NORTH WEST Introduction Ms Sue Duncalf Regional Manager

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NORTH WEST Introduction Ms Sue Duncalf (Regional Manager) Arpan Guha and Huw Twamley (R-CLOD)

NORTH WEST Introduction Ms Sue Duncalf (Regional Manager) Arpan Guha and Huw Twamley (R-CLOD) 21 st May 2013 Organ Donation Past, Present and Future

Programme 10: 05 Introduction 10: 15 Donation in the UK Dr Paul Murphy 11:

Programme 10: 05 Introduction 10: 15 Donation in the UK Dr Paul Murphy 11: 00 Coffee 11: 15 Donor Identification and Referral Dr Huw Twamley 12: 15 Lunch 13: 15 Donation after brain-stem death Diagnosis of death Professor Arpan Guha Donor optimisation Professor Arpan Guha 14: 15 Coffee 14: 45 Family approach and consent Dr Paul Murphy 16: 00 Discussion and next step 16: 30 Close Organ Donation Past, Present and Future 2

Pauline's story • • https: //www. dropbox. com/s/zteqd 0 s 2 gkh 5 rjo/Pauline%27

Pauline's story • • https: //www. dropbox. com/s/zteqd 0 s 2 gkh 5 rjo/Pauline%27 s%20 Story. mov • • As a mp 4 https: //www. dropbox. com/s/xsm 9 scyi 8 rdl 1 w 6/Pauline%27 s%20 Story%20 mp 4. mo v • • • As a wmv (old microsoft) https: //www. dropbox. com/s/p 6 jgyfp 2 hm 6 eh 7 b/Pauline%27 s%20 Story%20 wmv. w mv • • • As an avi (old microsoft) https: //www. dropbox. com/s/myw 7 c 0 lrhd 6 p 5 ha/Pauline%27 s%20 Story%20 avi. avi • To start automatically after previous slide

Objectives 1. Update on progress since 2008 Organ Donor Taskforce Report and scene set

Objectives 1. Update on progress since 2008 Organ Donor Taskforce Report and scene set for future challenges. 2. Outline best practice, using regional and local data, and the most recent national guidance around: – – – The referral and identification of donors Donation after Brain Death Family approach and consent 3. Secure commitment to change practice in your hospital around key pinch points in deceased donation pathways Attendance at this meeting has been recognised for 5 CPD credits by the Royal College of Anaesthetists Organ Donation Past, Present and Future 4

North West Organ Donation Services Team Regional Clinical Lead Professor Arpan Guha Dr Huw

North West Organ Donation Services Team Regional Clinical Lead Professor Arpan Guha Dr Huw Twamley 35 Hospitals Pop of 7. 8 million 3 Transplant Centres SCOTLAND Regional Manager Sue Duncalf NORTHERN IRELAND YORKSHIRE NORTH WEST MIDLANDS EASTERN SOUTH WALES SOUTH CENTRAL SOUTH WEST SOUTH EAST Team Managers Emma Thirlwall Jane Monks Dawn Lee Niki Hargreaves 27 Specialist Nurses 4 Admin Staff Organ Donation Past, Present and Future 5

Donation in the North West 2003 -2013 140 26. 6% 120 100 -5. 1%

Donation in the North West 2003 -2013 140 26. 6% 120 100 -5. 1% 80 Total Deceased Donation after Brain Death 60 181. 3% 40 Donation after Circulatory Death 20 0 2003 -04 2004 -05 2005 -06 2006 -07 2007 -08 2008 -09 2009 -10 2010 -11 2011 -12 2012 -13 Organ Donation Past, Present and Future 6

Organ Donation Past, Present and Future st Ea W h So 26. 6 al

Organ Donation Past, Present and Future st Ea W h So 26. 6 al ut es h W Yo est rk sh ire h ut So l 50. 8 ut ra 75 nt Ce nd la 81. 8 So h ut ot nd la Ire n 44. 8 Sc n er t 87. 5 So er es 25 rth No W s nd la 100 rth No id on nd n 50 M Lo er st Ea Percentage Achievement 50% Target by Donor Team 150 148. 4 125 74. 1 46. 4 19. 7 30. 4 7. 1 11 0 7

Yorkshire Contribution to 50% by Donor South West 7% Eastern 13% 7% Team South

Yorkshire Contribution to 50% by Donor South West 7% Eastern 13% 7% Team South Wales 4% South East 8% London 13% 50% South Central 8% Scotland 8% Northern Ireland 3% Northern 8% Organ Donation Past, Present and Future Midlands 12% North West 10% 4 th 8

Organs from North West Donors: 2003 -13 180 160 140 120 Kidneys 100 Livers

Organs from North West Donors: 2003 -13 180 160 140 120 Kidneys 100 Livers 80 Pancreases 60 Hearts Lungs 40 2003/4 2004/5 2005/6 2006/7 2007/8 2008/9 2009/102010/112011/122012/13 Organ Donation Past, Present and Future 9

Where are potential donors in the North West lost? Organ Donation Past, Present and

Where are potential donors in the North West lost? Organ Donation Past, Present and Future 10

BUT if we adopted BEST PRACTICE 1800 Target Actual 1600 19. 1 ppm 1400

BUT if we adopted BEST PRACTICE 1800 Target Actual 1600 19. 1 ppm 1400 1200 1000 50% 13. 4 ppm 800 600 400 2007/08 2008/09 2009/10 2010/11 Organ Donation Past, Present and Future 2011/12 2012/13 Best Practice 11

BUT if we adopted BEST PRACTICE 1800 Target 26. 3 ppm Actual TOP 5

BUT if we adopted BEST PRACTICE 1800 Target 26. 3 ppm Actual TOP 5 in the WORLD 1600 19. 1 ppm 1400 1200 1000 50% 13. 4 ppm 800 600 400 2007/08 2008/09 2009/10 2010/11 Organ Donation Past, Present and Future 2011/12 2012/13 Best Practice 12

2008 2011

2008 2011

NHSBT Guidelines ED Strategy Donor Management Bundles and Guidance FICM & ICS endorsed: Brain-stem

NHSBT Guidelines ED Strategy Donor Management Bundles and Guidance FICM & ICS endorsed: Brain-stem Death Forms www. odt. nhs. uk Organ Donation Past, Present and Future 14