place more organs for research benefit.

Marketing

Throughout quarter two, there are a number of proactive media stories issued by NHSBT to generate positive media coverage and to encourage people to register their decision.

Organ Donation Week, 22-28 September 2025, is our main campaign of the year. This Organ Donation Week, we're highlighting the urgent need for people to register their decision to donate. Activity includes a national and regional media release, an ask to NHS Trust Chief Executive Officer’s, via the Organ Donation Committees, to support Organ Donation Week across their Trust, support from stakeholders and partner organisations to amplify the campaign, community engagement by organ donation ambassadors, Specialist Nurses Organ Donation and Organ Donation Committee’s, plus paid media advertising in England and Wales. 

Finances

Scotland were asked for a nearly 40% increase in financial contribution in 2025/26.  We are grateful to Scottish colleagues for their hard work in reaching a financial settlement for 2025/26, including a recent uplift of a further £800k on the interim position.

While NHSBT Organ Donation and Transplantation (ODT) has generally managed to contain inflationary pressures, there are two reasons that explain the size of this request:

1. An NHSBT review identified historic disparities in the funding levels from the different nations, following the Barnett formula for population-based share. 
2. A new model for full funding for NHSBT organ donation and transplantation’s overheads, which were previously subsidised by blood product prices in England.

We know that there will have been much work behind the scenes and appreciate all efforts. This is especially important because, at UK level, activity is rising. 

Looking ahead, all Health Departments advise that flat (possibly deflationary) funding is the most likely scenario for 2026 and beyond, but remain committed to raising additional funds where possible.  

NHSBT have advised that changes will be required to operate services within this funding envelope. These will take time to deliver and need to be done with Health Department engagement. We are committed to early conversations with Scotland.    

Organ Donation Joint Working Group (ODJWG)

The ODJWG was established to provide a mid-term stock-take of the deceased organ donation elements of the UK strategy. Jointly chaired by the Department of Health and Social Care and NHS Blood and Transplant, it brought together experts in the field of organ donation, including donor families and service providers, gaining insight through interviews, workshops, surveys, discovery groups and evaluations. The group’s remit was to identify further actions for the remaining to deliver the strategy, to ensure that all opportunities to maximise the number of lives saved through the gift of deceased organ donation.

The engagement work has completed, as has the analysis of the results. The report and its recommendations are currently being drafted, with the ambition of sharing the final report in October 2025. 

NHSBT leadership

Jo Farrar has stepped down as Chief Executive to become Permanent Secretary at the Ministry of Justice. We have welcomed Caroline Walker as interim Chief Executive, an experienced NHS leader with 25 years at board level, formerly interim group Chief Executive for Walsall Healthcare and The Royal Wolverhampton and previously Chief Executive at North West Anglia Foundation Trust, with senior roles at University Hospitals of Leicester, Great Ormond Street Hospital Foundation Trust and Barts Health, as well as Chief Operating Officer at Loughborough University, with a strong track record in improving patient care and building high performing teams. Wendy Clark has also stepped down as Deputy Chief Executive. Work to appoint her successor is underway.