Donation Collaboratives lessons for transplantation Dr Dale Gardiner National Clinical Lead for Organ Donation Consultant in Intensive Care Medicine, Nottingham dale.gardiner@nhsbt.nhs.uk @dalecgardiner

12 Donation Collaboratives 12 Lessons SCOTLAND Lay firm foundations Use data to drive best practice Are a way of working Create new ways of working Size Matters Build a community Innovate And then innovate some more Work with government Engage with each other Stretch and change the world Individuals can make a difference NORTHERN IRELAND NORTHERN YORKSHIRE NORTH WEST MIDLANDS EASTERN SOUTH WALES SOUTH CENTRAL SOUTH EAST SOUTH WEST

Lay firm foundations Organ donation collaboratives were established in 2011 as part of the original Taskforce implementation plan. They were in the “Don’t Let Up” Meet a minimum twice a year. SNODs, CLODs and ODC Chairs. Part of the regional structure Regional and Team Managers Regional CLOD Attendance is expected. South East Collaborative Stable leadership team. Consistently well attended and evaluated. SOUTH EAST

Use data to drive best practice DCD referral rate April 2015 October 2018 Relentless focus on comparator data Benchmark Congratulate Challenge Look for trends Every shared data slide should tell a story. SOUTH CENTRAL

Are a way of working Donation Collaboratives are more than a twice-yearly gathering of members. They are a way of working so that the sum is greater than the parts. YORKSHIRE Collaboratives are a vehicle for effective and transforming change in hospitals, the wider organ donation and transplantation community and the public. Spinning Coin by PresenterMedia

Northern Referral Model Create new ways of working Provide opportunities for pilot. Provide opportunities for national leadership. Size matters: small = nimble NORTHERN The aim of the Northern Referral Model was to ensure that all potential organ donors are referred to a SN-OD in a timely fashion and that in turn an expedient response is provided to the referring unit. Was the forerunner for DCD screening nationally. Northern Referral Model Introduced 2010 Northern referral 1st to 100% DBD 1st to 90% DCD Spinning Coin by PresenterMedia

Size Matters BIG Diverse Important #LODSTRC LONDON One third of families approached in London are from an ethnic minority. One half of all the UK ethnic minority families approached for organ donation are in London. LONDON https://www.timeout.com/london/blog/five-maps-that-quantify-exactly-how-rammed-london-is-021816

Build a community SNOD ODC Chair CLOD Triumvirate Billy Graham Non-executive Director      ODC Chair Billy was Chief Operating Officer for Northern Ireland Electricity. NI Regional Chair of Organ Donation Committees NORTHERN IRELAND

Innovate Norkshire YORKSHIRE NORTH WEST NORTH WEST Specialist Requestors SNODs in Uniform Lessons from regional collaboratives in America are that without ongoing support and investment, collaboratives will not maintain momentum and will be unable to deliver the transformation in donation and transplantation that is required in the UK. Amanda Jane Snape one of the North West SRs who has been with the SR team since the launch in 2016. 

And then innovate some more Education - simulation courses National Deceased Donation Course (pilot site) SNOD Simulation Training (with South East) Local Sim Teaching Embrace opportunities Donation Ambassadors Specialist Requestors Midlands Deceased Donation Care Guide Promoting Organ Donation (POD) which helped facilitate the MOU with the MOHAN Foundation in India and NHSBT. MIDLANDS

Detected 10% difference in consent rate Work with government Deceased Donors Government Human Tissue Authority Role of the family Jan Y T D DBD Consent Quarterly Monitoring, September 2018 Wales better England than Detected 10% difference in consent rate at < 0.05 significance SOUTH WALES

III Engage with each other DCD hearts We are two sides of the same coin. Our patients need us working together. I’ve seen too many good ideas fail (or get stalled) because one side forgets the other. Plan together (from the beginning), work together, find greatness together. III DCD hearts EASTERN The UK is the world leader and the Eastern team is the UK leader Spinning Coin by PresenterMedia

and change the world SAFER Admission policies from ED to ICU 2016 SAFER Admission policies from ED to ICU “Organ donation saves lives: sometimes the life of the donor” Manara, Thomas & Harding JICS 2016 DBI consensus statement BJA 2018 2018 It’s not enough to meet KPIs. Emerging out of our 2015 Congress we set ourselves STRETCH goals (usually run over two years) Goals a whole region could support. The South West stretch goal changed UK ICU. SOUTH WEST

Individuals can make a difference Embrace your uniqueness. Embrace your shared geography, culture and pride. It’s always Christmas at a Scottish collaborative. SCOTLAND

Individuals can make a difference Embrace your uniqueness. Embrace your shared geography, culture and pride. It’s always Christmas at a Scottish collaborative. SCOTLAND Lesley Logan One individual who came to represent a country. “It’s authorisation in Scotland not consent” “Scotland doesn’t have NHS Trusts” “Organ donation can also be green not pink.”

12 Donation Collaboratives 12 Lessons Lay firm foundations – South East Use data to drive best practice – South Central Are a way of working – Yorkshire Create new ways of working – Northern Size Matters – London Build a community – N. Ireland Innovate – North West And then innovate some more – Midlands Work with government – South Wales Engage with each other – Eastern Stretch and change the world – South West Individuals can make a difference – Scotland SCOTLAND NORTHERN IRELAND NORTHERN YORKSHIRE NORTH WEST MIDLANDS EASTERN SOUTH WALES SOUTH CENTRAL SOUTH EAST SOUTH WEST