Table 1: Summary of the key elements of reform Key elements of Spain Croatia Portugal Australia United Kingdom European Union (EU) reform An appropriate legal and introduced organ donor Croatia implement a Portugal introduced The Australian system of organ Guidance on ethical framework legislation in 1979, which presumed consent system transplant legislation donation is based on an informed donation was established presumed in 1988 and a new in 1993 and revised it consent (‘opt in’) model. Individuals published for each country consent Transplant Act in 2013 in 2007 have the option to record intent to and an UK Donation Ethics donate their organs after death on Committee was established the Australian Organ Donor in 2010 Register. Transplantation guidelines for ethical practice for health professionals were developed by the National Health and Medical Research Council (NHMRC) in 2007 A national coordinating body A national coordinating body A National Transplant A national A national coordinating body was The role of the NHS Blood The EU issued a directive was established in 1989 Coordinator was appointed coordinating body officially established in 2009 and is and Transplant was requiring member states to in 2001 and the Ministry of was introduced in responsible for implementing the expanded to be the organ identity a Competent Health employs staff 2007 and amended reform programme donation organisation for Authority with responsible to responsible for manage in 2012 the whole of the United ensure compliance with reform initiatives and a Kingdom various quality and safety coordination office requirements Hospital-based clinical Dedicated clinical staff were Hospital based teams of Hospital Donor A network of donation specialists Clinical leads for organ The action plan included an – donation specialists introduced in 1995 Transplant Coordinators Coordinators were the DonateLife Network - was donation were appointed action to promote transplant were initially established appointed in 2007 established across Australia and the Specialist Nurse for donor coordinators from 1998-2000 and 2008. Organ Donating network was reconfigured and expected to increase by 146% (as at 2011) Specialist training for clinical Training on organ donation Professional training to Professional training Specialist training for clinical staff The taskforce The action plan included an staff in management of was first made available in clinicians was first made was made in management of the deceased recommended all clinical action to improve the deceased donation process 1991 and is mandatory for available in 2003 and available in 2008 and donation process and family staff likely to be involved in knowledge and and family donation all doctors specialising in remains an ongoing priority all staff employed as donation conversations are the treatment of potential communication skill of conversations intensive care Hospital Donor available as part of the organ donors receive health professionals and Coordinator receive Professional Education Package mandatory training in the patient support groups on specific training principle of donation organ transplantation
Table 1: Summary of the key elements of reform Key elements of reform Spain Croatia Portugal Australia United Kingdom European Union (EU) An appropriate legal and ethical framework introduced organ donor legislation in 1979, which established presumed consent Croatia implement a presumed consent system in 1988 and a new Transplant Act in 2013 Portugal introduced transplant legislation in 1993 and revised it in 2007 The Australian system of organ donation is based on an informed consent (‘opt in’) model. Individuals have the option to record intent to donate their organs after death on the Australian Organ Donor Register. Transplantation guidelines for ethical practice for health professionals were developed by the National Health and Medical Research Council (NHMRC) in 2007 Guidance on donation was published for each country and an UK Donation Ethics Committee was established in 2010 A national coordinating body A national coordinating body was established in 1989 A National Transplant Coordinator was appointed in 2001 and the Ministry of Health employs staff responsible for manage reform initiatives and a coordination office A national coordinating body was introduced in 2007 and amended in 2012 A national coordinating body was officially established in 2009 and is responsible for implementing the reform programme The role of the NHS Blood and Transplant was expanded to be the organ donation organisation for the whole of the United Kingdom The EU issued a directive requiring member states to identity a Competent Authority with responsible to ensure compliance with various quality and safety requirements Hospital-based clinical donation specialists Dedicated clinical staff were introduced in 1995 Hospital based teams of Transplant Coordinators were initially established from 1998-2000 Hospital Donor Coordinators were appointed in 2007 and 2008. A network of donation specialists – the DonateLife Network - was established across Australia Clinical leads for organ donation were appointed and the Specialist Nurse for Organ Donating network was reconfigured and expected to increase by 146% (as at 2011) The action plan included an action to promote transplant donor coordinators Specialist training for clinical staff in management of deceased donation process and family donation conversations Training on organ donation was first made available in 1991 and is mandatory for all doctors specialising in intensive care Professional training to clinicians was first made available in 2003 and remains an ongoing priority Professional training was made available in 2008 and all staff employed as Hospital Donor Coordinator receive specific training Specialist training for clinical staff in management of the deceased donation process and family donation conversations are available as part of the Professional Education Package The taskforce recommended all clinical staff likely to be involved in the treatment of potential organ donors receive mandatory training in the principle of donation The action plan included an action to improve the knowledge and communication skill of health professionals and patient support groups on organ transplantation
discussion_doc-_international_reform_programmes.docx