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Independent Assessor bulletin: April 2016

Living organ donation news

Living organ donation

IA reports   

In the December bulletin, we informed you that we would be amending the portal form through which IA reports are submitted. These changes have now been implemented.

In Section G the two questions confirming the absence of duress, coercion and reward will be separated into two questions, one focussing on discussions held with the donor and one focussing on discussions held with the recipient. These changes are being made as these are the areas where we regularly have to seek further clarification. This change should help IAs to outline separate discussions had with both the donor and the recipient. This will help the Living Donation Assessment team make timely decisions. 

If you have questions regarding these changes please let us know. Thank you for your understanding. 

Respond to our IA survey 

Independent Assessors: Please find a link to the IA Survey. We are very keen to get your feedback on various issues including the recommendations from the recent HTA internal audit. The survey ends on 13 May 2016. 

Referral letters 

Independent Assessors: The HTA has recently received a number of referral letters containing incorrect information or where the relevant statutory information had not been confirmed i.e. tick boxes have been left unchecked. The referral letter acts as statutory referral to the HTA of a case for assessment, and therefore must contain the correct information. When you receive a referral please check that these letters contain the correct and relevant information before submitting it to the HTA along with the IA report. If you notice an error in the referral letter, please flag it up with the unit and the HTA to prevent any delays in case decisions.

Management of cases requiring donor coordinators 

Reminder for Living donor coordinators (LDCs): The HTA has seen an increase in requests for cases to be considered quickly, where the surgery date is scheduled within a week to ten days of the IA interviews. While we accept, in some circumstances, the need for a quick turnaround is unavoidable; we would like to remind you of our service standards so that suitable plans can be made by units. We aim to assess all: 
  • non-panel cases within five working days, and 
  • panel cases within ten working days 
The timeline begins once we have received all the information required in order to consider a case, as we may need to seek further clarity from an IA or LDC. Please note this includes receiving copies of the donor referral letter or donor declaration if these are being sent by post. 

It is the LDCs responsibility to notify us of a case requiring a prompt turnaround (we have had instances of IAs enquiring about a case decision) with as much forewarning as possible. 

We remain committed to ensuring that where it is possible to do so, prompt decisions are provided. However, the more we receive short notice requests, the less likely we will meet these deadlines.

We appreciate your support. 

Organs that cannot be implanted into the intended recipient: risks and implications 

Living Donor Coordinators: Although these cases are incredibly rare, for legal reasons the HTA must be made aware if a donor wishes that their organ be redirected to the deceased donor pool in the unlikely event it cannot be transplanted into the intended recipient. This is to ensure that valid consent is in place should the donation category change i.e. where a re-direction takes place, it technically becomes a non-directed altruistic donation when the organ enters the deceased donor pool (even though that was not the original intention of the donor). 

The donor’s decision should also be clearly documented in the HTA referral letter. If this is not possible, it is important that the donor arrives at the IA interview having already made their decision. The donor can change their mind at a later stage in the work up process, but the HTA must be alerted if the donor’s wishes change and they decide to redirect their organ to the deceased donor pool. Where the donor chooses for the organ to be re-implanted, please ensure that the donor is made aware of the additional surgery that this option would require. 

Independent Assessors: During IA interview, please check whether the donor has made a decision regarding the unlikely event that the organ cannot be implanted into the intended recipient. If it seems that the donor has not made a decision or was not provided with the relevant information, please make a note of it and inform the LDC after the interview. The LDC should provide appropriate information to the donor and a decision from the patient must be recorded before sending the IA report to the HTA. It is not the responsibility of the IA to provide information to donors about the options available.

If the donor would like to take some time to come to a decision, it is the LDCs responsibility to inform the HTA about the donor’s final decision after the interview. 

IA re-accreditation  

The process of IA re-accreditation has now been completed. All re-accreditation notices and information have been sent electronically for the 2016-2017 re-accreditation period. If you need any further information please contact us.

IA conference - 22 November: Save The Date!! 

We are pleased to advise that the HTA will be holding a conference for IAs on Tuesday 22 November 2016, in London. In order to help you get the most out of this conference, please send us any topics that you would like to be discussed during the conference. Please register you interest to attend the conference by sending us an email.

More details on the conference agenda will be provided in a direct email to IAs and LDCs in the coming months.

DBS check update   

Independent Assessors: Thank you for sending the HTA the relevant information to set up the secure accounts for enhanced DBS checks. We have registered your details and you will have received a secure link with full instructions to submit your personal information and a 'once only' login. These instructions were e-mailed to you on 13 April and your login will remain valid until you have completed the process of submitting your information.

If you are facing any problems with submitting your information, this could be due to browser issues. Please get in touch with us and we will resubmit your information on the website. 

Once this information has been submitted, the HTA will review your application for completeness and submit it to DBS. A certificate will be issued and sent directly to your home address. 

Stats and facts

Type of case

Month   Directed kidney   Directed altruistic kidney   Non-directed altruistic kidney   Paired or pooled kidney   Directed liver lobe
Jan   70   1   4   4   1
Feb   76   0   5   21   5
March   72   0   12   10   2

What do you want to see in the next issue? 

All of the sectors we regulate are constantly changing and we want to make sure our e-newsletter continues to be practically useful to those we work with. With that in mind, we would be happy to receive suggestions for future items and articles. Similarly, we always welcome feedback and ideas for improving this e-newsletter. Please let us know your comments and suggestions.
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