Despite these increases in the number of donors, the proportion of families saying yes to donation has remained stubbornly static between 55-60% in recent years. Families are more likely to say yes when their loved one is on the NHS Organ Donor Register and they have discussed their wishes.
Last year NHS Blood and Transplant and the four UK health administrations set out aspirations to match the best countries in the world for organ donation and transplantation. Taking Organ Transplantation to 2020 set out an aim to increase the family consent/authorisation rate to over 80%. If the UK reaches this, we would approach or match rates seen in the highest performing countries such as Spain.
Although most opinion polls within the UK show the vast majority of the population is in favour of organ donation and would consider donating some or all of their organs, evidence shows that there are low levels of awareness of organ donation and the need for transplants. Another challenge is that many people have never discussed organ donation with their families, making the decision to donate more difficult if and when the time comes.
As a first step to addressing the challenge, NHS Blood and Transplant had an independent audit of past and current public health behaviour change activity carried out. Over a three month period, NHSBT and an appointed agency 23Red, worked with our partners and stakeholders across the health and voluntary communities and with the four UK Governments to review activity at a local, national and international level. The aim of this work was to develop a consensus on the most appropriate interventions to achieve the 80% target over the six years to 2020.
The result is A strategy for delivering a revolution in public behaviour in relation to organ donation and the supporting Delivering a revolution in public behaviour in relation to organ donation: year one delivery plan.
These set out the initiatives and rationale for a number of activities which, together, are expected to deliver the change in behaviour necessary to help increase consent/authorisation rates.
No individual strand of activity will deliver the rise in consent rates needed. We have identified a range of activity which, if adopted, will provide the shift in attitudes to organ donation needed.
The strategy endorses work which is already underway and should continue:
- Partnerships programme
- Wider use of Government transaction sites
- Face-to-face community engagement
- Tools to support the end-of-life conversation
- Addressing myths and misunderstandings
- Testing and developing broadcast and social media content.
It identifies new areas which should be tested based on behaviour change experience elsewhere. These are that we should:
- Make more use of the existing NHS Organ Donor Register encouraging the 20 million plus registrants to become more vocal in their support for organ donation and target under-represented groups
- Reach out to children and young people as change makers who can stimulate conversations and debate in their families, with friends and in their communities
- Carry out a piece of research to understand why people say no at the point when they are faced with making a decision to support deceased donation
- Build on the sense of pride in donation to share the benefits to donor families at a very sad and difficult time as well as to recipients whose lives are saved or significantly improved.
Leonie Austin, Director of communications at NHS Blood and Transplant said:
"We've examined in detail how other inititiatives to change behaviour amongst the general population with regard to public health issues have been successful and we've learnt from these experiences.
"Our work with 23Red has identifed that there is no 'magic bullet' to solve the issue of low consent rates in the UK. What has become very clear is that we need to embark on a number of strands of activity over a sustained period of time.
"It's encouraging that we are already doing lots of things that we can evidence make a positive difference - for example partnerships with organisation such as the DVLA - but we know more needs to be done.
"Our next step will be to test out some of the ideas to see if they really will help change people's behaviour in relation to organ donation."